Corbin, Lesley2024-09-092024-09-092024-05http://hdl.handle.net/10713/22757Problem: Spinal anesthesia (SA) is commonly used for orthopedic and lower abdominal surgical procedures. Spinal anesthesia frequently results in hypotension and bradycardia, leading to hypoperfusion of the brain and other vital organs. At an academic hospital in Maryland, 70% of adult patients undergoing SA for orthopedic procedures experience spinal-induced hypotension (SIH). Purpose: The purpose of this Doctor of Nursing Practice quality improvement initiative was to implement the administration of 4mg IV ondansetron within 5 to 15 minutes before SA to reduce hypotension among adult patients undergoing SA for non-obstetric procedures. Methods: Anesthesia providers and change champions were mobilized to facilitate implementation. Stakeholders were educated on the intervention and additional resources were provided for clarity via email and as a visual aid. A clinical reminder was created in the electronic documentation system, visible upon opening the spinal documentation. Compliance data was collected weekly for all eligible surgical cases and analyzed via run chart over 15 weeks. Results: A total of 19 data points were collected over 15 weeks. There was 0% compliance with the intervention in the first week, 50% compliance in the second week, and 100% compliance during weeks 3 through 15. No spinals were performed during weeks 8 and 9. One positive run was identified from week 3 to 15, suggesting a consistent change in practice. Conclusions: Findings suggest that ondansetron before SA is a realistic and feasible intervention that can be sustained within the anesthesia department at this facility. Using various strategies and tactics tailored to the project site, the goal of 100% compliance was met early in the implementation phase. Based on current literature, ondansetron before SA is projected to decrease the incidence of SIH and improve patient outcomes at the project site.en-USAnesthesia, SpinalHypotensionBradycardiaOndansetronOrthopedic ProceduresDNP ProjectGayden, Johnny C.