DNP Final Project Depository

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1.Addressing CRNA Student Clinical Orientation through Needs Assessment and Education

Title Tesim:
Addressing CRNA Student Clinical Orientation through Needs Assessment and Education
Creador:
Jarvis, Morgan, M. and Starr, Sara R.
Descripción:
Background: Orientation programs are crucial for introducing individuals to educational institutions, internships, residencies, and workplaces, providing insight into expectations and operational procedures. However, at Marian University, there was a notable absence of a formalized orientation program for nurse anesthesia students before their immersion into the clinical setting. Purpose: This Doctor of Nursing Practice (DNP) project assessed the impact of a structured, student-led clinical orientation program on enhancing student preparedness in clinical environments. As part of this initiative, clinical site handbooks were developed to give students site-specific expectations, guidelines, and vital information pertinent to each clinical setting before their clinical immersion. Methods: Quantitative data were collected using electronic pre- and post-educational surveys using a 5-point Likert scale. Essential information for clinical site navigation was disseminated through handbooks created and posted on a dedicated Canvas page. Implementation: A convenience sample of 10 Marian University Student Registered Nurse Anesthesia (SRNA) students participated in this project. Before the educational orientation, pre- test surveys were provided to students to identify any practice or knowledge gaps among the participants and any additional information needed before their initial clinical rotation. Conclusion: Overall, the findings indicate a significant increase in student preparedness (p< 0.001) post-implementation of the clinical orientation program. Clinical site handbooks were found notably beneficial (p<0.05), and the adopted teaching methods were deemed significantly advantageous (p<0.001).
Declaración de derechos:
http://rightsstatements.org/vocab/InC-OW-EU/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
nurse anesthesia, curriculum development, orientation program, and SRNA
Fecha de Creacion:
2024

2.Adult Primary Care Providers’ Adverse Childhood Experiences (ACEs) Knowledge, Implementation, and Perceived Barriers: A DNP project

Title Tesim:
Adult Primary Care Providers’ Adverse Childhood Experiences (ACEs) Knowledge, Implementation, and Perceived Barriers: A DNP project
Creador:
McCalla, Ellen M.
Descripción:
Objective: Adverse Childhood Experiences (ACEs) are harmful or distressing events occurring within a child’s social or family environment which disrupt psychological and physical development. The goal of this DNP project is to answer this question: How do primary care providers (PCPs) perceive their knowledge, training, screening, and interventions when utilizing ACEs research in their practice? This DNP project seeks to answer this question using a mixed method quantitative design. Method: A 20 item electronic questionnaire was distributed to 33 adult outpatient primary care providers. Quantitative data was collected from 19 of the questions. These included inquiries concerning knowledge of ACEs, screening habits, and perceived barriers to integration of ACEs into adult primary care practice as well as participant demographics. The final item of the questionnaire was an invitation to discuss additional motivations and perceptions with the investigator. Results: Minimal statistically significant data is due to the small sample size. Data was analyzed utilizing a chi-square test, mean and median results, and inferential statistics to test project hypotheses. Descriptive statistics were utilized to describe the population, demographics, and data, via graphs and tables. Conclusion: The implementation and results of this project provide few significant findings. However, additional discussion of PCP motivations and perceptions offer a unique perspective to the concept of what is required to translate the ACEs information into adult primary care.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
primary care providers, adult outpatient, adverse childhood experiences, toxic stress, trauma-informed care, and motivations
Fecha de Creacion:
2022

3.Analgesic Efficacy for Total Knee Arthroplasty

Title Tesim:
Analgesic Efficacy for Total Knee Arthroplasty
Creador:
Penick, Tierra
Descripción:
Background: The number of annual total knee arthroplasties (TKA) had doubled over the last decade. Although this procedure treated chronic pain and restored mobility from end-stage osteoarthritis and other etiologies, it was associated with acute moderate-to-severe pain in the early postoperative period. Various analgesic techniques such as local infiltration, neuraxial blocks, and peripheral nerve blocks (PNB) were used in conjunction with multimodal anesthesia to prevent postoperative pain following TKA. The large variety of analgesic regimens accompanied with differing institutional and provider preferences challenged the ability to standardize a postoperative analgesic technique for TKA. Local Problem: Anesthesia providers at the project site often utilized the adductor canal block (ACB) alone or combined ACB and popliteal sciatic nerve block (PSNB) techniques for postoperative analgesia following TKA. However, it was unclear which technique was superior. Purpose: To understand the analgesic efficacy between ACB and combined ACB/PSNB following TKA. Methods: A retrospective chart analysis on 100 subjects that received ACB alone or ACB/PSNB for TKA in 2019. Pain was assessed upon post anesthesia recovery unit (PACU) admission, at 12 hours, and at 24 hours. Total opioid consumption was recorded for the first 24 hours. Length of hospitalization (LOH) was recorded per documentation. Results: Pain during PACU stay, pain at 12 hours postoperatively, and opioid consumption at 12 hours postoperatively were all significantly lower in the combined ACB/PSNB group (P = 0.0182, 0.0488, 0.0106 respectively). Pain and opioid consumption at 24 hours and LOH were not significantly different between the two groups. Conclusion: Combined ACB/PSNB therapy decreased pain and opioid consumption in the first 12 hours postoperatively following TKA. Large randomized controlled trials (RCT) need to be performed to deem the efficacy and incidence of related complications between these two blocks.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Palabra clave:
knee, sciatic nerve block, total knee arthroplasty, adductor canal block, and femoral nerve block
Fecha de Creacion:
2020

4.An Analysis of how Additional Simulation Scenarios Affect SRNAs’ Cognitive and Psychological Preparedness for Anesthesia Machine Malfunctions in the Clinical Setting

Title Tesim:
An Analysis of how Additional Simulation Scenarios Affect SRNAs’ Cognitive and Psychological Preparedness for Anesthesia Machine Malfunctions in the Clinical Setting
Creador:
Simon, Anthony and Earle, Jessica
Descripción:
Simulation experiences are a mandatory part of nurse anesthesia programs. Simulations are intended to improve students’ skills in a safe environment, but their effects on cognitive knowledge and confidence are not well documented. This study provided 28 student volunteers with additional simulation opportunities. The experimental group participated in additional simulation experiences and the control group did not. Both groups took a pre- and post-test designed to measure confidence and test students’ knowledge. The pre- and post-test scores were compared between the two groups. Despite the perceived importance of simulation, no significant relationship was demonstrated between additional simulation scenarios and cognitive improvement. There was also no significant change in confidence levels regardless of simulation participation or frequency.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
simulation experiences, cognitive knowledge and confidence, anesthesia machine malfunctions, CRNA, and voluntary simulation experiences
Fecha de Creacion:
2023

5.Analyzing a New Approach to the Assessment of Neonatal Abstinence Syndrome

Title Tesim:
Analyzing a New Approach to the Assessment of Neonatal Abstinence Syndrome
Creador:
Tiefel, Rachel
Descripción:
Background and Review of Literature: Neonatal abstinence syndrome (NAS) is becoming an increasingly complex problem across many facilities. The use of standardized assessment is vital to ensuring that infants are properly assessed and managed. The use of the Finnegan or modified Finnegan score has been the most common method for assessing infants but lacks statistical validity or reliability. It also suffers from a lack of interrater reliability. This technique also requires that an infant be disrupted at least every four hours to look for signs of withdrawal. A new model called Eat, Sleep, Console Approach (ESC) is evaluating the importance of first line interventions such as cuddling, swaddling, breastfeeding on demand, and low stimulation environments. The model focuses on a neonate's ability to maintain vital functions. Purpose: The purpose of this project is to find a new approach to assessing NAS that will enhance the ease and reliability of NAS assessment. Methods: A pre and post assessment survey of frontline staff will help to determine how implementation of the new model improves care and assessment. Implementation Plan: Implementation of this project included a PowerPoint training to help ensure that staff can utilize the new assessment technique. A side by side comparison of the Finnegan scoring and ESC model was done with both assessments taking place on each infant. Surveys will evaluate the before (Finnegan) and after (ESC) to see if staff perceive one method as superior in simplicity and reliability. Conclusions: ESC model has been well received by staff on the unit. It has been a better way to decrease interruptions for neonates and is perceived as an easier alternative to Finnegan's scoring.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Palabra clave:
Finnegan score, Eat, Sleep and Console Model, and Neonatal abstinence score
Fecha de Creacion:
2019

6.Anatomage Table and Effects on Improving Clinical Anatomy Knowledge and Competence in Anesthesia Procedures and Assessment

Title Tesim:
Anatomage Table and Effects on Improving Clinical Anatomy Knowledge and Competence in Anesthesia Procedures and Assessment
Creador:
Offiah, Chidimma N. and Hogo, Precious
Descripción:
<b>Background</b> The Certified Registered Nurse Anesthetist (CRNA) profession is fast growing and at an all-time high, with over 56 thousand licensed professionals. Nurse Anesthetist programs are tasked with developing a high academic curriculum with a strong anatomy course at its core. In a hospital setting, CRNAs are considered the airway experts that respond to airway emergencies, called to perform Transesophageal Echocardiograms (TEEs), Point of Care Ultrasounds (POCUs) including high risk procedures such as Peripheral Nerve Blocks (PNB), spinals and epidurals. Hence, a sound working knowledge of anatomical structures and their relationship to surrounding structures is vital. To bridge the gap in knowledge and comprehension of anatomy, several curriculums are starting to employ the use of virtual reality or 3D technology as an adjunct to learning anatomy. The Anatomage Table (AT) is the first 3D virtual dissection table that allows users to visualize anatomy at the highest level of accuracy. The AT is a fairly new technology developed in 2004 with limited research published to address its usefulness in graduate/undergraduate nursing programs. No research was found that evaluates the effectiveness and impact of the AT in learning anatomy in the Nurse Anesthesia Program. <b>Purpose</b>: The purpose of this project is to evaluate the effectiveness and perceived benefits of the AT to improve the knowledge of clinical anatomy and enhance performance of point-of-care assessments and interventional anesthesia procedures in first year student registered nurse anesthetists (SRNA) during the 2021-2022 academic year. <b>Methods</b>: This was a two-part project, a sequential explanatory mixed methods design. Quantitative and qualitative data were evaluated using a pre and post-test, a self-efficacy tool, an open-ended questionnaire, and a PNB simulation exam. Utilizing prebriefing video teaching airway anatomy and its innervations was published for students to view prior to attending a hands-on simulation. A pretest was given prior to the simulation experience followed by a posttest, a self-efficacy survey and an open-ended questionnaire. Subsequently, the AT was used as an adjunct to teach interscalene block prior to their PNB simulation exam. The previous cohort who received teaching using traditional methods (lecture, mannikin, cadaver) was used as a comparison group. <b>Results</b>: Mean knowledge scores increased from 9.40 ± 2.46 in the pretest to 10.56 ± 2.42 in the posttest (p=.052). p>0.05. However, students reported the AT as an effective teaching tool that enhanced their knowledge of anatomy, increased retention, and had a positive impact on clinical preparedness.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
Virtual reality, Anatomy Education, Anatomage, 3D Visualization, 3-dimensional education, three-dimensional image, and imaging
Fecha de Creacion:
2023

7.Anesthesia Provider Compliance with Intravenous Injection Port Disinfection Protocols

Title Tesim:
Anesthesia Provider Compliance with Intravenous Injection Port Disinfection Protocols
Creador:
Brechbuhl, Brittany
Descripción:
Background and Review of Literature: Intravenous (IV) catheter-associated bloodstream infections (CABIs) are a substantial problem in healthcare. Recently, intraoperative care was identified as a risk factor for the development of CABIs. Patient IV stopcocks (i.e. injection ports), which are bacterially contaminated during anesthesia administration, serve as a vector for bacterial transmission and subsequent infection development in patients. IV injection port disinfection was shown to reduce this bacterial contamination and decrease postoperative infection rates. Current clinical practice guidelines (CPGs) and hospital policies recommend IV injection port disinfection prior to IV access. Purpose: The purpose of this DNP project is to determine anesthesia provider compliance with intraoperative IV injection port disinfection protocols and anesthesia provider attitudes regarding intraoperative IV injection port disinfection. Methods: To investigate this, an online survey will be administered using the survey software program Qualtrics. Implementation Plan/Procedure: Anesthesia providers at IU Health Arnett Hospital will be invited to participate via e-mail. Participation will be entirely voluntary and confidential. All survey responses will be sent to Qualtrics and stored in a password protected electronic format. Implications/Conclusion: The survey completion rate among anesthesia providers was 41.38%. Survey respondents estimated scrubbing the IV injection port 68.83% of the time and allowing drying time after scrubbing the IV injection port 51.33% of the time prior to IV-line access. Only 49.99% of survey respondents agreed that intraoperative IV-line care contributes to bacterial transmission to patients. Furthermore, 58.33% of survey respondents disagreed that intraoperative IV-line care contributes to the development of postoperative infections. These results suggest that improvement is needed in this area of intraoperative infection control. They also suggest that certain anesthesia provider attitudes regarding intraoperative IV-line care may serve as a rationale for noncompliance. Future research and quality improvement (QI) initiatives should focus on such attitudes as a potential avenue for intervention for improving IV injection port disinfection compliance among anesthesia providers.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
intraoperative bacterial transmission, catheter hub disinfection, stopcock contamination, anesthesia workplace, and intraoperative infection control
Fecha de Creacion:
2022

8.Assessing Anesthesia Provider Recognition and Compliance of the World Health Organization Five Moments of Hand Hygiene in the Operating Room

Title Tesim:
Assessing Anesthesia Provider Recognition and Compliance of the World Health Organization Five Moments of Hand Hygiene in the Operating Room
Creador:
McSherry, Joseph
Descripción:
BACKGROUND AND LITERATURE REVIEW: Hand hygiene (HH) is the number one way to reduce healthcare associated infections (HAI). These infections account for increased morbidity and mortality and are linked with poor HH among anesthesia personnel. Anesthesia provider HH compliance is low, and with solid HH guidelines available, increasing their compliance is paramount in reducing HAIs. PURPOSE: This study aims to assess anesthesia provider HH recognition and compliance among student registered nurse anesthetists (SRNA) at Marian University and certified registered nurse anesthetists (CRNA) at a large urban academic hospital in St. Louis, Missouri. METHODS: A one-time eleven question survey will be administered online through Qualtrics assessing knowledge and compliance of the WHO five moments of HH in the operating room (OR). The survey is based on a validated survey instrument and consists of five questions regarding moments to perform HH and six questions regarding demographics. IMPLEMENTATION PLAN/PROCEDURE: Over four weeks, the survey will be administered to 170 anesthesia providers to include 101 CRNAs, 68 SRNAs, and 1 MDA. Qualtrics will be utilized to deliver the survey link to respondent emails and collect responses electronically. This project is supported by Marian University, Leighton School of Nursing, Department of Nurse anesthesia faculty. IMPLICATIONS/CONCLUSIONS: Increasing HH among anesthesia providers will reduce HAIs and increase patient outcomes. Multimodal strategies work best, including increased access to HH products and those that include an education element. Long term success of these interventions is related to sustainment efforts of the institution and will likely decrease over time without them. Understanding current HH recognition and compliance is the first step to increasing HH performance rates and is the focus of this study.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
guidelines, barriers, compliance, hand hygiene, operating room, and anesthesia
Fecha de Creacion:
2021

9.Assessing PACU Handoff Report Confidence

Title Tesim:
Assessing PACU Handoff Report Confidence
Creador:
Siddiqi, Majid Nasir
Descripción:
Effective communication during the handoff process between anesthesia providers and post-anesthesia care unit (PACU) nurses is crucial for ensuring patient safety. This Doctor of Nursing Practice (DNP) project aimed to investigate and develop an evidence-based educational intervention to enhance Student Registered Nurse Anesthetists' (SRNAs) confidence and competency in delivering standardized handoff reports, with the goal of promoting patient safety and reducing medical errors. Participants were required to complete a pre-test assessing baseline characteristics consisting of prior experience, confidence, knowledge, and comfort when giving PACU handoff reports. The pre-test was followed by the educational intervention which was provided in the form of an evidence-based presentation. Upon reviewing the presentation, participants were required to complete a post-test assessing confidence, knowledge, skills, and comfort when giving PACU handoff reports. The results indicated that the educational intervention improved SRNAs' confidence, knowledge, and skills related to post-operative care unit reports. The findings of this project have significant implications for practice, highlighting the importance of ongoing efforts to enhance SRNAs’ abilities to conduct standardized handoff reports in post-operative care units. Further research is needed to confirm the findings and investigate the long-term effects of educational interventions on patient outcomes.
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Research Paper
Palabra clave:
post-anesthesia care unit (PACU) , handoff process, standardized handoff reports, patient safety, educational intervention, and SRNA
Fecha de Creacion:
2023

10.Assessing Patient Perspective of Diet and Exercise in Patients Taking Semaglutide: An Educational Intervention

Title Tesim:
Assessing Patient Perspective of Diet and Exercise in Patients Taking Semaglutide: An Educational Intervention
Creador:
Young, Alexis
Descripción:
The DNP project aimed to: assess the effectiveness of an educational intervention focused on improving patient knowledge and receptiveness of making necessary diet and exercise changes during their semaglutide treatment plan. PICOT: “For patients 18 years and older who have received at least one semaglutide injection for weight loss, how will an educational handout compared to current verbal education, enhance patient understanding and perspective of lifestyle modifications necessary during and after treatment with semaglutide?"
Declaración de derechos:
http://rightsstatements.org/vocab/InC/1.0/
Idioma:
English
Tipo de recurso:
Poster
Palabra clave:
Semaglutide, educational intervention, lifestyle modifications, obesity, and glucagon-like-peptide (GLP-1)
Fecha de Creacion:
2023