Medicine and Health Sciences Commons^™

Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers

Doctor of Nursing Practice Scholarly Projects

The nurse anesthesia specialty is highly stressful, with educational training being no exception. High didactic demands and intensive clinical experiences are placed on student registered nurse anesthetists (SRNAs), increasing stress and anxiety in their personal and professional lives. High levels of psychological distress can lead to inadvertent consequences in students’ mental, emotional, and physical health and can contribute to illness, burnout, substance use, and compromise in patient safety. Some degree of stress is necessary for motivation to succeed and perform at high levels, and encountering stress while enrolled in a doctoral nurse anesthesia program is expected and unavoidable. A search …

Final Scholarly Project: Clinical Guidelines For The Perioperative Management Of Patients With Opioid Use Disorder Requiring Anesthesia, Jessica Kayla Joos

Doctor of Nursing Practice Scholarly Projects

Opioids have highly addictive properties that allow for high levels of misuse. Since the early 1990s, the misuse and deaths rates related to narcotics have steadily risen in the United States. Efforts to identify individuals using opioids prior to surgery have proven difficult. The number of patients misusing opioids and reporting for surgery can only be estimated due to under-reporting related to fear and self-stigma. With 50 million surgeries in the U.S. annually and 3.32 million people misusing opioids monthly, the chances of a patient with Opioid Use Disorder (OUD) presenting for anesthesia are exceptionally high. Moreover, patients who rate …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

Evidenced-Based Practice Guideline Development: Selection Of Local Anesthetics And The Additive Dexamethasone In Brachial Plexus Blocks, Sabina Lamichhane Wagle

Doctor of Nursing Practice Scholarly Projects

Brachial plexus blocks (BPB) are a type of regional anesthesia that inhibits the sensory and motor function of the upper extremity. The efficacy of a BPB depends on the type and dose of local anesthetics (LA), as well as the use of any additive agent. The selection of LA depends on the type, concentration, and volume of LA. Certain additives, such as dexamethasone, when added to BPB, were shown to increase motor and sensory block duration.

A chart audit conducted by the pharmacy and anesthesia departments revealed a significant variability of clinical practice in the use of LA and additives …

Professional Quality Of Life Indicators And Turnover Intention In Forensic Nurses, Leigh Anne Meyer

Doctor of Nursing Practice Scholarly Projects

Background/Significance: Significant barriers to forensic nurse workforce development exist, affecting patient access to care. Retention of forensic nurses is a persistent problem. Turn-over of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS).

Methods: A convenience sample of forensic nurse program coordinators was used to identify the effect of an educational session on professional quality of life and strategies for reducing stressors within the role on ProQOL-5 and TIS-6 scores using a pre- post-test quasi-experimental survey design. Correlation between professional quality of life indicators …

Eastern European Orthodox Christian Immigrant Women: A Pilot Study And Needs Assessment, Kimberly A. Babich-Speck

Doctor of Nursing Practice Scholarly Projects

The healthcare perceptions of the Eastern European Orthodox Christian immigrant women (EEOCIW) to the United States (U.S.) are under-represented in the literature. Although they appear similar to Americans, their cultural and religious traditions are outside the mainstream American culture. This pilot study and health needs assessment examines the women’s healthcare perceptions of 14 EEOCIW and identifies similarities and differences with 25 U.S. born Orthodox Christian women (USOCW). Between September and November 2020, interviews were conducted with Orthodox Christian immigrant women from Eastern Europe and Orthodox Christian women born in the U.S. Questions covered the perceptions of women’s healthcare, factors influencing …

Poster: The Beat Stops Here: A Nurse-Driven Protocol To Manage Telemetry Orders, Holly Dripps, Kirk Hummer

Doctor of Nursing Practice Scholarly Projects

At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian' s quality improvement framework of strnch1re-process-outcomes was utilized as the theorical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the …

Poster: Impact Of Educational Modules On Knowledge Among Neuroscience Nurses Working In The Epilepsy Monitoring Unit (Emu), Shivani Bhatnagar, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Background: Little data exists about nursing care and knowledge on an epilepsy monitoring unit (EMU). This study evaluated the impact of an educational series (three modules) on nursing knowledge and confidence in providing care, using a pre-test/post-test design. Objectives: There were three objectives for this study. The first objective was to improve nursing knowledge and competence in educating patients and families. The second, to increase nursing confidence in providing care and decision-making for the specialized patient population on the EMU. The third, to evaluate the effectiveness of educational modules. Subjects: Thirty-eight nurses working in the neuroscience unit participated in the …

Report:Impact Of Educational Modules On Knowledge Among Neuroscience Nurses Working In The Epilepsy Monitoring Unit (Emu), Shivani Bhatnagar, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Background: Little data exists about nursing care and knowledge on an epilepsy monitoring unit (EMU). This study evaluated the impact of an educational series (three modules) on nursing knowledge and confidence in providing care, using a pre-test/post-test design. Objectives: There were three objectives for this study. The first objective was to improve nursing knowledge and competence in educating patients and families. The second, to increase nursing confidence in providing care and decision-making for the specialized patient population on the EMU. The third, to evaluate the effectiveness of educational modules. Subjects: Thirty-eight nurses working in the neuroscience unit participated in the …

Pathophysiology Of Osteoarthritis, Lara Stover

Nursing Student Class Projects (Formerly MSN)

Osteoarthritis (OA) is one of the most common joint diseases worldwide, and especially in the United States. This disease can cause chronic pain and disability, and can impair a patient’s quality of life and ability to perform activities of daily living. There are many different factors that can contribute to the development, progression, and severity of OA. Chronic inflammation and the inflammatory response is the primary pathological process that contributes to the development of OA. With the number of cases of OA expected to increase in the United States, it is important that primary care providers have an understanding of …

Acute Bronchospasm Under General Anesthesia, Cody Rasmussen

Nursing Student Class Projects (Formerly MSN)

An acute bronchospasm during general anesthesia can become a life-threatening intraoperative condition for any patient. Bronchospasm occurs when the bronchial smooth muscle constricts which makes ventilating the patient difficult, and can ultimately lead to hypoventilation, hypoxemia, and metabolic acidosis. It’s imperative for any anesthesia provider to understand what a bronchospasm is, its pathophysiology, differential diagnosis, and algorithm of treatments. This poster presentation provides a summary based discussion of acute bronchospasm under general anesthesia.

Complex Regional Pain Syndrome, Maria A. Hendrix

Nursing Student Class Projects (Formerly MSN)

Complex regional pain syndrome (CRPS) is a chronic and often disabling condition that is seen in many patients seeking pain management. The condition leaves patients in excruciating pain that is disproportionate to the inciting injury. In addition, patients with this pain disorder experience abnormal sensations such as cold and heat allodynia, hyperalgesia, edema, abnormal sudomotor activity and trophic changes (D. Lee et al., 2015). CRPS disproportionally affects four times as many women as men (Alexander, Peterlin, Perreault, Grothusen, & Schwartzman, 2012). There are two types of CRPS: type 1, often referred to as reflex sympathetic dystrophy (RSD), is not evident …

Building Expert Consensus On Including Indicators Of Moisture Associated Skin Damage In The National Database Of Nursing Quality Indicators (Ndnqi), Mary Caroleen Arnold Long

Capstone Projects

Pressure ulcer (PU) data are collected by hospitals and reported quarterly as a nursing sensitive quality indicator via the National Database of Nursing Quality Indicators (NDNQI). Incontinence-associated dermatitis (IAD) and gluteal intertriginous dermatitis (ITD), both forms of moisture associated skin damage (MASD), are caused by moisture, not pressure or shear. These two forms of skin damage may be mistaken for PUs and may be reported in error as PUs. If the assessment of the skin damage is incorrect, the reporting is incorrect and the NDNQI database is incorrect. If the NDNQI database is incorrect then practice and policy regarding identification, …

The Contemporary Use Of Nurse Practitioners In U.S. Emergency Departments, Jeffrey L. Bevan

Doctor of Nursing Practice Scholarly Projects

Problem: The increased demand for emergency care in the United States (U.S.) has been well-documented and there is growing utilization of nurse practitioners in U.S. emergency departments. However, little is known about the nurse practitioner (NP) role in the emergency department setting within the past five years.

Purpose: The purpose of this project was to describe the demographic characteristics of patients, patient conditions treated, diagnostic tests ordered, and procedures performed by nurse practitioners in a national sample of U.S. emergency departments.

Methodology: This secondary analysis used a non-experimental quantitative, descriptive exploratory design to review data from the National Hospital Ambulatory …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Improving Patient Satisfaction After Primary Total Knee Arthroplasty Using Nurse Practitioner-Driven Preoperative Education, Jennifer A. White

Doctor of Nursing Practice Scholarly Projects

Total joint arthroplasty is an undisputed option for relieving pain and improving the function of an arthritic joint. The number of patients undergoing total knee arthroplasty (TKA) annually is expected to increase by 600% in the next two decades (Lau, Gandhi, Mahomed, & Mahomed, 2012).

Current research shows that while 81-89% of patients who have had a TKA are satisfied postoperatively, there is room to improve patient satisfaction by providing further education preoperatively. While research cannot agree on a single, specific variable that influences patient dissatisfaction, a review of the literature shows that patients repeatedly note their “unmet expectations” as …

An Evaluation Of Patient Satisfaction With Telephone Follow-Up In An Urgent Care, Audia L. Ellis

Doctor of Nursing Practice Scholarly Projects

Telephone follow-up (TFU) is a very valuable innovation. It is a service that is found to be desirable by both patients and health care professionals. It has been utilized successfully in a variety of settings, however, evidence of its use or evaluation of its use in the urgent care setting has not been found. Through evaluation of patient satisfaction (PS) with use of the protocol, new cost and labor effective interventions were constructed and implemented with the goal of meeting patients’ needs.

This study utilized mixed method methodology and employed a descriptive design. Convenience sampling was utilized and a sample …

Paramedic Students' Perceived Self-Efficacy At Airway Management, Holly Herron

Doctor of Nursing Practice Scholarly Projects

The out of hospital (OOH) environment is chaotic, unpredictable and unforgiving. Paramedics are the primary providers of life-saving, OOH airway management, which includes respiratory assessment, bag-valve-mask ventilation (BVM), and endotracheal intubation (ETI). OOH ETI is the most difficult skill for which to obtain and retain clinical competence. Preventable patient care errors and deaths related to OOH ETI are a healthcare concern. Clinical experience remains limited for paramedic students in the acquisition of adequate ETI experience.

The purpose of this study was to assess the perceived self-efficacy (PSE) of paramedic students in ETI. Bandura's self-efficacy theory was the theoretical framework for …

Prevention, Recognition, And Treatment Of Pediatric Obesity In The Ambulatory Care Setting, Susan Farrus-Brown

Doctor of Nursing Practice Scholarly Projects

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a “global epidemic.” The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases.

The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) …

Assessment Of Mild Traumatic Brain Injury By Advanced Practice Registered Nurses, Mary Lou Garey

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to evaluate the knowledge about assessing mild traumatic brain injured patient by the advanced practice registered nurse (APRN) as reflected in the Centers for Disease Control (CDC) Acute Concussion Evaluation (ACE) Tool Kit. A descriptive cross-sectional survey research design was used to assess knowledge about the evidenced based assessment of APRNs practicing in an urgent care setting as established by the CDC for the evaluation of acute concussion. Specifically the history and physical assessment practices of the APRNs for the mild traumatic brain injured patient (MTBI) were evaluated in relationship to the CDC / …

Attitudes And Beliefs Of Registered Nurses About The Process Of Changing To An Electronic Medical Record In A Community Hospital: A Mixed Method Investigation, Roberta Jo Myers

Doctor of Nursing Practice Scholarly Projects

The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any …