Date of Award

Spring 2024

Document Type

DNP Project

Project Team Faculty Member

Leah Baecht

Project Team Faculty Member

Jenna Tebbenkamp

Keywords

cesarean section, non- pharmacological interventions, obstetric anesthesia, pharmacological interventions, shivering protocol, subarachnoid block

Abstract

In obstetric patients undergoing a cesarean section, a spinal anesthetic is the most common form of anesthesia (Hannallah, 2016). An intrathecal (or spinal) block is not benign. Postpartum shivering is a potential risk with any neuraxial procedure, with an incidence of 40-80% specifically following a spinal anesthetic (Feng et al., 2021). Patients who experience shivering are at a greater risk for postoperative complications, impaired mother-newborn bonding, and decreased patient satisfaction. Both nonpharmacological and pharmacological treatment options exist for prevention and treatment of postpartum shivering. The objective of this project was to introduce a standardized, evidence-based protocol to decrease the incidence of shivering and untoward sequela in patients undergoing a cesarean section with spinal anesthesia. A comprehensive review of the literature was performed to identify contributing factors, prevention of, and treatment for postpartum shivering. The project study design utilized a non-experimental pre- and post-evaluation method completed by 29 obstetric nurses and anesthesia providers. Following the educational PowerPoint presentation, the post-evaluation survey was utilized to assess participant comprehension. Overall, participants improved their knowledge as evidenced by the rate of correct responses. The implementation of the postpartum shivering protocol was directed at improving patient outcomes and enhancing provider knowledge; further research is needed to follow-up on patient outcomes.

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