Date of Award

Spring 5-6-2022

Document Type

DNP Project

Project Team Faculty Member

Leah Baecht

Project Team Faculty Member

Rebecca Collier


Postdural puncture headache, obstetric anesthesia, dural puncture, epidural, medical management, PDPH treatment


In obstetric laboring patients, neuraxial anesthesia is a common form of analgesia. However, neuraxial procedures are not without risk. Accidental dural puncture (ADP) is a potential risk with any epidural procedure. Patients who experience ADP are at a greater risk of developing postdural puncture headache (PDPH). The presentation of PDPH is commonly described as a dull, throbbing, headache worsening upon standing and relieved with supine positioning (Patel et al., 2020). Symptoms of PDPH may range from mild to debilitating and develop within five days of ADP. A variety of treatment options exist for PDPH ranging from conservative to invasive. The purpose of this project was to introduce a standardized evidence-based treatment protocol for patients suffering from PDPH. A comprehensive review of the literature revealed the most recent evidence on contributing factors, prevention, and treatment of PDPH. The project study design utilized a non-experimental pre and post-evaluation method completed by nine anesthesia providers. The post-evaluation was collected following the educational PowerPoint presentation to analyze knowledge gained. Overall participants improved their rates of correct responses. Thus, implementation of the PDPH algorithm was directed at improving patient outcomes and enhancing provider knowledge.

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McVey & Shulman into aim & lit review PDPH protocol.docx (1361 kB)
Literature Review

McVey & Shulman Conceptual framework.docx (14 kB)
Conceptual Framework

McVey & Shulman Project Methods.docx (19 kB)
Project Methods

McVey & Shulman Evaluation and Outcomes.docx (16 kB)
Evaluation Process/Instruments

McVey & Shulman Final Reference List updated.docx (27 kB)
Final Reference List



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