Digital Commons Network^™

Clinical Practice Update On A Temperature Guideline To Decrease Intraoperative Hypothermia In Patients Undergoing General Anesthesia, Ashley Rigdon

Doctoral Projects

Intraoperative hypothermia is a common problem within the operating room. Anesthesia inhibits the body’s normal thermoregulatory response to hypothermia, redistributing heat from the core to the periphery (Brandt et al., 2009). In the event of hypothermia, the incidence of infection triples as there is an increased risk for blood loss, increased risk for cardiac complications, and the thermal discomfort of patients (Brandt et al., 2009). Following a recent clinical practice guideline can help prevent hypothermia.

A descriptive project was organized utilizing current literature. The sample for this study is 45 CRNAs practicing at a multiple system healthcare facility in the …

Implementing Computerized St-Segment Analysis Utilizing 5-Lead Ecg Cables During The Perioperative Period For Myocardial Ischemia Detection In Patients At Risk For Cardiovascular Disease, Lauren Robertson

Doctoral Projects

Cardiovascular disease (CVD) is one of the leading causes of death in the United States (U.S.) annually (Centers for Disease Control and Prevention, 2011). Mississippi has a disproportionately higher percentage of citizens likely to have CVD (Mississippi State Department of Health [MSDH], n.d.). The numerous stressors related to surgery are alone enough to increase the demand of the heart and lead to ischemia of the myocardium. Surgical stressors combined with preexisting CVD can exponentially increase the risk of ischemia. It is estimated that over a third of all surgical patients have ischemic heart disease. Puelacher et al. (2015) reported 40% …

Administering Dexamethasone Prior To Peripheral Nerve Blocks, Jacob Millwood

Doctoral Projects

Post-operative pain creates burdens for the patient and their family members while also drastically increasing the price of cost to the healthcare system. The Institute of Medicine Committee on Advancing Pain Research, Care, and Education states that the annual economic cost of chronic pain in adults is $560-630 billion (IOM, 2011). Regional anesthesia has been shown to provide potent analgesia that often times leads to a reduction in systemic analgesic requirements, opioid related side effects, general anesthesia requirements, and possibly the incidence of chronic post-operative pain. There are several adjunct medications that can be combined with peripheral nerve blocks to …

Proposed Practice Change To Perform Ultrasound Lung Scans Immediately Following Upper Extremity Peripheral Nerve Blocks To Rule Out A Pneumothrax, Robert Gaston

Doctoral Projects

Regional anesthesia is a technique that can be used for a variety of surgeries. There are risks involved when regional anesthesia is performed. Specifically when upper extremity nerve blocks are performed a potential complication is a pneumothorax. The purpose of this DNP project was to propose a practice change to perform ultrasound (US) lung scans immediately following upper extremity peripheral nerve blocks to rule out a pneumothorax. A needs assessment was conducted at the host facility to determine if the anesthesia providers were aware that US was a method that could be useful for detection of a pneumothorax. Currently, the …

Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin

Doctoral Projects

Anesthesia practice is learned in a stressful environment, and these stressors may lead to the students’ development of maladaptive coping mechanisms. Despite significant improvements in our understanding of addiction and our approaches to combat this problem, the risk of substance misuse remains high in nurse anesthesia students. Education and intervention are imperative when taking preventative measures. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether delivery method of chemical dependency/wellness educational program effects the level of understanding of anesthesia providers and substance misuse and the development of healthy coping mechanisms.

In determining whether the delivery …

Increasing Student Registered Nurse Anesthetists Clinical Self-Efficacy Using Peer Mentoring, Megan Christine Bass

Doctoral Projects

The purpose of this project is to determine if clinical self-efficacy is increased in SRNAs at The University of Southern Mississippi after participation in the peer mentoring program. The project was a one-group pre and posttest design in a sample of SRNAs who received peer mentoring. To evaluate the students’ perceived clinical self-efficacy before and after the peer mentoring educational intervention, the Rowbotham and Schmitz Student Self-Efficacy scale (SSE) (2013) was adapted and administered to second-year SRNAs (N=17). Clinical performance, skill and knowledge development, social interaction with clinical faculty, and coping with clinical stress are the four areas evaluated by …

Non-Invasive Positive Pressure Ventilation In The Obese Patient Population An Intervention To Enhance Oxygenation: A Quality Improvement Project, Justin Smith

Doctoral Projects

Obesity is a comorbidity that can be challenging to the anesthetist. Patients who are obese are at risk for rapidly desaturating after becoming apneic during the induction of a general anesthetic. This rapid desaturation is mainly attributed to their decreased oxygen reserve that is a result of their obesity. Mississippi is known to have a disproportionately higher percentage of citizens who are obese, compared to other states (Johnson, 2016). Desaturation in the obese is important to avoid because it leads to atelectasis and prolongs recovery. When an anesthetist is providing a general anesthetic to the obese patient population, it is …

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified registered nurse …

The Use Of Culturally Sensitive Education On Organ Donation And Its Impact On Attitudes And Willingness To Donate Organs, James Winters

Doctoral Projects

In regards to transplantation, ethnic minorities are disproportionately affected by the donor shortage. The high morbidity rates and decreased willingness to donate commonplace among these demographics has created a devastating imbalance. Increasing minority donor presence will make the allocation process more favorable for minority candidates. The current study entailed the provision of a culturally sensitive educational intervention to sixty-five (n=65) students at the University of Southern Mississippi. Surveys were administered pre/post intervention to assess knowledge and attitudes towards donation. Pre-intervention data reflected findings from prior research, post-intervention data showed that the intervention was able to mitigate these findings and that …

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

Implementation Of The Sleep Treatment And Education Program For Students (Steps) In Student Registered Nurse Anesthetists, Nicolina Marie Vaught

Doctoral Projects

In the pursuit of graduate level education, student registered nurse anesthetists (SRNAs) undertake curricula requiring an immense investment of time attending didactic classes and clinical training, studying, and completing assignments. The required time commitment combined with the stress accompanying these responsibilities have the potential to leave the SRNA with inadequate time for an optimal amount of sleep, contribute to sleep disturbances, and ultimately result in sleep-related fatigue (SRF). SRF in the SRNA population is a problem because it is imperative for both patient and student safety that SRNAs attain adequate sleep to allow for optimal cognitive function.

This DNP project …

Preoperative Fluid Therapy To Decrease Postoperative Nausea And Vomitting In High Risk Populations: Practice Change Outcomes, Brandi Scarbrough Carmichael

Doctoral Projects

Postoperative nausea and vomiting (PONV) continues to be a negative complication that impacts patient satisfaction and potentiates unfavorable patient outcomes. Certified Registered Nurse Anesthetists (CRNA) are in a unique position to help alleviate this problem. However, CRNAs must be vigilant in utilizing evidence-based practices that decrease PONV and identifying patients who have increased risk factors for developing PONV.

For this doctoral project, an educational in-service on the use of preoperative fluid therapy to decrease PONV in high risk populations was held with participating CRNAs. This doctoral project’s main purpose was to evaluate CRNAs’ willingness to make a practice change after …

The Effects Of In-Service Education On Workplace Incivility For Crnas, Tran King

Doctoral Projects

Workplace incivility (WPI) affects many healthcare providers, including Certified Registered Nurse Anesthetists. This project was an exploration of the prevalence, nature, and sources of WPI affecting CRNAs. The project’s intervention was an in-service education on WPI for CRNAs. The purposes of the project were to measure the effectiveness of the in-service education in increasing awareness of CRNAs about WPI; and to offer a practice change proposal in terms of a policy against WPI in the anesthesia department.

A Needs Assessment Survey and Demographic Data Information form were distributed from Survey Monkey to participants’ email by way of blind copy. Data …

Student Registered Nurse Anesthetist Simulation Training With The Use Of Cognitive Aids In Malignant Hyperthermia Recognition And Treatment, Daniel Martin

Doctoral Projects

One of the most stressful times in the life of a student registered nurse anesthetist (SRNA) is during the integration of didactic work with that of clinical anesthesia practice (Chipas et al., 2012). One method that has been proven effective in other avenues of student nursing education is the use of procedural simulation labs. These simulation labs allow SRNAs to experience what it is like to be in the operating room setting, while also showing distinct differences within each case, treatment, and the importance to be familiar with all aspects of anesthesia. The purpose of this project was to examine …

How To Effectively Improve Nurse-Physician Communication, Savannah R. Lacoste

Honors Theses

A study of the issue of Nurse-Physician communication, its causes, effects, importance, and possible improvements through research. The results suggest both physicians and nurses agree that nurse-physician communication is an important problem, and can be effectively improved in many ways including: a required nurse-physician communication class for pre-medical and pre-nursing students at an undergraduate level, improved and structured communication tools, and inter-professional education (IPE) between nurses and physicians. The research provides the outlooks of twenty-five nurses and twenty-five physicians independently, as well as demonstrating the nurse-physician disconnect through data comparison and analysis.

Incivility: The Lived Experiences Of Nursing Students, Stephanie M. Pecua

Honors Theses

In this paper, the experience of incivility on nursing students was explored. This project aimed to answer the question: How do acts of incivility among nursing students affect the victims emotionally, psychologically, and physically? A significant part of answering this question involved exploring the meaning of the experience of incivility to the participant students. The research design was qualitative with a phenomenological approach. The participants of the study consisted of 5 volunteer, current nursing students attending the Bachelor of Science in Nursing program at The University of Southern Mississippi-Gulf Park campus during the fall 2016 semester. The participants were asked …

The Msaabcr Operon Mutant Staphylococcus Aureus Is Deficient In Persister Cells, Aaliyah D. Cole

Honors Theses

Persister cells comprise a phenotypic variant that shows extreme antibiotic tolerance resulting in chronic infections. While this phenomenon has posed a great threat in public health, mechanism underlying their formation in Staphylococcus aureus remains largely unknown. Increasing evidence of the presence of persister cells in recalcitrant infections underscores the great urgency to unravel the mechanism by which these cells are developed. The Elasri Research group characterized msaABCR operon that plays roles in regulation of virulence, biofilm development and antibiotic resistance. It was hypothesized that the operon also plays a role in persister cell formation. In this study, the persister cell …

Professional Nursing Values: Accounts Of The Witnessed, Ashley N. Costello

Honors Theses

In this research, the lived experience of nursing students in the clinical setting, specifically experiences relating to professional nursing values, were explored. This project aimed to answer the following questions: 1) How do student nurses describe observations of professional nursing values exhibited or violated by licensed nurses during the students’ clinical rotations? (2) What meaning do student nurses’ assign to and extract from their observations, particularly as it relates to how students believe it will influence their own future nursing practice? This research was qualitative with a phenomenological approach. Eight participants enrolled in senior level nursing clinical courses at The …

William Walker And The Seeds Of Progressive Imperialism: The War In Nicaragua And The Message Of Regeneration, 1855-1860, John J. Mangipano

Dissertations

For a brief period of time, between 1855 and 1857, William Walker successfully portrayed himself to American audiences as the regenerator of Nicaragua. Though he arrived in Nicaragua in June 1855, with only fifty-eight men, his image as a regenerator attracted several-thousand men and women to join him in his mission to stabilize the region. Walker relied on both his medical studies as well as his experience in journalism to craft a message of regeneration that placated the anxieties that many Americans felt about the instability of the Caribbean. People supported Walker because he provided a strategy of regeneration that …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

An Analysis Of Ed Nurse Opinion Of Their Ed Nurse Manager Leadership Characteristics And Outcomes, Charlotte Ann Gore

Dissertations

The purpose of this cross-sectional, descriptive, correlational study was to examine ED staff nurses’ opinions of their ED nurse managers’ full range of leadership characteristics , the degree to which the characteristics correlate with specific outcomes of leadership behavior, and how the results of the measure and subscale compare to other nursing groups in literature. The Multifactor Leadership Questionnaire 5X Rater Form (MLQ 5X Rater Form) was used to measure ED staff nurses’ opinions of their ED nurse managers, along with an ED Staff Nurse Demographics Questionnaire to gather information about the characteristics of the population. The population for this …

An Exploratory Study Of The Utilization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron

Dissertations

The purpose of this study was to explore the relationship of adherence to evidence-based guidelines for pharmacologic management by select Mississippi hospitals and their hospital readmission rates. This was an exploratory study with a retrospective design. This design offered insight into the relationship between readmissions of heart failure patients and adherence to the national guidelines for the pharmacologic treatment of heart failure. The study took place in a hospital in the southeastern section of the United States. Data were collected from a database of patients with heart failure seen between January 2011 and June 2014.

The unit of analysis for …

A Motivational Profile Of Nurses Who Pursue Doctoral Education, Tomekia Yvette Luckett

Dissertations

The need for nurses to pursue doctoral education is imperative to the professionalization of the discipline of nursing in light of the changing healthcare environment. Presently, < 1% of the nursing workforce possesses a doctoral degree (“Transforming Nursing Education,” 2016), albeit recommendations from the Institute of Medicine (IOM) (2010) admonish the need to increase the number of doctoral-prepared nurses. The need to understand characteristics of nurses who seek doctoral education is critical in planning long-term strategies for nursing education in the United States (US) (Kovner, Brewer, Katigbak, Djukic, & Fatehi, 2012). In conjunction with describing characteristics of nurses pursuing doctoral education, this research describes the motivational orientation and factors of registered nurses (RNs) pursuing doctoral education.

A descriptive correlational design was utilized to examine concepts relating to motivational orientation of RNs pursuing doctoral education. Participants were divided into two categories: (a) RNs seeking the Doctor of Philosophy (Ph.D.) degree and (b) RNs pursuing the Doctor of Nursing Practice (DNP) degree. A total of 173 RNs enrolled in either a Ph.D. or DNP program in the Gulf South region of the US comprised the final sample. Binary logistic regression was utilized …

Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini

Doctoral Projects

Colorectal cancer is a leading cause of cancer death in the United States (Mandel, Tanner, Lichtenstein, Metz, Katzka, Ginsberg, & Kochman, 2008; Siegel, DeSantis, & Jemal, 2014). Because this lethal disease claims lives of many people every year, more patients are undergoing screening colonoscopies, which have greatly aided in decreasing the number of colorectal cancer deaths (Siegel et al., 2014). The most common form of sedation for colonoscopies is moderate sedation with a benzodiazepine and an opioid (Cohen, Hightower, Wood, Miller, & Aisenberg, 2004; Lera dos Santos, et. al., 2013). However, sedation by anesthesia providers using propofol is becoming more …