Digital Commons Network^™

Caring Is Not Just For Patients, Michelle J. Palokas

Group: King International Nursing Group

How is it that nursing is considered a profession of caring, yet we have some of the highest rates of lateral violence of any profession? As nurses, we must not only care for our patients, but each other, too.

Caring fosters a healthy working environment causing a continuation of caring acts by each member of the interprofessional team. Using Watson's Theory of Human Caring as a philosophical framework, the three concepts of compassion, empathy, and self-awareness/self-knowing can be easily encompassed under the grand theory. The middle-range theories that help to operationalize and guide practice as a caring nurse should include: …

Imogene King For New Users, Beverly J. Whelton

Group: King International Nursing Group

This presentation is an overview of Imogene King's nursing theories.

Applying King's Conceptual Framework And Theory Of Goal Of Attainment: Telehealth Content In Nursing Education, Ann E. Fronczek, Nicole A. Rouhana, Judy Kitchin

Group: King International Nursing Group

The purpose of this presentation is to discuss the application of King's conceptual framework and theory of goal attainment to education of nurses in telehealth. The interacting personal, interpersonal, and social systems are all important concepts to consider in developing telehealth content. Educators need to assure that nursing students understand how these three systems interact to support health outcomes for client especially as technology and the technology choices are vast in numbers. The ways that nurses are interacting with their clients to set and attain mutual goals are increasing through the use of telehealth technologies and are evolving daily. King …

Answering The Challenge Of Globalized Health Care To The Work Of Imogene King, Beverly J. Whelton

Group: King International Nursing Group

This philosophical presentation will outline the potential need (and progress the discussion) of a change in Imogene King’s Conceptual Systems and metaparadigm concepts that ground her nursing theory of Mutual Goal Attainment. It was proposed at the 2015 conference that the contemporary globalization of health care requires nurses to be able to include in their assessment political, economic, local health, safety, and cultural issues. A fourth, Global System, was proposed by this author. The members from Japan objected that Dr. King would not accept this and that her concept Environment could be expanded in scope to include these parameters. Last …

Evolution Of An Empowerment Instrument, Christina Leibold Sieloff

Group: King International Nursing Group

Purpose:
The purpose of this presentation is to detail the evolution of a reliable and valid instrument: the Sieloff-King Assessment of Work Team/Group Empowerment within Organizations (SKAWTGEO©).

Rationale and Significance:
The SKAWTGEO, initially developed and psychometrically tested in 1996, is the only nursing-theory based instrument designed to estimate the empowerment of a work team or group within a health care organization. The instrument has been used internationally, translated into Finnish and Hebrew, and is currently being translated into Korean and Turkish. The researcher proposes that work team/group empowerment is a critical factor in the further improvement in the delivery of …

Contemporary Models For Clinical Nursing Education, Lauren Hill, Ellen P. Williams

Group: King International Nursing Group

Approaches for clinical nursing education remain inadequate despite manifold calls for the use of alternative methods of experiential learning in schools of nursing. Mandates for transformation of clinical nursing education arise from multiple sources, including reports by the Institutes of Medicine and the Carnegie Foundation. On a pragmatic level, changes are driven by a scarcity of available clinical sites, generational differences in ways of learning, increased student/teacher ratios in traditional clinical settings, and an explosion of knowledge relative to health promotion, disease prevention, and treatment. Continuing use of traditional clinical nursing education models contributes to poor critical thinking and reasoning …

Patient Perceptions Of Nurse Listening Behaviors, Nancy Loos

Group: King International Nursing Group

The purpose of this proposed interpretive phenomenological study is to discover, describe, and interpret patient perceptions of nurse listening behaviors. Because nurse listening is linked to an enhanced patient experience and improved patient outcomes, it is considered important enough that patient perception of its occurrence is solicited by the United States (US) Centers for Medicare or Medicaid (CMS) as part of the “HCAPHS” (Hospital Consumer Assessment of Healthcare Providers and Systems) survey (https://www.cms.gov, n.d.). However, little can be found in the literature describing which nursing behaviors patients perceive as listening behaviors. For inpatient nurses to reflect on and improve their …

Extensions Of King: Measurable Outcomes And Expanded Nursing Process, Mary B. Killeen

Group: King International Nursing Group

This presentation provided a review of King Theoretical concepts and relevance to nursing outcomes thereby expanding the nursing process to include a theoretical foundation.

Validating The Saligan Fatigue Inventory (Salfi), Kristin Dickinson, Tara Angela Albrecht, Christina M. Wilson, Sumiyya Raheem, Xuemin Zhang, Leorey N. Saligan

General Submissions: Instruments, Tools, and Measurements

Background: Cancer-related fatigue (CRF) is a very distressing symptom reported by oncology patients. Currently, CRF is measured by self-report instruments. Although clinician-administered questionnaires are more sensitive than self-report scales, there is no available clinician-administered instrument that is validated to measure CRF.

Purpose: This nurse-led, prospective, repeated measures study investigated the reliability and validity of a 7-item Saligan Fatigue Inventory (SalFI), a recently developed, clinician-administered tool to measure CRF.

Methods: Significant correlations between SalFI and other reliable and valid CRF measures (Functional Assessment of Cancer Therapy-Fatigue [FACT-F], revised Piper Fatigue Scale [rPFS]) were explored using Spearman correlation tests. …

Modified Fresno Test - Acute Care Nursing, Margo A. Halm

General Submissions: Instruments, Tools, and Measurements

The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of 14 items required revision to achieve acceptable psychometrics. The aim of this second validation study was to revise and validate a new version of the test to determine if it could distinguish EBP knowledge/skills among acute care nurses.

Japanese Disaster Nursing Readiness Evaluation Index (Jdnrei), Carol Ann Huebner, Maeda Takayo, Kotera Sayaka, Matsuda Nobuko

General Submissions: Instruments, Tools, and Measurements

The Japanese Disaster Nursing Readiness Evaluation Index (JDNREI) is an index purposed for nurses' self-evaluation on their readiness and preparation for dispatch to perform medical care at disaster sites. This scale is based on the Readiness Estimate and Deployability Index (READI), which was developed in the U.S. in 1997, and was newly created in consideration of the Japanese cultural background. JDNREI is composed of 37 items pertaining to the following six subscales: (i) emergency nursing skills, (ii) practical skills for disaster response, (iii) communication skills for teamwork, (iv) effective coping with daily stress, (v) adaptability to stressful situations at disaster …

Readiness Estimate & Deployability Index, Carol Ann Huebner

General Submissions: Instruments, Tools, and Measurements

The Readiness Estimate & Deployability Index measures the level of individual deployment readiness among military and civilian nursing personnel for operations in austere environments such as conflicts and natural disasters. Versions for the U.S. Army, Navy, and Air Force as well as civilian nurses have been developed and tested.

Parallel And Factor Analysis For Delimiting Items In A Three-Dimensional Construct Of Clarity For Nurses, Jayne Felgen, John W. Nelson

General Submissions: Instruments, Tools, and Measurements

The purpose of this study is to decrease the number of items that respondents are required to respond to, while maintaining the validity of the construct.

A Multistudy Validation Of An Instrument For Nurse Job Satisfaction, John W. Nelson, Georgia J. Persky, Mary Ann Hozak, Alice Albu, Pamela S. Hinds, Kay Savik

General Submissions: Instruments, Tools, and Measurements

This study aims to validate an instrument of nurse job satisfaction, the Healthcare Environment Survey (HES), across settings and time through an organizational change.

Readiness Estimate & Deployability Index (Readi), Carol Ann Huebner, Takayo Maeda

General Submissions: Instruments, Tools, and Measurements

The Readiness Estimate & Deployability Index (READI) measures the level of individual deployment readiness among military and civilian nurses to deploy to austere environments during conflicts or natural disasters. The READI has been tested in the U.S. Army, Navy, and Air Force Nurse Corps as well as in Japan and Republic of Korea.

Fire Safety In The Operating And Procedural Room - An Online Education Module, Christopher Souchek

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

An evidence-synthesizing project utilizing research from scientific literature and recommendations from leading professional organizations on fire safety was completed for this module. The purpose of this module is to educate staff about fire safety in the operating and procedural room. Specifically, this module will educate providers about: (1) the importance of fire safety, (2) the fire triangle, (3) scenarios highly conducive to fire, (4) fire prevention using the fire risk assessment score, (5) management of fires on the patient and in the airway, and (6) fire interventions. For the purposes of this paper, the term "operating room (OR)" will include …

Mepivacaine And Bupivacaine Spinal Comparisons For Motor Function Return, Discharge Time, And Transient Neurologic Symptoms: An Evidence Based Practice Analysis, Grant M. Backman

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Bupivacaine is the most common local anesthetic used in spinals for total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures, despite its extended duration (3-9 hours). Most TKA's can be completed in approximately 60-90 minutes and most THAs in 60-120 minutes. This leaves TKA and THA patients largely immobile for much longer than needed when the spinal anesthesia duration exceeds surgical time. Prolonged immobility leads to longer time in PACU, slower discharge times, and increased cost. Mepivacaine may be an excellent alternative for these ambulatory procedures, due to its more reasonable duration of 90-150 minutes, but most providers fear …

Anesthesia Protocol For Bariatric Surgery: A Quality Improvement Process, Brooke N. Greisen

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Objective: The purpose of this quality improvement process was to review current enhanced recovery after surgery (ERAS) protocols for bariatric surgeries, analyze the current anesthesia protocol used at a midwestern medical center, and propose potential system modifications for best practice in the bariatric surgical population.

Methods: All articles published between 2009 and March 2019 that contained specific keywords were critically appraised or discarded. Additional articles were discovered through cross references from previously found articles.

Major points: The midwestern medical center protocol reviewed followed ERAS guidelines closely. Both parties agreed on the use of antiemetics, multimodal analgesics, positioning, oxygen therapy, and …

Effects Of Perioperative Midazolam Administration On Postoperative Nausea And Vomiting In Patients Undergoing General Anesthesia: An Evidence-Based Practice Analysis, Haley R. Mcmillin

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Patients undergoing general anesthesia are at risk of developing postoperative nausea and vomiting (PONV) with reported incidences ranging from 30% to as high as 80% in high-risk populations. The fear of experiencing nausea or vomiting after surgery is often stated to be the number one concern of patients, even over postoperative pain. PONV is a distressing experience for patients and can lead to longer stays in the post-anesthesia care unit (PACU), prolonged time to discharge, patient dissatisfaction, and increased costs. The incidence of PONV depends on a variety of factors including age, sex, non-smoking status, use of opioids postoperatively, history …

12-Lead Ecg Monitoring With The Easi System In The Or: A Quality Improvement Project, Marilyn S. Stephenson

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

The intent of this project was to assess current use and knowledge of the EASI^TM system, educate anesthesia providers about the EASI^TM system, and re-assess knowledge and use of this system in clinical practice. The use of the EASI^TM system for patients with clinical risk factors was assessed.

An Integrative Review: The Incidence Of Transient Neurologic Symptoms With The Administration Of Intrathecal Lidocaine Or Bupivacaine, Ellen Brightweiser

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Aims and Objectives: The aim of this integrative review is to analyze the effects of intrathecal administration of lidocaine and bupivacaine on transient neurologic symptoms (TNS).

Methods: A review of the literature was performed utilizing the following electronic databases: Ebsco, Medline, Pubmed, CINAHL Complete, and Cochrane Complete. Search results were critically appraised based on study method and design that aligned with this integrative review's guiding questions.

Results: The use of lidocaine is associated with an increased risk of TNS when compared to other local intrathecal medications. The specific etiology of TNS remains unknown. This review revealed several contributing factors to …

Coadministration Of Ketamine And Magnesium: An Integrative Review, Lauren Chiavetta

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Objective: The object of this integrative review was to investigate the analgesic benefit and side effect profile of the coadministration of ketamine and magnesium. Secondary goals were to provide an evidence-based recommendation on the ideal dosing, frequency, and order of administration of the medications. Methods: Relevant articles published between January 2001 and May 2019 were examined for quality, strength, and generalizability. Results: Beginning evidence suggests ketamine may interact with magnesium to provide synergistic NMDA receptor antagonism and analgesia. Evidence from animal studies proposes that order of administration may influence potency, with ketamine prior to magnesium producing better analgesia. Coadministration of …

Lung-Protective Ventilation Effects On Oxygenation In The Obese Patient Undergoing A General Anesthetic With Endotracheal Tube: An Evidence-Based Practice Analysis, Ashley Chapman

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

The purpose of this evidence-based practice review is to investigate the effects of lung-protective ventilation strategies on oxygenation in the obese patient undergoing a general anesthetic with endotracheal tube. A population, intervention, comparison, and outcome (PICO) question was used to provide the clinical framework, "In the obese patient undergoing a general anesthetic with endotracheal tube (P), what effect does lung-protective ventilation (I) compared to conventional ventilation (C) have on oxygenation (O)?"

Implementation Of An Orientation Program For Student Registered Nurse Anesthetists (Srnas) And Their Support Persons: A Program Evaluation, Chelsea F. Murrell

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Research has shown that the support persons of graduate students may experience stress just as their students experience stress. This effect is known as the crossover effect. Prior surveys from support persons of Student Registered Nurse Anesthetists (SRNAs) have demonstrated a need for preventative interventions in order to mitigate stress. An orientation seminar was developed and implemented for the primary support persons of SRNAs and the SRNAs. The orientation seminar was held at a small Midwestern Doctor of Nurse Anesthesia Practice (DNAP) program. All primary support persons were invited to complete a survey about stress 5 months after the orientation …

The Implications Of Local Anesthetic Volume In Adductor Canal Blockade: An Integrative Review, Michaela Purcell

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Introduction: Maintaining patient safety is of utmost concern for anesthesia providers. The adductor canal block, a peripheral nerve block identified as a motor-sparing sensory block, may decrease fall risk and associated adverse outcomes seen in total knee arthroplasty patients following femoral nerve block. A large volume of local anesthetic administered in the adductor canal has been questioned due to concern about impaired quadriceps strength if volume extends beyond the adductor canal, causing an unintended femoral nerve block due to spread of local anesthetic into the femoral triangle.

Methods: A review of literature was performed on the following databases: PubMed, CINAHL …

Anesthetic Management In Eras Protocols For Total Knee And Total Hip Arthroplasty: An Integrative Review, Laura Oseka

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).

Methods: Articles published between 2006 and December 2016 were critically appraised for validity, reliability, and rigor of study.

Results: The administration of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, gabapentinoids, and steroids result in shorter hospital length of stay (LOS) and decreased postoperative pain and opioid consumption. A spinal anesthetic block provides benefits over general anesthesia, such as decreased 30-day mortality rates, …

Dexmedetomidine As An Intrathecal Adjuvant For Subarachnoid Block For Women Undergoing Elective Cesarean Section: An Integrative Review, Mark Funk

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Aims and Objectives: This integrative review aims to evaluate the safety and effectiveness of intrathecal dexmedetomidine as an adjunct to hyperbaric bupivacaine for elective cesarean sections using subarachnoid block (SAB).

Methods: A review of the literature was performed on the following databases: PubMed, CINAHL Complete, Google Scholar, and Cochrane Collection. Relevant research articles were critically evaluated and added to a literature matrix for synthesis.

Results: Intrathecal dexmedetomidine-5 mcg enhances the efficacy of intrathecal bupivacaine 0.75% by 24% in women undergoing elective cesarian sections using SAB. Intrathecal bupivacaine administered with 5 mcg dexmedetomidine produced a similar analgesic effect as intrathecal morphine …

Cuffed Verses Uncuffed Endotracheal Tubes For Pediatric Patients, Bryce Scott

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Pediatric airway management can present many challenges for anesthetists. One such challenge is whether to use a cuffed or uncuffed endotracheal tube (ETT) for pediatric patients younger than eight years. Practitioners have used uncuffed ETTs for smaller children due to the risk of cuffed ETTs causing airway mucosal injury which may lead to subglottic stenosis and stridor.1 In recent years, cuffed ETTs have been used more frequently in order to reduce tube exchanges, ventilation leak around the tube, unreliable end-tidal carbon dioxide (ETCO2) monitoring, and the risk of aspiration. The purpose of this evidence based practice analysis is to compare …

Target Receptors Of Cbd & Potential Clinical Implication(S): An Integrative Review, Teran A. Walford

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

The purpose of this integrative review is to investigate the potential receptors of cannabidiol (CBD) in order to better understand any potential clinical implication(s) during administration of anesthesia and analgesia. A total of eight full-text review articles were included from multiple databases. All eight of the review articles were analyzed for evidence related to the target receptors of CBD. Analysis of the review articles focused on potential receptors and implications of CBD as it relates to anesthesia and analgesia. Two primary receptors were discovered, 5-HT1A and TRPV1. In total, 14 potential receptors of CBD have been identified resulting in multiple …

Post Anesthesia Care Unit Nurses’ Perceptions On Handoff Communication From Anesthesia Providers: A Mixed Methods Study, Megan R. Elsasser

Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection

Background and significance: anesthesia providers and post anesthesia care unit (PACU) nurses engage each other multiple times each day, delivering and receiving handoffs regarding patients. Purpose: To measure PACU nurse perceptions of communication, based on the handoff received from anesthesia providers when transferring care of patients.

Methods: A quantitative descriptive design was utilized. A 27-question survey was sent to a study sample composed of nine responses from nurses working in the PACU for a minimum of one year.

Results: nine participants completed the Google Forms Survey. Specific topics that were answered with "disagree" or "strongly disagree" when asked if anesthesia …