Date of Award

Spring 4-28-2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Brian Garrett, DNP, CRNA

First Committee Member

Dr. Joy Shoemaker, DNP, RN, APRN.CNP, FNP-C, CNE

Second Committee Member

Dr. Amy Bishop, DNP, AGCNS


Preprocedural, Ultrasound, Neuraxial, Labor, Anesthesia

Subject Categories

Medicine and Health Sciences | Nursing


Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to facilitate neuraxial anesthesia is low despite evidence found in the literature describing its benefits. The project’s main objective is the development and implementation of evidence-based practice (EBP) recommendations for using preprocedural ultrasound to facilitate neuraxial anesthetics provided to laboring patients. If implemented, the project has the potential to increase first-pass success rates of needle placement and decrease adverse events such as unintentional dural puncture, post dural puncture headache, and failed neuraxial block. Additional objectives for the project include developing EBP recommendations for using preprocedural ultrasound when providing neuraxial anesthesia to the laboring patient, a comprehensive plan to implement the EBP recommendations, and a method to monitor and measure the EBP recommendations. The theoretical framework for this project is the John Hopkins Evidence-Based Practice Model (JHEBP) for Nursing and Healthcare Professionals.

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, all rights reserved. Fair Use

Included in

Nursing Commons



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