IMPROVING INFORMED CONSENT FOR EPIDURAL ANESTHESIA TO INCLUDE POSTDURAL HEADACHE EDUCATION

The purpose of this Doctor of Nursing Practice scholarly project was to improve the epidural informed consent process for CRNAs at Kaiser Permanente San Bernardino County by implementing an educational module emphasizing a standardized epidural informed consent to include PDPH education for laboring parturients. Background - CRNAs are ethically responsible for informed consent for all procedures. Parturients are a unique challenge to obtaining informed consent due to the labor process and its environment. Lack of standardization for obtaining informed consent from this population can lead to unintentional omission of risks of the procedure, including postdural puncture headache. Methodology - This was a pilot study with data collected At Kaiser San Bernardino County from September 6, 2023 to November 19, 2023. Participants were 15 CRNAs (n=15) that worked the most OB CRNA shifts from April 2022 to April 2023. Pre-post intervention evaluation was based on an abstraction tool and suggested scoring approach developed by the British Journal of Medicine. A paired t-test statistical analysis compared pre-education module consent scores with post-education module scores. Results - The difference between the pre-education module scores and the post-education module scores was statistically significant (p<0.001). Additionally, there was no correlation between the participant’s demographic data and their pre- and post-intervention scores, including how many years worked as a CRNA. Thus, standardization of informed consent processes improved the quality of informed consent, increasing patient education on postdural puncture headaches.