Medicine and Health Sciences Commons^™

Clinical Practice Update On A Temperature Guideline To Decrease Intraoperative Hypothermia In Patients Undergoing General Anesthesia, Ashley Rigdon

Doctoral Projects

Intraoperative hypothermia is a common problem within the operating room. Anesthesia inhibits the body’s normal thermoregulatory response to hypothermia, redistributing heat from the core to the periphery (Brandt et al., 2009). In the event of hypothermia, the incidence of infection triples as there is an increased risk for blood loss, increased risk for cardiac complications, and the thermal discomfort of patients (Brandt et al., 2009). Following a recent clinical practice guideline can help prevent hypothermia.

A descriptive project was organized utilizing current literature. The sample for this study is 45 CRNAs practicing at a multiple system healthcare facility in the …

Implementing Nerve Blocks For Patients Undergoing A Bilateral Mastectomy With Immediate Reconstruction: A Practice Change, Corey Beene Auerswald

Doctoral Projects

Breast cancer is one of the most commonly diagnosed cancers in women. A mastectomy is one of the first line treatments for breast cancer, but it is associated with considerable postoperative pain. Literature suggests current methods of pain management are ineffective and regional anesthesia can help reduce postoperative complications following a bilateral mastectomy with immediate reconstruction. Information from the literature review was used to inform five anesthesia providers at a rural hospital in Mississippi about the benefits of regional anesthesia for patients having a mastectomy. A presentation was given to anesthesia providers regarding the benefits of paravertebral blocks (PVB) for …

Implementing The Use Of Intracuff Alkalinized Lidocaine Among Certified Registered Nurse Anesthetists: A Practice Change Proposal, Shawn Taylor

Doctoral Projects

Patients today are experiencing comorbidities predisposing them to increased risk under general anesthesia. Emergence cough reflex is a response that can lead to hemodynamic alterations occurring during emergence and the postoperative period for many patients requiring general endotracheal tube anesthesia (GETA). It is proposed that 38% to 96% of patients receiving GETA will experience coughing during emergence (As, Iqbal, & Ali, 2009; Watkins, Lee, White Jr, & Mundy, 2012).

The use of intracuff alkalinized lidocaine is an intervention shown to be effective in previous studies at blunting this response during anesthesia emergence. Through verbal communication with CRNAs, it was discovered …

The Effects Of In-Service Education On Workplace Incivility For Crnas, Tran King

Doctoral Projects

Workplace incivility (WPI) affects many healthcare providers, including Certified Registered Nurse Anesthetists. This project was an exploration of the prevalence, nature, and sources of WPI affecting CRNAs. The project’s intervention was an in-service education on WPI for CRNAs. The purposes of the project were to measure the effectiveness of the in-service education in increasing awareness of CRNAs about WPI; and to offer a practice change proposal in terms of a policy against WPI in the anesthesia department.

A Needs Assessment Survey and Demographic Data Information form were distributed from Survey Monkey to participants’ email by way of blind copy. Data …

Curriculum Development Of California Correctional Institution (Cci) Nursing Staff Performance During Simulation Training Related To Cardiac Emergency Response, Dina Wang

Doctoral Projects

The Cycle 4 OIG medical reports published in January 2016 for California Correctional Institution (CCI) noted emergency medical response (EMR) inadequacies. Nursing was specifically called out for EMR care deficits. Chest pain and respiratory distress were amongst the top signs and symptoms identified as having substandard nursing care issues within the report. The cycle 4 OIG medical inspection report gives specific incidences of patient care inadequacies.

As a result of the EMR portion results of the cycle 4 OIG reports, there was a need for improvement planned interventions. The Doctor in Nurse Practice (DNP) project is a quantitative quasi-experimental study …

An Assessment Of The Associate Degree Nursing Students’ Understanding Of Health Literacy Concepts When Providing Health Promotion For The Diabetic Patient, Donna L. Lebaron

Doctoral Projects

Health literacy (HL) concept deficiencies exist in undergraduate nursing curricula (Smith and Zsohar, 2011; Cornett, 2009; Jukkala, Deupree, Graham, 2009). As future nurses who will have a significant impact on client health literacy assessment, it is essential that health literacy-related content be integrated into undergraduate nursing educational curricula (Sand-Jecklin, Murray, Summers, Watson, 2010; McCleary-Jones, 2012). The prevalence of Type 2 diabetes (T2D) has significantly increased resulting in greater morbidity and mortality risks to the general public; therefore, programs for diabetes prevention, education, and health literacy assessments have become a national priority (Whittemore, Rosenberg, Gilmore, Withey, and Breault, 2013; Hemingway, Stephenson, …

The Perceptions Of Registered Nurse To Bachelor Of Science In Nursing Students Of Motivational Interviewing, Christie M. Smart

Doctoral Projects

Purpose: The purpose of this study was to collect information on the perceptions of motivational interviewing (MI) among Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) students and whether or not the students felt it could increase holistic practice. Methodology: A qualitative descriptive study was used to collect data through semi-structured one on one interviews from six RN-BSN students post a module taught on MI. Qualitative content analysis was utilized to process the data. Findings: The students felt that MI was a useful tool for practice in improving patient communication and would contribute to holistic practice.

Implementing Evidence Based Practices For Preventing Cardiac Implantable Electronic Device (Cied) Infection And The Role Of Post-Operative Oral Antibiotics, Ingrid Mitchell

Doctoral Projects

Cardiac pacemakers and implantable cardioverter defibrillators (ICD) are standard therapy for patients with a bradyarrhythmia, tachyarrhythmia or heart failure (HF) with a left bundle branch block (LBBB) (Wilkoff, et al., 2008). Millions of cardiac implantable electronic devices (CIED) have been implanted worldwide and this clinical practice has improved the quality of life for millions (Epstein, DiMarco, & Ellenbogen, 2008). With the increase of implants there has been an increase in the infection rates (Klug et al., 2007). Research studies have evaluated pre-procedure, during procedure and after procedure risk and protocols. Studies have also evaluated operative factors, procedural related factors, intravenous …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Efficacy Of Continuous Passive Motion After Total Knee Arthroplasty In Veteran Patients, Jaimee Riza B. Hare

Doctoral Projects

Since the early 1980s, continuous passive motion has been used as adjunct therapy in patients’ rehabilitation following total knee arthroplasty. Although existing literature challenged the benefits of continuous passive motion claiming it had no added short-term or long-term benefits after knee arthroplasty (Boese et al., 2014; Chen et al., 2012; Herbold et al., 2014; Leach et al., 2006; Maniar et al., 2012), the existing literature is difficult to generalize and apply to the veteran population at San Francisco Veterans Affairs Medical Center. This study was undertaken to determine the efficacy of continuous passive motion in helping veteran patients at San …

Stress In New Graduate Nurses: Can They Sweat It? A Correlational Study Of Exercise And Stress In New Graduate Nurses, Kathleen Helgesen

Doctoral Projects

Stress in new graduate nurses has been a known issue in nursing for decades. The number of new graduate nurse turnover rates has reached up to 50% within the first three years of practice, according to some studies. Most new graduate nurses who choose to leave their job, or even the profession, cite stress as a major factor.

Methods: Single point correlation survey of new graduate BSN students in Southern California (n=32).

Results: Initial results showed a statistically significant difference between those who exercised three to five hours per week, versus though who exercised more than five hours per week. …

Impact Of Behavioral Genetic Traits On Weight Maintenance Success Following Medically Supervised Very Low Calorie Diet, Lori Elizabeth Arguello

Doctoral Projects

Obesity has reached worldwide epidemic proportions and is associated with the leading causes of death. A person’s predisposition to obesity is strongly related to genetics and specific genes have been identified that influence weight control. The aim of this quantitative retrospective chart review is to identify the impact of behavioral genetics on weight loss maintenance following a medically supervised very low calorie diet. A total of 330 patient charts that met inclusion criteria were reviewed. Six behavioral genetic results were reviewed which included snacking, hunger, satiety, eating disinhibition, food desire, and sweet tooth along with patient weight at 3, 6, …