Date of Award

Spring 4-30-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Kacy Ballard

First Committee Member

Dr. Brian Garrett


Nurse Anesthesia, Ultrasound, Intravenous Catheter, Training Program, Anesthesia

Subject Categories

Medicine and Health Sciences | Other Education | Perioperative, Operating Room and Surgical Nursing


The American Association of Nurse Anesthetists (AANA) has defined the scope of nurse anesthesia practice to include services in acute, chronic, and interventional pain management, as well as the use of ultrasound (U/S) and other diagnostic technologies. However, there are no standard curriculum requirements in place that mandate graduate programs to educate student nurse anesthetists in U/S-related modalities. In addition to the AANA, the use of U/S in nurse anesthesia practice has recently been adopted by The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which characterizes U/S use by its clinical impact on the reduction in complications, increased effectiveness of regional anesthesia, and enhanced quality of vascular catheter placement. The COA has strongly recommended that student registered nurse anesthetists (SRNA) have U/S education incorporated into their curriculum for its use both in regional anesthesia and vascular access.

Currently, a Nurse Anesthesia Program (NAP) at a private university in the Midwest incorporates both didactic and simulation-based experiences into the education and training of SRNAs to establish a strong foundation of knowledge and proficiency upon which a safe and effective nurse anesthesia practice can be built. However, despite the COA recommendations and surmounting evidence supporting the use of simulation-based education in improving U/S knowledge and skill proficiency, the NAP did not have a formal ultrasound training course within its curriculum to prepare its SRNAs for the clinical setting. Consequently, a recent audit report conducted by the Director of the NAP revealed that 54.7 percent of the program’s SRNAs (N = 64) have never received any U/S training prior to entering the NAP (B. Garrett, personal communication, August 1, 2021). Given the recent data and the COA recommendations, the NAP recognized a critical need to educate SRNAs in the utilization of U/S in a simulation-based


environment prior to entering their clinical practice rotations. Therefore, the purpose of the quality improvement project was to determine whether the implementation of a simulation-based U/S-guided peripheral intravenous catheter placement (U/SGPIV) training workshop would improve clinical knowledge and skill proficiency among the NAP SRNAs.

The following objectives and methods were framed using the quality improvement Plan- Do-Check-Act (PDCA) Model and were established to achieve the project’s overall aim: 1) review and synthesize the evidence from the literature, AANA guidelines, and COA recommendations towards the development of an U/S training workshop using simulation-based techniques; 2) develop and implement a simulation-based U/SGPIV course; 3) evaluate the effects of the workshop on SRNA’s clinical knowledge and proficiency related to U/S and U/SGPIV; 4) develop plan for sustainability and present project findings (e.g., pre- and post- intervention observational clinical audit data and identified compliance barriers/lessons learned), evidence-based recommendations, and a sustainment plan to the key program faculty stakeholders as well as NAP executive leaders. The project was significant as it helped the NAP in its efforts to comply with the AANA guidelines and COA requirements for education programs to incorporate U/S training into their program curriculums in preparing its SRNAs for the clinical settings.

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, all rights reserved. Fair Use



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