Medicine and Health Sciences Commons^™

Dexmedetomidine Use In The Pediatric Postoperative Patient With Emergence Agitation: A Systemic Review, Elizabeth Kittredge

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Emergence Agitation is a frequent complication in the pediatric postoperative population; with up to 80% incidence (Stamper, Hawks, Taicher, Bonta & Brandon, 2014). These patients will present with crying, overexcitement, thrashing, agitation and is seen within the first 30 minutes of emergence of general anesthesia (Mohkamkar, Farhoudie, Alam-Sahebpour, Mousavi, Khani & Shamomhammadi, 2014). Dexmedetomidine, a selective alpha 2 agonist, reduces norepinephrine output, initiates firing of inhibitory neurons such as the gama aminobutric acid system and reduces release of substance P and other catecholamines. These actions provide the patient with sedation, analgesia, and anesthesia (Nagelhout & Elisha, 2018). Due to the …

Comparing Sugammadex In The Adult And Geriatric Population, Jason Medeiros

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A comparison of using sugammadex for neuromuscular blockade reversal in adult and geriatric populations, examining time to recovery and adverse outcomes related to residual neuromuscular blockade.

Stress And Coping Methods Utilized By The Srna, Dawn Hughes

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this survey was to was to determine stressors and coping methods utilized by the SRNAs enrolled in the combined RIC/SJHSNA program. A survey was sent to the students and analyzed. The findings of increased stress in the SRNA are similar to previously studies.

A Review Of Phenylephrine Versus Norepinephrine For The Treatmemnt Of Maternal Hypotension During Spinal Anesthesia For Cesarean Delivery, Megan S. Sullivan

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Maternal hypotension is a common sequala of spinal anesthesia used during cesarean delivery. The current first line vasopressor used for treatment of maternal hypotension is phenylephrine. Administration of phenylephrine can cause a physiologic decrease in cardiac output that could contribute to adverse maternal or fetal outcomes. This systematic review was conducted to investigate the use of norepinephrine as an alternative vasopressor for the treatment of maternal hypotension. A database search was conducted using electronic sources including CINAHL, MEDLINE, Google Scholar and PubMed. Inclusion and exclusion criteria were used to narrow search results and the Critical Appraisal Skills Program checklist was …

Comparing Recovery Times Of Desflurane And Sevoflurane, Gina M. Stangel

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

General anesthesia is intended to deliver proper comfort and pain relief, with a safe and rapid recovery with minimal side effects. Ideally, patients are optimized prior to undergoing anesthesia, (an asthmatic receiving an albuterol treatment to reduce the likelihood of bronchospasm, for example). Emergence from anesthesia involves the reversal of a neuromuscular blockade if used, a patient breathing spontaneously, regaining consciousness, and the ability to follow commands. Patients requiring general anesthesia can be given intravenous propofol, an inhaled anesthetic gas or a combination of both. Volatile anesthetic gases used today allow for rapid recovery from anesthesia due to their low-blood …

Comparing Pretreatment Modalities, Corey Mammen

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This manuscript investigates the negative sequelae (in particular, myalgia) of using succinylcholine for patients undergoing tracheal intubation, pretreatment strategies to minimize or eliminate these untoward effects, and compare their efficacy. Various strategies are commonplace in the clinical setting, and there are a number of research studies that discuss the efficacy of individual agents as well as compare them against others. This manuscript explains the anatomy and physiology of neuromuscular junctions, muscle contraction, and their relationship with muscle relaxants used in the clinical setting.

A Systematic Review To Examine The Effectiveness Of Antibiotic Educational Programs In Outpatient Settings At Reducing Antibiotic Prescribing?, Mathew Reynolds

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Antibiotic resistance has been identified by both the Center for Disease Control and the World Health Organization as a worldwide epidemic. Antimicrobial stewardship programs have been utilized at inpatient settings that include educational programs about antibiotic resistance. A systematic review was conducted to evaluate the effectiveness of antimicrobial resistance education in outpatient settings. The databases searched were MEDLINE, PubMed, Google Scholar and CINAHL. PRISMA checklist and flow diagram were used for identifying the randomized control trials for the systematic review. A total of five articles were identified and organized using data collection tables. The Critical Appraisal Skills Programme (CASP) checklist …

Dexamethasone In The Adult Diabetic Surgical Patient, Jessie Mcburney

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this systematic review was to investigate the current literature and examine the impact of dexamethasone on blood glucose levels in the adult diabetic surgical patient when used in the prevention of postoperative nausea and vomiting. The findings of this systematic review concluded dexamethasone 8mg IV was associated with an increase in perioperative blood glucose levels, although the increase may not have been statistically significant.

An Iv Anesthetic Decision Tree For Cardiac Surgery, Brian Doucette

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A thorough literature review was conducted covering the topics Intravenous anesthetics, pathophysiology of structural heart disease, and decision-making in anesthesia. A systematic review of randomized controlled trials was performed guided by the PRISMA protocol. Through the lens of Information Processing Theory, the results of the systematic review were used to guide the creation of a decision tree for the selection of the appropriate intravenous anesthetic for cardiac surgery.

Improving Patient Engagement Among Homeless Veterans, Shonda L. Escobar

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This integrative review was conducted to examine research that explores the effectiveness of open-access interdisciplinary care and outreach in engaging homeless veterans in health care. The literature reviewed for this study provided substantial evidence for the benefits of open-access clinics, an interdisciplinary team, and outreach for the sustainability of engaging homeless veterans in health care. The advanced practice nurse plays a valuable role in this process as there is need for enhanced program and policy development to meet the needs of this population as well as the demand to disseminate population-specific education to the interdisciplinary team.

Improving Compliance With Best Practice Standards For Patients At Risk For Opioid Use Disorder, Casey Williams

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Available literature suggests that provider adherence to best practice guidelines regarding the prescribing and management of opioid therapies is low. Documentation of patient screening for present or future opioid use disorder is inconsistent. Provider incorporation of evidence-based guidelines into routine patient care is essential to optimizing outcomes related to opioid use disorders.

Purpose/Specific Aims: The purpose of this scholarly project was to facilitate recognition of patients at high risk for opioid use disorders and facilitate best evidence based practices in the care of this population. Specific aims were to achieve provider compliance with: patient risk screening, PDMP review, completion …

Examining Knowledge Of Pain Management, Sunita D. S. Dutt

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Pain places a significant burden on the society and individuals through health care costs, loss of productivity, and loss of income. A widening gap exists between increasing knowledge about pain and the application of this knowledge to treat pain. The Joint Commission (TJC) provides guidelines for nursing care of patients with pain. The purpose of this paper explore the application to practice of TJC guidelines for nursing care of the patients with pain.

Knowledge, Skill, And Attitude Towards Workplace Violence Interventions Among Emergency Department Nurses, Jessica Lynn Collinson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This study investigates the knowledge, skills, and attitudes towards workplace violence interventions among emergency department nurses.

Implementation And Evaluation Of The Peg Pain Assessment Scale In A Primary Care Setting, Nancy L. Harritos

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Inadequate pain assessment is a significant problem and a key barrier to appropriate pain management. This project evaluates the feasibility, effectiveness, and impact of using the PEG scale, a 3-item pain assessment tool in place of the unidimensional Numeric Rating Scale to assess chronic pain in a primary care setting. A multidimensional pain assessment tool that evaluates not only the severity of pain, but also the impact of pain on quality and functioning could improve patient care and pain management.

Critical Care Nurses' Attitudes Towards End-Of-Life, Ny My Tran

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The goal of this project was to identify current attitudes in end-of-life care and evaluate the needs for additional education to improve patient outcomes. Two categories were observed within the survey results; nurses' attitudes towards family members of the terminally ill patients and the nurses' attitudes towards caring for dying patients. Overall, the survey indicated a high confidence and positive attitude in both patient and family care. Nurses should continue to advocate and deliver optimal end-of-life patient care and reflect on their personal beliefs that may challenge caring for dying patients and their families.

Registered Nurses’ Knowledge Of Cardiac Rehab: A Qi Project, Karen Reyes

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This Major paper, with evidence from the literature, describes what cardiac rehab is and acknowleges the importance. The literature supports the benefits and favorable outcomes of cardiac rehab however, CR programs remain underutilized. This paper identifies the need for CR educational programs to increase nurses’ knowledge of CR and to effectively educate patients on the benefits of CR. The content included numerous rearch articles and govement journal articles to support the purpose of this project.

Knowledge/Attitudes Of Rns Toward Veterans With Ptsd/Sud, Jennifer Sloan

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Nurses' knowledge of and attitudes toward treating Veterans with a dual diagnosis of PTSD and SUD were evaluated before and after an educational PowerPoint Presentation. Knowledge was assessed using a brief, 10 question quiz. Attitudes were assessed using the Medical Condition Regard Scale. Results were analyzed according to gender, age range, level of education, years in nursing, and employment on a medical or psychiatric unit.

Dexmedetomidine Use In Alcohol Withdrawal Syndrome: A Retrospective Chart Review, Elizabeth Catherine Stefanilo

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A comprehensive literature review of alcohol withdrawal and it's treatment. A retrospective chart review was performed that examined if the use of Dexmedetomidine (Precedex) during alcohol withdrawal decreases the amount of benzodiazepines administered in an intensive care unit.

Baclofen Use In Alcohol Withdrawal Patients In Inpatient Settings: A Systematic Review, Mona T. Patel

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Aim: To carry out a systematic review of the available evidence from health decision makers, patients, and therapists regarding the ability of Baclofen use in decreasing alcohol withdrawal symptoms to patients in inpatient settings. acute care setting.

Methodology: Systematic searches were carried out on the following databases: Academic Search Premier, CINAHL, Cochrane and PsycINFO via EBSCO Host, Embase, MEDLINE via PubMed, and Web of Science. The last search date was May 28, 2019. The search was limited to the last 10 years, i.e., from January 1st, 2010.

Findings: Four studies were included in the final review. The total population was …

Emergency Department Nurses Ability To Identify St-Elevation Myocardial Infarction In Electrocardiogram: A Quality Improvement Project, Bruce Gillard

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A quality improvement project was developed using a pre-test, education intervention, post-test design to assess nurse’s ability identify STEMI ECGs from non-STEMI ECGs and to assess the impact of a brief educational program on nurses’ performance. The pre-tests were available to nursing staff over a two-week period to obtain the nurses’ baseline knowledge. Following the pre-test period nurses were provided the educational sessions followed immediately by distribution of the post-test. The pre-tests were then compared to the post-tests to assess whether or not the education improved nurses’ performance in STEMI recognition.

Propofol Versus Midazolam On Reducing The Incidence Of Post-Operative Nausea And Vomiting: A Systematic Review, Kimberly Luckett

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A systematic review comparing the efficacy of Propofol vs midazolam on the incidence of PONV in the adult population. The review suggests the use of either medication alone or in combination with other anti-emetics to effectively prevent and/or reduce the incidence or severity of PONV. Both medications have anti-emetics properties and CRNAs should implement either medication into their practice to prophylactically treat PONV. More research on this topic is needed because there was limited research pertaining to midazolam as an anti-emetic.

An Educational Module Related To Medical Marijuana For Aprn, Lauren E. Slater

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This master's thesis evaluated the impact of an educational module providing advanced practice registered nurse (APRN) students essential knowledge of medical marijuana. Perceived level of knowledge was surveyed before and after participants watched a 30-minute educational video module. Data indicated somewhat poor to very poor level of knowledge prior to watching the video and somewhat good to very good level of knowledge post video. Findings support the integration of essential medical marijuana knowledge into APRN curriculum.

Exploring Nurses' Knowledge Of Medication Error Reporting, Karina Santos

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Managing the care of critically ill patients is a highly complex and stressful position requiring high levels of critical thinking skills and judgment. Medical errors, including medication errors continue to happen in hospitals across the nation. Despite decades of focus and efforts on this area from the Institute of Medicine and other national and federal agencies, literature suggests that medication errors in critical care are highly prevalent and underreported. The purpose of this project was to explore the knowledge base of critical care nurses in relation to medication error reporting. A survey was created, which included 10 questions that were …

Preoperative Multimodal Analgesia In Total Hip Arthroplasty: A Retrospective Chart Review, Bonnie A. Blaney

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A retrospective chart review which examined the number of preoperative multimodal analgesics administered and their effect on the first 24 inpatient opioid administration in patients undergoing total hip arthroplasty.

Procalcitonin: Can It Impact The Length Of Antimicrobials, John Mannino

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A systematic review investigating if using procalcitonin levels to guide antimicrobial therapy has an impact on the number of days an adult septic patient is exposed to antimicrobial therapy.

Impact Of Early Mobility Of Abcdef Bundle On Delirium, Brent Medeiros

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A systematic review was performed utilizing the PRISMA checklist to evaluate the impact of early mobility of the ABCDEF bundle on delirium in critically-ill patients. Critical appraisal of the research utilizing CASP and cross analysis was performed of 5 studies that met inclusion criteria revealing two statistically significant results on the impact of early mobility on delirium. Summary and conclusion as well as recommendations for application within the advanced practice role were included.

A Comparison Of The Efficacy Of Mupirocin Versus Povidone-Iodine In The Treatment Of Nasal Colonization With Mrsa/Mssa To Prevent Pos-Operative Infections: An Integrative Review, Ashley O'Rourke

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Six research studies were included in this review as selected following the PRISMA flow diagram. Each article was critically appraised using Polit and Beck's guide to critical appraisal. Data collection was performed followed by a cross study analysis. The results showed that five out of six studies recommened the use of povidone-iodine over mupirocin intranasally to prevent surgical site infections due to cost-effectiveness, ease of use, higher compliance rates, and effectiveness.

Increasing School Nurse Teachers' Awareness Of The Social..., Andrea Sharkey

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

According to the Centers for Disease Control and Prevention (CDC) (2013) and the National Library of Medicine (2013), the numbers of emotional and mental health issues in children have increased significantly. The National Institute of Mental Health (NIMH) (2017) indicates that the prevalence of mental illness in these age groups is 20 percent. Schools are increasingly implementing social-emotional programs and curricula to address these needs. School nurse teachers provide care for many of these children and are in a position to promote positive outcomes for them. However, many school nurse teachers are not aware of the social-emotional programs and curricula …

Increasing Access To Skilled Nursing Facilities For Obese And Morbidly Obese Populations: An Educational Program Development Project, Melissa Sousa

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Public Health is defined as “the science of protecting and improving the health of people and their communities” (Centers for Disease Control and Prevention, 2019). The Centers for Disease Control and Prevention has listed obesity as one of the top ten public health concerns facing communities today. According to The Centers for Disease Control and Prevention (CDC), more than one-third of adults are considered obese or morbidly obese. Out of that one-third, approximately 41% are adults aged 60 or older who will require at least one nursing home level of care stay in their lifetime. The purpose of this project …

Propofol Based Tiva Vs. Sevoflurane Inhalation Anesthetic For Breast Cancer Surgery: A Systematic Review, Jacqueline Elizabeth Conte

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Metastasis from breast cancer leads to a higher chance of death from that cancer.

According to the National Cancer Institute (2018) breast cancer survival rates among all three SEER stages (localized, regional, and distant) was approximately 90% between the years 2008 and 2014.

Among these patients, those with distant metastasis had a survival rate of 27% and those with regional metastasis had an 85% survival rate (American Cancer Society, 2019). When creating an individualized anesthetic plan for a patient presenting for tumor excision of breast cancer, the anesthesia provider should create a plan that l

owers the risk of metastasis …