Medicine and Health Sciences Commons^™

Student Registered Nurse Anesthetists’ Perception Of Simulation As A Positive Reinforcement To Classroom Lecture In Handling A Difficult Airway, Kayla Forbis

Doctoral Projects

The management of a difficult airway by anesthesia providers is a core component of providing safe care. Simulation provides an opportunity for the student to manage uncommon clinical scenarios without harm to an actual patient. This project aimed to determine if the use of simulation may be useful in training Student Registered Nurse Anesthetist in the management skills of a difficult airway. The proposed intervention of this project was the addition of simulation experience to didactic lecture covering difficult airway management techniques. As supported in the Adult Learning Principles of Medical Learners, by allowing the SRNA to actively participate in …

Elevating The Head Of Bed During Preoxygenation For Obese Patients Undergoing General Anesthesia: A Clinical Policy Proposal, Brian F. Seymour Jr.

Doctoral Projects

Preoxygenation plays a vital role in ensuring patient safety for all patient populations, especially those considered clinically obese. The negative pathophysiological effects obesity has related to body habitus and respiratory mechanics increases the risk of unexpected adverse events. Obese patients encounter a 50% decrease in functional residual capacity (FRC) when undergoing general anesthesia. Dixon et al., (2005) addressed the link between efficient oxygenation and improving oxygen storage by lessening atelectasis and intrapulmonary shunting via preoxygenation in a more upright position. Can standardizing preoxygenation techniques among anesthesia providers improve patient safety and decrease hospital system’s risk by implementing an evidence-based clinical …

Drug Diversion Reporting And Response: A Policy Analysis, Lauren Roberts

Doctoral Projects

Despite the significant improvements made to address addiction and drug diversion by healthcare personnel, the issue continues to be problematic for most healthcare facilities. Current literature suggests that healthcare institutions incorporate early drug diversion and addiction education, implementation of effective policies and procedures, and continuous drug screening will strongly aid in decreasing the prevalence of drug diversion by healthcare providers.

Among all the different types of healthcare providers, anesthesia providers continue to be at a disproportionately higher risk for addiction and drug diversion when compared to other providers (AANA, 2016). The stress of a demanding profession, personality, and easy access …

Tools To Increase Compliance And Decrease Mortality Due To Sepsis, Cody F. Carr

Doctoral Projects

Severe sepsis is a leading cause of death in the United States and is the most common cause of death among critically ill patients in non-coronary intensive care units (Mayr, Yende, & Angus, 2014). The incidence of severe sepsis is estimated to be 300 cases per 100,000 population and cost an estimated $14 billion in the United States (Mayr et al., 2014). This Doctor of Nursing Practice (DNP) project focused on identifying an early-assessment tool to identify sepsis and increase compliance when using the tool. Identifying sepsis early is important in starting a treatment plan to prevent morbidity and mortality. …

Best Practice Policy Recommendation For Neuraxial Anesthesia Skin Antiseptic Solutions, Kyle Adams

Doctoral Projects

A clinical affiliate hospital in Mississippi lacked a best practice clinical policy regarding the most appropriate skin preparation solution to use prior to neuraxial anesthesia. The evidence showed that alcoholic chlorhexidine is the optimal solution due to advanced characteristics which help reduce infection. Reducing infections can potentially reduce further complications for the patient, hospitalization length, and cost. Also, chlorhexidine was found safe to use for neuraxial anesthesia if cross-contamination is avoided and adequate drying time is allowed. Lastly, alcoholic povidone-iodine is an appropriate alternate if 0.5% chlorhexidine is unavailable.

A best practice clinical policy was formulated and presented to a …

Following Epidural Pca Use, Do Obstetric Patients Feel Satisfied With Their Pain Control, James Mcrae

Doctoral Projects

ABSTRACT

Pain is a source of anxiety for many patients, and uncontrolled pain can have deleterious effects on patient outcomes (Patak et al., 2014). Pain associated with labor is a particular concern of obstetric patients. Epidural analgesia is currently the frontline treatment for pain associated with labor, with epidural patient-controlled analgesia (PCA) often being utilized (Braveman, Scavone, Blessing, & Wong, 2013). Little evidence exists that details what factors of epidural PCA that patients considered important (Patak et al., 2014). In this project, a randomized questionnaire was administered to obstetric patients to assess satisfaction levels with their epidural PCA. The questionnaire …

Nurse Expectations As Compared To Perceived Reality, Kathryn Mckelvy

Dissertations

Burnout and turnover in nursing have been well documented in nursing literature, but little is known about a nurse’s expectations of the profession compared to their perceived reality of the profession. Do these expectations meet the reality of the workplace, and does this cause the nurse to make a career change? What factors influence a nurse to leave the profession, job-hop, or return to school to further their education? The rate of nurse turnover is an ongoing issue with a lack of research regarding the foundation of nurse expectations compared to the realities of the profession.

The purpose of this …

Self-Care Vs. Self-Sacrifice In Medical-Surgical Nursing Culture: A Critical Ethnography, Elise Jordan Juergens

Dissertations

The critical ethnography research examines need prioritization culture among medical-surgical nurses. Grove, Burns, and Gray (2013) define the problem statement as an explicit identification of the research need. Literature search yields scarce ethnographic research on the nursing population as a culture-sharing group, and no qualitative research exists regarding medical-surgical nurses’ self-need prioritization. The purpose of this critical ethnography is to observe medical-surgical nursing culture, related to personal need prioritization, as reflected by behavior and dialogue.

Qualitative research methodology is appropriate where statistical data is not. Research motivation involves seeking insight and sociocultural understanding. Critical ethnography is the chosen qualitative research …

Male Nurse Practitioners' Views On Nursing Education As A Career Option: An Inductive Qualitative Content Analysis, James Mcdavid

Dissertations

As the nursing shortage continues, the demand for new nurses will increase. In 2015, nursing schools in the United States turned away 62,361 qualified applicants in the baccalaureate and graduate nursing programs (Fang, Li, Arietti, & Trautman, 2016). The number of funded, vacant nursing faculty positions increased from 6.9% in 2014 to 7.1% in 2015 (Fang et al., 2016). One idea to help with the nursing faculty shortage is to recruit male RNs into nurse faculty positions. Males count for 10.6% of nurses in the United States (U.S. Bureau of Labor Statistics, 2016). However, men only count for 5.5% of …

Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To

Doctoral Projects

Certified Registered Nurse Anesthetists (CRNAs) are the main anesthesia providers in over 70% of rural hospitals providing anesthesia. Each year, over 2,000 student registered nurse anesthetists (SRNAs) graduate and continue as licensed CRNAs. This Doctor of Nurse Practice (DNP) project emphasizes the importance of developing culturally competent providers in anesthesia by promoting early outreach in cultural competence education of SRNAs. Cultural competence is described as possessing characteristics of congruent attitudes, awareness, and conduct that provides and enables effective skills in cross-cultural encounters. Encompassing cultural competency education early in the SRNAs profession may provide valuable lifelong cultural skills that will benefit …

Analysis Of Current Practices For Measuring Endotracheal Cuff Pressures, Myisha Jessie Dixon

Doctoral Projects

The current practice for the measurement of endotracheal tube (ETT) cuff pressure intraoperatively is subjective, potentially leading to negative consequences for patients. The purpose of this best practice project was to examine and synthesize the current evidence-based literature on measuring ETT cuff pressure and developed a policy recommendation for measuring ETT cuff pressure in the intraoperative setting by anesthesia providers. The ACE star model of knowledge transformation guided this best practice project. An extensive literature review was performed to evaluate and synthesize the current evidence-based research that can be used to develop the policy on measuring endotracheal tube cuff pressure. …

Alveolar Recruitment Maneuvers And Noninvasive Positive Pressure Ventilation In Obese Patients: A Quality Improvement Project, Ryan Miles

Doctoral Projects

Obesity is considered a complex, and often difficult to manage the diseasethat develops due to many factors. Over one-third of the U.S. population is considered to be obese with Mississippi ranked as second highest in adult obesity (WHO, 2016). With the increasedprevalence of obese patients, it is inevitable that these patients will be presenting for surgical procedures. Obesity and its comorbidities can prove to be challenging for anesthesia providers. These patients often will have compromised respiratory function due to an accumulation of adipose tissue on the abdominal, thoracic, and diaphragmatic structures(Nagelhout, 2014). General anesthesia causes atelectasis and reductions in lung …

Laryngeal Mask Airway: A Postoperative Sore Throat Clinical Practice Guideline, Logan Williams

Doctoral Projects

One of the most common and preventable complications experienced by patients undergoing general anesthesia is a postoperative sore throat (POST). Up to 70% of patients who receive a laryngeal mask airway (LMA) during anesthesia suffer from POST. Despite its regular occurrence and designation as a minor complication, POST has proven to be a distressing complication for patients afflicted. Consequently, a perceived minor complication can, in fact, play a major role in a patient’s perception of their care, the skill of their anesthesia provider, and their overall satisfaction with their experience.

Evidence shows that inflation of LMA cuffs beyond the recommended …

Intraoperative Ketamine Administration: An Adjunctive Therapy That Reduces Postoperative Pain For Patients Undergoing Spinal Surgery, Brittany Pierce

Doctoral Projects

In 2017, the United States Department of Health and Human Services declared that the country was experiencing an opioid crisis (U.S. Department of Health and Human Services, 2018). As a result of this phenomenon, healthcare providers are examining how they are managing pain and researching new avenues for the treatment of pain. Anesthesia providers are in a unique position to help reduce postoperative pain and ultimately the development of chronic pain. This doctoral project was conducted in order to write an evidence-based policy that directs and educates anesthesia providers in the administration of intraoperative ketamine to reduce postoperative pain in …

Use Of A Vietnamese Pain Scale And Report Of Pain Or Discomfort In Vietnamese Patients With Limited English Proficiency During The Post-Operative Period, Kristine Ho

Doctoral Projects

Language and the ability to communicate with the patient are foundational for effective anesthesia/patient relationships (Rosse, Bruijne, Suurmond, Essink-Bot, &Wagner, 2015). The burgeoning population of Vietnamese people in the United States demands implementation of procedures to ensure adequate communication and safe care. The present project sought to determine if the Wong-BakerVietnamese Pain Rating® Scale assisted Vietnamese patients with limited English proficiency to adequately report pain or discomfort relief during the post-operative period. A convenience sample of adults (N = 25) that meet inclusion criteria constituted the sample. Inclusive criteria were patients who were Vietnamese, between the ages of 30 …

Utilizing The Stop-Bang Questionnaire As A Preoperative Assessment Tool In Patients Undergoing Endoscopic Procedures, Emily Randle

Doctoral Projects

In the world of anesthesia, obstructive sleep apnea (OSA) can cause a conglomeration of post-operative complications. One of the best ways to avoid these complications is to alter one’s anesthetic to accommodate the needs of a patient with OSA. The current issue with altering one’s anesthetic is that a majority of patients with OSA still remain undiagnosed. My project that will showcase just how many patients have undiagnosed OSA.

The goal of this project was to recognize how many patients were at moderate to high risk for OSA. I did this by providing an in-service on OSA and the STOP-Bang …

Referral Policy For Moderate To High-Risk Obstructive Sleep Apnea Patients Identified By The Stop-Bang Questionnaire: A Quality Improvement Project, Martha Kate Goforth, Price Roberts

Doctoral Projects

BACKGROUND: An increase in the prevalence of Obstructive Sleep Apnea is as high as 70% in the surgical population. OSA is associated with a higher incidence of complications in the perioperative setting showing the increased need for proper identification of moderate to high-riskpatients for referral to local sleep clinics. Identifying and treating OSA is an important step to improve managementof chronic diseases, decrease complications both inside and outside the perioperative setting, and reduce healthcare spending.

METHODS: The purpose of this project was to create an OSA referral program for patients undergoing general anesthesia at a hospital in Mississippi. The recommended …

Implementation Of A Sustainable Peer Mentor Program In Student Registered Nurse Anesthetists (Srnas)”, Kristin Cox

Doctoral Projects

Evidence has shown that Student Registered Nurse Anesthetist’s (SRNAs) stress is perceived as above average and is correlated with substandard patient care during clinical courses (Chipas et al., 2012). Some studies have indicated SRNAs experience low self-efficacy during clinical, which could lead to difficulty in thinking clearly or responding to clinical situations (Imus, Burns, & Weglarz, 2017). Peer mentoring has shown to result in stress reduction and improvement in self-efficacy in students (Barker et al., 2012; Giordana & Wedin, 2010). Despite the current evidence, a nurse anesthesia program in the southeastern United States did not have an organized peer mentor …

A Quality Improvement Project To Increase Hand Hygiene Opportunities For Anesthesia Providers, Brad Margherio

Doctoral Projects

Hand hygiene is considered to be the far more superior method for preventing the spread of bacteria from a patient care provider to the patient (Allegranzi & Pittet, 2009; Rowlands et al., 2014; Tartari & Mamo, 2011). The addition of easily accessible hand hygiene devices to the anesthesia carts in the operating room may help to improve the opportunities for the anesthesia providers to perform hand hygiene. Hand sanitizer devices were placed on each of the eight anesthesia carts located in the surgery department of a rural hospital in south Mississippi. The devices were measured weekly for a two-week period …

Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, Madison Nowell

Doctoral Projects

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at …

Best Practice Policy: Utilizing A Standardized Handoff Tool Postoperatively In An Intensive Care Unit For Patients Undergoing Cardiac Surgery, Alexandra Bradley

Doctoral Projects

Communication is a key aspect of care in the health care setting. Handoff communication occurs between medical provider’s numerous times a day. Each patient handoff performed has the potential for ineffective communication, leading to poor patient outcomes. The Joint Commission has recognized handoff communication as one of the main causes of sentinel events, or unexpected events that results in patient harm or death, in the health care setting (Joint Commission on Accreditation of Health care Organizations [JCAHO], 2012). The Joint Commissions National Patient Safety Goal requires “a standardized approach” for provider handoffs. The introduction of a checklist or handoff tool …

Indirect & Displaced Aggression: The Role Of Comparison Based Traits And Cognitive Vulnerabilities, Niki M. Knight

Dissertations

The present study explored the relationships of contingent self-esteem, dispositional envy, and two cognitive vulnerabilities (i.e., anger rumination and fear of negative evaluation) to indirect aggression (IA) and displaced aggression (DA) in a college student sample (N = 346). Despite the theoretical relevance of these personality and cognitive factors to aggression, there is little empirical evidence linking them to the perpetration of IA and DA. Bivariate correlations and hierarchical multiple regression were used to test the utility of these constructs in accounting for unique variance in IA and DA and to assess the potential role of participant gender. Participants …

Impact Of Prolonged Sitting On Cognitive Function: Implications For Cardio-Metabolic Risk, Sabina Miller

Master's Theses

Purpose: To determine if prolonged sitting negatively impacts cognitive function, cerebral perfusion, and central cardiovascular hemodynamics; and secondly, to test whether weight or physical activity status alters this response. Methods: Participants (N=20, age=26±7; BMI=30±7 kg/m²; 7 female) were taken through 3 hrs of sitting followed by a 10-min walk (treadmill). Cognitive function was assessed during sitting (10, 60, 120, and 180 mins) and following the walk using a color/word Stroop test. Cerebral perfusion was measured via near infrared spectroscopy (total hemoglobin—tHb). Central cardiovascular hemodynamics and aortic stiffness (pulse wave velocity—PWV) were measured using the SphygmoCor XCEL device before, …

The Relationship Between Employment And Diabetes Self-Management, Josie Allison Lami

Honors Theses

Diabetes Mellitus is a disease that is becoming more prevalent in the world each day, and it can be deadly if it is not properly controlled. There are multiple aspects that go into self-management of diabetes such as diet, glucose control, physical activity, and lifestyle choices. This study focused on the physical activity aspect of diabetes self-management. Fifty-four subjects completed a survey that questioned time spent sitting while at work, physical activity done outside of work each week, and the results of their most recent Hemoglobin A1C check. The study found that over 50% of the participants who spent more …

Assessing Speech-Language Pathologists’ Knowledge And Use Of Language Acquisition Through Motor Planning, Mary Catherine Cazalas

Honors Theses

Many individuals who are nonverbal require augmentative and alternative communication devices to communicate. The purpose of this research was to assess speech-language pathologists’ knowledge of a particular method of implementing augmentative and alternative communication devices known as language acquisition through motor planning (LAMP). Further, this research was designed to determine the percentage of speech pathologists who have used LAMP during their careers as well as the perceived level of success speech pathologists have found with LAMP. Mississippi speech-language pathologists were used as the sample for this study. A survey was created electronically via the online survey development software, “Survey Monkey,” …

Breastfeeding In Public: Perceptions Of College Students In South Mississippi, Kaitlyn Sierra Kendall

Honors Theses

Breastfeeding rates have increased and declined throughout time. Perceptions of breastfeeding are mixed, with those finding it to be inappropriate and others finding it to be natural. The purpose in this study is to gain a better understanding of how college students in south Mississippi perceive breastfeeding. The Iowa Infant Feeding Attitudes Scale (IIFAS), a 17-item questionnaire aimed to explore an individual’s attitudes toward infant feeding. The Breastfeeding Behavior Questionnaire (BBQ) presented 12 scenarios of breastfeeding in public as a means to explore how participants would react to those encounters. Data was collected from 151 college students through an online …

The Knowledge Of Sexually Transmitted Diseases Among College Students, Annie Doster

Honors Theses

The purpose of this study was to address the perceived and actual knowledge levels of sexually transmitted diseases (STDS) among college students at a southern university. The sample consisted of 138 participants over the age of 18 enrolled as undergraduate students at the University of Southern Mississippi (USM). A questionnaire was distributed via email listserv to the undergraduate population at USM assessing the attitudes and knowledge surrounding sexually transmitted diseases. The survey included three sections for the assessment of each variable: 12 demographic questions, 20 statements assessing student attitudes regarding the quality of their previous sex education and perceived knowledge, …

Perceptions Of College Students Towards Healthcare Provisions On Campus, Sarah Houtz

Honors Theses

Healthcare on university campuses is not a new concept. There is little evidence surrounding the effectiveness and adaptability of services provided to students by providers or healthcare facilities located on campus. Literature describes individual concepts of healthcare resources provided on campus including convenience, holistic care, abilities to refer to off campus specialty clinics, and factors related directly to the patient’s beliefs and values. However, there is a considerable gap in tools used to measure opinions directly related to the services, quality, perception, initiatives, and overall satisfaction with the provisions provided by healthcare professionals located on university campuses. Of the 23 …

The Prospective Influence Of Religiousness On Alcohol Use: What Role Do Perceived Norms Play?, Corey Todd Brawner

Dissertations

Alcohol misuse is recognized as one of the most pressing health hazards for college students. Previous research has supported a protective relationship between religiousness and problematic alcohol use, but it is less clear what aspects of religiousness are protective and through what mechanisms its effect is exerted. The current study utilized a prospective design to accomplish three primary goals: (1) Delineate the protective effects of religious motivation and public participation on alcohol use and alcohol-related problems in a sample of undergraduates at a large public university in the southeastern United States, (2) determine whether effects were maintained long-term, and (3) …

An Investigation Of The Impact Of Family Dynamics On Obesity Among African American Adolescent Girls, Tina Mcdyess

Dissertations

Children who are overweight and obese are more likely to maintain their weight status into adulthood (Fletcher, Cooper, Helms, Northington, & Winters, 2009; World Health Organization [WHO], 2015). The prevalence of obesity has shown a more consistent increase among African Americans aged 2-19 (Flegal, Carroll, Kit, & Ogden, 2012; Ogden, Carroll, Kit, & Flegal, 2012; Ogden, Carroll, Kit & Flegal, 2014) with an even greater disparity among African American girls (Ogden & Carroll, 2010). Family dynamics is one of the many factors of the environment that has been linked to obesity among children and adolescents. The purpose of this study …