Medicine and Health Sciences Commons^™

Evaluating The Effectiveness Of Simulation-Based Education Of Venous Gas Embolism On Novice Nurse Anesthesia Trainees, Angelica Rejczak, Jenna Fitzpatrick

College of Science and Health Theses and Dissertations

Background: Simulation-based education is a learning modality utilized in healthcare curriculum among nurse anesthesia trainees (NATs) for crisis management training. This learning modality may improve confidence and knowledge in novice NATs responding to a crisis scenario, such as a venous gas embolism (VGE).

Purpose: Evaluate the effectiveness of simulation-based education in effectively managing a crisis scenario, VGE, as measured by novice NATs confidence and knowledge levels.

Methods: An observational, cross-sectional study with a pretest-posttest design on a group of novice second-year NATs (NAT-2s) from NorthShore University HealthSystems (NorthShore) School of Nurse Anesthesia was utilized. A total of 15 NATs participated …

Examining Certified Registered Nurse Anesthetists’ Perspective On The Utilization Of Regional Anesthesia In Outpatient Orthopedic Surgery, Hannah M. Robert, Jessica O. Stasinski

College of Science and Health Theses and Dissertations

Regional anesthesia has played a significant role in the reduction of perioperative opioid consumption while still providing high-quality analgesia, making it a fundamental practice in outpatient orthopedic surgery. The purpose of this study was to qualitatively examine the experiences and perspectives of CRNAs surrounding the utilization of regional anesthesia in outpatient orthopedic surgery. A qualitative study design using semistructured interviews was conducted (N =14). Study participants described their current practices and experiences with regional anesthesia utilization in the outpatient orthopedic surgery setting. In particular, four themes describing factors that promote CRNAs’ utilization of regional anesthesia for outpatient orthopedic surgery emerged: …

Podcasting As An Education Modality On The Environmental Effect Of Desflurane, Jacob Bonnema

College of Science and Health Theses and Dissertations

Background: Climate crisis is well-documented as posing a major threat to the population. The provision of anesthesia utilizes gases that contribute to this problem. Podcasts may serve as a useful modality to educate anesthesia providers on best practices.

Purpose: The purpose of this study was to evaluate the effectiveness of an evidence-based educational intervention in the form of a podcast which focuses on the evaluation of knowledge, attitudes, and practice habits related to the use of desflurane among anesthesia providers.

Methods: An observational cross-section study using survey methodology was utilized in this pre-test post-test design. Knowledge, attitudes, and practice habits …

Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth

College of Science and Health Theses and Dissertations

Transgender individuals experience healthcare-related discrimination, resulting in significant disparities and negative health outcomes in comparison to the general population. Many CRNAs do not receive formal or adequate education before being expected to care for transgender patients that contributes to these negative health outcomes. To correct this problem, an educational intervention was created to improve anesthesia providers' knowledge of genderaffirming therapies and to survey anesthesia provider attitudes towards transgender patients and knowledge, beliefs, and preferences towards treating transgender patients. A sample of anesthesia providers was collected (n=27) that included SRNAs and CRNAs at varying levels of professional experience from diverse sociodemographic …

Isolated & Impulsive: A Quality Improvement Pilot Survey Of The Perceived Icu Nurse Workload Implementing The A2f Care Bundle For Isolated Covid-19 Patients With Delirium., Ranier Calimlim

College of Science and Health Theses and Dissertations

Background: Existing research focused on A2F Care Bundle efficacy to optimize patient care and improve patient outcomes among ICU patients. Perceived workflow evaluation has been validated for healthcare task analysis endorsed by the Agency for Healthcare Research and Quality. A needs assessment was identified to evaluate nursing challenges with the A2F Care Bundle interventions, inform allocation where support and resources may be necessary when providing patient care for isolated patients with COVID-19 delirium.

Purpose: The purpose of this study was to evaluate the perceived workload of ICU nurses when implementing the A2F Care Bundle among isolated COVID-19 patients with delirium. …

Multiple Myeloma: Validation Of The Values And Preferences Elicitation Questionnaire- Cure And Survival Preference Scale (Vpeq-Csps), Anastasiia Savchenko

College of Science and Health Theses and Dissertations

Background: With the emergence of many novel therapies, the treatment decisions for multiple myeloma (MM) are increasingly guided by concerns of quality of life, achievement of cancerfree remission, living a longer overall survival, and a relentless search for a cure; however, the impact of these various treatment options on patients’ choices and lives is mainly unknown. Oncology clinicians face the challenge of uncovering their patient’s preferences and values and putting them into the actual treatment decision-making. Purpose: This study examined the psychometric properties of the Values and Preferences Elicitation Questionnaire-Cure and Survival Preference Scale (VPEQ-CSPS) instrument. Methods: The VPEQ-CSPS instrument …

The Dnp Project Maze, Martin Schiavenato

Nursing Faculty Scholarship

No abstract provided.

Reducing 30-Day Psychiatric Inpatient Hospital Readmission Of Mentally Ill Homeless Men With Substance Use Disorder By Using A Discharge Checklist, Chibuogwu E. Ogbuka

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men with substance use disorder is greater than that of the non-use population. Substance use disorder co-occurs with high prevalence among patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health, behavior, and medication non-compliance, resulting in hospital readmission.

Problem: In acute psychiatric facilities in Northern California, the greatest readmission after inpatient hospitalization occurs at 53% in a week and 74.8% within two weeks of discharge. For homeless individuals, substance use disorder exacerbates personal problems and decreases the likelihood of …

Preoperative Hba1c And Postoperative Outcomes In Spine Surgery: A Systematic Review And Meta-Analysis, Tao, Abhijith V. Matur, Paolo Palmisciano, Fatu S. Conteh, Louisa Onyewadume, Henry Ofori Duah, Geet Shukla, Phillip Vorster, Sahil Gupta, Sai S. Chilakapati, Owoicho Adogwa

College of Nursing Faculty Research and Publications

Study Design. 

Systematic review and meta-analysis.

Objective. 

To perform a systematic review and meta-analysis of previous studies on HbA1c in preoperative risk stratification in patients undergoing spinal procedures and provide an overview of the consensus recommendations.

Summary of Background Data. 

Diabetes mellitus (DM) and hyperglycemia have been shown to be independent risk factors for increased surgical complications. Glycated Hemoglobin A1C (HbA1c), a surrogate for long term glycemic control, is an important preoperative parameter that may be optimized to reduce surgical complications and improve patient-reported outcomes. However, comprehensive systematic reviews on preoperative HbA1c and postoperative outcomes in spine surgery have been …

The Importance Of Family Presence At The Bedside Of Critically Ill Patients, Brenda K. Ramsey

MSN Capstone Projects

The purpose of this paper is to discuss the visitor restrictions on patients and their families during the COVID-19 pandemic. At the beginning of the pandemic, visitation was highly restricted with only telecommunication as a means of “visiting” with your loved one who were hospitalized, especially in the ICU settings. During my research of keeper studies for my capstone project, the articles discussed different forms of communication. The articles discussed interventions such as electronic (e-visits) for physician offices and diaries kept in the ICU for communication between family and staff. Some discussed the effects of visitor restrictions and how it …

Opioid Use Disorder (Oud) And Neonatal Abstinence Syndrome (Nas) Education In An Undergraduate Nursing Program, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

In 2018 the American Academy of Nursing urged all nursing schools to adopt curriculum to address the opioid epidemic, although few programs have begun this work.

Minimal background training in nursing school is focused on caring for patients with Opiate use disorder ( OUD) and Neonatal Abstinence Syndrome (NAS) leaving nurses to develop the necessary skills for optimal patient engagement to be formulated in practice. An undergraduate nursing program in an urban setting developed OUD and NAS education into their curriculum.

Undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Previous research indicates …

Addressing Inpatient Substance Use Stigma And Bias: An Examination To Support Training For Healthcare Professionals, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.

Acute Inpatient Stabilization Study Primary Stakeholders Evaluation, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.

Seeking Patient-Centered Care Through Bedside Handoff In The Postpartum Unit, Evelyn Ndaki

Master's Projects and Capstones

Problem: Patient discontent with nurse compassion and attentiveness prompted the implementation of standardized bedside shift handoff (BSH) for nurses in the postpartum unit of a Northern California teaching hospital.

Context: Pandemic stressors led to nurse practices not reflecting patient-centered care. Bedside handoff offers an opportunity to improve patient-centered nurse behaviors.

Intervention: To standardize BSH, a modified SBAR (Situation, Background, Assessment, Recommendation) tool was implemented.

Measures: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question on “Nurses kept you informed” was tracked, and nurse satisfaction with the handoff process was measured with a pre- and post-implementation survey.

Results: Final …

Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado

Doctor of Nursing Practice (DNP) Projects

Background: Globally, adverse health effects, including deaths and disabilities, occur from living or working in unhealthy domains where exposure to environmental and occupational hazards exists. A multitude of these hazards are present in clinical settings in the healthcare environment where nurses care for patients and risk ongoing exposures to toxic substances.

Problem: Environmental and occupational health education is rarely included in the standard undergraduate nursing curriculum, contributing to a deficit among nurses in environmental health awareness and knowledge.

Methods: The study design was a pre/post evaluation of a single cohort (n=32) of undergraduate nursing students to assess environmental and occupational …

Simplifying Qualitative Case Study Research Methodology: A Step-By-Step Guide Using A Palliative Care Example, Elizabeth M. Miller Mrs, Joanne E. Porter Professor, Michael S. Barbagallo Dr

The Qualitative Report

Qualitative case study research can be a helpful methodology when conducting health research. However, it can be overlooked or dismissed as a possible methodological choice due to different epistemological positionings by case study theorists and often confusing and contradictory definitions and terminology. Much has been written about case studies, but it takes time to wade through volumes of often philosophically and methodologically dense material to locate a theorist who presents case study research at a depth the novice researcher can understand. Case study research literature may offer a condensed summary of processes but often needs more theoretical detail. Therefore, discerning …

Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan.

Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the …

An Implementation Of Combined Fecal/Gastric Occult Blood Testing In The Emergency Department, Desiree Long

Master's Projects and Capstones

Problem: The gastrointestinal occult blood test is a point-of-care (POC) test used to detect the presence of occult (hidden) gastrointestinal bleeding via stool or gastric contents. Existing fecal and gastric occult blood point-of-care (POC) testing requires separate and unique sampling cards and developer, respectively. Separate fecal/gastric tests are less definitive and take longer than a combined test. Fecal/gastric testing can be improved and more effective using a combined testing mechanism.

Context: This project includes the microsystem of the emergency department, which involves groups of medical professionals, such as groups of clinicians and staff working together with a shared clinical goal …

Factors Affecting The Healthcare Of Adults With Communication Difficulties Due To Autism Spectrum Disorder And/Or Intellectual And Developmental Disability, Kathryn L. Shady

MUSC Theses and Dissertations

Purpose: This dissertation explores the healthcare barriers and facilitators experienced by autistic adults and adults with intellectual and developmental disabilities (IDD) who have communication difficulties (CD).

Problem: Approximately 5-10% of Americans have CD, including difficulties such as stuttering, aphasia, apraxia, and other forms of language impairment(1,2). Communication difficulties are present in about 25-30% of autistic individuals and 57.9% of those with IDD, which accounts for a large and poorly studied portion of those with CD(3,4). Individuals with CD report negative healthcare experiences and decreased levels of satisfaction with healthcare providers secondary to practices such as communication solely with a …

Understanding Healthcare Worker Experiences And Personal Protective Equipment (Ppe)-Related Skin Reactions/Injuries During The Covid-19 Pandemic: A Mixed Methods Approach, Susan Solmos

Theses & Dissertations

Personal protective equipment (PPE)-related facial skin reactions/injuries occurred in 75.13% of healthcare workers during the COVID-19 pandemic. Critical appraisal of cross-sectional studies identified methodological gaps as the majority of survey questions were not content-validated and those that were lacked descriptions of methods and psychometrics for the survey questions/tool. The aims of this dissertation study were to describe the nature, severity, and distribution of selfie captured PPE-related facial injuries using a validated tool (quantitative) and describe the contextual factors associated with PPE-related facial injuries and what factors influence nurses and Health Care Workers (HCWs) to share their experiences (qualitative). The setting …

Enhancing Compliance Rates: The Impact Of Implementing A Bed Bath Bundle, Lizeth Rosales, Destinee Unabia, Dennisse Espinoza, Nicole Razi, Russell Hall

Master's Projects and Capstones

Abstract Problem: Bed baths are routine bedside procedures offered in hospitals to support patients'

cleanliness and promote comfort and overall well-being. This bedside procedure represents fundamental care provided by healthcare professionals. Ensuring proper bed bathing compliance in the healthcare setting of a medical-surgical observation and telemetry unit has been significantly challenging. After thorough monitoring of the unit, key factors contributing to low bed bath compliance include time constraints, staffing shortage, and barriers specific to patients and staff. The evidence-based interventions to improve bed bath compliance include a bed bath bundle emphasizing teamwork and effective communication, as identified through an extensive …

Fall Risk Identification And Reduction Among The Gerontological Population At A Long-Term Care Facility, Esther A. Lowe, Breanna Cates, Lisa James, Ashley Samson, Jowel Ochoa, Matthew Ng

Master's Projects and Capstones

Abstract

Problem: Data obtained from the facility from February 2022 to July 2023 showed that there were a total of 110 falls at the facility with 51% resulting in injury. The facility also lacked a standardized fall assessment tool with minimal follow up after fall incidents.

Context: A microsystem assessment of the geriatric population at the long-term care facility indicated the need for a standardized fall risk screening tool to accurately assess patients.

Interventions: A staff presentation was created highlighting the high rate of falls at the facility as well as to educate on the implementation of the Morse Fall …

Prevention And Reduction Of Catheter-Associated Urinary Tract Infection, Lea F. Garin

Master's Projects and Capstones

Abstract

Problem: Fifteen to twenty-five percent of hospitalized patients receive indwelling urinary catheters (IUCs) during their hospital stay and are at high risk for catheter-associated urinary tract infections, according to the Centers for Disease Control and Prevention (CDC, 2015).

Context: A CAUTI Prevention program was implemented in a community hospital surgical unit to address concerns of high rates of CAUTI.

Interventions: Staff training/education, pre-CAUTI and post-CAUTI prevention survey, hand hygiene, bundle care audit, and staff competency for indwelling urinary catheter insertion were implemented to prevent and reduce CAUTI cases in the surgical unit.

Measures: The Standardized Infection Ratio …

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Impact Of Strokes: The Burden Of Care, Post-Cva Fatigue & Caregiver Role Strain, Tanya G. Schlemmer

Nursing Faculty Publications and Presentations

Strokes and cerebral vascular accidents (CVAs) and related disease events are an unfortunate circumstance that inflicts individuals around the world and impacts people every day as individuals and their caregivers. The consequences of these strokes or CVA events are life-changing for all those involved. As a result of long-term disability related to strokes, the caregiver may undergo many emotional, psychological, and physical factors that impact their daily lives. There is a relatively short period of time to react to the necessary change and as a result there may be differences in coping associated with these unexpected health circumstances. Many stoke …

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

The Dnp Is A Mess, Martin Schiavenato

Nursing Faculty Scholarship

No abstract provided.

Emergency Department To Medical Telemetry Bed Flow Optimization, Anne Rochelle P. Taco

Master's Projects and Capstones

Abstract

Background: The setting for this quality improvement project is a 22-bed medical telemetry unit that receives approximately 85% of ED admissions. The capacity challenges are one of the major causes of ED admissions beyond the 60-minute benchmark. To create capacity, discharges should happen earlier on the day or before 1:00 p.m. to be able to admit patients within 60 minutes from when the physician writes an order to patient transfer to the telemetry unit.

Problem: Patients are being boarded in the ED for extended times while waiting for an inpatient bed assignment. Longer boarding time in the ED is …

Reducing Hospital-Acquired Clostridium Difficile, Tracy Esposo

Master's Projects and Capstones

Background: This project focused on implementation of clostridium difficile (C. diff) education sessions at Hospital A, a not-for-profit, short-term, acute care hospital serving the Greater Sacramento community. It comprises of 241 staffed beds in the medical-surgical, telemetry, and intensive care units.

Problem: My Clinical Nurse Leader project focused on preventing hospital-acquired C. diff. At Hospital A, there were 19 hospital-acquired C. diff cases for the 2022 performance year. Of the 19 clostridium difficile cases, 12 were related to C. diff testing criteria fall-outs.

Despite huddling with staff on opportunities and providing education through health stream modules, Hospital A continues to …

Analyzing Reporting Of Hospital Acquired Pressure Injuries In The Acute Care Setting, Trineca R-N Godfrey, Gabriella Garcia, Ameerah Tolentino, Gisselle Chairez, Jane Kwak

Master's Projects and Capstones

This project was conducted at a level one trauma center, acute care hospital consisting of 459 beds. With more patients than wound care nurses, hospital-acquired pressure injuries (HAPIs) have become a significant problem for this hospital. A gap between reporting in the Safety and Quality Information System (SQIS) and the reporting that takes place in electronic health record (EHR) with wound care consults has been observed. A root cause analysis (RCA) was used to identify discrepancies. The accurate collection of data was identified as paramount providing information necessary to create improvements and lower the occurrence of HAPIs. The conceptual framework …