DNP Final Project Depository
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Last Updated: 2021-10-04
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21. Cricothyrotomy: The Life-saving Airway Procedure
- Title Tesim:
- Cricothyrotomy: The Life-saving Airway Procedure
- O Criador:
- Tokarz, Merandah and Harris, Hannah
- Descrição:
- Background: Anesthesia providers are trained to adapt and rapidly respond to cannot intubate cannot ventilate situations based on a difficult airway algorithm. In anesthesia education, simulated events allow for effective learning in a safe environment. Currently, at Marian University, there is no simulated education on the cricothyrotomy procedure. Purpose: This DNP project was developed to assess the effectiveness of a cricothyrotomy simulation on student confidence level, knowledge base, procedural accuracy, and satisfaction in learning compared to the current didactic curriculum. Methods: This project collected quantitative data through electronic pre- and post-simulation surveys. Information for the simulation was published through a Canvas page. The questions were derived from the curriculum textbooks and the Student Satisfaction and Self-Confidence in Learning instrument. Implementation: A total of 12 SRNAs participated in this project. Students were given access to the Canvas course before the simulation date, which contained access to the pre-test. All students underwent the same simulation set-up and were asked to perform the procedure based on the information provided on Canvas. After completion of the simulation, students were asked to complete the post-test survey. Conclusion: Simulation education increased the student’s knowledge and self-confidence regarding the cricothyrotomy procedure (p<0.05; p<0.05). Overall, students revealed that they had increased satisfaction in learning with simulated events versus didactic learning (p<0.05). Similarly, the knowledge base of the students increased because of this simulation (p=0.01).
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Anesthesia, SRNA, Simulation, Cricothyrotomy, CICV, INACSL, and Education
- Data Criada:
- 2024
22. Debriefing After a Difficult Airway Algorithm Simulation
- Title Tesim:
- Debriefing After a Difficult Airway Algorithm Simulation
- O Criador:
- Curley, Connor
- Descrição:
- The difficult airway algorithm is a necessary technique that must be mastered by all student nurse anesthetists. Students in Marian University’s Nurse Anesthesia Program are taught the potentially life-saving skills included in the difficult airway algorithm. This project added a debriefing component to the simulation training usually conducted in the program. The purpose is to prove that debriefing increases their knowledge on the subject, enhances their confidence and satisfaction when applying difficult airway situations.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- difficult airway algorithm, debriefing component, and simulation training
- Data Criada:
- 2022
23. Differences in Dosing of Dexamethasone and the Effect on Post-Operative Emesis in Healthy Surgical Patients
- Title Tesim:
- Differences in Dosing of Dexamethasone and the Effect on Post-Operative Emesis in Healthy Surgical Patients
- O Criador:
- Miller, Austin
- Descrição:
- Background and Review of Literature: Post-operative nausea and vomiting remains a constant threat to patients undergoing anesthesia. As such a myriad of drug compounds are utilized in the practice of anesthesia to prevent and thwart the unpleasant experience of post-operative nausea and vomiting. Although there has been agreement on the drug compounds that can successfully prevent such outcomes, little consensus has been developed for certain compounds, specifically dexamethasone. Purpose: To determine differences in efficacy in the prevention of post-operative emesis based on dosing of dexamethasone. Methods: A retrospective chart review was conducted on 10 healthy patients receiving > 0.1mg/kg of dexamethasone and 10 healthy patients receiving < 0.1mg/kg of dexamethasone at the induction of anesthesia. An evaluation of emesis in the post-operative period was evaluated. Microsoft Excel and Stat Crunch were used to analyze the data. Conclusion: A comparison of the group receiving <0.1 mg/kg and > 0.1 mg/kg of dexamethasone yielded no statistical difference in the ability to prevent postoperative emesis between the two groups.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Post-operative nausea and vomiting, Anesthesia, and Dexamethasone
- Data Criada:
- 2022
24. Disproportionate Impact of COVID-19 on BIPOC Communities
- Title Tesim:
- Disproportionate Impact of COVID-19 on BIPOC Communities
- O Criador:
- Walker II, Frederich L.
- Descrição:
- COVID-19 is an infectious respiratory illness that has taken hundreds of thousands of lives and infected millions more in the United States. Unfortunately, Black Indigenous and People of Color (BIPOC) communities are over-represented in deaths and infections. Healthcare disparities are multifactorial, and dependent on a complex interplay of demographic, socioeconomic, cultural, genetic, and historical variables. This education was given to CRNAs to educate them on the different issues contributing to the disproportionate impact of COVID-19 on BIPOC communities. Healthcare workers who on the front lines of this pandemic are not routinely educated by employers of this social issue, which leads to a lack of education for their patients. A lack of knowledge of one's risk factors has negative effects on more a vulnerable part of the population attempting to mitigate exposure risk to COVID-19. In addition, these communities of color are shown to have decreased access to healthcare, overrepresentation in essential jobs, reduced ability to work from home which leads to the reduced ability to social distance.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Healthcare disparities, COVID-19, Black Indigenous and People of Color (BIPOC), and Risk factors
- Data Criada:
- 2021
25. DNP Project Proposal: Nurse Practitioners’ Knowledge and Behaviors in Recommending Colorectal Cancer Screening
- Title Tesim:
- DNP Project Proposal: Nurse Practitioners’ Knowledge and Behaviors in Recommending Colorectal Cancer Screening
- O Criador:
- Dorsett, Julie K.
- Descrição:
- The United States Preventative Services Task Force (USPSTF) recommends initiating colorectal cancer screening for asymptomatic, average-risk individuals at age 45, which is a new update to the previous recommendation of age 50. Early detection of colorectal cancer reduces mortality compared to treatment in advanced stages of disease. Strategies shown to increase screening rates include the discussion of multiple modalities for screening, a systematic approach to identifying eligible patients, healthcare provider recommendation and teaching for screening, and overcoming individualized patient barriers to screening. This project was conducted in partnership with the Coalition of Advanced Practice Registered Nurses of Indiana (CAPNI) to better understand the knowledge and recommendation practices of Indiana nurse practitioners. A survey based on a previous study of primary care physicians by Chapman et al. (2012) was distributed to CAPNI membership regarding recommendation practices and utilization of screening guidelines. Colonoscopy was the most commonly recommended screening modality, followed by fecal immunoassay testing with DNA testing (FIT-DNA). No statistically significant difference was found in completion rates between colonoscopy and stool-based tests, as reported by providers. Most participants utilized guidelines from a professional organization to guide their recommendations for screening, but only 37.25% utilized those from the USPSTF. The majority of providers indicated they utilized a chart notification system to identify patients for screening and would offer additional modalities for screening if patients declined their first-recommended modality. USPSTF guidelines changed during the implementation of the project, influencing responses. Additional research with a larger sample size may aid in targeted educational opportunities to increase screening.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- colorectal cancer screening, USPSTF, nurse practitioners, FIT-DNA, and colonoscopy
- Data Criada:
- 2021
26. Does an Online Educational Workshop for Certified Registered Nurse Anesthetists Reduce the Perceived Clinical Barriers and Promote Willingness to Change Practice to the Use of Spinal Anesthesia for Patients Undergoing Total Hip Arthroplasty?
- Title Tesim:
- Does an Online Educational Workshop for Certified Registered Nurse Anesthetists Reduce the Perceived Clinical Barriers and Promote Willingness to Change Practice to the Use of Spinal Anesthesia for Patients Undergoing Total Hip Arthroplasty?
- O Criador:
- Sensi, Harjyot
- Descrição:
- Total Hip Arthroplasty (THA) is a commonly performed procedure in the operating room and often the patient population undergoing this procedure are elderly with multiple comorbidities. Despite new research on spinal anesthesia (SA) many hospital facilities continue to utilize general anesthesia (GA). One of the most important adverse outcomes noted with GA is the activation of the neuroendocrine stress response. The neuroendocrine stress response is responsible for increased mortality and morbidity and is activated through pain under general anesthesia. The utilization of spinal anesthesia prevents the activation of the neuroendocrine stress response as pain signals are blocked along the ascending nerve fibers. The purpose of this DNP project was to educate certified registered nurse anesthetist (CRNAs) at an acute care hospital in an urban city in the Midwest via an online educational workshop and identify the perceived barriers that prevent CRNAs from utilizing SA technique in practice for THA patients. This was measured through an online power point presentation module along with a pre-and post-survey. The surveys were designed by using Likert-based questions focusing on the impact of SA and GA on patients presenting for THA, barriers to the use of SA, and their confidence in use of SA in this patient population after participating in the power-point presentation. The results of the survey showed a statistical significance in their confidence in the use of SA of p < .05, demonstrating the impact of the educational module in the post-survey results. Some limitations notable in this study were small study sample, lack of compliance and incentive for participating in this project, technical issues, and lack of in-person training.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- general anesthesia, spinal anesthesia, barriers, facilitators, neuraxial anesthesia, regional anesthesia, total hip arthroplasty, total hip replacements, post anesthesia recovery unit, hemodynamic complications, comorbidities, and CRNAs
- Data Criada:
- 2023
27. Educating SRNAs on Substance Use Disorder Prevalence, Risk, and Prevention
- Title Tesim:
- Educating SRNAs on Substance Use Disorder Prevalence, Risk, and Prevention
- O Criador:
- Smith, Kursten R.
- Descrição:
- <b>Background and Review of Literature</b>: Substance use disorder (SUD) is increasing nationwide, including within the anesthesia provider community. Anesthesia providers are shown to be at an increased risk of developing SUD compared to other healthcare professionals. Detrimental effects on those under the care of an anesthesia provider with SUD can, and do, occur. Current Council of Accreditation (COA) guidelines necessitate the inclusion of limited SUD teaching to student registered nurse anesthetists (SRNAs), but professional organizations, such as the American Association of Nurse Anesthesiologists (AANA), recommend the provision of additional information. <b>Purpose</b>: This DNP project’s purpose was to provide education regarding SUD in anesthesia personnel via a virtual module to second-year SRNAs to increase prior knowledge and awareness on the topic. <em>Methods</em>: This project utilized a quasi-experimental design and was evaluated by an expert-certified pretest/post-test questionnaire. A convenience sample was obtained using currently enrolled second-year SRNAs at Marian University in Indianapolis, Indiana. <b>Results</b>: Thirty-two SRNAs participated in the project and 22 participants completed all questions in the pretest and post-test for a 69% completion rate. Pretest responses were matched with post-test responses. Using a paired t-test, the results show the provided education module significantly increased prior knowledge of SUD in the anesthesia profession (p= <0.001). Participants gained an average of 1.87 points (95% CI) on post-test scores after completing the module. <b>Implications/Conclusion</b>: The introduction of an in-depth SUD education module increased SRNA’s knowledge of SUD in the anesthesia profession. Enhancing SUD knowledge related to incidence, risk factors, warning signs, and prevention in anesthesia providers in training is recommended by experts to prevent providers’ illicit use of substances, which can harm both providers and patients (Bell et al., 1999 & Booth et al., 2002). Further, increased awareness about SUD among anesthesia providers and the provision of available resources is beneficial to assist those affected by SUD.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- CRNA, drug diversion, medication diversion, anesthe*, substance abuse, and drug dependence
- Data Criada:
- 2023
28. Education for Student Registered Nurse Anesthetists on Preoperative Ultrasound Guided Assessment of Gastric Content
- Title Tesim:
- Education for Student Registered Nurse Anesthetists on Preoperative Ultrasound Guided Assessment of Gastric Content
- O Criador:
- Schandorf, Stephen Sai
- Descrição:
- Background: Since its introduction by Mendelson in 1946, preoperative fasting has been utilized to produce an empty stomach and decrease the risk of aspiration in the surgical patient. Patient adherence to NPO recommendations, certain comorbidities, and/or medications that can decrease gastric motility increases the risk of aspiration. Additionally, anesthesia induction drugs blunt airway reflexes making patients susceptible to reflux and possible aspiration, resulting in adverse outcomes. Identification of patients at increased risk and prevention of aspiration is therefore imperative for the CRNA to achieve successful perioperative outcomes. Ultrasonography, a safe noninvasive tool frequently used by anesthesiologist can be utilized in identification of patients at increased risk of aspiration. It is however currently underutilized. Purpose: This DNP project aims at teaching SRNAs how to perform an ultrasound gastric assessment as well as develop a check sheet to guide performance of the gastric ultrasound scan (GUS) in order to increase use and patient safety. Method: A 30 minute voice over instructional PowerPoint together with a pretest/posttest survey was deployed to all registered Marian University SRNAs with instructions to complete the pretest prior to reviewing the PowerPoint tutorial and the post test afterwards. Results: Participant’s knowledge based scores significantly increased from the pretest (M = 50.5, SD = 14.4) to the post test (M = 93.8, SD = 9.3; t = -11.1, p < .001, d = -2.86). Additionally SRNA confidence in performing a GUS significantly increased from the pretest (M = 6.6, SD = 18.5) to the post test survey (M = 57.2, SD = 19.6; t = -7.99, p < .001, d = -2.06). Conclusion: Student participation in the DNP project significantly increased their knowledge on the gastric ultrasound assessment procedure and their confidence for performing the procedure.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- gastric ultrasound, gastric content, gastric volume, preoperative fasting, and aspiration
- Data Criada:
- 2024
29. Effect of an Educational Presentation to Increase Preemptive ondansetron Administration for Reducing Spinal-Induced Hypotension and Bradycardia
- Title Tesim:
- Effect of an Educational Presentation to Increase Preemptive ondansetron Administration for Reducing Spinal-Induced Hypotension and Bradycardia
- O Criador:
- Brandes, Cody
- Descrição:
- Background: The utilization of lower extremity total joint arthroplasty (TJA) has increased over time, with over 2.2 million hip and knee arthroplasty procedures performed between 2012 and 2020. These procedures are very painful for patients; therefore, providers may choose to perform a neuraxial anesthesia to block the initiation and conduction of the pain nerve pathway. However, there are side effects from neuraxial anesthesia. Hypotension and bradycardia from neuraxial anesthesia are common side effects and are caused from the blocks ability to elicit the Bezold-Jarisch reflex (BJR). A prophylactic administration of the medication ondansetron (Zofran®), can attenuate some side effects of spinal anesthesia. Purpose: This project was developed to educate anesthesiologists and CRNAs that there is a new safe and effective intervention to add to their current practice. To attenuate the side effects from choosing a neuraxial anesthetic for patients undergoing a total knee arthroplasty. Methods: This DNP project collected quantitative data through electronic pretests and posttest. A retrospective chart review was conducted to evaluate if there was an increase in prophylactic administration of ondansetron (Zofran®) prior to a spinal anesthetic after participating in an educational presentation. Implementation: Five anesthesia providers at a rural hospital in northern Indiana participated in this project. The providers were given an online pre-test and then once completed there was a link provided with education from a PowerPoint presentation. Following the presentation, a post-test was administered. Additionally, a retrospective chart review was conducted three months before and three months after the educational intervention to determine if a practice change had been made regarding the timing of ondansetron administration. Conclusion: The introduction of an education intervention suggest a generalized improvement in knowledge about prophylactic administration of ondansetron for total knee arthroplasty under a spinal anesthetic, the Bezold-Jarisch reflex, and alternative interventions in pre-test to post-test scores despite not being statistically significant. Additionally a retrospective chart review indicated that before the educational intervention, successful prophylactic administration of ondansetron prior to a spinal anesthetic improved and incorrect administrations decreased post-educational presentation.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Ondansetron, Spinal, Lower extremity total joint, Neuraxial, Spinal induced hypotension, Spinal-induced hypotension Co-loading, Zofran®, Total joint arthroplasty (TJA), Bezold-Jarisch Reflex (BJR), attenuate, and vasopressors
- Data Criada:
- 2024-04-24
30. The Effect of Formal Online Peer Mentor Training on Mentor Self-Confidence
- Title Tesim:
- The Effect of Formal Online Peer Mentor Training on Mentor Self-Confidence
- O Criador:
- Hughes, Angelica
- Descrição:
- The stress levels experienced by student registered nurse anesthetists (SRNAs) make them excellent candidates to experience the benefits of peer mentoring. Many students assigned as mentors lack the necessary skills to support an adequate mentoring relationship. Mentor training programs have proven successful in providing mentors with the skills, knowledge, and selfconfidence to support the next generation of SRNAs. The purpose of this quality improvement project was to determine if DNP nurse anesthesia peer mentors, who have undergone formal online mentor training, experience higher levels of confidence after participating in formal mentor training. Thirty-eight students from two cohorts of the nurse anesthesia program were invited to enroll in the online Mentor Training Workshop via Canvas. The mentor training workshop featured education about mentorship best practices for developing a successful mentoring relationship. Participants began by assessing their pre-workshop confidence level through an adapted version of the Mentor Competency Assessment survey. Participants were granted self-guided access to the workshop modules with a deadline of three weeks. The workshop entitled “SRNA Mentor Training” consisted of four education modules based on objectives criterion. Participants then completed the same survey after completion of the workshop. Participant’s responses indicated improved overall confidence with mentoring and in their ability to meet the needs of their mentees. These results were found to be statistically significant with a value of 0.018 and 0.009, respectively (P< 0.05).
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- graduate nursing mentor, peer mentor training, Mentor Competency Assessment, SRNA mentors, and mentor self-confidence
- Data Criada:
- 2022