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Articles 1 - 21 of 21
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Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao
Doctoral Projects
Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.
Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square …
Noise: Its Impact In The Operating Room, Brennon Wesley Sloan
Noise: Its Impact In The Operating Room, Brennon Wesley Sloan
Doctoral Projects
Orthopedic and neurologic cases routinely reach noise levels exceeding 120 decibels (Katz, 2014). Modern equipment and monitors used by anesthesia personnel only reach 85 decibels (Katz, 2014). These monitors can go undetected during peak noise levels creating a serious safety concern for patients that could lead to patient injury or death (Gawande, Zinner, Studdert, & Brennan, 2003). A clinical question was developed to determine if the education of noise levels in the operating room affects change in practice. For operating room managers and staff, does education of noise levels in the operating room compared to no education initiate a change …
The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar
The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar
Doctoral Projects
Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in trauma …
Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo
Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo
Doctoral Projects
Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …
Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton
Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton
Doctoral Projects
Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.
Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?
A convenience sample of 6 Native American participants obtained at a primary care clinic were given …
Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgical Patients 65 Years Of Age Or Older, Simon Jack Gibson
Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgical Patients 65 Years Of Age Or Older, Simon Jack Gibson
Doctoral Projects
Postoperative delirium (POD) is the most common postoperative complication in the elderly, accounting for approximately $164 billion in costs per year in the United States (Inouye, Westendorp, & Saczynski, 2014, p. 911). This complication occurs in as many as 50% of elderly patients, but can be prevented as much as 40% of the time (Inouye et al., 2014). The use of processed encephalographic monitoring, such as Bispectral Index (BIS) monitoring, to guide anesthetic dosage is the single intraoperative intervention with enough evidence to support it as a recommendation for use to reduce POD (American Geriatrics Society, 2015). There were two …
Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps
Reducing Hypotension In Elective Cesarean Section Patients With Administration Of Ondansetron Prior To Spinal Anesthesia: A Retrospective Chart Analysis, Linsey Erin Phipps
Doctoral Projects
The birth of a child is one of the most memorable moments in a woman’s life, and many women undergo an elective cesarean section, requiring spinal anesthesia. At this time, the patient and the unborn child’s well-being become the anesthetist’s main focus. The ultimate goal of anesthesia providers is to provide the safest care to the patient. Spinal anesthesia has many benefits, but has a common side effect of hypotension, which can also result in nausea. Hypotension, dangerous to mother and child, is often treated with vasopressors, but can also cause nausea, which is treated by the administration of ondansetron. …
Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler
Efficacy Of Intravenous Ondansetron In Relieving Nausea/Vomiting And Pruritus Post Epidural Administered Opioids In The Obstetric Patient, Benjamin Stephen Butler
Doctoral Projects
One prominent side effect in the use of a neuraxial anesthesia is pruritus, with an incidence in the obstetric patient of 60-100% (Kumar & Singh, 2013). Another side effect of an epidural placement is nausea and vomiting. Nausea and vomiting occurs frequently during the progress of labor and is difficult to determine an incidence that is related to epidural opioid administration (Chestnut, Wong, Tsen, Ngan Kee, Beilin, & Mhyre, 2014). A review of literature was performed and established evidence that ondansetron is effective in reducing incidence of pruritus in intrathecal administered opioids for cesarean sections in the obstetric patient. No …
The Use Of Simulation To Decrease Stress In First Year Student Registered Nurse Anesthetists, Jared Scott Seymour
The Use Of Simulation To Decrease Stress In First Year Student Registered Nurse Anesthetists, Jared Scott Seymour
Doctoral Projects
Each year, critical care nurses across the nation make the decision to become anesthesia providers. In order to become a certified anesthesia provider, nurses must meet the high standards required to be considered for entrance into anesthesia school. Once accepted, these students, known as Student Registered Nurse Anesthetists (SRNAs), must successfully complete a rigorous curriculum consisting of both didactic and clinical training. Due in part to the high degree of difficulty of anesthesia programs, SRNAs are at risk for experiencing high levels of stress. Chipas and McKenna (2011) shows SRNAs experience a self-reported average daily stress level of 7.2 on …
Regional Anesthesia Introduced Into An Emergency/Trauma, Jennifer Bryant Covalt
Regional Anesthesia Introduced Into An Emergency/Trauma, Jennifer Bryant Covalt
Doctoral Projects
Emergency rooms across the United States have an incredibly large number of shoulder dislocations that need to be manipulated and reset on a daily basis. A cost-benefit analysis in this Doctor of Nursing Practice Project will demonstrate a new form of care for shoulder dislocations in the emergency room with certified registered nurse anesthetists (CRNA) providing regional anesthesia with local lidocaine injections into the shoulder joint. A level II trauma center in Mississippi with many shoulder dislocations was the location that was used to evaluate conscious sedation, length of procedure, and pain scores. A retrospective chart review was performed at …
Use Of A Handoff Communication Tool Between Certified Registered Nurse Anesthetists, Anesthesiologists, And Post Anesthesia Care Unit Nurses, Rachel Louise Johnson
Use Of A Handoff Communication Tool Between Certified Registered Nurse Anesthetists, Anesthesiologists, And Post Anesthesia Care Unit Nurses, Rachel Louise Johnson
Doctoral Projects
Ineffective communication in the post-anesthesia care unit (PACU) is considered to have incidences of increased error, mortality, morbidity, which leads to decrease patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the …
In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel
In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel
Doctoral Projects
Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus …
Parturient Safety: Proper Positioning Education Prior To Neuraxial Anesthesia, Christina Joy Young
Parturient Safety: Proper Positioning Education Prior To Neuraxial Anesthesia, Christina Joy Young
Doctoral Projects
In the United States, 61% of parturient patients elect neuraxial anesthesia for labor pain (Koyyalamudi et al., 2016). The incidence of postdural puncture headache is estimated up to 81% following accidental dural puncture-especially in pregnant women receiving elective epidurals (Ragab & Facharzt, 2014). Although the combined rates of complications for spinal and epidural anesthesia are low (2.78%) (American Society Anesthesiologists, 2014), patient safety is extremely important and should be addressed by the overall healthcare system. The purpose of this project assessed a willingness to change which focused on the CRNAs incorporation of proper positioning education prior to neuraxial anesthesia into …
Electronic Communication Among Anesthesia Providers, Joseph K. Wells
Electronic Communication Among Anesthesia Providers, Joseph K. Wells
Doctoral Projects
Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.
This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public …
Oral Carbohydrate Administration Prior To Colorectal Surgery: Practice Change Outcomes And Economic Analysis, Joshua Kendrick Ezelle
Oral Carbohydrate Administration Prior To Colorectal Surgery: Practice Change Outcomes And Economic Analysis, Joshua Kendrick Ezelle
Doctoral Projects
Difference in recovery times has been an interest of mine for many years. I observed that an open heart surgery routinely recovered and discharged on the third post-op day, while a colorectal patient often required a hospital stay of five to ten days. I began researching recovery methods of colorectal patients. I found enhanced recovery techniques like decreased narcotic, use of NSAID’s, early ambulation, and the use of medications that assist with bowel peristalsis are being employed nationally. Other techniques are now starting to be used with positive results. One of these is Carb-loading. Carb-loading is the oral intake of …
Opioid Use In The Cesarean Section Patient With The Preoperative Administration Of Intravenous Acetaminophen, Dana Edwards Bernardo
Opioid Use In The Cesarean Section Patient With The Preoperative Administration Of Intravenous Acetaminophen, Dana Edwards Bernardo
Doctoral Projects
Cesarean sections are one of the most common surgical procedures and there are no current guidelines for the management of postoperative pain control (Darvish, Ardestani, Shali, & Tajik, 2013). Unresolved pain in this population can lead to long lasting problems, such as chronic pain and depression (Booth, Harris, Eisenach, & Pan, 2015). The goal of multimodal therapy with IV acetaminophen for CS mothers was to ensure a rapid and safe recovery process with reduced adverse complications and shortened hospital length of stay. The independent t-test was used to compare the mean time for length of stay, first request of pain …
Optimizing Anesthesia Providers’ Timing Of Administration Of Dexamethasone For The Prevention Of Post-Operative Nausea And Vomiting: Translating Clinical Guidelines Into Practice, Tanner Young Mixon
Optimizing Anesthesia Providers’ Timing Of Administration Of Dexamethasone For The Prevention Of Post-Operative Nausea And Vomiting: Translating Clinical Guidelines Into Practice, Tanner Young Mixon
Doctoral Projects
Research has shown that post-operative nausea and vomiting (PONV) is a significant contributing factor to extended recovery times and unwanted hospital admissions following ambulatory surgery. The purpose of this DNP project was to assess current practice regarding administration of dexamethasone for the prevention of PONV, provide information based on best practice guidelines, and assess willingness to change practice based on the guidelines set forth by the Society for Ambulatory Anesthesia (SAMBA). Administration of dexamethasone is aimed at decreasing the incidence of PONV, optimizing PACU times, and increasing patient satisfaction regarding perioperative care.
An electronic presentation and survey were emailed to …
Is Current Evidence That Avoidance Of Inhalation Agents And Opioids May Decrease Metastasis Strong Enough For Crnas To Show A Willingness To Change Practice?, Michael Wesley Tillman
Is Current Evidence That Avoidance Of Inhalation Agents And Opioids May Decrease Metastasis Strong Enough For Crnas To Show A Willingness To Change Practice?, Michael Wesley Tillman
Doctoral Projects
Metastasis following the surgical resection of primary site breast cancer is a medical issue, which plagues mastectomy patients. The intention of this project was to synthesize current literature in order to make a presentation and disseminate it to Certified Registered Nurse Anesthetists (CRNAs) in southern Mississippi and assess the providers' willingness to change practice. CRNAs took part in a Qualtrics survey after viewing a PowerPoint presentation of evidence regarding anesthesia and metastasis. The presentation illustrated the anesthetic techniques and pharmacological agents utilized, which either mitigate or potentiate a patient's risk for metastasis. The survey assessed for a willingness to change …
Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel
Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel
Doctoral Projects
Problem: Pain has been historically mismanaged potentially leading to a host of negative physiological consequences. Today’s dynamic health care reform offers an opportunity to increase satisfaction with care. Utilizing the PICO question, in adults undergoing laparoscopic cholecystectomy over a 12 month period, does medication with fentanyl during emergence versus not medicating during emergence reduce the need for pain medications and discharge times? Evidence/Background: Two national studies surveyed patient perception of pain management following surgery. The first, conducted by Apfelbaum et.al (2003) showed that 80% of patients experienced acute pain after surgery with 86% rating that pain as moderate …
A Comparison Of The Features And Functions Available In Electronic Health Records, Kathryn Marie Tetreault
A Comparison Of The Features And Functions Available In Electronic Health Records, Kathryn Marie Tetreault
Doctoral Projects
The Institute of Medicine (IOM) (2007) estimates that medical errors transpire at a rate of 1.5 million per year. The IOM (2000), approximates 7,000 deaths per year are related to preventable medication errors, which are the leading cause of medical errors. Adverse drug events (ADE) occur due to medication errors, which are 100% preventable. Annually, approximately $21 billion dollars are spent to care for patients’ who experience ADE due to medication errors (IOM, 2007).
This doctoral project evaluates the current features and available functions for pediatric medication administration within the electronic health record (EHR). This comparison explored the EHR functionalities …
Development Of A Social Marketing Plan To Decrease Long Term Care Nurses Use Of Unnecessary Pharmacological Interventions To Address Residents' Behavioral Disturbances, Kela Spikes Bickham
Development Of A Social Marketing Plan To Decrease Long Term Care Nurses Use Of Unnecessary Pharmacological Interventions To Address Residents' Behavioral Disturbances, Kela Spikes Bickham
Doctoral Projects
Seventy-six percent of long term care (LTC) residents display behavioral disturbances associated with psychiatric disorders, including dementia, which “often occur in clusters and include depression, psychosis, aggression, agitation, anxiety, and wandering” (Agency for Healthcare Research and Quality [AHRQ], 2014 para. 2; Perkins, 2012). Forty percent of LTC residents with behavioral disturbances receive pharmacological treatments to manage their behavioral disturbances, but these medications have limited efficacy and significant adverse effects (Gustafsson, Karlsson, & Lövheim, 2013). This remains important because the population, ages 65 and older (approximately 88% of all LTC residents), represent the most vulnerable to the effects of pharmacological interventions …