Digital Commons Network^™

Towards Generalizable Machine Learning Models For Computer-Aided Diagnosis In Medicine, Yiyang Wang

College of Computing and Digital Media Dissertations

Hidden stratification represents a phenomenon in which a training dataset contains unlabeled (hidden) subsets of cases that may affect machine learning model performance. Machine learning models that ignore the hidden stratification phenomenon--despite promising overall performance measured as accuracy and sensitivity--often fail at predicting the low prevalence cases, but those cases remain important. In the medical domain, patients with diseases are often less common than healthy patients, and a misdiagnosis of a patient with a disease can have significant clinical impacts. Therefore, to build a robust and trustworthy CAD system and a reliable treatment effect prediction model, we cannot only pursue …

Simulation Education For Ultrasound Guided Peripheral Intravenous Catheter Insertion, Ronald Mack

College of Science and Health Theses and Dissertations

The purpose of this study was to evaluate student registered nurse anesthetist (SRNA) knowledge and confidence of ultrasound guided peripheral intravenous catheter insertion (UGPIV) before and after viewing an educational video. As a basis for developing a single group pre-test and post-test study, the dual coding theory was used. The authors hypothesize that SRNA knowledge and confidence would improve after an educational video intervention. A convenience sample of first, second, and third year SRNAs was used (N=31). The study participants completed a pre-survey to evaluate UGPIV knowledge and confidence, along with demographic questions. Participants were then instructed to view a …

A Qualitative Examination Of Opioid Sparing Anesthesia Practices Among Crnas, Stephanie Knell

College of Science and Health Theses and Dissertations

The opioid epidemic has had significant consequences across the healthcare system in the United States. While anesthesia providers have historically provided quality intraoperative analgesia utilizing opioids, research to date suggests that these care experiences may have lasting implications on patients’ long term health outcomes. In contrast, opioid sparing anesthesia can provide patients superb analgesic coverage without the noxious side effects of opioids or the risk of misuse. As an emerging topic, no known study to date has described anesthesia providers’ qualitative experiences with opioid sparing anesthesia. Therefore, the purpose of this qualitative descriptive study was to conduct semi-structured interviews to …

Implications Of An Education Tool As A Noise Reduction Strategy In The Operating Room, Sona Wardius, Amanda Parker

College of Science and Health Theses and Dissertations

Noise in the operating room (OR) can be from many sources, including personnel and medical equipment. Excessive noise is prevalent in the OR and can lead to distractions, interruptions, stress, and medical errors. These distractions have been well-documented in the literature and can reduce the quality of patient care. Awareness and education have proven to be solutions to noise reduction, but there is little evidence in the literature regarding the adoption of a clinical guideline. The goal of this study is to bring awareness of noise levels in the OR, the most common noise distractions, and how these relate to …

Implementation Of An Emergency Reflex Action Drill To Improve Perceived Knowledge And Confidence In Intubation Skills Of Nurse Anesthesia Trainees, Amanda Lamacki

College of Science and Health Theses and Dissertations

Direct laryngoscopy remains the primary method for achieving intubation of the airway in general anesthesia. Novice laryngoscopists may encounter high stress and cognitive load when unexpectedly faced with a Cormack-Lehane Grade III or IV view in an unfamiliar and time-pressured environment. An Emergency Reflex Action Drill (ERAD) is a specifically designed action sequence intended to execute clinical interventions with minimal cognitive load in the setting of marked time pressure. The purpose of this study was to examine the implementation of the ERAD “Head-Neck-Reset” to improve perceived knowledge and confidence in intubation skills of nurse anesthesia trainees. A convenience sample of …

Perioperative Non-Opioid Modalities (Pnom) Questionnaire Implementation And Validation Of Its Psychometric Properties, Liliya Sprisovskiy

College of Science and Health Theses and Dissertations

Introduction: The opioid epidemic and prescription opioid related deaths continue to grow in the US. Contributing factors to this epidemic include nonrestrictive opioid administration in the perioperative period. Though solutions to the epidemic has been discussed by anesthesia providers, there is no tool to quantiatively evaluate of their beliefs and practices for the perioperative management of pain. Over the past three years, there has been advancement in the science of nurse anesthesia on this front and in 2020 Tucker and Wong completed the development of a quantitative tool aimed at assessing CRNA beliefs and practices with regard to their use …

Simulation Education For Ultrasound Guided Peripheral Intravenous Catheter Insertion, Ryan Lewandowski

College of Science and Health Theses and Dissertations

The purpose of this study was to evaluate student registered nurse anesthetist (SRNA) knowledge and confidence of ultrasound guided peripheral intravenous catheter insertion (UGPIV) before and after viewing an educational video. As a basis for developing a single group pre-test and post-test study, the dual coding theory was used. The authors hypothesize that SRNA knowledge and confidence would improve after an educational video intervention. A convenience sample of first, second, and third year SRNAs was used (N=31). The study participants completed a pre-survey to evaluate UGPIV knowledge and confidence, along with demographic questions. Participants were then instructed to view a …

Examining Provider-Related Factors Associated With Role Competence In Shared Decision Making In Oncology Nurses, Alexandria Tarvainis

College of Science and Health Theses and Dissertations

Abstract

Purpose: To examine provider-related factors associated with higher levels of competence in shared decision-making (SDM) in oncology nurses.

Design: This study is a retrospective secondary data analysis of SDM survey data collected from 230 participants (oncology nurses that are active members of the Oncology Nursing Society) during February 2017 to September 2017.

Methods: Data collected from oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest. Participants completed an online or mail survey on the following: knowledge, attitudes, communication, and adaptability which scores were derived from a 5-point …

Enhancing The Braden Scale Pressure Ulcer Risk Assessment In Long-Term Care Facilities: A Cohort Study, Rachel Deutsch

College of Science and Health Theses and Dissertations

The development of pressure ulcers remains challenging as they are associated with overwhelming costs, pain and suffering, prolonged hospitalization, and morbidity and mortality. In the United States, the Braden scale is the most widely used risk assessment tool among all healthcare organizations to identify high-risk individuals for pressure ulcer development. The objective of risk assessment is to detect high-risk patients, implement immediate interventions, and evaluate patients not at risk who do not require intervention. The purpose of this cohort study is to determine the pressure ulcer predictability of the Braden score in comparison to the Braden score with additional predictor …

The Barriers To The Timely Diagnosis And Treatment Of Adhd By Advanced Practice Nurses In The Pediatric Primary Care Setting, Annette Kowalczyk

College of Science and Health Theses and Dissertations

Introduction: This purpose of the study was to identify barriers to diagnosing and treating attention-deficit-hyperactivity-disorder (ADHD) in pediatric primary care. Method: This study utilized a survey tool sent to Advanced Practice Nurse members of the Pediatric Nursing Certification Board in March of 2020 and gathered information from 415 participants. Results: In a linear regression analysis, participants who received ADHD specific training showed a significantly increased level of comfort in overall ADHD management (p<0.001). Providers who are screening, diagnosing and managing ADHD most often, are also the most comfortable in doing so. Discussion: Barriers to the treatment and diagnosis of ADHD include the lack of training as it relates to varying levels of decreased provider comfort, absence of schedule II prescribing authority for APNs in some states and provider bias towards treating and managing ADHD.

Prevention Of Shaken Baby Syndrome Among High-Risk Neonates: Program Implementation And Evaluation, Rebecca Tortolano

College of Science and Health Theses and Dissertations

Abstract Background: Studies suggest that the implementation of high-quality education and support services for caregivers may reduce the incidence of unplanned harm to infants and young children under high-stress circumstances. Purpose: This study evaluates the usefulness of the Period of PURPLE Crying program in a high-acuity NICU at The University of Chicago Comer Children’s Hospital based on six measurable objectives. Methods: The study utilized a Likert-style pretest-posttest survey design to evaluate how the Period of PURPLE Crying program was perceived by NICU nurses. Nurses were educated on the program content during an in-service aimed to teach participants how to utilize …

Acute Asthma Exacerbation Treatment And Impact In A Pediatric Emergency Department, Sarah Jindoyan, Paige Barber

College of Science and Health Theses and Dissertations

Pediatric asthma exacerbation account for more than 1.8 million Emergency Department visits annually and has been labeled as a global epidemic as the prevalence, morbidity and mortality have significantly increased over the past forty years (Dexheimer et al., 2013). While asthma is recognized as the most common chronic disease in children, issues of under-diagnosis and undertreatment persist (Serebrisky & Wiznia, 2019). Because of the severity of this issue, it is important to further examine the current process in place and what steps can be taken to improve this process.

Acquired knowledge on the research topic is based on objective findings …

Intraoperative Management Of Lumbar Cerebrospinal Fluid Drains: A Reference Tool, Victoria Shink

College of Science and Health Theses and Dissertations

Lumbar cerebrospinal fluid (CSF) drains are invasive interventional devices implemented for patients suffering from neurosurgical and complex aortic conditions. CSF drain management can be an infrequent task for anesthesia providers. Infrequent exposure can lead to inadvertent mismanagement leaving the patient vulnerable to increased morbidity and mortality. The purpose of this study was to develop a reference tool for basic intraoperative management of lumbar CSF drains and determine if CRNA and SRNA knowledge was improved with its use. This study utilized a pre-test/post-test design. The pre-test revealed significant knowledge gaps in content crucial for safe drain manipulation and management. Improvement in …

Use Of Fiberoptic Intubation Simulation To Enhance Skill And Confidence Among Anesthesia Providers, Kris Toribio

College of Science and Health Theses and Dissertations

Background The purpose of this study was to describe the usefulness of a video-recorded low-fidelity Fiber Optic (FO) intubation simulation and its effect on anesthesia providers’ confidence and skill in performing FO intubation. Method The study was conducted during the 2019 IANA Airway Workshop using a post-test only study design. All participants who volunteered to participate in the simulation were asked to watch a video-recorded instruction on FO intubation. Immediately after viewing the video, the participants completed a hands-on simulation while the researchers recorded their FO intubation times. Participants were allowed up to three recorded attempts. Results Fifty-eight participants completed …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Anne Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

An Examination Of Certified Nurse-Midwives’ Attitudes And Beliefs Surrounding Breastsleeping: Implications For Advanced Nursing Practice And Education, Lucy Wiesemann

College of Science and Health Theses and Dissertations

Introduction: Breastsleeping, defined as co-sleeping while breastfeeding, is a practice commonly employed in breastfeeding families. However, literature examining this concept, its prevalence, and related education for safe breastsleeping is scant. Providers' attitudes surrounding breastsleeping play an essential role in practice and outcomes when caring for breastfeeding patients and families. The purpose of the study was to examine and describe Certified Nurse-Midwives' attitudes and beliefs surrounding breastsleeping.

Methods: An adapted 18-item Nurse Attitudes and Beliefs Questionnaire-Revised (NABQ-R) online-survey that measured breastsleeping attitudes and beliefs of Certified Nurse-Midwives was administered via an online survey platform (Qualtrics). The quantitative analysis utilized SPSS 25 …

Improving Care For Homeless Young Adults: A Shelter Client And Health Service Provider Perspective, Kenya K. Hemingway

College of Science and Health Theses and Dissertations

The purpose of this study was to determine if the healthcare needs of homeless young adults from the client, shelter staff, and shelter healthcare provider’s perspectives. Data was collected via focus group with homeless unaccompanied young adults (n=4), and an online survey with shelter staff and healthcare staff (n=8) of The Night Ministry (TNM) and Ignite Promise. The focus group was recorded, transcribed, and coded for themes. Inductive analysis revealed themes focused on improving the quality of services provided. Based on the findings, recommendations include assessing the needs of homeless unaccompanied young adults from their perspective utilizing larger sample sizes, …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

Improving Care For Homeless Young Adults: A Shelter Client And Health Service Provider Perspective, Kenya K. Hemingway

College of Science and Health Theses and Dissertations

The purpose of this study was to determine if the healthcare needs of homeless young adults from the client, shelter staff, and shelter healthcare provider’s perspectives. Data was collected via focus group with homeless unaccompanied young adults (n=4), and an online survey with shelter staff and healthcare staff (n=8) of The Night Ministry (TNM) and Ignite Promise. The focus group was recorded, transcribed, and coded for themes. Inductive analysis revealed themes focused on improving the quality of services provided. Based on the findings, recommendations include assessing the needs of homeless unaccompanied young adults from their perspective utilizing larger sample sizes, …

Pilot Study: Educational Tool Reduces Parental Stress At Home Post Pediatric Cardiac Surgery, Rachel Barsella

College of Science and Health Theses and Dissertations

Congenital heart disease is a prevalent health issue in patients around the world. Approximately 8 in 1,000 live births are complicated by congenital heart disease (Ndile & Kohi, 2011). Increased levels of stress and anxiety have been reported by parents of children with congenital heart disease throughout the process of cardiac surgery, hospitalization, and especially discharge home (Brown & Smith, 2018). This pilot research study utilized pre-intervention and post-intervention survey methodology to examine the impact of an educational tool on parental stress while caring for their child at home post cardiac surgery. The educational tool created by the researcher was …

Peer Mentorship: Reported Outcomes Among Student Registered Nurse Anesthetists, Aja Rivera, Champagna Conner

College of Science and Health Theses and Dissertations

Background: Student Registered Nurse Anesthetist (SRNAs) experience high levels of stress and anxiety while enrolled a demanding nurse anesthesia program; a peer mentorship program fosters an encouraging support system for SRNAs. Purpose: The purpose of this project was to evaluate if a peer mentorship program was effective at diminishing stress & anxiety, social isolation, enhancing preparedness amongst the first and second-year SRNAs, and to evaluate the perceived effectiveness of mentorship amongst students enrolled in the NorthShore University HealthSystem School of Nurse Anesthesia (NSUHS SONA). Methods: This quantitative, descriptive, cross-sectional study design involved three cohorts of SRNAs. Participants communicated through personal …

Cultural Competence In Student Registered Nurse Anesthetists In Illinois, Lisa Brown, Saad Iqbal

College of Science and Health Theses and Dissertations

Objective: To determine the level of perceived cultural competence in student registered nurse anesthetists (SRNAs) in Illinois and make educational recommendations. Methods: A descriptive, cross-sectional study was completed using the Clinical Cultural Competency Questionnaire (CCCQ) to evaluate the perceived level of cultural competence among SRNAs in Illinois. Four domains of clinical cultural competency [knowledge, skills, attitudes (awareness), and encounters] were evaluated and reported. Results: The survey response rate was 16.7% (N=57). A statistically significant positive correlation was observed between cultural knowledge and age (p=0.03). There is a statistically significant difference in cultural knowledge between students attending a nurse anesthesia program …

Improving Knowledge And Self-Efficacy In Student Registered Nurse Anesthetists Through Simulation Based Learning On Pulmonary Artery Catheter Insertions, Neal Allen Johnson, Amanda Lipa

College of Science and Health Theses and Dissertations

Simulation is increasingly being used within the educational setting for invasive procedures, such as pulmonary artery (PA) catheter insertion. The purpose of this study was to assess how student registered nurse anesthetists (SRNAs) knowledge and confidence is effected by viewing an educational video and participating in a low-fidelity simulation. Dual coding theory was used to develop a single group pre-test and post-test study. A convenience sample of second year SRNAs was used. Participants completed a knowledge assessment tool and a confidence survey. Each participant then viewed the video and completed a hands on low-fidelity simulation. Following both these, each participant …

Certified Registered Nurse Anesthetist’S Awareness And Knowledge Of Herbal Supplements And Perioperative Interactions, Catherine Carman, Victoria N. Rosinski

College of Science and Health Theses and Dissertations

Previous studies have asserted that anesthesia providers are deficient in their knowledge of herbal supplements and their perioperative interactions. The purpose of this project was to examine the impact of an educational handout on Certified Registered Nurse Anesthetists’ (CRNAs) knowledge and attitudes of herbal supplements and their perioperative interactions utilizing a pre-posttest project design. The survey components were sent to approximately 1,600 members of the Illinois Association of Nurse Anesthetists (IANA) with a response of 140 surveys. Data was analyzed using descriptive Cohen’s d and nonparametric statistical tests. Reliability of the instruments used were assessed using Cronbach’s ɑ coefficients. The …

What We Say Matters: A Survey Of Anesthesia Providers’ Knowledge And Beliefs, Stefanie Glasgow, Lindsey Harris

College of Science and Health Theses and Dissertations

Pain is a serious concern and fear of patients. Due to the Joint Commission’s introduction of standards to address undertreatment of pain, it is now a focus of healthcare providers. Emerging research is focused on language in assessing pain. This study investigated the knowledge gap among anesthesia providers on positive language and pain assessment. The study objectives were to conduct a survey of Illinois Association of Nurse Anesthetists (IANA) members’ current knowledge and beliefs on Positive Language and the Nocebo Effect related to patient outcomes, and to educate anesthesia providers with an evidence-based fact sheet. The fact sheet and Qualtrics …

Identifying Pediatric Obesity In The Retail Health Setting And Implications For Quality, Jodie Nicole Guardi

College of Science and Health Theses and Dissertations

Pediatric obesity has reached an epidemic status. The purpose of this study was to examine the prevalence of overweight and obese patients, as well as how often and how accurately a diagnosis was coded. The population for this study included children ages 3-18. This cohort presented to retail health clinics in a large urban health system for school or sports physicals from June 1, 2017 to November 30, 2017. Method. A retrospective chart review was conducted. Statistical analysis was performed to determine if there was a relationship between obesity and age, ethnicity, race, and gender. Results. The study identified 15.9% …

Cost Differences Between Sugammadex And Neostigmine Use In Non-Operating Room Anesthesia Care, Lindsey Marie Kilsdonk, Mindy Ruan

College of Science and Health Theses and Dissertations

rior to the introduction of sugammadex, the only option to reverse rocuronium-induced neuromuscular blockade (NMB) were cholinesterase inhibitors (i.e. neostigmine) and anticholinergics (i.e. glycopyrrolate). Sugammadex administration has been shown to provide a more effective and complete reversal of rocuronium. However, the higher cost of sugammadex has been cited as a limiting factor to its use. The medication costs of sugammadex and neostigmine with glycopyrrolate have been studied in the operating room setting. There is a lack of information regarding the usage and medication costs of sugammadex and neostigmine with glycopyrrolate for non-operating room anesthesia care (NORA). A retrospective chart review …

Pre-Anesthetic Evaluation: A Needs Assessment Of Student Registered Nurse Anesthetists Transitioning To Clinical Practice, Amanda B. Munnich, Cara A. Murphy

College of Science and Health Theses and Dissertations

The pre-anesthetic evaluation (PAE) is a critical part of providing anesthesia, and an important component of patient safety. Student registered nurse anesthetists (SRNAs) are often required to independently perform the PAE upon entering their clinical training. Stress, anxiety, doubt, a novel environment and time constraints can lead to a lack of confidence and competence at this time. These barriers can result in an inefficient and inadequate assessment. The purpose of this qualitative study was to conduct a needs assessment to determine the overall readiness of SRNAs to independently perform a thorough PAE upon entering clinical residency. A focus group was …

Exploring The Protective Effects Of Judaism On Risky Behaviors In College Students, Michelle E. Neuman

College of Science and Health Theses and Dissertations

Background: Common risky behaviors among college-aged young adults include risky sexual behaviors and substance use. Purpose: This study examines the protective effects of Judaism on students’ engagement in risky behaviors, building on a body of research on the protective effects of religious beliefs on risky health behaviors. Methods: Validated and reliable measures were used to assess religiosity and risky behaviors through anonymous surveys. Data was collected in Fall 2018 from a small cohort (N=15) of Jewish day school students. Results: Higher religiosity was more associated with delayed sexual activity than substance use behaviors. Judaism and religiosity were more strongly associated …

Examination Of Reflections From Nurse Anesthesia Trainee Volunteers In Honduras, Thomas M. Boyce

College of Science and Health Theses and Dissertations

There is a lack of surgical and anesthesia services in low-income and middle-income countries (LMICs) which creates an increased burden of disease from otherwise surgically treatable conditions. Nurse anesthesia trainees (NATs) can serve to fill this lack of anesthesia services while also gaining real life experience that can enhance their training. Identifying common experiences and barriers among NATs that have volunteered on a surgical brigade is important to understand the benefits experienced by NATs and to increase volunteer surgical brigade programs among nurse anesthesia programs. A retrospective thematic analysis of 23 written reflections of NATs who participated in a one-week …