DNP Final Project Depository
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Last Updated: 2021-10-04
Trabalho (93)
41. Efficacy of Video Laryngoscopy versus Direct Laryngoscopy
- Title Tesim:
- Efficacy of Video Laryngoscopy versus Direct Laryngoscopy
- O Criador:
- Branch, Chad
- Descrição:
- Background and Review of Literature: Laryngoscopy is one of the most important skills that an airway provider performs, and recent technological advances through video laryngoscopes have changed the canvas for performing this skill. Video laryngoscopes have been regarded to offer improved outcomes when conducting laryngoscopy. The current research is inconclusive as to if these newly perceived benefits of video laryngoscopes are maximized in the hands of inexperienced providers. Purpose: This project was developed to obtain data about the results of laryngoscopy in the hands of inexperienced airway providers when comparing direct laryngoscopy to video laryngoscopy and to gain insight into the effectiveness of video laryngoscopes in this population. Methods: This project collected data through Qualtrics surveys and quantitative data by the project designer during the conduction of the project in the simulation lab. This data was analyzed with Excel and paired t-testing through SPSS software. Qualtrics survey questions were created by the project designer in collaboration with the project Chair member. Implementation Plan/Procedure: Eighteen first year anesthesia students participated in this project by conducting laryngoscopy in the simulation lab with the project designer and completing the Qualtrics survey. Implications/Conclusion: In the hands of inexperienced first year anesthesia students, laryngoscopy was able to obtain faster times to intubation, improved glottic views, decreased perceived manipulation of airway and damage, and improved ease of laryngoscopy when compared to direct laryngoscopy. Continued research into this area is warranted. Also included are Appendices A & B in the files section.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- ENglish
- Tipo:
- Research Paper
- Palavra-chave:
- laryngoscopy, airway provider, video laryngoscopes, simulation lab, and direct laryngoscopy
- Data Criada:
- 2024
42. Evaluating Anesthesia Providers’ Adherence to Enhanced Recovery After Surgery (ERAS) Protocol’s Dexamethasone Dosage Recommendations
- Title Tesim:
- Evaluating Anesthesia Providers’ Adherence to Enhanced Recovery After Surgery (ERAS) Protocol’s Dexamethasone Dosage Recommendations
- O Criador:
- Sanchez, Ashley
- Descrição:
- This project is submitted to the faculty of Marian University Leighton School of Nursing as partial fulfillment of degree requirements for the Doctor of Nursing Practice, Nurse Anesthesia track. Enhanced Recovery After Surgery (ERAS) protocols are a significant aspect of postoperative and anesthesia care. Dexamethasone administration, specifically, is an essential component of each protocol. The use of dexamethasone helps to prevent and combat common postoperative complications. However, an adequate dosage must be administered to reap the full benefits of its use. Each healthcare facility develops and establishes its own ERAS protocol for use by anesthesia providers and includes the specific amount of dexamethasone that should be provided. However, variations in dosage administration may occur. To investigate this issue, a retrospective chart review was conducted. The purpose of the review is to assess compliance by anesthesia providers to facility-specific ERAS protocol dexamethasone administration recommendations.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Dexamethasone , Enhanced Recovery After Surgery (ERAS), retrospective chart review, and anesthesia care
- Data Criada:
- 2022
43. Evaluating Effectiveness of Marian Mentorship Program Enhancements
- Title Tesim:
- Evaluating Effectiveness of Marian Mentorship Program Enhancements
- O Criador:
- Bonam, Taylor T.
- Descrição:
- Marian University utilizes a student-led mentorship program to assist fellow graduate students of Doctorate of Nursing Practice (DNP) Nurse Anesthesia Program (NAP). Marian’s NAP accreditor, The Council of Accreditation of Nurse Anesthesia Educational Programs (COA) found that there were opportunities for improvement in the student mentorship program (2022). In response to this, in May of 2022, there was a student-led implementation of a series of changes designed to improve the mentorship relationship between students such as; providing access to an informational website, weekly Webex meetings, and a 2-hour voluntary educational seminar. This paper is designed to evaluate the effectiveness of these changes to the student mentor program at improving the relationship between mentors and mentees.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- mentorship, informational website, educational seminar, evaluate, and Council of Accreditation of Nurse Anesthesia Educational Programs
- Data Criada:
- 2023
44. Evaluating the Preemptive Use of Ofirmev to Address Post-Cesarean Pain
- Title Tesim:
- Evaluating the Preemptive Use of Ofirmev to Address Post-Cesarean Pain
- O Criador:
- Huerta, Kris
- Descrição:
- Uncontrolled postpartum pain has been linked to increased opioid use, increased risk for opioid dependency, depression, and the development of persistent pain (Bateman et al., 2016). The purpose of this project is to assess the use of a preemptive dose of Ofirmev (Tylenol, acetaminophen, paracetamol) 1,000 mg IV in decreasing post-cesarean pain and consequently opioid usage within the first 24-hour postoperative period. This project will evaluate documented pain scores charted in the EPIC charting system by the obstetrics nurses at Hendricks Regional Health. The 24-hour postoperative pain scores of cesarean patients who received acetaminophen before cesarean section will be compared to those who did not receive acetaminophen. Reducing post-cesarean pain scores and opioid usage within the first 24-hours may reduce the risk of opioid dependency, persistent pain, and depression.
- Sujeito:
- Anesthesia and Analgesia, Maternal, Child Health and Neonatal Nursing, Obstetrics and Gynecology, and Nursing
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Palavra-chave:
- Tylenol, Ofirmev, paracetamol, post-cesarean, acetaminophen, EPIC charting system, and preemptive
- Data Criada:
- 2020
45. Evidence-Based Bag Mask Ventilation Education in the Simulation Setting
- Title Tesim:
- Evidence-Based Bag Mask Ventilation Education in the Simulation Setting
- O Criador:
- Jammes, Cara and Rosenheck, Miriam
- Descrição:
- Background and Review of Literature: Bag-mask ventilation (BMV) is a critical skill in the perioperative setting and is difficult to master for student registered nurse anesthetists (SRNAs). BMV has been shown to be the superior method of adequately pre-oxygenating patients prior to securing an airway. There is a growing body of evidence that all anesthesia providers including CRNAs, resident physicians, and attending physicians have lower levels of confidence with this skill in comparison to other, more invasive skills. Additionally, most providers prefer having access to annual BMV courses to refresh themselves on the latest BMV guidelines. Purpose: This study assessed changes in first year SRNA competence, knowledge, satisfaction, and confidence levels with BMV after implementing a BMV refresher simulation session prior to beginning clinical rotations. Methods: A systematic review of the literature was conducted using “bag mask ventilation” or “bag valve mask”. Inclusion criteria included text available in English, articles less than 5 years old, BMV as an intervention, and ventilation as an assessment. Exclusion criteria were laryngeal mask ventilation, passive oxygen insufflation, pilot studies, and unrelated research purposes. This resulted in 14 articles. The Marian University Internal Review Board (IRB) approval was obtained prior to initiating the DNP Project. First year SRNAs at Marian University Leighton School of Nursing were given a survey to assess their knowledge and confidence surrounding BMV prior to, and after attending a simulation session hosted by upper level SRNAs. The simulation session focused on the latest evidence based BMV techniques as well as indications to perform BMV and troubleshooting for patients who are difficult to ventilate. Paired t-tests were employed to compare pre and posttest scores. Implementation Plan/Procedure: This prospective cohort study and systematic review assesses whether implementation of a hands on, evidence based BMV refresher course, in the simulation setting, improves first-year SRNA knowledge, satisfaction, confidence, and competence regarding BMV. The International Nursing Association of Clinical Simulation Learning (INASCL) standards of simulation education were upheld. Surveys were given prior to and after the simulation sessions on Qualtrics. Data was exported to Excel where statistical analysis was done. Implications/Conclusions: Eight first year SRNAs participated in the BMV simulation and completed the pre and posttests. There was a statistically significant improvement in SRNA confidence (p = 0.0084) and knowledge (p = 0.00058). This study underscores the importance of implementing BMV refresher courses to SRNAs. Additionally, this intervention should be considered by other anesthesia providers to increase confidence, knowledge, and competence surrounding BMV.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- bag-mask ventilation (BMV), student registered nurse anesthetists (SRNAs), patient pre-oxygenation, BMV guidelines, BMV refresher simulation, and e International Nursing Association of Clinical Simulation Learning (INASCL) standards of simulation
- Data Criada:
- 2024
46. Expanding Renal Transplant Selection Criteria to Include HIV Infected Candidates
- Title Tesim:
- Expanding Renal Transplant Selection Criteria to Include HIV Infected Candidates
- O Criador:
- Hatfield, Smyrna
- Descrição:
- Background and Review of Literature: Renal transplantation has a significant survival benefit over dialysis and is the recommended treatment modality for ESRD in the eligible HIV infected candidate. However, there are multiple disparities in accessing renal transplant among this group including restrictive selection criteria as determined by individual transplant centers. Only 20% of potentially eligible HIV infected candidates progress towards activation to the renal transplant waiting list in comparison to 73% of their non-HIV infected counterparts. Purpose: Ensure equitable access to renal transplant by modifying the existing selection criteria at a faith-based institution to include eligible HIV infected candidates for renal transplantation. Methods: A single center, prospective observational cohort study was conducted to determine the influence of modifying selection criteria to include eligible HIV infected individuals with ESRD in reducing disparities for access to renal transplantation. As the theoretical framework, Lewin's Change Management model served to assess organizational readiness and permanency of selection criteria modification. Implementation Procedure: 329 dialysis units were notified in writing of the modified selection criteria with instructions on referring patients for renal transplantation. A comparative analysis of the volume of HIV infected ESRD patient referrals, evaluations, listings and transplants six months prior to and three months post. intervention was performed. Conclusions: Six HIV infected patients with ESRD were referred for renal transplantation postintervention which correlated to a 200% increase by volume. 33% advanced to the evaluation phase. None of the participants were activated to the waiting list or received a transplant. Additional observation is warranted to establish the efficacy or modifying selection criteria in increasing the access of HIV infected ESRD patients to renal transplantation.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Palavra-chave:
- renal transplant, end stage renal disease, and HIV Infection
- Data Criada:
- 2019
47. How Does the Utilization of Non-pharmacologic Pain Management Techniques Affect Pain Outcomes and Long-term Memories in Young Children During Painful Procedures?
- Title Tesim:
- How Does the Utilization of Non-pharmacologic Pain Management Techniques Affect Pain Outcomes and Long-term Memories in Young Children During Painful Procedures?
- O Criador:
- Graybill, Sheryl
- Descrição:
- Background: A child’s pain is different from pain experienced as adults. Different emotional and psychological factors can affect the child’s pain comprehension and stimulate their response to pain. Procedural pain can have long-term negative effects on children. It may cause increased pain sensitivity, fear, and avoidance of healthcare as adults. Parents may also experience anxiety during their child’s procedure, which may increase their child’s perceived pain. Problem: This DNP project aimed to implement and evaluate the usage of the Buzzy device during painful procedures of children ages three through six years at this pediatric hospital. Distraction can be used to decrease pain perceptions in children and parents, which could positively affect long-term memories. Interventions: The nurses utilized Buzzy with children aged three to six years of age needing venipuncture. Staff provided a pain survey to each patient who received Buzzy before and during a painful procedure. Parents were contacted at 2 weeks and 1-month post-procedure to assess pain perceptions. Results: Ninety-six patients participated in the study. An 84.6% response rate was acquired from the surveys. Ninety-seven percent of parents and patients surveyed reported decreased pain with venipuncture using Buzzy. Pain perceptions decreased with the use of Buzzy both short-term and long-term. Conclusion: The positive response from patients and parents demonstrates Buzzy may be used to decrease pain perceptions in children and families. The success rate shown in this study will aid in distraction techniques used as pain management to be added to evidence-based practice in the future.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Buzzy, pediatric pain, distraction techniques, pain perceptions, and vibration
- Data Criada:
- 2021
48. The Impact of Anesthesia Machine Check Cognitive Aids on Student Registered Nurse Anesthetist Simulation
- Title Tesim:
- The Impact of Anesthesia Machine Check Cognitive Aids on Student Registered Nurse Anesthetist Simulation
- O Criador:
- Erazo, Edward
- Descrição:
- Cognitive aids have been shown to enhance clinical performance and improve patient care by increasing the completion of essential tasks and facilitating clinical decision-making. Cognitive aids have also been demonstrated to be effective teaching tools. Simulation is a crucial teaching exercise that allows student registered nurse anesthetists (SRNAs) to practice clinical decision-making without risking patient harm. The anesthesia machine check simulation can be improved by adding cognitive aids. An anesthesia machine check cognitive aid would simplify the learning process and lead to a more productive simulation experience. This project aims to provide SRNAs with anesthesia machine check cognitive aids to assess if this would improve SRNA knowledge, satisfaction, and self-confidence regarding anesthesia machine check simulation exercises. Knowledge was assessed using a five-question test designed to measure anesthesia machine knowledge (Appendix C). SRNA satisfaction and self-confidence were measured using the National League for Nursing’s student satisfaction and self-confidence in learning survey (SSSL) (Appendix D). Participants were divided into control and experimental groups. Pretest and posttest knowledge and SSSL survey results were analyzed, and found no statistical significance among the groups (p < 0.05). Limitations of this study were the small sample size and poor coordination with the simulation faculty. Further research regarding the implications of cognitive aids in simulation is needed to determine their impact on knowledge, satisfaction, and self-confidence.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- cognitive aids, simulation, anesthesia machine check, knowledge, satisfaction, and self-confidence
- Data Criada:
- 2023
49. Implementation and Evaluation of a Checklist in the Postanesthesia Care Transitions
- Title Tesim:
- Implementation and Evaluation of a Checklist in the Postanesthesia Care Transitions
- O Criador:
- Milling, Kaleigh
- Descrição:
- The transition from the operating room to the postoperative care unit is a critical time in the perioperative period for patients. Patients are physically transferred from one location to another and critical information regarding patients’ intraoperative period must be delivered accurately to ensure patient safety. Over the past few years, many healthcare regulating agencies have advocated for a standardized care transitions by suggesting a handoff checklist should be implemented but this has failed to be universally executed. There is not one template universally implemented in post anesthesia standardized handoffs but many different models. Nonetheless, research has shown using a standardized template for this care transition has shown that more information was delivered to the receiving parties and safety events related to miscommunication in postoperative transitions were decreased. The purpose of this project is to refine care transitions through a standardized handoff which will improve communication and decrease safety-related events. Nurses and anesthesiologists were anonymously surveyed about their perception of postanesthesia transitions prior to and after introduction of the intervention. A postanesthesia handoff checklist formatted in a Situation, Background, Assessment, and Recommendation method was implemented at a level one trauma center in the Midwest based on feedback from the organization. The documented handoffs indicated there was a high compliance with using the checklist. The postsurveys presented low participation and neutral feelings regarding the use of a handoff checklist.
- Sujeito:
- Anesthesiology and Perioperative, Operating Room and Surgical Nursing
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Palavra-chave:
- postanesthesia, handover report, admission, PACU, handoff, patient transfer, nurses, postoperative, care transitions, surgery, team, communication, and anesthesia
- Data Criada:
- 2020
50. Implementation of Standardized Post-anesthesia Care Handoff and Airway Management in Recovery
- Title Tesim:
- Implementation of Standardized Post-anesthesia Care Handoff and Airway Management in Recovery
- O Criador:
- Falasca, Carrie and Scroggham, Haley
- Descrição:
- When a patient arrives at the postoperative anesthesia care unit (PACU), a transfer of care report from the anesthesia provider to the PACU nurse occurs at the bedside. Historically, there has been a lack of completeness in handoff reporting that has led to numerous avoidable medical errors. The goal of this quality improvement project at a 25-bed critical access hospital in rural Indiana was to implement a standardized handoff tool in the PACU. Secondly, an in-service was provided on airway management amongst special populations across the lifespan to improve the quality and safety of patient care in rural communities. A pre-test survey was used to evaluate the anesthesia department and perioperative nurse’s opinions of the current handoff process. A standardized handoff tool was then implemented along with an in-service on airway management of special populations. A post-intervention survey was used to determine if the post-anesthesia tool made handoff a more streamlined process. Unfortunately, due to the lack of participation from participants, results were inconclusive to determine if the standardized handoff tool improved the transition of care process in the recovery room
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- perioperative, handoff, post-anesthesia care unit, communication, standardized tool, checklist, and reporting tool
- Data Criada:
- 2024