Student Registered Nurse Anesthetist’s Perception of Clinical Preparedness to Place Ultrasound Guided Epidurals in Patients with a BMI greater than 30kg/m2

Abstract

Anesthesia providers have traditionally placed epidurals for analgesia using landmark palpation. The use of ultrasound technology to place epidurals is not commonly used but has been identified as a recent option in the literature. This literature review was focused on comparing epidural placement by the conventional landmark palpation versus using ultrasound guidance. The use of ultrasound has been shown to increase accurate epidural placements on the first attempt, leading to decreased complications in patients. Since ultrasound is a newer method, many anesthesia providers do not know how to perform this procedure. In addition, student registered nurse anesthetists (SRNAs) lack an education of this way of performing epidurals. This project was intended to provide an online educational module to SRNAs at AdventHealth University (AHU) on the placement of epidurals using ultrasound guidance. The aim of this project was to assess the perceived clinical preparedness of SRNAs in the cohorts 2022 and 2023 at AdventHealth University to use ultrasound to aid in the placement of epidurals both prior to and after participating in a sixty-minute online module. The Learning Self-Efficacy Scale (LSES) for Clinical Skills was utilized to assess the SRNAs perceived clinical preparedness. This scholarly project used convenience sampling of SRNAs in cohorts 2022 and 2023 at AHU. There was a significant increase in perception of clinical preparedness in SRNAs who participated in this scholarly project. Recommendations from this scholarly project is that the DNAP at AHU should consider including the use of the ultrasound when teaching epidural placement to SRNAs.