Perioperative Advanced Directives

Author

Derek WasherFollow

Date of Award

Fall 12-20-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Mary E. Zerlan DNP, CRNA, APN

Keywords

perioperative advanced directives, perioperative do-not-resuscitate, perioperative dnr, perioperative consent, anesthesia consent, dnr under anesthesia

Abstract

Technology and surgical techniques continue to improve, resulting in more clients with advanced directives presenting to the operative suite for surgery or procedures requiring anesthesia. Anesthesia providers are in a critical position to discuss with the surgical patient or surrogate any alteration or reconsideration to their advanced directive. Unfortunately, patients and anesthesia provider discussions at a North Texas hospital were limited due to a knowledge deficit, an outdated hospital policy rescinding all directives perioperatively, and an inadequate consenting mechanism. The perioperative advanced directives project involved updating the hospital policy to current national guidelines and developing a “DNR Under Anesthesia” consenting tool. The implementation process consisted of two separate presentations tailored to educate both nursing and anesthesia staff about the importance of maintaining patient autonomy and the right to self-determination perioperatively. The results demonstrated improvement in all areas of knowledge and comfort when dealing with the perioperative directives. With the project's success, education is now included in all perioperative staff's yearly competency modules, thus promoting sustainability. Most importantly, the patients now retain their rights to autonomy and self-determination in the perioperative arena.

Recommended Citation

Washer, Derek, "Perioperative Advanced Directives" (2020). Doctor of Nursing Practice Projects. 133.
https://spark.siue.edu/dnpprojects/133

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