Digital Commons Network^™

Propofol Dispension And Waste In Nebraska: A Descriptive Study, Brittany M. Nelson

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

Propofol is an intravenous sedative hypnotic drug with addictive properties commonly used in anesthesia. Despite official statements from the American Association of Nurse Anesthesiology (AANA) and the American Society of Anesthesiologists (ASA) recommending that the Drug Enforcement Agency (DEA) schedule propofol, only three states categorize propofol as a controlled substance. The purpose of this exploratory study was to examine how Nebraska anesthesia practitioners dispense and waste propofol in the perioperative setting. A total of 89 surveys were mailed to hospitals in Nebraska with an anesthesia department, and 53 completed surveys were returned for a response rate of 59.5%. All Nebraska …

Recommendations For Breast Feeding Mothers After Anesthesia: A Quality Improvement Project, Blake Meyers

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

Quality improvement projects aim to address a clinical issue and subsequently improve patient care. Projects may improve or promote safe care, interpersonal care aspects, and life quality.1 The clinical issue addressed by this project was the lack of consistent, evidenced based, instructions for the resumption of breastfeeding following an anesthetic provided to mothers by anesthesia providers. This inconsistency was frustrating to patients and other health care providers within the hospital setting. The goal of this project was to bring consistency to the evidenced based recommendations for resumption of breastfeeding after outpatient anesthesia made by anesthesia providers and RNs in the …

An Orientation Program For Student Registered Nurse Anesthetists (Srnas) And Their Support Persons: A Program Evaluation, Tyler N. Memmott

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

Graduate programs have been studied and shown to be stressful for their students. Students and their support persons can experience similar emotions which can impact the students' performance, this is known as the crossover effect. Student Nurse Anesthetists (SRNA) as well as their support persons attended an orientation program at a small Midwestern Doctor of Nurse Anesthesia Practice (DNAP) program. All support persons were asked to complete a stress survey several months after the orientation program. Overall, the support persons reported that the orientation program was valuable. First year SRNAs were surveyed regarding their stress levels which had elevated levels …

Neuraxial Anesthesia’S Role In External Cephalic Version: An Integrative Review, Jessica L. Kuhr

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

Background: External cephalic versions (ECVs) are used to move a fetus from breech position into a vertex position to allow for safer vaginal delivery. Neuraxial anesthesia has been studied as a method of pain control and for its ability to increase ECV success rates with mixed results. The purpose of this integrative review is to examine the current evidence and provide guidance in neuraxial anesthetic care of patients undergoing external cephalic version.

Methods: A search of the electronic databases PubMed and Cochrane was performed. Twenty-one articles published from 1994 -2020 were analyzed using an evidence matrix. Twenty of those articles …

Perceived Clinical Orientation Needs Of Student Registered Nurse Anesthetists: A Quality Improvement Needs Assessment, Madison N. Cooper

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

The purpose of this project was to identify the perceived clinical orientation needs of a cohort of student registered nurse anesthetists (SRNAs) at one clinical site. Two focus group interviews were conducted with five participants at specific time intervals prior to and after starting clinical rotations. This method was utilized in anticipation that perceived needs would differ at various timepoints in the clinical rotation. Data from the focus group were analyzed through the generation of themes and lists to develop a site-specific orientation manual. General consensus from the focus group interviews revealed gaps in the clinical orientation process, and the …

The Effects Of Preoperative Carbohydrate Loading On Postoperative Nausea And Vomiting: An Integrative Review, Jennifer Meyer

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

Background: Postoperative nausea and vomiting (PONV) is a very common problem among surgical patients. Despite improved methods of risk identification, the incidence of PONV remains as high as 20-40%. It can increase hospital length of stay and greatly reduce patient satisfaction. The purpose of this integrative review is to examine the effects of both oral and IV preoperative carbohydrate loading on the incidence of postoperative nausea and vomiting in surgical patients. Methods: A review the literature was completed by searching for the terms related to preoperative carbohydrate loading and PONV. Results: Twenty studies met the criteria and were analyzed for …

Iv Ketamine Infusions For The Treatment Of Depression: An Evidence Based Practice Analysis, Sergio A. Quinones

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

According to the World Health Organization, major depressive disorder (MDD) is a mental health condition which affects a significant portion of the worldwide population and is projected to become the leading cause of disability by 2020. There are several treatment options for the diagnosis of depression, with the most popular being antidepressant drugs such as the selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs); and electroconvulsive therapy (ECT). The significant drawbacks to the current treatments are the extended timeframe required for drugs to reach therapeutic efficacy and resistance to ECT over time. These disadvantages can lead to increased risk …

The Use Of Spontaneous Vs. Pressure Support Ventilation With A Laryngeal Mask Airway: An Integrative Review, Jordan Brink

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

Objective: The aim of this integrative review is to provide current evidence along with recommendations for practice regarding the effects of spontaneous and pressure support ventilation with the use of a Laryngeal Mask Airway (LMA)in the adult population. Emphasis has been placed on the incidence of leak and gastric insufflation and the impact ventilation holds on the perioperative period.

Methods: A search of the electronic databases CINAHL complete, PubMed, Scopus, Google Scholar, and Cochrane Library was performed. Thirteen articles published from 1994-2022 were critically appraised for reliability.

Results and Conclusion: Evidence suggests that the use of pressure support ventilation, inclusive …

The Perceived Levels Of Stress And Anxiety In Student Nurse Anesthetists During A Pandemic: A Descriptive Cross-Sectional Study, Bryant A. Gaudreau

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

Background and Significance: Limited research exists regarding Student Registered Nurse Anesthetists' (SRNAs') perceptions of stress and anxiety during a pandemic such as the COVID-19 outbreak. Clinical effects of stress and anxiety have been shown to be detrimental to the active learning process in students.

Purpose: To explore the differences in stress and anxiety among three different cohorts of SRNAs in a nurse anesthesia program during the COVID-19 pandemic.

Methods: Purposive sampling was utilized to select SRNAs who were full-time second or third-year nurse anesthesia students from a Midwestern nurse anesthesia program actively enrolled during the COVID-19 pandemic. Surveys were sent …

Efficacy Of Chlorhexidine Versus Listerine Perioperative Mouthwash In Preventing Ventilator-Acquired Pneumonia: An Integrative Review, James Owen Clements

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

Objective: To compare the safety and efficacy of chlorhexidine versus Listerine in perioperative and intensive care settings in preventing ventilator-acquired pneumonia (VAP).

Methods: An integrative review using a keyword search was conducted in Cochrane, Cinahl, and Google Scholar databases. Data was collected regarding the efficacy of chlorhexidine and Listerine in preventing ventilator-acquired pneumonia, safety and side effect profiles, and in vivoin vitro secondary outcome measures.

Results: Chlorhexidine demonstrates superiority to Listerine in reducing ventilator-acquired pneumonia. Secondary in vivo tests including plaque and gingivitis reduction, and in vitro tests measuring the effect on bacterial loads, also favors chlorhexidine over Listerine. …

Conventional Epidural Versus Dural Puncture Epidural For Labor Analgesia: An Evidence Based Practice Analysis, Andee Pauley

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

Purpose Statement: The purpose of this evidence based practice analysis (EBPA) is to provide evidence-based recommendations for lumbar epidural techniques for labor analgesia in adult women in active labor (parturients) with uncomplicated pregnancy.

Methodology: A population, intervention, comparison, and outcome (PICO) question was established to guide a review of the current literature. The PICO question used to afford structure and direct analysis was: In (P) adult women in active labor with uncomplicated pregnancy, what is the effect of (D) dural puncture epidural (C) compared to conventional epidural on (O) time to adequate analgesia, presence of asymmetric block and incidence of …

Ondansetron Administration Prior To Subarachnoid Block In Cesarean Section: An Evidence Based Practice Analysis, Jeremy Bustamante

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

Subarachnoid block (SAB) is a preferred regional technique utilized by many institutions for caesarean section. A sensory block height of T5 is necessary for a successful caesarean under SAB. Unfortunately, side effects often emerge related to the physiological changes as a result of sympathetic nervous system inhibition. Current research suggests up to 55%-90% of parturients experience extended block height resulting in hypotension and bradycardia.There is a reduction in cardiac output due to a decrease in systemic vascular resistance and venous pooling. Similarly, the shift of cardiac autonomic balance toward parasympathetic stimulation causes bradycardia and activation of left ventricular mechanoreceptors due …

The Efficacy Of Using Dexmedetomidine Compared To Midazolam In Pediatric Anesthesia: An Integrative Review, Megan Gangwish

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 a practice recommendation for the administration of dexmedetomidine versus midazolam in the pediatric population prior to undergoing anesthesia. Methods: Articles published from 2011-2018 were critically evaluated for their validity, reliability, and rigor of study. Articles were selected based on study designs and methods that assisted in answering the guided research questions. Results: The efficacy of preoperative dexmedetomidine and midazolam were compared in pediatrics. The initial search using keywords yielded 163 articles. Articles were chosen based on their relevance. Common variables within studies were chosen to examine and data …

Efficacy Of Pre-Procedural Ultrasound In Facilitating Neuraxial Anesthetics: An Integrative Review, Jonathan Brinser

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

The purpose of this integrative review is to investigate the efficacy of pre-procedural ultrasound examination to facilitate neuraxial anesthesia techniques and its impact on first attempt success rates, number of attempts required, and duration of procedure. A literature review was performed to obtain current research involving the use of ultrasound for neuraxial anesthesia. Fourteen randomized-control trials (RCT) met criteria and were included in this review. Six RCTs demonstrate significant increases in first attempt success rates and four RCTs suggest no significant difference in the first attempt success rate when ultrasound is utilized for neuraxial anesthesia techniques. Ten of the RCTs …

Prioritizing Wellness In A Multi-Site New Graduate Nurse Residency Program, Andrea Wilkins Howard, Kristie Richardson, Abby Jones, Julianne Rella, Amalia Acevedo-Sanic, Klaria Turnbull, Halea Caudill, James C. Gay, Sophia Bannis, Jennifer Fruitticher, Amy Ross, Belinda Chambers, Stephanie Robinson, Catherine Palmer

Group: American Nurses Credentialing Center (ANCC)

New Graduate Registered Nurse (NGRN) burn-out is an increasing, but not well studied phenomena (Xie et al., 2021). Purpose: The purpose of the study is to determine if prioritizing wellness in a newly built, multi-site,12-month, nurse residency program will increase retention and decrease early NGRN burn-out. Relevance: Nurse wellbeing is imperative to address. The pandemic has shown addressing mental health in all workplaces is necessary, but in healthcare this is especially true. NGRN do not have the tools to properly care for themselves and need ongoing, evolving and varied strategies to be effective. Strategy: The site is a fifteen-hospital healthcare …

Cauti Path To Zero: A Triple-Pronged Approach To Minding Our Pees And Cues, Stephanie Huckaby

Group: American Nurses Credentialing Center (ANCC)

Successful reduction of Catheter Associated Urinary Tract Infections (CAUTIs) is a transdisciplinary effort requiring consistent attention. The goal of this project was to use evidence to implement strategies to reduce CAUTIs in a large academic medical center hospitals.

The results of this EBP project demonstrated a 34% decrease from 2017 to 2018 in CAUTI events. The SIR was decreased from .975 (460 bed hospital) and 1.22 (150 bed hospital) to 0.753 and 0.445, respectively to meet the goal for 2018. The 2019 year to date is on track to meet the goal of 0.74 SIR. The utilization rates decreased by …

Innovative Residency Strategies For Transitioning To Practice New Graduate Nurses, Barbara Patterson

Group: American Nurses Credentialing Center (ANCC)

The purpose of this study is to stimulate change in how new registered nurses are trained and transitioned from their academic preparation to the workforce. Through specific individualized learning modalities which support evidenced based practice and enhance the application of knowledge learned.

Multi-Site Research Playbook: A Practical Guide To Support Multi-Site Research Studies For Greater Impact, Maria Shirey, Jen Bonamer, Sean Clarke, Sheila Haas, Catherine Ivory, Simon Kitto, David Price, Marianne Weiss, Olga Yakusheva, Kathy Chappell, Meg Johantgen

Group: American Nurses Credentialing Center (ANCC)

Rigorous, high-quality nursing research creates an evidence base that advances nursing practice, shapes health policy, and contributes to improving nurse, patient, and system outcomes. Yet, too often, nurse researchers conduct studies that are narrow in scope, underpowered, or lack elements such as a comparison group, thereby limiting generalizability of results and application in practice. Multi-site studies offer the opportunity to increase the rigor of research and the generalizability of findings.

Multi-site studies leverage the power of Magnet® and other research-engaged nursing organizations to conduct research across multiple units and settings. Options for research designs are expanded with larger and more …

Sip And Paint: The Art Of Well-Being, King Simmy, Kristi Myers

Group: American Nurses Credentialing Center (ANCC)

The complexity of the nurse's work is challenging and has an impact on an individual's emotional and physical health, impacting well-being. Arts programing for healthcare providers offers an opportunity for creativity and self-expression that allows them to integrate their experiences and emotions instead of carrying them into their workplace or home (State of the Field Committee, 2009). Art can also enhance healthcare clinicians' mental health and well-being, reducing stress, awakening creativity, and increasing a sense of community.

Medication Safety: Bolus From The Bag, Patricia Giovannini, Diane Melrose

Group: American Nurses Credentialing Center (ANCC)

This poster presents a process improvement project that was implemented leveraging current IV pump technology to standardize safe medication administration through calculation support of boluses given from the infusing bag. The electronic medical record (EMR) had not supported documentation of this safe practice, leading to variation in practice.

Learning Outcomes:

• Discuss how current technology can be leveraged to assist with error reduction within a hospital environment
• Review how a multidisciplinary team worked together to improve patient safety surrounding IV medication administration
• Identify cost and efficiency savings related to bolusing medication from a running infusion bag

Adding The Patient's Perspective To Hand Cleaning Compliance, Barbara Arnold, Cynthia James

Group: American Nurses Credentialing Center (ANCC)

The aim of this project is to improve hand cleaning compliance rates of HCPs by adding the patient's perspective to the multi-modal hand cleaning practices. Patients' views and opinions are usually not included in these initiatives but could help to reduce HAIs by adding another layer of monitoring.

Better Together - Nurse Residency Collaborative Council, Kelly La Frentz, Heather Wallace

Group: American Nurses Credentialing Center (ANCC)

Hospitals across the United States are competing for top talent and newly graduated nurses want to be granted a spot in a transition to practice program (TTP). How can the needs of both the hospital and graduate nurse be met? A panel of TTP coordinators from multiple institutions within the Houston/Galveston area were invited to discuss and share about their programs at a local Association for Nursing Professional Development (ANPD) meeting. Through this interaction, the TTP coordinators recognized that they were facing similar issues and trends in their programs and desired an external support system. This recognition helped guide the …

Marco...Polo: Real Time Location, Mady Hirsch, Emily Kite, Kerigan Mcdonald, Abbi Zanger

Group: Blessing-Rieman College of Nursing and Health Sciences

Implementation of Real-Time Location Systems for senior leadership nursing students. Real-Time Location Systems help locate students and ensure safety.

Effect Of A Hand Hygiene Compliance System, Charlotte Horman, Aleassa Hruska, Claudia King, Lori Leathers

Group: Blessing-Rieman College of Nursing and Health Sciences

In critical care patients, how does tracking hand hygiene by using BioVigil as opposed to not tracking hand hygiene affect hospital acquired infrection rates?

Reducing Medication Administration Errors, Kealey Atkinson, Allison Coonrod, Addison Martin, Taylor Knuffman

Group: Blessing-Rieman College of Nursing and Health Sciences

Would medication administration errors be reduced with adequate nursing staff and through performing multiple safety checks prior to and during medication administration in the clinical setting?

Animal-Assisted Therapy And Mental Health, Brianna Butler, Cade Cameron, Elizabeth Talley

Group: Blessing-Rieman College of Nursing and Health Sciences

In oncology patients, how does animal-assisted therapy affect their mental health compared to no animal intervention, in conjuction with other treatments?

You Narcan Save Lives, Erin Miller, Tanya Moore, Abbigale Daughtery, Brianne Shaffer

Group: Blessing-Rieman College of Nursing and Health Sciences

Allow Blessed Beginnings (BB) at Blessing Hospital (BH) the use and access of naloxone (Narcan) to be distributed and available to postpartum women at risk for opioid addiction.

Exercise And The Menstrual Cycle, Jena Craig, Peri Ehmen, Kayli Harshman, Brooke Walbring

Group: Blessing-Rieman College of Nursing and Health Sciences

Does adding physical activity, in comparison to inactivity, throughout the menstrual cycle result in a decrease in PMS symptoms in females that have reported experiencing PMS?

Caring Cupboard Ii: Revamped, Megan Boschert, Andrew Hardy, Cameron Morford

Group: Blessing-Rieman College of Nursing and Health Sciences

The purpose of this project is the movement of Caring Cupboard (CC) to increase student use/decrease food insecurity.

Pain Control Methods In Perioperative Patients, Emily Owens, Sara Pate, Paige Phelps

Group: Blessing-Rieman College of Nursing and Health Sciences

In perioperative patients, nonpharmacological and non-opioid methods may result in adequate pain control and less adverse effects than opioids.