Impact of an Educational Intervention on Current Guidelines to Attenuate Spinal-induced Hypotension with Ondansetron

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Rebecca R. Bates (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Vadim Korogoda

Abstract: Background: Spinal anesthesia (subarachnoid block; SAB) is the preferred anesthetic technique used for elective cesarean sections (CS). While this technique is safe, hypotension and bradycardia are commonly occurring complications, putting both mother and baby at risk. Recent studies have examined the practice of administering prophylactic ondansetron, co-loading of crystalloids, and using sequential compressive devices as effective methods to reduce the incidence of spinal induced maternal hypotension and bradycardia. Purpose: This Doctor of Nursing Practice (DNP) project aimed to examine the impact of an educational intervention provided to Certified Registered Nurse Anesthetists (CRNAs) on evidence-based guidelines to attenuate spinal induced maternal hypotension and bradycardia. Outcomes assessed included identifying knowledge gaps, knowledge gained post educational intervention, and perceptions of ondansetron's efficacy on reducing spinal induced hypotension (SIH). Methods: The project utilized a post-intervention follow-up study design consisting of a pre-intervention survey, an online educational voice-over PowerPoint, and a post-intervention survey. Results: Although results were not statistically significant, they revealed improvement of CRNA knowledge on best-practice guidelines to reduce SIH. CRNA’s who implemented preprocedural ondansetron in their practice reported an apparent reduction in SIH. In addition,two knowledge gaps were identified providing insight for future practice change opportunities. Conclusion: The findings of this project identified SIH as an adverse effect of spinal anesthesia and a noted reduction with the administration of preprocedural ondansetron. Educational interventions containing EBR, and best practice guidelines could enhance provider knowledge encouraging clinical practice change.

Additional Information

Language: English
Date: 2022
ondansetron, spinal anesthesia, hypotension, cesarean section

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