DNP Project Title
Date of Award
Project Team Faculty Member
Dr. Mary E. Zerlan DNP, CRNA, APN
perioperative advanced directives, perioperative do-not-resuscitate, perioperative dnr, perioperative consent, anesthesia consent, dnr under anesthesia
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patients and anesthesia provider discussions at a North Texas hospital were limited due to a knowledge deficit, an outdated hospital policy rescinding all directives perioperatively, and an inadequate consenting mechanism.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.
Washer, Derek, "Perioperative Advanced Directives" (2020). Doctor of Nursing Practice Projects. 133.
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Instruments & Evaluation Process
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Final Reference List