DNP Final Project Depository
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Last Updated: 2021-10-04
Trabalho (93)
51. Implementing Fluid Education and Adherence with Hemodialysis Patients
- Title Tesim:
- Implementing Fluid Education and Adherence with Hemodialysis Patients
- O Criador:
- McDougal, Renée
- Descrição:
- Background: Outpatient hemodialysis (HD) requires patient compliance and adherence to their prescribed treatment, including fluid and dietary restrictions. Without compliance and adherence, patients are at an increased risk of morbidity and mortality. Regardless, hemodialysis patients continue to struggle with compliance and continue to have increased hospitalizations and mortality. Purpose: The purpose of this project was to examine whether individualized education on the importance of fluid and dietary restrictions is done with hemodialysis patients will increase compliance. Methods: An educational intervention was done with hemodialysis patients who were given a pre-assessment questionnaire to assess baseline knowledge before education. After education, a post-assessment questionnaire was completed to assess if the individualized education increased their knowledge. Implementation Plan: Implementation of this project included pre-and post-assessment of hemodialysis patients' knowledge of fluid and dietary restrictions. Comparison or patients' pre and post-intervention fluid weight gain was assessed, documented, and compared. The findings were shared with the dialysis unit staff and patients. Conclusions: The post-assessment showed that there was an increase of knowledge among patients who participated. There, was no significant correlation between understanding of fluid gain and patients' demographics. Patients' who adhered to their fluid restrictions had decreased fluid weight gain between their treatments and reported feeling better overall. As with some hemodialysis patients, there were outlying factors that went beyond the control of the patient, including family involvement, living environment, and multiple chronic diseases which had conflicting dietary needs.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Palavra-chave:
- hemodialysis, fluid restrictions, hemodialysis education, and Chronic renal failure
- Data Criada:
- 2019
52. Implementing Mindfulness Meditation Among Nurse Anesthesia Students to Decrease Stress and Anxiety and Improve Self-Awareness
- Title Tesim:
- Implementing Mindfulness Meditation Among Nurse Anesthesia Students to Decrease Stress and Anxiety and Improve Self-Awareness
- O Criador:
- Thompson, Terineka
- Descrição:
- Throughout the country, Student Registered Nurse Anesthetists (SRNAs) are experiencing stress at an alarming rate. While stress is unavoidable, it tends to upset academic and clinical performance and overall health. This project was the implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness. The implementation of mindfulness meditation among nurse anesthesia students to decrease stress and anxiety and improve self-awareness will subsequently enhance the ability to learn. Literature supports the effects and importance of mindfulness interventions to reduce stress, anxiety, improve self-efficacy, resiliency and general health. Mindfulness interventions are not routinely incorporated into graduate nursing curricula; therefore, students are not learning these types of stress reduction techniques needed on a day-to-day basis. This study selected a convenience sample of nurse anesthesia students enrolled in the only two programs in Indiana. A pre/postsurvey via the Perceived Stress Scale-14 along with instructions to download the Mindfulness app to a mobile device and utilize it for 10 minutes a day for 14 days. Upon completion of the mindfulness meditation implementation, a reassessment of the perceived stress level of each participant was administered post-final exams of the spring semester. Findings suggest that the implementation of the Mindfulness app for meditation can be fundamentally related to decreased perceived stress and improve self-awareness among nurse anesthesia students.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Palavra-chave:
- Mindfulness, Stress, Medical, Resilience, Awareness, Nursing, Anxiety, and Graduate Students
- Data Criada:
- 2019
53. Improving Pharmacologic Preparedness of First Year SRNAs Prior to Clinical
- Title Tesim:
- Improving Pharmacologic Preparedness of First Year SRNAs Prior to Clinical
- O Criador:
- Johnson, William Zane
- Descrição:
- The Marian University Nurse Anesthesia program offers two pharmacology courses prior to students entering the clinical setting. The pharmacology I course provides students with foundational knowledge of medications used daily. This includes common doses, their mechanism of action, indications for use, contraindications, and special considerations for each. This knowledge is key for safe and successful practice of Anesthesia providers. The six-month gap between the completion of the pharmacology I course and the start of clinicals for Marian University SRNAs potentially risks students’ ability to retain information learned. In an effort to prevent this, first year SRNAs at Marian University were provided a lecture covering most common pharmacologic agents used in the operating room aimed at enhancing both knowledge and confidence level. First, a literature review was conducted to help highlight the most efficacious ways of enhancing students’ knowledge and confidence. A total of ten articles were selected and found to contribute to the purpose of the project; enhancing students’ knowledge and confidence level. The educational intervention took place on May 10th, 2023 on the campus of Marian University. The presentation was composed of 41 slides and was presented throughout the duration of an hour and composed of a pre and post-test. Topics included, most common induction agents, vasopressors, vasodilators, neuromuscular blockers, reversal agents, and cardiac medications. The pre and post-test were composed of seven questions, five knowledgebased questions, one measuring quantifying confidence level, and one asking for the last four digits of their Marian University student ID number. After implementation, it was found that the mean confidence level of students increased from 5.1 to 7 (on a scale of 1-10). Furthermore, students improved overall average scores for knowledge-based questions from 78% to 96%.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- pharmacology, foundational knowledge, medications, SRNA, retention of learned information, and knowledge and confidence levels
- Data Criada:
- 2024
54. Improving Simulation Training: Rapid Sequence Induction with a Debriefing Component
- Title Tesim:
- Improving Simulation Training: Rapid Sequence Induction with a Debriefing Component
- O Criador:
- Downham, Kelsey S.
- Descrição:
- Background: Simulation based training continues to be a growing element of healthcare education. Simulation training allows student registered nurse anesthetists (SRNAs) to practice critical skills in a low stress environment. Implementing simulation education with an evidence-based framework can improve educational outcomes. Simulation debriefing has been proven to be a key component of simulation education. The Promoting Excellence and Reflective Learning in Simulation (PEARLS) model can be used as a framework to implement a formal debriefing component to simulation training. Purpose: The purpose of this project was to add the PEARLS debriefing model to the current rapid sequence induction (RSI) simulation at Marian University, and determine if this addition improved knowledge, confidence, and satisfaction of first year SRNAs. Methods: This project utilized a quality improvement design. Quantitative data was collected using the 13-question National League for Nursing (NLN) Survey and a 5-question knowledge assessment. Data was analyzed using JASP (Jeffrey’s Amazing Statistics Program) to determine if statistical significance occurred between the control and experimental group. Implementation Plan/Procedure: The project took place at the Marian University Evans Center Simulation Laboratory. Twenty-four first year SRNAs were randomly divided into a control group, which received current simulation education, and an experimental group, which received current simulation education with the addition of the PEARLS debriefing model. Implications/Conclusion: The implementation of the PEARLS debriefing model improved student confidence scores on the NLN Survey. Students who completed simulation training with a debriefing component rated higher self-confidence scores than students who did not receive a debriefing component (p = 0.005). A formal debriefing component should be added to the rapid sequence induction simulation training at Marian University.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- debriefing component, Rapid sequence induction, satisfaction, simulation-based training, confidence, simulation, and knowledge
- Data Criada:
- 2022
55. Improving Ultrasound Simulation Education: Vascular Access
- Title Tesim:
- Improving Ultrasound Simulation Education: Vascular Access
- O Criador:
- Sparks, Michael D.
- Descrição:
- Background: Throughout the last decade simulation education has become an integral part of healthcare education. Designing simulation training for educational programs takes careful consideration and thought to plan an effective and efficient design. To design an effective simulation and learning experience for students a standardized framework must be used. The Jeffries simulation framework can help design an effective simulation experience. Within the framework the debriefing component is listed as an essential variable of simulation design. Its impact on simulation education outcomes is presented in literature. The current simulation education practice at Marian University lacks a formal debriefing period following simulation testing. Purpose: The purpose of this project was to add a debriefing component to the current practice of ultrasound simulation education, and determine if students’ knowledge, confidence, and satisfaction increased. Methods: This DNP project used a quality improvement design. Quantitative data was collected with post-test questionnaires and surveys. The data was used to assess for differences in satisfaction, confidence, and knowledge scores between the experimental and control group. Implementation Plan/Procedure: 24 students were randomly divided in two groups. The control group received the current practice, and the experimental group received the current practice with the addition of a debriefing period based on the PEARLS debriefing model. Following each simulation every student was asked to fill out a post-test survey including a knowledge test and the NLN satisfaction and self-confidence survey. Implications/Conclusion: A debriefing period enhanced student knowledge (p = 0.00) and increase student self-confidence (p = 0.01). Debriefing periods should be added as fundamental components of US simulation education. This project shows that students in nurse anesthesia programs would benefit with the addition of a formal debriefing period after simulation testing.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- prebriefing period, debriefing period, ultrasound simulation education, simulation education, and confidence level
- Data Criada:
- 2022
56. INACSL Simulation-Based Training for Bag-Mask Ventilation
- Title Tesim:
- INACSL Simulation-Based Training for Bag-Mask Ventilation
- O Criador:
- Wotring, Spencer
- Descrição:
- Background and Review of Literature: The ability to manage a patient's airway is a critical skill an anesthesia provider must possess. Poor airway management can result in inadequate ventilation, which can lead to brain damage and death. Simulation training in anesthesia providers' education is an effective and safe way to allow providers to improve technical and nontechnical skills without putting patients at risk. INACSL standards of best practice provide a way to standardize health care simulation to optimize and enhance simulation-based learning. Purpose: This DNP project was a quality improvement project to examine the effect on SRNA knowledge, satisfaction with learning, and confidence in their ability to adequately ventilate a patient via bag-mask ventilation when using simulation-based training that incorporates INACSL best practices compared to current simulation-based training. Methods: This DNP project utilized a quality improvement design and was evaluated by the Student Satisfaction and Self-Confidence in Learning instrument and a post-test knowledge assessment. Implementation Plan/Procedure: A total of 24 SRNA's enrolled in an anesthesia simulation course were divided into 2 groups. Group 1 had been intended to receive standard practices of self-directed learning of BMV skills, while Group 2 received a 2:1 hands-on instructional activity during the prebrief period. Both groups underwent the same simulation checkoff for BMV skills. Both groups were given a pre-test and post-test of the Student Satisfaction and Self- Confidence in Learning instrument. Additionally, both groups also completed a post-test knowledge assessment after the simulation checkoff. Implications/Conclusion: Overall, the participants in the experimental group consistently scored higher in agreement in the satisfaction (U= 15.5, p=.001) and self-confidence of student learning (U= 16.0, p=.001). Moreover, they scored higher percentages in the knowledge section despite the individuals in the control group having additional undue outside influence during this project. If simulation is used, INACSL best practice standards should be incorporated. This will allow nurse anesthesia educational programs to implement more effective BMV training within their program, which will improve the safety of their care.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- Bag-mask ventilation (BMV), INACSL, SRNA, Simulation, CRNA, and Jeffries Simulation Model
- Data Criada:
- 2022
57. Inadvertent Perioperative Hypothermia: A Retrospective Chart Review
- Title Tesim:
- Inadvertent Perioperative Hypothermia: A Retrospective Chart Review
- O Criador:
- Petro, Kailee
- Descrição:
- Background: Inadvertent perioperative hypothermia (IPH), defined as recorded temperature at or below 36°C (96.8°F), is a common adverse effect that can occur during any surgical procedure, leading to increased postoperative morbidity and mortality. The data was analyzed for statistical significance and plotted on a graph to show the mean and median temperatures, along with the highest and lowest during each phase of care. Purpose: The purpose of this project is to examine core temperatures in total knee arthroplasty (TKA) patients at four different phases of care: preoperatively, procedure start time, procedure stop time, and postoperatively. Methods: A retrospective chart review will be completed to collect temperatures for using the 3M Spot-On core temperature monitoring device on 38 patients undergoing TKA procedures. Implementation: The data will be analyzed plotted on a graph to show the mean temperatures, along with the highest and lowest temperatures during each phase of care. Conclusion: Patients were found to be hypothermic at the beginning and end of the procedure. On average, patients were 95.5°F at the start of the procedure and 96°F at the end. Preoperatively, patients were 98°F and 97.3°F in the recovery room.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- inadvertent perioperative hypothermia, hypothermia, and total knee arthroplasty
- Data Criada:
- 2021
58. Infection Rates in Posterior Instrumented Spinal Fusions: A Retrospective Review of Infection Control Practices and Outcomes
- Title Tesim:
- Infection Rates in Posterior Instrumented Spinal Fusions: A Retrospective Review of Infection Control Practices and Outcomes
- O Criador:
- Case, Ellen
- Contribuinte:
- Fox, Tara
- Descrição:
- Background and Review of Literature: A surgical site infection after posterior instrumented spinal fusion can negatively affect the patient and increase healthcare costs. Spinal fusions are becoming increasingly common as a surgical intervention to correct a variety of spinal pathologies. Infection in this population poses a significant problem as infection can lead to additional surgeries, debility, or mortality. Purpose: A group of neurosurgeons implemented a novel protocol to prevent surgical site infection, including irrigating the wound with Clorpactin and applying vancomycin powder intrawound before closing. This investigation seeks to identify surgical site infections and compare infection control measures. Methods: A retrospective chart review was conducted on patients who underwent posterior instrumented spinal fusion between August 2017 and December 2020. Data was collected from the Electronic Medical Records. The data was analyzed using statistical software. Implications/Conclusion: The results significantly reduce postoperative infections in the group exposed to the Clorpactin/vancomycin infection control protocol.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- vancomycin powder, instrumented spinal fusion, Clorpactin irrigation, surgical site infection, and intrawound antibiotic
- Data Criada:
- 2021
59. Intraoperative Cuff Pressure Monitoring of Airway Devices: An Evidence-Based Educational Intervention
- Title Tesim:
- Intraoperative Cuff Pressure Monitoring of Airway Devices: An Evidence-Based Educational Intervention
- O Criador:
- Osorio, Alvaro A.
- Descrição:
- Background and Review of Literature: Subjective methods for assessing airway device cuff pressures (CP) remain in use to determine correct inflation, despite evidence indicating inadequate sensitivity for identifying under and overinflation. Inadequate CP can cause tissue ischemia, mucosal ulcers, stenosis, and aspiration. Recommendations for endotracheal tubes (ETT) CP are 20 to 30 cmH2O and ≤ 60 cmH2O for supraglottic airway (SGA) devices. Currently, there are no guidelines for intraoperative monitoring of airway devices. Manometers are the most accurate and accepted method for assessing CP; however, they are underutilized intraoperatively. Purpose: The project goal was to promote CP assessment intraoperatively with manometry and create a practice guideline for measuring and monitoring CP. Methods: A literature review was performed to evaluate recent evidence on CP assessment for airway devices to develop practice guidelines for intraoperative monitoring of CP. A group of 23 licensed anesthesia providers participated in the project. Pre-and post-surveys were utilized. Evaluation of current knowledge, methodology, rating of importance, and willingness to adopt manometry for CP intraoperative monitoring was obtained. Education on CP monitoring was discussed with participants, followed by post-survey. Pre-survey was used to evaluate participants’ current methods for ETT and SGA CP assessment. During routine intubation, participants were asked to inflate an airway device using their preferred technique to determine adequate CP. Readings for CP were measured using a manometer device approved by the Food and Drug Administration (FDA). Data for their corresponding CP reading was shared with participants, and educational information reflecting current evidence for CP monitoring. Post-survey was then performed to evaluate the participants’ willingness to adapt CP assessment with manometry into their practice. Conclusion: Intraoperative CP was predominantly performed with subjective techniques. Anesthesia providers expressed a willingness to assess CP with manometry, posing education as a possible foundational step for future implemention of CP monitoring in the operating room (OR). Lack of guidelines for CP monitoring intraoperatively and variability in monitoring CP due to subjective assessment methods emphasized the need for standardization and the increased availability of manometry devices for intraoperative use.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- laryngeal mask airway, supraglottic airway manometer, Endotracheal cuff pressure, tracheal injury, anesthesia, and pharyngolaryngeal complications
- Data Criada:
- 2021
60. An Introduction to Carotid Intima-Media Thickness Scan (CIMT)
- Title Tesim:
- An Introduction to Carotid Intima-Media Thickness Scan (CIMT)
- O Criador:
- Baker, Carla J.
- Descrição:
- <b>Objective</b>: Carotid intima-media thickness (CIMT) is utilized to predict cardiovascular risk. CIMT uses ultrasound to measure the thickness of the two innermost layers of the carotid artery. Increased plaque in the carotid arteries reduces the blood flow in the vessels, increasing the risk of cardiovascular disease. High patient satisfaction with CIMT testing may positively empower the patient to incorporate lifestyle changes to reduce the risk of experiencing a cardiovascular event. The study aims to determine the value of CIMT testing in primary care based on patient feedback. <b>Methods</b>: The family practice staff in Central Indiana will email an electronic questionnaire to patients who completed a CIMT scan in the fall of 2022 or the spring of 2023. The current literature will be reviewed to compare the results with the results of this study to determine if patient satisfaction with the CIMT testing influences patient motivation to change lifestyle behavior and is suggestive that CIMT testing is beneficial in family practice. <b>Results</b>: All respondents were extremely satisfied with the professional care they received during the procedure and the care and treatment they received afterward. One participant, or twenty-five percent, improved their dietary choices and medication compliance after the CIMT scan. None of the participants made any changes in their exercise routine. <b>Conclusion</b>: Additional studies using a more extensive population base would be beneficial and recommended to provide statistically significant results. All participants were happy with the CIMT scan process and their results, which suggests its use benefits patient satisfaction with cardiovascular disease risk assessment.
- Declaração de direitos:
- http://rightsstatements.org/vocab/InC/1.0/
- Língua:
- English
- Tipo:
- Research Paper
- Palavra-chave:
- carotid intima-media thickness, patient satisfaction, demographics, family practice, and CIMT
- Data Criada:
- 2023