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Education and Implementation of the Fascia Iliaca Block for Acute Hip Fracture Patients

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Education and Implementation of the Fascia Iliaca Block for Acute Hip Fracture Patients Education and Implementation of the Fascia Iliaca Block for Acute Hip Fracture Patients Item Type text; Electronic Dissertation Authors Roberts, Chrisanna Marie Citation Roberts, Chrisanna Marie. (2021). Education and Implementation of the Fascia Iliaca Block for Acute Hip Fracture Patients (Doctoral dissertation, University of Arizona, Tucson, USA). Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 07/10/2021 05:44:23 Link to Item http://hdl.handle.net/10150/658627 EDUCATION AND IMPLEMENTATION OF THE FASCIA ILIACA BLOCK FOR ACUTE HIP FRACTURE PATIENTS by Chrisanna Roberts ________________________ Copyright © Chrisanna Roberts 2021 A DNP Project Submitted to the Faculty of the COLLEGE OF NURSING In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF NURSING PRACTICE In the Graduate College THE UNIVERSITY OF ARIZONA 2 0 2 1 2 3 ACKNOWLEDGMENTS I would like to acknowledge my fellow group members, Kaitlin Tilton and Jenna Hernandez for their hard work and collaboration on this project. I would like to acknowledge Dr. Sarah Torabi for chairing this project and academic guidance throughout my doctoral degree. Without her hard work and leadership, this project would not have been possible. I would like to acknowledge Dr. Kristie Hoch and Dr. Chris Herring for their mentorship and educational contributions to my nurse anesthesia practice. I would like to acknowledge Dr. Patricia Daly for her involvement in this project as a committee member. I would like to acknowledge Ray Walker, chief CRNA, and the rest of the anesthesia staff at the hospital in Texas for expressing interest in our topic and participation in this project. 4 DEDICATION To my mother Valerie Jo Roberts. Thank you for allowing me to be my authentic self and supporting me in all my dreams. You are the role model for work ethic, and kindness that I employee daily in my nursing profession. You are such a blessing in my life. 5 TABLE OF CONTENTS LIST OF FIGURES ......................................................................................................................... 8 LIST OF TABLES .......................................................................................................................... 9 ABSTRACT .................................................................................................................................. 10 INTRODUCTION ....................................................................................................................... 12 Background Knowledge .............................................................................................................. 13 American Academy of Orthopedic Surgeons (AAOS) Recommendations ................ 14 Local Problem .............................................................................................................................. 15 Intended Improvement ............................................................................................................... 15 Project Purpose ................................................................................................................ 15 Project Question .............................................................................................................. 16 Project Objectives ............................................................................................................ 16 Theoretical Framework .............................................................................................................. 16 Literature Synthesis .................................................................................................................... 19 Evidence Search ............................................................................................................... 19 Comprehensive Appraisal of Evidence .......................................................................... 20 Strengths of Evidence ...................................................................................................... 23 Weaknesses of Evidence .................................................................................................. 23 Gaps and Limitations ...................................................................................................... 24 METHODS ................................................................................................................................... 24 Project Design .............................................................................................................................. 24 Model for Implementation .......................................................................................................... 26 Plan ................................................................................................................................... 27 Do ...................................................................................................................................... 28 Study ................................................................................................................................. 28 Act ..................................................................................................................................... 29 Setting and Stakeholders ............................................................................................................ 30 Planning the Intervention ........................................................................................................... 30 Developing the Guidelines .............................................................................................. 31 6 TABLE OF CONTENTS - Continued AGREE-Rex Tool ........................................................................................................................ 31 Domain I: Clinical Applicability .................................................................................... 32 Domain II: Values and Preferences ............................................................................... 32 Domain III: Implementability ........................................................................................ 32 Evaluating the Clinical Practice Guideline ............................................................................... 32 Participants and Recruitment .................................................................................................... 33 Consent and Ethical Considerations .......................................................................................... 33 Data Collection ............................................................................................................................. 33 Data Analysis ............................................................................................................................... 34 RESULTS ..................................................................................................................................... 34 Outcomes ...................................................................................................................................... 34 AGREE-Rex Scores ......................................................................................................... 35 Pre-survey Results ........................................................................................................... 36 Post-survey Results .......................................................................................................... 39 Proficiency Quiz Results ................................................................................................. 43 30-day Follow-up Survey Results ................................................................................... 45 DISCUSSION ............................................................................................................................... 46 Summary ...................................................................................................................................... 46 Interpretation ............................................................................................................................... 46 Implications .................................................................................................................................. 46 Limitations ................................................................................................................................... 47 Weaknesses ................................................................................................................................... 47 DNP Essentials Addressed .......................................................................................................... 48 DNP Essential I: Scientific Underpinnings for Practice .............................................. 48 DNP Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking ..................................................................................................... 48 DNP Essential III: Clinical Scholarship and Analytical Methods for Evidence Based-Practice .................................................................................................................
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