Assessing Perspective of Diet and Exercise in Patients Taking Semaglutide: An Educational Intervention
Creatore:
Young, Alexis
Descrizione:
Semaglutide is a prescription medication for weight loss and combating obesity. Current evidence indicates patients are regaining weight after discontinuing the medication unless diet and exercise regimens are sustained. Additionally, there is a lack of evidence regarding specific dietary recommendations for patients taking once-weekly subcutaneous semaglutide injections for weight loss. The purpose of this DNP project was to assess the effectiveness of an educational intervention focused on improving patient knowledge and receptiveness of making diet and exercise changes during their semaglutide treatment plan.
The study included adult patients who were overweight or obese and currently taking semaglutide for weight loss at a specified outpatient medical practice in Indianapolis. The study spanned 21 days and included two data collection periods. Data was collected via surveys to assess knowledge, diet and lifestyle habits, and readiness to change utilizing the Readiness Ruler tool. The educational intervention included a video and written information focused on evidence-based diet and exercise recommendations while taking semaglutide.
The project’s results indicated the educational intervention was beneficial and positively impacted participant knowledge and perspectives regarding diet, exercise, daily caloric intake, and water intake as recommended while taking semaglutide for weight loss. Recommendations for practice include incorporation of the educational intervention as part of the plan of care for patients prescribed semaglutide at the outpatient practice.
Research shows that the addition of extended reality (XR) in healthcare education is advantageous as it enhances the learning experience and improves students’ knowledge and motivation to learn. Its use has been documented in nearly all areas of healthcare education but is much less explored in the realm of anesthesia. This research project focuses on a branch of XR known as augmented reality (AR) and its use as an adjunct learning tool in the curricula for nurse anesthesia. Keller’s Attention, Relevance, Confidence, and Satisfaction (ARCS) Model of Motivation guided the design of this project to understand the impact AR technology had on second year student registered nurse anesthetists’ (SRNA) motivation towards learning. Students used an AR mobile application to interact with a realistic anatomical structure of the human larynx and completed a related worksheet. A post-assessment Likert-type Instructional Materials Motivation Survey (IMMS) was used to assess AR’s impact on learner motivation as it relates to each of the four ARCS model constructs. Each construct yielded a high average score amongst participants, thereby indicating a positive learning experience. The results imply that AR enhances current learning modalities and may directly influence students’ motivation to learn. The evidence is supportive for the use of AR as an adjunct learning tool in nurse anesthesia education. Future studies are needed to evaluate the efficacy of AR as a result of its integration into curricula.
Capnography Monitoring Education for the Perianesthesia Nurse
Creatore:
Makoyi, Bobette
Descrizione:
Background: Respiratory compromise is one of the most common complications that occur in the Post Anesthesia Care Unit (PACU) and accounts for half of the closed claims involving death in the PACU. However, with appropriate monitoring like capnography, identification of respiratory depression or apnea can occur prior to the adverse respiratory events (ARE). Although capnography is not currently considered a standard monitor in the PACU, it retains many advantages when used in conjunction with pulse oximetry and other standard monitors. Current research supports its use, and many organizations have created position statements and clinical practice recommendations for the use of capnography when patients are given any pharmacotherapeutic that alters sensorium. A knowledge deficit regarding capnography has been found among the perianesthesia nurses of the Indiana University Health Arnett Hospital, and inservice training was deemed a necessity in improving the quality of care provided to the patients. Aim: This project aims to evaluate a knowledge deficit about the utilization and interpretation of capnography among the perianesthesia nurses and subsequently provide in-service training. Methods and Procedure: A repeated measures, pre/post-test design was utilized to evaluate perianesthesia nurses (n = 23). A dependent paired samples t-test was used to compare mean score differences between the pre-and post-test scores. A 15 minutes in-service session was provided in the PACU to a group of 2-5 perianesthesia nurses at the time for three days. Results: Post-test scores were significantly higher than the pre-test scores following the educational intervention (p < 0.001), based on a two-tailed Wilcoxon ranked test. Conclusion: Providing education on the use and interpretation of capnography resulted in better post-test scores indicating an increased acquisition of knowledge pertaining to capnography.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Parola chiave:
PACU monitoring, respiratory depression in PACU, and capnography monitoring
Comparing Patient Systolic Blood Pressures with Tourniquet Inflation pressures and the Effects on Estimated Blood Loss. (A retrospective chart review)
Creatore:
Dzigbordi, Anthony
Descrizione:
During surgical interventions of upper or lower extremities, one of the methods in which blood loss can be decreased is through application of the pneumatic tourniquet. A bloodless field provides important advantages for the surgeon, and the pneumatic tourniquets provide a relatively good bloodless field to minimize intraoperative blood loss. (Naglehout & Elisha, 2018). Recent literature supports the use of personalized tourniquet inflation pressures (PTIP) as opposed to universal tourniquet inflation pressures. (UTIP) The purpose of this DNP project was to investigate what systolic blood pressures were measured on patients undergoing lower extremity surgeries prior to tourniquet inflation, what tourniquet inflation pressures were being used, and determine whether these tourniquet inflation pressures conform with PTIP, or UTIP standards, and further determine their effects on estimated blood loss (EBL), and other tourniquet related complications. This project comprises of a retrospective review of patient charts. A total of 186 electronic anesthesia records were reviewed and 75 patients were included in the DNP project. Identification of a project site was the first step. Approval was sought from the health facility and the various internal review boards (IRBs). A retrospective chart review was conducted to examine three full months of surgeries involving the lower extremities which required the use of pneumatic tourniquets. Data was collected and subsequently analyzed by use of Microsoft Excel. This data included the systolic blood pressures of patients prior to tourniquet inflation, tourniquet inflation pressures, ASA physical status, patient BMI, age and Gender. By completion of this retrospective chart review, it has been discovered that 75 patients received lower extremity surgeries with the use of pneumatic tourniquets. Of the 75 patients, tourniquets were inflated to 275mmHg on 57 (76%) of them regardless of their systolic blood pressure (SBP). 63 patients (84%) had a recorded EBL less than 100mL. No tourniquet related complications were recorded. Only one patient (1.3%) had a tourniquet inflation pressure greater than 300mmHg, with EBL recorded at 10mL.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
Tourniquet inflation pressure, estimated blood loss, and systolic blood pressure
Comparing postoperative pain scores and opioid consumption in patients receiving Lumbar Plexus block versus Fascia Iliaca block after undergoing hip arthroplasty
Creatore:
Ritter, Mark
Descrizione:
Background and Review of Literature: Lumbar plexus block and fascia iliaca block are two commonly used anesthesia modalities for patients underdoing hip arthroplasty at Union Hospital in Terre Haute, Indiana. Currently, there are not any studies that demonstrate which block is more effective at reducing postoperative pain and opioid consumption after hip arthroplasty. Review of literature demonstrates that both blocks have their advantages and disadvantages for providing postoperative pain relief.
Purpose: To determine which block is more effective at reducing postoperative pain, opioid consumption, and length of stay in hospital after hip arthroplasty procedures. These findings will then be presented to anesthesia staff at Union Hospital.
Methods: A retrospective chart review will be conducted on 25 patients that received a lumbar plexus block and 25 that received facia iliaca block. Pain scores and opioids consumed will be calculated for each patient in each group to determine which block provides superior pain relief. Overall length of stay will be calculated for each block group as well. Microsoft Excel and SigmaXL were utilized to analyze the data. ClinCalc opioid equivalent calculator was utilized to convert all opioids administered into intravenous morphine milliequivalents
Conclusion: This project demonstrated that the fascia iliaca block was superior at reducing postoperative pain (P = 0.045) in PACU as well as reducing overall opioid consumption (P = 0.0056) when compared to the lumbar plexus block. However, length of stay in hospital and pain score at 24 hours were similar. Difficulty of block and anesthesia provider experience must also be considered.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
Lumbar plexus block, Fascia iliaca block, and Hip arthroplasty
Complementary and Integrative Medicine (CIM) in Primary Care
Creatore:
Thompson, Jacqueline
Collaboratore:
Fox, Tara
Descrizione:
Background: Many patients seek the advise from their primary care providers (PCPs) to provide insight into alternative treatment options, however, little is known about the practices of primary care providers (PCPs) and the referring of Complementary and Integrative Medicine (CIM) treatments for patients with migraine pain. CIM is the practice of evidence informed modalities such as traditional Chinese medicine and mindbody strategies to assist in the health and healing processes.
Purpose: The purpose is to determine if Ascension St. Vincent Indianapolis PCPs are referring CIM treatments to their migraine patients, and if not, what prohibits providers from utilizing these treatments with their migraine patients.
Methods: A 10-question survey was distributed to 243 primary care providers (PCPs) of the Ascension St. Vincent Indianapolis network.
Implementation Plan: The 10- question survey was distributed to the PCPs of Ascension St. Vincent Indianapolis via their Ascension emails. The collection and analysis was conducted through the online database, REDCap from September 29 to October 31,2021.
Results: 29 responses were received (11.90%). There was no significant correlation between the provider’s professional background and their perceptions of CIM. There was a significant correlation between the provider survey responses and the provider’s gender.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
Complementary and Integrative Medicine (CIM), Complementary Alternative Medicine (CAM), Migraines in Primary Care, primary care providers (PCPs), and randomized controlled trial (RCT)
Coping with Microaggression in the Operating Room: Education for Student Registered Nurse Anesthetists
Creatore:
Kaur, Supreet
Descrizione:
A common theme among Student Registered Nurse Anesthetists is an impact on their mental and physical wellbeing during didactic and clinical education. This DNP project is aimed for the current Marian University graduate nursing students in the Nurse Anesthesia Program. An evidence-based educational intervention was developed to enhance Student Registered Nurse Anesthetists’ (SRNAs) confidence and knowledge on how to prevent microaggression in the operating room. Over four weeks, the survey was administered to the class of 2024, 2025 and 2026. To investigate this, an online survey was administered using the survey software program Qualtrics. Qualtrics was utilized to deliver the survey link to respondent emails and collect responses electronically. The participants for this project were required to complete a pretest assessing their baseline knowledge on microaggression. After viewing a 20-minute educational PowerPoint presentation, participants were required to complete a posttest. In addition, participant’s confidence will be assessed by the Student Satisfaction and Self-Confidence in Learning. This is a 13-item instrument designed to measure student satisfaction with simulation activity and self-confidence in learning using a five-point scale (Pence, 2022). This questionnaire was distributed with the pre-and posttest. The results of this project indicated that the educational intervention improved SRNA’s confidence and knowledge related to microaggression in the operating room.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
microaggression, depression, graduate students, nurse anesthesia students, microaggression prevention, and Student Satisfaction and Self-Confidence in Learning
Correlation of Increased Stress with Depression and Suicidal Thoughts Experienced by Student Registered Nurse Anesthetists (SRNAs)
Creatore:
Urbaez, Hiranya
Descrizione:
This DNP project’s significance is to help SRNAs self-recognize psychological and physical manifestations of negative stress, manifested as anxiety, depression, and suicidal thoughts during anesthesia training. The objective is to supply education to promote mental health awareness and resilience, overcome mental health stigma, screen SRNAs for early signs of depression and anxiety, and identify students at risk. SRNAs have displayed an increased risk for depression and suicidal thoughts due to additional stressors stemming from the program, including a lack of a paycheck. Other factors exacerbating the issue are exhaustion, despair, and substance abuse which can steer students to a mental health crisis. The population selected includes all SRNAs currently enrolled in the program (n=88). Educational information to promote wellness and tools for students to reach out for help if necessary was provided via Canvas. Qualtrics software was used to disseminate and collect data. The data consisted of 3 anonymous surveys that included the GAD-7, PHQ-9, and an additional survey of general questions based on the student’s perceptions of their mental health status. Students’ participation was voluntary and anonymous. Students received instructions on interpreting their survey results and information to follow up with counseling if needed. Utilizing qualitative statistical analysis, the GAD-7 showed 23.3% of students with severe anxiety. The PHQ-9 identified 14% with severe depression; 11% stated having thoughts of quitting, and 11.6% reported having suicidal thoughts during the anesthesia program. The parameters estimated on the regression model test confirmed that when depression, anxiety, and high levels of stress were combined significantly contributed to the outcome variable of suicidality. There is an increased need to incorporate a systematic protocol to screen students for early signs of depression, anxiety, and burnout. Nurse anesthesia programs must find ways to accelerate interventional efforts to help decrease and manage distress among students and build an atmosphere that restores resilience and well-being to the students.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
suicide prevention, nurse anesthesia students, depression, suicide and nurses, suicide ideation and graduate students, suicide ideation, suicide prevention program for nurses, and suicide awareness
COVID-19 and the PAH patient: A retrospective chart review
Creatore:
Schmit, Ann
Collaboratore:
Fox, Tara
Descrizione:
The COVID-19 pandemic has highlighted the need for additional health precautions in medically fragile populations. COVID-19 is a respiratory virus demonstrating increased mortality in individuals with risk factors such as pulmonary and cardiac disease. Pulmonary arterial hypertension, WHO group 1, is a rare condition that leads to cardiopulmonary symptoms. Pulmonary arterial hypertension, WHO group 1 (PAH), leads to constriction of the pulmonary vasculature which increases pressure in the right ventricle, and eventually leads to right heart failure. Additional research is needed to understand the risk PAH patients have with COVID-19 and if they are at a greater risk for disease worsening as evidenced by increased need for medical intervention, hospitalization, or even death. This project explores the relationship between the COVID-19 pandemic and pulmonary arterial hypertension, WHO group 1, patients at a single center. Adult patients diagnosed with PAH prior to March 1, 2019, at the Ascension St. Vincent Pulmonary Hypertension Clinic will be included in the study. A retrospective chart review will index hospitalization events, markers of disease worsening, and mortality in established patients and compare if there is statistical significance between the pre-pandemic period of March 1, 2019, through February 29, 2020, and during the COVID-19 pandemic period of March 1, 2020, through February 28, 2021. This study will increase the information known about the impact of COVID-19 on patients with PAH.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
PAH, COVID-19, and pulmonary arterial hypertension
Cricoid Pressure: Closing the Knowledge-Practice Gap
Creatore:
Brown, Jacob M.
Collaboratore:
Monteiro, Derrianne and Pepin, Christina
Descrizione:
Background and Review of Literature: Cricoid pressure is a technique of applying digital pressure along the outside of the upper airway to reduce the risk of aspiration of stomach contents during anesthesia induction. Improper placement can cause harm or make endotracheal intubation difficult. No accepted alternative practice exists, but it is performed incorrectly in most attempts. Incorrect placement and amount of force are typical causes of failure to occlude the esophagus and protect the airway There is no standardized training for cricoid pressure.
Purpose: This project was developed to determine whether incorporating simulated training, an educational session, and practice applying pressure with force measurement would be able to improve knowledge of and ability to correctly place cricoid pressure. This could determine if such an intervention is a viable option for future standardization of education on the topic.
Methods: A quality improvement design was used to test an education/simulation experience using the results of a 12 question pretest-posttest questionnaire and measurement of force placed on an airway manikin during three separate attempts with and without measured force feedback.
Implementation Plan/Procedure: A convenience sample of 33 Marian University first-year nurse anesthesia students completed the educational/simulated training experience and practice attempts, and 26 of the students finished the posttest survey to compare against the pretest data.
Implications/Conclusion: Average total questionnaire scores improved from 47.9% to 69.1% (p < 0.001) and cricoid pressure deviation from the target range decreased from 4.53 to 1.42 pounds (p < 0.001). There is still some room to improve, but the combined interventions created positive change in both data sets and could be a good starting point for standardizing education to reduce cricoid pressure variability in the clinical practice setting.
Dichiarazione dei diritti:
http://rightsstatements.org/vocab/InC/1.0/
Lingua:
English
Tipo di risorsa:
Research Paper
Parola chiave:
cricoid pressure, Sellick(‘s) maneuver, practice, education, and training