Dissertation
Improving Anesthesia Provider Use of Lung Protective Ventilation
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Postoperative pulmonary complications (PPCs) are among the most frequent surgical complications, contributing to morbidity and mortality and increased use of health care resources. Robotic-assisted abdominal surgery has been associated with an increased risk of PPCs. Evidence suggests that lung protective ventilation (LPV) can prevent PPCs.Purpose: This project aimed to enhance anesthesia providers knowledge and adoption of LPV strategies during robotic-assisted abdominal surgery, optimize intraoperative lung mechanics, and decrease PPCs.Methods: Using the Iowa Model of Evidence-based Practice, this project assessed anesthesia providers' knowledge and use of LPV before and after education sessions and the introduction of a clinical protocol. Intraoperative LPV protocol adherence, driving pressure, lung compliance, and PPCs were also measured.Findings: Eleven providers completed the pre-implementation survey, and seven providers completed the post-implementation survey. Self-reported knowledge and use of LPV did not meaningfully change after project implementation. However, in a post-implementation group of 44 patients, provider adherence to LPV best practices of maintaining tidal volumes of 6-8 mL/kg ideal body weight (IBW), positive end-expiratory pressure (PEEP) of 0.3 * body mass index (BMI), and a fraction of inspired oxygen (FiO2) ? 40% significantly improved. Lung mechanics, specifically driving pressure and dynamic lung compliance, significantly improved compared to the pre-implementation group. Postoperative oxygen desaturation events and supplemental oxygen administration significantly decreased.Discussion: Consistent use of LPV strategies can increase the safety of anesthesia care. This project demonstrated that educational sessions and a structured protocol can improve anesthesia providers use of LPV practices, optimize lung mechanics, and decrease PPCs after robotic-assisted abdominal surgery.
Details
- Title: Subtitle
- Improving Anesthesia Provider Use of Lung Protective Ventilation
- Creators
- Joseph LaFeve - University of Iowa
- Contributors
- Cormac O'Sullivan (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Nurse Anesthesia
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Joseph LaFeve
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841035302771
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