Medicine and Health Sciences Commons^™

Mortality And Length Of Stay In Patients With Covid-19 On Ecmo: A Retrospective Before And After Quality Improvement Study, Chantal Branco

DNP Scholarly Projects

The use of extracorporeal membrane oxygenation as a supportive modality for patients with COVID-19 pneumonia emerged as the gold standard of care for those who do not respond to traditional therapies. The primary aim of this 10-month, quantitative, retrospective, quality improvement project was to identify if V-V ECMO treatment guidelines, implemented in the treatment of COVID-19 pneumonia, led to decreased mortality rates and lengths of stay. A total of 27 patients met inclusion criteria during queried time frames (n = 14 in Wave 1 and n = 13 in Wave 2). Data collected demonstrated no significant difference (p = .385) …

Development Of A Resilience Program To Combat Burnout In Nursing Practice, Maggie Lynch

DNP Scholarly Projects

Burnout has been identified as a national health crisis, with implications for the retention and health of critical healthcare workers. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the United States. Understanding resilience and how to foster it in nurses will contribute to burnout prevention and consequently improve the quality of health care provided Americans. Resilience training has been identified as a valuable approach to retention of the workforce. This scholarly project developed a resilience training program for newly licensed registered …

Evaluating Advanced Nurse Clinicians’ Readiness To Use Augmented Reality For Delivery Of Simulated Teaching Sessions, Kelly Carbone

DNP Scholarly Projects

Background

Since the start of the COVID-19 pandemic, nurses have adapted numerous new processes and procedures. Keeping patients safe is dependent on the education and experience of providers caring for them. By utilizing the capabilities of augmented reality (AR), clinical nurse educators (CNEs)/advanced nurse clinicians (ANCs) can provide real-time learning while providing feedback to nurses during simulated instructional experiences. AR instructional methods hold promise for educators due to staff shortages, time constraints, and inadequate facility space for in-person teaching sessions.

Purpose

The purpose of this doctoral project was to evaluate the ANCs readiness to adopt new AR technology, the Microsoft …

Effectiveness Of An Instructional Program On Decreasing Fall Incidents In Geriatric Patients With Psychiatric Disorders, Maurice Washington

DNP Scholarly Projects

Falls occur in 25% of older adults, resulting in over 8 million fatal and nonfatal injuries. In addition to the human suffering, associated medical and legal costs amount to over 50 billion dollars a year. This study examines the impact on fall rates of an evidence-based fall prevention program provided to a multidisciplinary staff on a psycho geriatric unit in Philadelphia, Pennsylvania. Staff knowledge of effective fall prevention interventions was measured before and after their participation in an evidence-based instructional workshop provided by the Project Director using the Falls Prevention Knowledge Test by Dykes et al. (2019). While there were …

Effect Of A Community Hospital’S Sustainable And Enhanced Fall Prevention Quality Improvement Program On Inpatient Falls And Falls With Injury: A Before And After Study, Anne Catino

DNP Scholarly Projects

The frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 …

An Evidence-Based Teaching Plan For Preventing Wrong-Site Block Placement During Regional Anesthesia, Mark A. Michetti, Kristen E. Newbrough

DNP Scholarly Projects

Wrong-site regional anesthetic block placement is a threat to patient safety and quality perioperative care. The adverse outcomes for patients, providers, and institutions demonstrate safety risks that are linked to inconsistent use of comprehensive guidelines in clinical practice. The purpose of this Doctor of Nursing Practice Project is to create a comprehensive evidence-based Teaching Plan for preventing wrong-site block (WSB) placement during regional anesthetic induction and for use in institutions by anesthesia providers to prevent wrong-site anesthetic block placement. The teaching plan focuses on four main constructs to prevent WSBs, which include the incidence of WSBs, the consequences of WSBs, …

Cognitive Aid For Anesthesia Providers Caring For Lactating Mothers, Danielle Pantella, Dana Lawrence

DNP Scholarly Projects

Evidence on the transfer of medications into breastmilk during the administration of anesthesia and sedation medications may not be well known by anesthesia providers. As they teach lactating mothers, anesthesia clinicians may not be comfortable explaining details about breastfeeding, such as the effects of anesthesia on breast milk and when mothers can safely resume breastfeeding. Lack of provider knowledge may be a safety threat that can be decreased by an evidence-based cognitive aid. The purpose of this patient safety project is to develop a cognitive aid that includes anesthetic agents and knowledge components to structure the provision of care to …

An Evidence-Based Teaching Plan For Anesthesia Providers On Intraoperative Blood Glucose Monitoring In Diabetic Patients Undergoing Noncardiac Surgery, Brian Sabec, Christopher Mcmichael

DNP Scholarly Projects

As the incidence of diabetes continues to rise both locally and nationally, anesthesia providers must be prepared to manage diabetic patients intraoperatively during the administration of anesthesia. Literature suggests that blood glucose levels are not adequately monitored in the operating room, potentially contributing to many postoperative complications. Therefore, this doctoral project aims to develop an evidence-based teaching plan for monitoring intraoperative glucose levels in the diabetic patient population to enhance anesthesia provider knowledge.

Evidence-Based Interprofessional Education For The Labor And Delivery Team On Nitrous Oxide Anesthesia For Laboring Mothers, Amanda Rota, Jessica Stoffey

DNP Scholarly Projects

Pain management in the laboring patient continues to arise with challenges of safety, efficacy and comfort. Nitrous oxide is an option for managing laboring women’s pain. However, the lack of education for perinatal teams across the United States regarding nitrous oxide administration in the labor patients omits a successful pain management option. The purpose of this Doctor of Nursing Practice project is to create an evidence-and theoretically-based education module for the labor and delivery team, incorporating an instructional video to build knowledge on the use of nitrous oxide in the laboring mother.

Performance Improvement Project Implementing Rapid Cycle Deliberate Practice Simulation To Improve Team Performance During Administration Of Moderate Sedation By Non-Anesthesia Providers In The Interventional Platform, John Kost, Matthew Snyder

DNP Scholarly Projects

A steady increase in procedures in interventional platforms has required the administration of moderate sedation and analgesia by non-anesthesia providers. Of concern is managing the delicate balance between different levels of sedation on a continuum to ensure safe and effective care. Moderate sedation achieves suppression of consciousness while maintaining a patent airway and intrinsic respiratory drive compared to deep sedation where airway patency and respiratory function can be compromised. Administration of moderate sedation by non-anesthesia providers in interventional platforms leads to a higher rate of procedural complications. Rapid Cycle Deliberate Practice (RCDP) simulation will be utilized to educate non-anesthesia providers …

An Evidence-Based Teaching Plan For Anesthesia Providers On The Patient Safety Aspects And Pharmacoeconomic Advantages Associated With Sugammadex Use, Amanda Cruz, Courtney Keil

DNP Scholarly Projects

Anesthesia providers are often required to administer neuromuscular blockade during surgical procedures to optimize both surgical conditions and allow for mechanical ventilation. Reversal of neuromuscular blockade at the conclusion of surgery assists anesthesia providers in preventing adverse events and optimizing patient safety. Current literature supports the use of sugammadex as the safest neuromuscular blockade reversal agent in many cases, but also shows a lack of provider education regarding its use. The hesitancy of anesthesia providers and medical institutions to utilize sugammadex as a standard of care despite evidence-based literature supporting its regular use implies that there is either a knowledge …

An Evidence-Based Teaching Plan For An Anesthesia Crisis Resource Management Simulation Targeting Malignant Hyperthermia, Jacqueline Dowe, Michael Reynaltti

DNP Scholarly Projects

Most medical errors in health care are preventable and result from lack of communication and teamwork among health care workers. Despite health care providers’ training on preventing medical errors and managing medical crises, patient care services may be compromised and result in patient harm when teamwork and communication decrease among clinicians. Anesthesia Crisis Resource Management (ACRM) was designed to help anesthesia providers effectively manage crises by working in multidisciplinary teams to improve and develop both teamwork and technical skills. The purpose of the Doctor of Nursing Practice project is to design an evidence-based teaching plan for a ACRM simulation targeting …

Differences In Anxiety In New-To-Practice Traditional And Non-Traditional Registered Nurses In Clinical Practice, Sharon Mingo

DNP Scholarly Projects

New-to-practice RNs experience anxiety during licensure preparation and orientation. Such anxiety is anticipated to linger for approximately 6 months as the RN transitions to practice and adapts to professional nursing. Many new-to-practice RNs report feelings of anxiety. Their anxiety can negatively affect the quality and safety of nursing care and increase nurse turnover. Unfortunately, the literature on anxiety in traditional post-licensure in new-to-practice RNs in clinical practice lacks information on non-traditional post-licensure new-to-practice RNs' experiences when starting professional practice roles in health care settings. This descriptive comparative study compares differences in anxiety in new-to-practice RNs of traditional and non-traditional Bachelor …

Development Of An Evidence-Based Process For Implementing Stanford Cognitive Aids In Offsite Anesthesia Practice Facilities, Christopher Delaney, Jennalise Eiswerth

DNP Scholarly Projects

Failure to rescue patients during medical emergencies often results in significant morbidity and mortality outcomes in outpatient surgical settings. The purpose of this Doctor of Nursing Practice project is to develop an implementation process with the Stanford Anesthesia Cognitive Aid manual (Stanford Anesthesia Cognitive Aid Group) for perioperative critical events in outpatient surgical sites to increase emergency preparedness for the surgical team, including anesthesia and other direct care providers. An educational intervention will be used for the surgical team, including anesthesia and other direct care providers, at outpatient surgical sites on utilization of the Stanford Anesthesia Cognitive Aid manual (Stanford …

Evidence-Based Educational Modules On Applying The Aana Infection Control Guidelines, Rachel Bassett, Keli Costa

DNP Scholarly Projects

Inadequate hand hygiene and contamination of the anesthesia workstation have resulted in pathogen transmission and subsequent healthcare-associated infections. This clinical problem poses a significant safety threat as healthcare-associated infections are one of the leading causes of preventable patient harm and death. Research literature and the American Association of Nurse Anesthetists illustrate the need for universal infection prevention precautions and standardized anesthesia workstation cleaning practices to decrease workstation contamination and healthcare-associated infections. The purpose of this project will be to create a teaching plan based on research literature and the American Association of Nurse Anesthetists infection prevention and control guidelines to …

Development Of An Evidence-Based Teaching Module Using Educational Videos For The Novice Crna Simulation Educators, Alexis Bishop, Ashley Frugoli

DNP Scholarly Projects

Research has emphasized the benefits of incorporating a well-structured pre-brief and debrief into a simulation learning experience. Current themes in the literature suggest a lack of resources offered to simulation instructors, resulting in inconsistent pre-briefing and debriefing approaches amongst instructors. Ultimately, the learner suffers, compromising the knowledge and skills taken into the clinical setting. The primary purpose of this Doctor of Nursing Practice (DNP) project was to create an educational intervention for novice certified registered nurse anesthetists (CRNA) who are new to being a simulation educator. The intervention will utilize a self-paced teaching module with embedded videos and active learning …

Evidence-Based Educational Modules On The Safe Delivery Of Anesthesia In Mri Suites, Mandy Cesco-Cancian, Taylor Crofoot

DNP Scholarly Projects

Few citations were located on the formal education on MRI patient safety for anesthesia providers administering anesthesia services in MRI suites. Consequently, patients and staff may be at risk for injury or death during MRI procedures and health care institutions can be threatened with financial loss secondary to legal exposure, equipment damage and resultant morbidity and mortality associated with MRI patient safety events. This doctoral project will create three evidence-based continuing education modules to educate anesthesia providers on the operation of the MRI unit, potential MRI associated risks and complications, and specific anesthesia considerations for providers assigned to the MRI …