Dissertation
Reduction of postoperative reintubation through the use of capnography
Doctor of Nursing Practice (D.N.P.), Drexel University
15 Mar 2026
DOI:
https://doi.org/10.17918/00011285
Abstract
Postoperative reintubation (POR) is a serious complication following general anesthesia, associated with increased morbidity, mortality, and healthcare costs. Despite the known benefits of capnography in detecting respiratory compromise earlier than pulse oximetry, its utilization in the post-anesthesia care unit (PACU) remains inconsistent. This quality improvement project aimed to reduce POR by increasing anesthesia providers' willingness to order capnography monitoring for high-risk patients using the ARISCAT risk assessment tool. The outcome results were reviewed upon completion of this project. Guided by the Iowa Model and Rogers' Diffusion of Innovation Theory, the project implemented an educational intervention targeting provider knowledge, attitudes, and practices. Thirty-two matched pre and post surveys were analyzed, and all variables demonstrated significant improvement following the educational intervention. Wilcoxon Signed Rank testing showed increased familiarity and confidence with the ARISCAT tool, greater willingness to use both ARISCAT and ETCO2 monitoring in PACU, and stronger belief in their effectiveness for reducing postoperative reintubation (all p < .001). Participants also reported increased willingness to advocate for ETCO2 use in high-risk patients. Post-interventional POR rates at HSX increased in the month following the intervention when compared to previous 24-month averages. These findings indicate that the intervention had no effect on decreasing the incidence of POR. However, the educational session demonstrated a meaningful impact on provider knowledge, beliefs, and planned clinical behavior in identifying and preventing POR.
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Details
- Title
- Reduction of postoperative reintubation through the use of capnography
- Creators
- Robert StensonMike Yelyev
- Contributors
- Dawn M. Specht (DNP Chair) - Drexel University, Nurse Practitioner Master of Science in Nursing (MSN)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University
- Number of pages
- 64 pages
- Resource Type
- Dissertation
- Academic Unit
- Nurse Anesthesia; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 991022165739704721