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Full-Text Articles in Medicine and Health Sciences

General Anesthetic Induction Sequence High Fidelity Simulation: Determining Efficacy Among Novice Student Registered Nurse Anesthetists, Alex Wilkie, Steven Urbick, Kenn B Daratha Aug 2019

General Anesthetic Induction Sequence High Fidelity Simulation: Determining Efficacy Among Novice Student Registered Nurse Anesthetists, Alex Wilkie, Steven Urbick, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background High Fidelity Simulation (HFS) is used across multiple health professions. Despite the wide variety of clinical experiences that Student Registered Nurse Anesthetists (SRNA) possess prior to training, the induction sequence to a General Anesthetic (GA) is a daunting task. Although the efficacy of HFS has been widely studied within undergraduate nursing programs, there are no studies published determining the efficacy of HFS on SRNA training. The purpose of this study was to determine the efficacy of simulation training amongst entry-level SRNA’s and examine any individual participant factors that may influence clinical performance within HFS.

Methods • Human subjects were …


Comparisons Of Preoperative Blood Pressures In Surgical Patients, Brian Stacy, Kenn B Daratha Aug 2019

Comparisons Of Preoperative Blood Pressures In Surgical Patients, Brian Stacy, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Surgical patients expect anesthesia providers to provide high quality care. Blood pressure variability must be mitigated by establishing the patient’s blood pressure baseline and sustaining it through surgery. A consensus has not been established on which blood pressure measurement should be used as the patient’s baseline. Blood pressures before surgery in multiple care settings have been shown to vary. This may result in differences in drug and fluid administration, depending on the blood pressure considered baseline by the anesthesia provider. The purpose of this observational evidence-based practice project was to compare mean blood pressures leading up to surgery among …


Comparison Of Ondansetron, Dexamethasone, And Its Combination In The Prevention Of Postoperative Nausea And Vomiting, Alina Palanchuk, Kenn B Daratha Aug 2019

Comparison Of Ondansetron, Dexamethasone, And Its Combination In The Prevention Of Postoperative Nausea And Vomiting, Alina Palanchuk, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative nausea and vomiting remains a common and unpleasant side effect for patients following surgery. Uncontrolled PONV can result in prolonged hospital stays, unanticipated hospital readmissions, and decreased patient satisfaction. The Apfel score identifies and counts independent risk factors for PONV; females, non-smokers, postoperative opioid use, and history of PONV or motion sickness. Rates of PONV increases as the number of risk factors increase. The primary intervention to decrease PONV is administration of prophylactic antiemetics. Research supports the use of combination antiemetic therapy for patients with a high number of risk factors. The purpose of this evidence based practice …


Intraoperative Hypotension In Non-Cardiac Surgery Patients At Providence Sacred Heart Medical Center, Genna Ledrew, Kenn B Daratha Aug 2019

Intraoperative Hypotension In Non-Cardiac Surgery Patients At Providence Sacred Heart Medical Center, Genna Ledrew, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Intraoperative Hypotension (IOH) during non-cardiac surgery is a common side effect of anesthesia that is associated with acute kidney injury (AKI), myocardial injury (MI), mortality, and other adverse outcomes1,3,4. These risks increase as the duration and severity of IOH exposure increase3,4. Blood pressure is a modifiable risk factor of mortality and organ damage that can be readily treated by the anesthesia provider2 . Limiting IOH can improve patient outcomes and produce monetary savings5 . The objective of this project is to report the incidence of IOH at a large tertiary teaching hospital, and extrapolate the risks of mortality and …


Hyperoxia: Current Practice Of Oxygen Delivery During General Anesthesia, Christa Kirby, Kenn B Daratha Aug 2019

Hyperoxia: Current Practice Of Oxygen Delivery During General Anesthesia, Christa Kirby, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background While supplemental oxygen is routinely administered during anesthesia to prevent oxygen desaturation and optimize tissue oxygenation, oxygen delivery practices after intubation are largely unknown. Compiled evidence suggests limiting intraoperative fraction of inspired oxygen (FiO2) to below 60%. The deleterious effects of hyperoxia and the mortality benefit of conservative oxygen administration are being demonstrated in contemporary critical care literature. The lack of consensus guidelines and high level evidence on the topic of intraoperative oxygen delivery begs the question to what degree are patients being exposed to hyperoxia during general anesthesia. The purpose of this evidence-based practice project was to better …


Ultrasound Simulation For Regional Anesthesia, Kayla Brown, Kenn B Daratha Aug 2019

Ultrasound Simulation For Regional Anesthesia, Kayla Brown, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Regional anesthesia is an essential skill in the practice of Nurse Anesthesia, and future employment demands expertise. Literature supports the addition of simulation training to existing didactic and apprenticeship education to improve clinical expertise. The purpose of this project was to trial simulation training, focused on anatomical visualization with ultrasound for regional anesthesia, as a means to improve student performance and confidence.

Methods • Facility project approval and exemption determination by IRB. • Hands-On Test: Ultrasound to obtain visualization for axillary (cohort 1), interscalene (cohort 2) block on live-model. Expert CRNA observed performance to determine if image was clinically …


Intraoperative Opioid Administration Among Cancer Patients, Amanda Barrett, Kenn B Daratha Aug 2019

Intraoperative Opioid Administration Among Cancer Patients, Amanda Barrett, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cancer prevalence continues to rise. In vitro and in vivo studies have demonstrated that opioid receptor agonists may be associated with poor outcomes for cancer patients. Laboratory studies have shown that opioids cause immunosuppression; tumor cell progression, recurrence and metastasis. The surgical environment further decreases immune function, causes an inflammatory response and promotes cancer cell mobilization. Anesthesia providers are in a unique position to influence postoperative outcomes. Opioid free anesthetic delivery is a growing trend amongst anesthesia providers and is supported by the literature. The purpose of this project is to compare intraoperative opioid administration rates for patients with …


Sugammadex Versus Neostigmine: Operating Room Time And Cost, Annie Benscheidt, Kenn B Daratha Aug 2019

Sugammadex Versus Neostigmine: Operating Room Time And Cost, Annie Benscheidt, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The choice of neuromuscular blockade reversal agents impacts cost and operating room time. Currently, the two medications used to reverse neuromuscular blockade are Neostigmine and Sugammadex. These medications differ in both cost and pharmacologic profiles which effect the time and predictability of reversal (Carron, Zarantonello, Tellaroli, & Ori, 2016). Evaluating cost and time differences in reversal using Sugammadex and Neostigmine helps anesthesia providers select the appropriate medication. This evidence based practice project examined the difference in case length and operating room and reversal agent costs in cases using Sugammadex and Neostigmine at Providence Sacred Heart Medical Center.

Methods • …


Teaching Medical Students Optimal Consulting Skills: The Challenge Of Generating Better Referring Physicians., Andrew W Phillips, Terence Potter, Brittany Z Dashevsky, Nicholas Masse, Brent Greenberg, Christopher M Straus Jul 2019

Teaching Medical Students Optimal Consulting Skills: The Challenge Of Generating Better Referring Physicians., Andrew W Phillips, Terence Potter, Brittany Z Dashevsky, Nicholas Masse, Brent Greenberg, Christopher M Straus

Articles, Abstracts, and Reports

Rationale and objectives We sought to incorporate a new teaching module into the traditional medical student radiology clerkship, to improve the necessary skills for future referring physicians. Materials and methods A new required and graded module was introduced in 2014 into the radiology clerkship in year three of medical school: the Mystery Case. Each student was provided a unique and undifferentiated case from a dedicated teaching file containing de-identified images and requisition data. Students were expected to complete three serial tasks over one week: 1) prepare a voice recognition-derived, structured radiological report utilizing appropriate and relevant vocabulary; 2) discuss pertinent …


Critical Incident Stress Management: Care For Our Caregivers, Linda Winston, Mft, Ceap Mar 2019

Critical Incident Stress Management: Care For Our Caregivers, Linda Winston, Mft, Ceap

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Marijuana; Types & Effects, Ernst Rasyidi, Md Mar 2019

Marijuana; Types & Effects, Ernst Rasyidi, Md

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Understanding The Transgender Patient, Hudson Tibbetts, Msn, Rn Mar 2019

Understanding The Transgender Patient, Hudson Tibbetts, Msn, Rn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Use Of Aroma Oils With Geriatric Patients In An Acute Care Setting, Aubreylynne Abiva Porras, Msn, Rn, Kim Rosillo, Msn, Rn, Pccn-K, Mary Wickman, Phd, Rn, Elizabeth Winokur Mar 2019

Use Of Aroma Oils With Geriatric Patients In An Acute Care Setting, Aubreylynne Abiva Porras, Msn, Rn, Kim Rosillo, Msn, Rn, Pccn-K, Mary Wickman, Phd, Rn, Elizabeth Winokur

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Ob Triage: An Ebp Project, Jessica Laske Msn, Rn, Rnc-Ob, Lindsay Brill, Rn, Paula Ghassan Rn, Maria Guzman Rn, Gaby Tyapak Rn, Susan Dragoo Dnp, Rnc-Ob, Whnp, Deirdre Degenaar Msn, Rn, Whnp, Mary Harmon Msn, Rn, Whnp, Ellie Saddady Msn, Rn, Whnp Mar 2019

Ob Triage: An Ebp Project, Jessica Laske Msn, Rn, Rnc-Ob, Lindsay Brill, Rn, Paula Ghassan Rn, Maria Guzman Rn, Gaby Tyapak Rn, Susan Dragoo Dnp, Rnc-Ob, Whnp, Deirdre Degenaar Msn, Rn, Whnp, Mary Harmon Msn, Rn, Whnp, Ellie Saddady Msn, Rn, Whnp

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Identifying High Risk Patients Outside Of The Intensive Care Unit Using An Early Warning System, Leslie Farrington Mar 2019

Identifying High Risk Patients Outside Of The Intensive Care Unit Using An Early Warning System, Leslie Farrington

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Are Two Mentors Better Than One? Formalizing Mentoring In The Critical Care Setting, Rebecca Mauzey Rn, Bsn, Ccrn Mar 2019

Are Two Mentors Better Than One? Formalizing Mentoring In The Critical Care Setting, Rebecca Mauzey Rn, Bsn, Ccrn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Decreasing Hospital Readmissions With Lace-Driven Interventions, Richard Urgel, Bsn, Rn, Cmsrn Mar 2019

Decreasing Hospital Readmissions With Lace-Driven Interventions, Richard Urgel, Bsn, Rn, Cmsrn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Transgender Health Care Needs: Can We Improve The Care Of Our Lgbtqia Patient Population?, Christine Marshall, Rn, Msn, Cen, Cn Iv Mar 2019

Transgender Health Care Needs: Can We Improve The Care Of Our Lgbtqia Patient Population?, Christine Marshall, Rn, Msn, Cen, Cn Iv

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Implementation Of Routine Foot Assessment In The Adult Hemodialysis Population: An Evidence Based Approach To Improved Outcomes, Rachna Thakur Bsn, Rn, Cnn, Jose Loyola Bsn, Cdn, Renal Center Ubc Mar 2019

Implementation Of Routine Foot Assessment In The Adult Hemodialysis Population: An Evidence Based Approach To Improved Outcomes, Rachna Thakur Bsn, Rn, Cnn, Jose Loyola Bsn, Cdn, Renal Center Ubc

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Improving Staff Well-Being On A Telemetry Unit, Adriana Velez Msn, Rn, Cn Iii, Pccn, Atc, Elizabeth J. Winokur Phd, Rn, Cen;, Kim Rossillo, Msn, Rn, Pccn-K, Krissy Maurin, Ms, Atc Mar 2019

Improving Staff Well-Being On A Telemetry Unit, Adriana Velez Msn, Rn, Cn Iii, Pccn, Atc, Elizabeth J. Winokur Phd, Rn, Cen;, Kim Rossillo, Msn, Rn, Pccn-K, Krissy Maurin, Ms, Atc

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Needs Assessment: Driving Oncological Emergency Education, Stephanie Boncheff, Bsn, Rn, Ocn, Cn Iv, Christina Delannoy, Bsn, Rn, Ocn, Cn Iii, Susan Hampton-Ash, Msn, Rn, Cn Iii,, Denise Boyd, Msn, Rn, Ocn Mar 2019

Needs Assessment: Driving Oncological Emergency Education, Stephanie Boncheff, Bsn, Rn, Ocn, Cn Iv, Christina Delannoy, Bsn, Rn, Ocn, Cn Iii, Susan Hampton-Ash, Msn, Rn, Cn Iii,, Denise Boyd, Msn, Rn, Ocn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Bringing Evidence To The Bedside: An Ed-Based Research / Ebp Council, Belinda N. Leos, Msn, Rn, Cen, Elizabeth J. Winokur, Phd, Rn, Cen, Christiane Pepitone, Bsn, Rn, Cen, C.J. Pfeiffer, Msn, Rn, Cen Mar 2019

Bringing Evidence To The Bedside: An Ed-Based Research / Ebp Council, Belinda N. Leos, Msn, Rn, Cen, Elizabeth J. Winokur, Phd, Rn, Cen, Christiane Pepitone, Bsn, Rn, Cen, C.J. Pfeiffer, Msn, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Enhanced Recovery Program: General Surgery Department, Jacoba Walsh, Rn, Bsn, Pccn-K, Darleen Nguyen, Rn, Bsn, Cn Iii, Cmsrn, Cassie Cecil Rn, Bsn, Cn Ii Mar 2019

Enhanced Recovery Program: General Surgery Department, Jacoba Walsh, Rn, Bsn, Pccn-K, Darleen Nguyen, Rn, Bsn, Cn Iii, Cmsrn, Cassie Cecil Rn, Bsn, Cn Ii

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Implementing A Personal Comfort Menu In An Observation Unit, Sharon Verona Rn, Bsn, Cmsrn, Leila Balete Rn, Bsn, Cmsrn, Karee Chrysovergis Rn, Msn, Amy Hayes, Rn, Msn, Pccn-K Mar 2019

Implementing A Personal Comfort Menu In An Observation Unit, Sharon Verona Rn, Bsn, Cmsrn, Leila Balete Rn, Bsn, Cmsrn, Karee Chrysovergis Rn, Msn, Amy Hayes, Rn, Msn, Pccn-K

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Assessing The Risk Of Falls In The Elderly In The Emergency Care Center: How Does An Rn Administered 2-Question Survey Compare With A Patient Perception 3-Question Survey In Predicting Fall Risk?, Dixie Stiles, Rn, Msn, Fnp-Bc, Gnp-Bc, Cen, Ccrn, Cn Iv Mar 2019

Assessing The Risk Of Falls In The Elderly In The Emergency Care Center: How Does An Rn Administered 2-Question Survey Compare With A Patient Perception 3-Question Survey In Predicting Fall Risk?, Dixie Stiles, Rn, Msn, Fnp-Bc, Gnp-Bc, Cen, Ccrn, Cn Iv

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Heart Failure (Hf) Nurse Navigator Program Interventions Decrease Hf Readmission Rates, Aileen Ingles Mar 2019

Heart Failure (Hf) Nurse Navigator Program Interventions Decrease Hf Readmission Rates, Aileen Ingles

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Human Trafficking: Educational Essentials For Staff: Identifying & Caring For A Vulnerable Population In The Emergency Care Center (Ecc), Laura Derr, Rn, Cen, Cn Iv Mar 2019

Human Trafficking: Educational Essentials For Staff: Identifying & Caring For A Vulnerable Population In The Emergency Care Center (Ecc), Laura Derr, Rn, Cen, Cn Iv

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Let’S Move That Body: Progressive Early Mobility In A Step-Down Unit, Joan Aquino, Rn, Bsn, Ccrn, Cn Iv, Diana Sanches, Rn, Bsn, Pccn Mar 2019

Let’S Move That Body: Progressive Early Mobility In A Step-Down Unit, Joan Aquino, Rn, Bsn, Ccrn, Cn Iv, Diana Sanches, Rn, Bsn, Pccn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Effects Of Transport On Oral Temperature Of Post-Surgical Patient Transported From Pacu To Nursing Units, Kathy Dureault, Msn, Rn, Cpan, Susan Violette, Bsn, Rn, Cpan, Lauren Langer, Cna Mar 2019

Effects Of Transport On Oral Temperature Of Post-Surgical Patient Transported From Pacu To Nursing Units, Kathy Dureault, Msn, Rn, Cpan, Susan Violette, Bsn, Rn, Cpan, Lauren Langer, Cna

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.


Early Nutritional Interventions For Patients At Risk For Malnutrition, Connie Lin, Bsn, Rn, Ccrn, Cecille Lamorena Bsn, Rn, Ccrn, Shadid Hayat, Md, Beth Asano, Rd, Rhonda Farkas, Ms, Rd, Linda Boose-Shutes, Bsn, Rn, Ccrn, Gemma Seidl, Msn, Rn, Mph Phn, Cara Buenaventura, Msn, Rn, Ccrn, Denise Beck, Msn, Rn, Lynn Tamanaha, Lisa Evans, Dnp, Acnp-Bc, Juliet Vapel-Phillips, Msn, Rn, Ccrn Mar 2019

Early Nutritional Interventions For Patients At Risk For Malnutrition, Connie Lin, Bsn, Rn, Ccrn, Cecille Lamorena Bsn, Rn, Ccrn, Shadid Hayat, Md, Beth Asano, Rd, Rhonda Farkas, Ms, Rd, Linda Boose-Shutes, Bsn, Rn, Ccrn, Gemma Seidl, Msn, Rn, Mph Phn, Cara Buenaventura, Msn, Rn, Ccrn, Denise Beck, Msn, Rn, Lynn Tamanaha, Lisa Evans, Dnp, Acnp-Bc, Juliet Vapel-Phillips, Msn, Rn, Ccrn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.