Medicine and Health Sciences Commons^™

Traits Of Character That Facilitate Formation Of Exemplary Nurses In Bachelor Of Science Nursing Programs, Jean Marks

Dissertations

Constructivist grounded theory methods were applied in this study to explore traits of character that facilitate the formation of exemplary nurses in Bachelor of Science Nursing (BSN) programs. Interest in this study was prompted by a desire to examine attributes beyond academics alone that contribute to the formation of excellent nurses. The intent was to promote clarity in describing these attributes for further scholarly discussion.

Framing this study was Aristotle’s doctrine of the golden mean (Aristotle, 350 B.C.E./1934). Operational definitions consistent with this doctrine were created for the concepts of character, character traits, and exemplary nursing practice. The concept …

Childbirth And Control Behind Bars: A Descriptive Qualitative Analysis Of The Maternal Perception Of Control In Women Who Have Given Birth While Incarcerated, Lorin Raines

Dissertations

The perception of control during childbirth has been widely studied in various setting and groups. Many factors have been found to aid or impede the perception of control for birthing women. Significance of that perception of control during childbirth has also been measured in past studies. This descriptive qualitative study advances the knowledge of the perception of control during childbirth and examines a population that has thus far been excluded. Four previously incarcerated women participated in semi-structured interviews about their experience of giving birth while incarcerated and their perception of control during that time. The women were from diverse backgrounds …

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre

Doctoral Projects

Developing interdisciplinary teamwork and patient communication skills are essential for the student registered nurse anesthetist (SRNA) to provide quality patient care when administering epidural anesthesia. The synthesis of the evidence revealed limited available information on simulation use for SRNA epidural administration and collaboration. This doctoral project examined the effectiveness of learning through traditional simulation to enhance communication and collaboration between the Bachelor of Science in Nursing (BSN) and the Nurse Anesthesia Program (NAP) students. The BSN and NAP students were provided with a simulation environment to care for a laboring patient while improving patient safety and quality outcomes. The project …

Cultural Competence Objective Structured Clinical Examination For Student Nurse Anesthetists, Ashley Nicole Minor, Loryn Elise Jamison

Doctoral Projects

The landscape of ethnicity is growing increasingly diverse. In 2017, the U.S. Census Bureau estimated that by the time the 2020 Census is conducted, over half of the nation’s children will be of a minority group (U.S. Census Bureau, 2017). With this evolution in cultural variety comes a necessity to incorporate exposure and training of cultural competency into professional health programs. Student registered nurse anesthetists (SRNAs) are a key demographic to professional growth within the realms of cultural competence as related to the field of nurse anesthesia. Along with clinical skills and advanced knowledge, cultural competence should be equally developed. …

A Best Practice Recommendation: Decreasing Perioperative Fentanyl Used Through The Utilization Of Dexmedetomidine Prior To Surgical Incision, Shelby Harriel, Amy Houck

Doctoral Projects

Upon anesthesia induction, patients often receive fentanyl, an opioid medication that is linked to addiction, dependence, morbidity, and mortality (Stanley, 2014). The goal of this practice recommendation was to propose an alternative way of managing pain and the increased sympathetic response in the perioperative setting, specifically during the induction phase, through evaluating published research. A possible substitute for fentanyl is a drug called dexmedetomidine (Precedex™). Through a comparison of pharmacology, indications, risks, and benefits, one can conclude that if Precedex™ is given prior to induction, in the place of large doses of fentanyl, it can potentially achieve a smoother intraoperative …

Improving Door To Transfer Times For St Segment Elevation Myocardial Infarction In Small Emergency Departments: A Quality Performance Improvement Project, Amber Ryals

Doctoral Projects

Heart disease is a leading cause of death in the United States (Centers for Disease Control [CDC], 2020). ST-elevation myocardial infarctions are around 38% of all coronary syndrome patients that present to the emergency department (Akbar et al., 2020). Smaller, outlying facilities can be at a disadvantage due to the lack of readily available specialties and services, such as a cardiac catheterization laboratory, which has the potential to cause a delay in inpatient care. With standardized cardiac protocols in place at many facilities, initial identification and treatment of myocardial infarctions are begun long before a patient enters a facility, often …

Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper

Doctoral Projects

Healthcare-associated infections are not a new concept in health care. Many different health-care-associated infections have been established over the years including but not limited to healthcare-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bacterial infection. While these infections are common in healthcare facilities, the rates of these infections are still prevalent in hospitals across the United States. This DNP project focused on central line-associated bacterial infections.

An interdisciplinary team checklist to assess readiness for appropriate medical removal of central venous catheter (CVC) was developed to assess intensive care unit patients for early appropriate medical CVC removal. The interdisciplinary team …

Educating Student Registered Nurse Anesthetist On Malignant Hyperthermia Using An Objective Structured Clinical Examination, Ednita Street Fountain, Faith Sherman

Doctoral Projects

Malignant hyperthermia (MH) is a low-frequency, high-impact event that many student registered nurse anesthetists (SRNA) may be unprepared to manage due to limited exposure in clinical practice (Hackl et al., 1990). Lack of preparation for dealing with such low frequency, high impact events can lead to unfortunate adverse events resulting in death (Hackl et al., 1990). Thus, students should be are prepared to handle these situations if an event should occur.

An objective structured clinical examination (OSCE) is a structured method used to assess certain skills and underpinning knowledge required for practice (Harden & Gleeson, 1979). Students are allowed to …

Ultrasound-Guided Peripheral Venous Access: An Objective Structured Clinical Examination (Osce), Christopher Smith

Doctoral Projects

Intravenous (IV) access is essential to anesthetic practice as it allows the provider to administer fluids, sedative agents, and resuscitation medications. There is, however, a large subset of patients in which IV access can be difficult to obtain due to confounding factors such as preexisting disease, body habitus, and volume status (Sabado & Pittiruti, 2019). Bedside ultrasonography is an effective tool that can be used to gain IV access in these difficult patient populations. The downside to this technology is that there is a learning curve associated with its use, and proper training in ultrasound-guided venous access techniques is crucial …

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who …

Implementing A Practice Strategy In Primary Care Using An Assessment Tool To Screen For Depression, Donna Snow

Doctoral Projects

Increased efforts are being made to move individuals with co-morbid medical and psychiatric diagnoses toward integrated care. Lack of consistent screening in primary care has caused missed opportunities to identify depression during a routine healthcare provider visit. This project sought to implement a practice strategy in primary care using an assessment tool to screen for depression. Interviews were used to ask patients to answer two questions related to the frequency of depressed mood in the last two weeks. The project was seeking to show by screening patients in primary care for depression, the number of referrals to behavioral health would …

Improving Medication Adherence In African American Adult Females With Hypertension, Donald Welch

Doctoral Projects

The World Health Organization (WHO) reported that adherence among patients with chronic diseases averages nearly 50% in developed countries (Lam & Fresco, 2015). Medication non-adherence is recognized as a significant public health issue that leads to poor health outcomes and added healthcare costs. Multiple African American adult females with hypertension have a high prevalence of non-adhering to their treatment plan. Numerous factors lead to poor medication adherence, including socioeconomic factors, therapy-related factors, patients-related factors, condition-related factors, and health system/healthcare team-related factors (Lam & Fresco, 2015). Medication adherence can lead to a decreased risk of adverse outcomes such as stroke and …

Assessment Of Intrapartum Nurses' Beliefs Related To Birth Practices, Janice Scaggs

Doctoral Projects

Intrapartum nurses’ beliefs influence nursing behavior and nursing interventions during labor and birth. Assessing these beliefs in a regional hospital in the Southeastern United States was the focus of the doctoral project. Before the project, there was no objective data that assessed individual nurse’s beliefs and birth practices in the labor and delivery unit, or among the nursing staff as a whole. A knowledge gap existed in understanding if the nursing culture valued, promoted, and supported intended vaginal birth. Nursing leadership recognized that the overall cesarean birth rate and primary cesarean birth rate in the hospital were similar to State …