Dissertation
The Development of Pediatric Non-Operating Room Anesthesia Guides
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
Abstract
Background: Non-operating room anesthesia (NORA) locations present unique challenges for anesthesia providers, particularly in pediatric populations, due to variability in environment, equipment, staffing, and workflow. These factors contribute to increased risk of adverse events and decreased provider satisfaction. At a large academic medical center, a lack of standardized processes and limited familiarity with pediatric-specific resources further complicate care delivery in NORA settings. Purpose: The purpose of this quality improvement project was to develop and implement site-specific pediatric NORA quick reference guides to improve anesthesia provider knowledge and satisfaction related to workflow, resource management, and patient care. Methods: This mixed-methods quality improvement and evidence-based practice project was guided by the Iowa Model for Evidence-Based Practice and the Iowa Implementation for Sustainability Framework. Pediatric NORA guides were developed through stakeholder collaboration and implemented across multiple NORA sites. Pre- and post-implementation surveys were administered to anesthesia providers to assess changes in knowledge and satisfaction. Data were analyzed using descriptive statistics and independent t-tests. Findings: Post-implementation results demonstrated improvements in both provider satisfaction and knowledge. Satisfaction with workflow and efficiency significantly improved (p = 0.006), while overall satisfaction increased but was not statistically significant (p = 0.345). Knowledge of communication pathways (p = 0.0002) and management of pediatric emergencies (p = 0.041) showed statistically significant improvement. Knowledge of resource and equipment availability increased but did not reach statistical significance (p = 0.079). Discussion: The implementation of pediatric NORA guides improved key aspects of provider knowledge and satisfaction, supporting the use of cognitive aids to standardize care in high-risk, variable environments. These findings align with existing literature emphasizing the role of structured tools in enhancing communication, workflow efficiency, and preparedness in NORA settings. Keywords: pediatric anesthesia, non-operating room anesthesia, NORA, cognitive aids, quality improvement, patient safety, workflow standardization
Details
- Title: Subtitle
- The Development of Pediatric Non-Operating Room Anesthesia Guides
- Creators
- Charles Sinton - 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 2026
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2026 Charles Sinton
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9985217823002771
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