Date of this Version

2023

Document Type

DNP Project

Abstract

Background: Since the 1880’s, nitrous oxide has been utilized for labor analgesia; however, its availability in the United States has drastically diminished, leaving laboring women with fewer anesthetic options than those in other developed countries. Prior analysis demonstrates a lack of provider knowledge to be a significant deterrent to widespread use of nitrous oxide for labor analgesia.

Methodology: A quality improvement project was conducted utilizing a pre-test and post-test survey to assess attitudes and knowledge regarding Nitrous Oxide use for labor analgesia. Evidence-based research was applied to construct an educational module regarding the use of nitrous oxide for labor analgesia purposes. Participants included Doctorate of Nurse Anesthesia Practice (DNAP) alumni from Florida International University. Participants were asked to complete a pre-test assessing their knowledge of nitrous oxide use for labor analgesia and their willingness to incorporate its use into their practice. Following the educational module, participants then completed a post-test.

Results: The invitation for participation yielded a 20% response rate (n=6). One hundred percent of participants were doctorate-level education certified registered nurse anesthesiologist’s (CRNAs) who had been practicing for 1-2 years. Pre-test results demonstrated 50% of participants failed to recognize proper administration practices of nitrous oxide for labor analgesia. Pre-test data also showed 33% of participants were unlikely to very unlikely to request access to nitrous oxide for labor analgesia at their facility. Post-test data demonstrated an increase to 100% of participants correctly identifying timing of administration of nitrous oxide during labor. Furthermore, post-test data revealed an increase to 83% of participants being extremely likely to discuss the option of nitrous oxide for analgesia with their laboring patients, as well as request access to nitrous oxide at their facility.

Discussion: The project demonstrated success in utilizing education to motivate anesthesia providers to expand their utilization of nitrous oxide for labor analgesia. The author is hopeful that other facilities will be able to successfully implement similar educational modules and will expand labor analgesia options to include nitrous oxide for women in the United States.

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