College of Science and Health Theses and Dissertations

Date of Award

Fall 11-23-2021

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Susan M. Krawczyk, DNP, CRNA

Second Advisor

Shannon D. Simonovich, PhD, RN

Third Advisor

Jessica Bishop-Royce, PhD, MS


Introduction: The opioid epidemic and prescription opioid related deaths continue to grow in the US. Contributing factors to this epidemic include nonrestrictive opioid administration in the perioperative period. Though solutions to the epidemic has been discussed by anesthesia providers, there is no tool to quantiatively evaluate of their beliefs and practices for the perioperative management of pain. Over the past three years, there has been advancement in the science of nurse anesthesia on this front and in 2020 Tucker and Wong completed the development of a quantitative tool aimed at assessing CRNA beliefs and practices with regard to their use of non-opioid modalities for the treatment of perioperative pain, the Perioperative Nonopioid Modalities (PNOM) Questionnaire. Our study administered their innovative tool to a large sample of CRNAs practicing in the US and to performed factor analysis for further validation. Materials and Methods: This study utilized a cross-sectional research design, distributing the PNOM Questionnaire electronically to CRNAs practicing the US. Data was evaluated with exploratory factor analysis (EFA) as well descriptive statistics to evaluate current CRNA practice. Results: After adequate factorablility was established, EFA was conducted and revealed 10 factors or themes. Five factors were deemed reliable with cronbach’s alpha ≥ .70. Three important factors had questionable reliability with cronbach’s alpha ≥ .6, yet < .70 and are discussed. Overall, practicing CRNAs are favorable and knowledgeable regarding the use of non-opioid modalities for the treatment of perioperative pain, however they do demonstrate room for further and/or continued education. The results also demonstrated time constraints and organizational support as limiting factors for the use of non-opioid modalities perioperatively. Conclusion: The underlying constructs impacting beliefs and behaviors of opioid vs. non-opioid administration among CRNAs have significant impacts on non-opioid policy, practice and education.

SLP Collection


Included in

Nursing Commons