Educating Srnas On Barriers And Facilitators Of Clinical Learning, Mesud Dedic, Richard Heuermann

Doctor of Nursing Practice Projects

A national survey of 143 Student Registered Nurse Anesthetists (SRNAs) conducted by Clancy and Bruinius (2022) revealed that factors impeding effective SRNA clinical education include unstable preceptorship, hostile environments, limited autonomy, and heavy didactic burdens. Clancy and Bruinius (2022) also found that facilitators of SRNA clinical education include rapport with preceptors, effective feedback, strong clinical site orientation, and beginning of day discussions. This project aimed to enhance second-year SRNAs' clinical success by mitigating these evidence-based barriers and employing these evidence-based facilitators by developing a presentation for SRNAs and assessing its effectiveness through a pre-implementation survey and post-implementation survey. The literature …

Emotional Intelligence And Srna Success Utilizing A Sim Experience, Melody Gassoway, Kaleigh Peters

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) face many challenges in meeting the rigorous demands of their doctoral-level training. Research demonstrates that high levels of emotional intelligence (EI) contribute to SRNAs’ academic and clinical success and improve patient safety and quality of care. Simulation is emerging as an educational tool to enhance the EI skills of students training in highly stressful professions and demonstrates promising benefits for SRNAs, such as improved decision-making, critical thinking, self-awareness, and self-regulation (Moriber & Beauvais, 2017; Dix et al., 2021). This doctoral project aimed to determine the efficacy of a high-fidelity simulation for strengthening the EI skills …

Development Of High-Fidelity Simulations For Srnas: Airway Fire And Venous Air Embolism, Ashlyn Russo, Brooke Skaggs

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) must swiftly recognize and treat high-risk, low-incidence complications in a high-stress environment. Most SRNAs do not experience high mortality or rare emergencies throughout their training. This project involves developing and implementing two high-fidelity simulations for airway fire and venous air embolism (VAE) to help SRNAs improve their skills in a safe learning environment. Objectives for this project include examining current evidenced-based literature to determine the efficacy of high-fidelity simulation on the SRNA’s knowledge and performance post-simulation, determining the incidence, pathophysiology, and treatments for airway fires and VAE, creating two high-fidelity simulation scenarios, and integrating the …

Educating Anesthesia Providers On The Physiological Effects And Anesthesia Implications Of Cannabis, Carmel Loud

Doctor of Nursing Practice Projects

In the U.S., currently 37 states have legalized cannabis for medicinal use prescribed by qualified medical professionals (National Conference of State Legislatures [NCSL], 2022). In 2012, the legalization of recreational cannabis began; as of 2022, 19 states have legalized the recreational use of marijuana (NCSL, 2022). This project aimed to optimize care for patients using cannabis by increasing anesthesia provider knowledge about cannabis. The project's aim was accomplished through a thorough review of the current medical literature and implementation of education to anesthesia providers about the physiological effects and anesthesia implications of cannabis. Thirteen CRNAs took a pre- and post-quiz …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

Best Practice In Airway Management Of The Neonatal Population, Brittaney Montcalm

Doctor of Nursing Practice Projects

The historical idea that uncuffed endotracheal tubes (ETT) are the best method for pediatric airway management is being challenged in today’s current anesthetic practice. Whether to use a cuffed or uncuffed ETT in the neonatal population remains controversial. This project involved a comprehensive literature review of best-practice recommendations for neonatal airway management, focusing on the use of uncuffed versus cuffed ETTs. Literature review findings were presented as an educational PowerPoint presentation, and a quick reference guide for pediatric airway management was developed. A post-implementation questionnaire was administered to determine the effectiveness of the presentation and its perceived application in clinical …

Anesthetic Management Of The Parturient With Increased Intracranial Pressure Disorders, Madeline Olson

Doctor of Nursing Practice Projects

The parturient experiences various physiologic changes that contribute to the potential for increased intracranial pressure (ICP). Patients with preexisting neurologic conditions such as Chiari Malformation I, pseudotumor cerebri, and mass occupying lesions are at significant risk of increased ICP. A literature review was conducted to determine the safest labor anesthesia options for the parturient with increased intracranial pressure. After the literature review, a PowerPoint presentation and reference guide were given to a group of anesthesia providers at a central Illinois hospital that discussed the evidence-based recommendations. A voluntary survey was completed after the presentation to assess an improvement in knowledge …

Evaluating The Efficacy Of Perioperative Methadone In Cardiac Surgery, Brock Thornton

Doctor of Nursing Practice Projects

Cardiac surgery includes a myriad of highly invasive and complex procedures that can lead to the development of chronic pain and delayed patient recovery (Murphy et al., 2015). Despite frequent administration of opioid medications, cardiac surgery is associated with moderate to severe pain in up to 75% of patients (Bolton et al., 2019; Choinière et al., 2014; Wang, Song, & Nault, 2021). Methadone, a long-acting synthetic opioid medication, improves analgesia and decreases the risk of chronic pain syndromes among multiple surgical populations. Literature within the last five years suggests a single dose of intravenous methadone in cardiac surgery (0.1-0.3 mg/kg …

Local Anesthetic Systemic Toxicity: Last Protocol Development, Implementation, And Evaluation For Healthcare Providers, Rachel Vaughn

Doctor of Nursing Practice Projects

LAST is an uncommon but deadly complication of local anesthetic administration. Healthcare facilities benefit from protocol implementation to help streamline best evidence-based practice. The American Society of Regional Anesthesia and Pain Medicine warrants a LAST emergency protocol for any healthcare facility practicing regional anesthesia. Healthcare personnel encountering patients at risk for LAST must understand the symptoms and treatment of LAST to improve response time and patient outcomes. The project implemented a LAST protocol at a rural hospital in Southern Illinois in July 2023. The investigator held an educational service to discuss the new LAST protocol and implementation. The educational service …

Discharge Lounge Utilization, Jessica Goneh, Areo Comonal

Doctor of Nursing Practice Projects

Efficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative …

Procedural Sedation Training: Competency Verification Through Simulation, Christine Hawknuff

Doctor of Nursing Practice Projects

A 450-bed tertiary hospital in Central Illinois lacked a standardized process for competency verification for procedural sedation care by registered nurses (RNs). Despite recommendations by many organizations, there are no consistent or standardized guidelines for verifying competency in nursing care of the procedural sedation. This project implemented a Procedural Sedation Training Course which comprised an in-person prelearning lecture, a group simulation learning experience, and an individual verification of competency through simulation.

Fifty-six RNs completed the Procedural Sedation Training Course and demonstrated competency through simulation, and 24 of these RNs completed a procedural sedation within the eight-month pilot period. Qualitative and …

Increasing Ob/Gyn Clinic Nursing Staff Knowledge And Comfort Level In Providing Breastfeeding Education, Nancy Moore

Doctor of Nursing Practice Projects

There are well known benefits of breastfeeding for both mother and child, yet the educational support from providers during prenatal visits is not consistent or well-documented. An educational presentation discussing guidelines of breastfeeding education, common breastfeeding problems and barriers to breastfeeding was developed and presented to a “Baby Friendly” hospital-based OB/GYN clinic staff at an urban St. Louis hospital. The goal was to increase staff knowledge and comfort providing education and resources surrounding breastfeeding to be used to increase discussion of breastfeeding during prenatal and postpartum visits. Evaluation of pre and posttest data showed an increase in knowledge regarding managing …

Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Implementation Of Prenatal And Postpartum Depression Screening For A Telehealth Company, Allison Herrmann, Lori Deibel

Doctor of Nursing Practice Projects

Abstract

Depression is a leading mental health disorder. Depression occurring during the perinatal and postpartum periods has become highly prevalent throughout the world, impacting 5-10% of women during (van de Loo et al., 2018) and 9-23.5% postpartum (Bauman et al., 2020). Proper diagnosis and treatment of perinatal and postpartum depression (PPD) is crucial, as depression can lead to poor outcomes including relationship complications and negatively affect child development (Slomain, 2019). The implementation of screening tools can help identify women at risk based on their signs and symptoms of PPD (Bauman et al., 2020). The primary goal of this project was …

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Using The Confusion Assessment Method For The Intensive Care Unit (Cam-Icu) To Decrease Length Of Stay: A Scoping Review, Brooke D. Ward Bsn, Rn, Dnp Agacnp Student, Martina Little Bsn, Rn, Dnp Agacnp Student, Tracy Mcclinton Dnp, Agacnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a prevalent challenge among ICU patients, impacting approximately 30% of admissions (Brennan et al., 2023). If left untreated, delirium can increase use of restraints, hospital length of stay, intensive care unit length of stay, and ultimately, morbidity and mortality. This scoping review assesses the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) to gauge its efficacy in reducing the length of stay in the ICU for adult patients with delirium.

Methods

A literature review from 2018 and 2023, using PubMed, CINAHL, and Medline were utilized for the search along with key words such as: length of …

Medication Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates, Kayla Sherea Williams Bsn, Rn, Hannah Lee Brenner Bsn, Rn, Madison Makenzie Yount Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Background The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing …

Strategies To Reduce Ventilator-Associated Pneumonia Incidence In Mechanically Ventilated Pediatric Critical Care Patients: A Scoping Review, Morgan A. Moore Bsn, Rn, Kianna Cherry Bsn, Rn, Mallory Crenshaw Bsn, Rn, Rachel Kincy Bsn, Rn, Christen N. Parnell Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background

Ventilator-associated pneumonia (VAP) is a severe problem in pediatric intensive care units (PICUs), resulting in increased morbidity, mortality, duration of stay, and healthcare expenses. Traditional preventative measures are well-established, but the influence of ventilator filters in preventing VAP is unknown. The current evidence on the efficacy of VAP bundles and ventilator filters is variable and challenging to address. This scoping review aims to determine how VAP bundle compliance and ventilator filter utilization impact the incidence of VAP in mechanically ventilated pediatric critical care patients.

Methods

A scoping review was carried out per the Population, Concept, and Context (PCC) framework. …

Evaluating The Effectiveness Of Sglt2i Or Glp1ra Vs. Sulfonylurea Initiation After Hospital Admission For Congestive Heart Failure And Type Ii Diabetes Mellitus: A Scoping Review, Alyssa Ptacek Bsn, Rn, Amber Majors Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Carrie Harvey Phd, Aprn-Bc, Acnp, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The need for effective pharmacological management in patients with congestive heart failure (CHF) and type II diabetes mellitus (T2DM) is an ever-growing task for healthcare providers, especially in the primary care setting. Patients with multiple comorbidities are less likely to adhere to required rigorous medication schedules and lifestyle modifications, resulting in accelerated disease progression and defeated efforts of healthcare providers. Traditionally, sulfonylureas have been the medication management of choice by healthcare providers due to their affordability compared to modern medication. Current guidelines recommend that individuals with poor glycemic control could benefit significantly from using older sulfonylureas with other antidiabetic …

Decreasing Re-Intubation Rates In Mechanically Ventilated Adult Patients: A Scoping Review, Anne J. Shearin Bsn, Rn, Wesley Gray Bsn, Rn, Philip Habegger Msn, Aprn, Fnp-C, Evan Gregory Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Decreasing Re-Intubation Rates in Mechanically Ventilated Adult Patients: A Scoping Review

Purpose/Background

Critically ill patients often require mechanical ventilation to support respiratory function. Prolonging mechanical ventilation can increase adverse outcomes. Weaning patients from the ventilator as soon as clinically appropriate can decrease adverse outcomes. The decision to wean mechanical ventilation lacks a standardized approach. This scoping review will evaluate the literature about the effectiveness of a standardized weaning protocol in decreasing the number of reintubations within 72 hours of extubation.

Methods

We conducted a literature search on PubMed, CINAHL, Scopus, and Medline between November 2020 and November 2023 using key …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Procedural Oxygen Mask Use For Inpatient Bariatric Endoscopy: A Scoping Review, Makinlee Meadows, Marion Millette, Brittany Morgan, Lauren Pegrim, William Collier Phillips, Dwayne Accardo Dnp, Crna, Faana, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Hypoxia is a severe adverse event that is often associated with sedated endoscopy procedures, and bariatric patients have a significantly higher risk for complications related to oxygenation during sedation due to pathophysiological changes to the respiratory system. This scoping review compares the rate of hypoxemic events with the use of a binasal cannula versus a procedural oxygen mask during inpatient endoscopic procedures in patients aged 19-64 with a BMI greater than 40.

Methods

The scoping review includes control trials with and without randomization, case-control/cohort studies, systematic reviews, and qualitative/descriptive studies. With limited research regarding the PICOT, extending the age …

Effectiveness Of Virtual Reality In Anesthesia Machine Education, Heather Milder, Rachel Geisendorfer

Doctor of Nursing Practice Projects

The anesthesia machine is an essential part of anesthesia practice, as it connects the patient to the provider and provides a constant stream of vital information. Therefore, the Certified Registered Nurse Anesthetist (CRNA) should be trained to utilize and troubleshoot the anesthesia machine to deliver high-quality patient care. Education about the anesthesia machine begins with Student Registered Nurse Anesthetists (SRNAs) through various learning opportunities. Immersive virtual reality simulation has emerged as a potential educational aid to engage active learners. This project aimed to determine the effectiveness of utilizing the immersive virtual reality simulator SIMVANA for first-year Southern Illinois University Edwardsville …

Emr Templates For Age-Appropriate Well-Child Pediatric Visits, Alison Drerup, Kelsey Piper

Doctor of Nursing Practice Projects

The world of pediatric medicine is continually evolving. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) regularly update guidelines to have the most current information available to providers and their patients. The overwhelming majority of primary care offices have transitioned to electronic medical records (EMRs) for charting purposes. Templates included in EMRs ease the workflow and documentation process for providers. In the primary care setting, templates include essential information discussed at well-child visits, such as developmental milestones, vaccination schedules, and anticipatory guidance. The project’s purpose was to update the age-specific well-child templates at …

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.

Depression Screening In Type 2 Diabetes In Adolescent 12-18 Year Olds, Mykyla Coleman Bsn,Rn, Chelsea Conlee Bsn,Rn, Carol Gracia Msn, Aprn, Fnp-Bc, Emily Jennewine Msn, Aprn, Cpnp-Pc, Ibclc, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background

Although more commonly diagnosed in adults, type 2 diabetes is increasingly diagnosed in pediatric populations in the United States. Research suggests a correlation between depression and type 2 diabetes, however, a gap in research exists regarding depression and type 2 diabetes among pediatrics, specifically adolescents. This scoping review aims to address this gap by assessing the impact of depression screening on glycemic control in this specific population.

Purpose

The goal of the review is to contribute to the development of effective strategies for depressing screening in adolescents with type 2 diabetes, with the expectation this may positively impact glycemic …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Medicinal Treatment Versus Dialysis In End Stage Renal Disease Patients With Perioperative Hyperkalemia: A Scoping Review, Haley Bishop, Bsn, Rn, Hannah White, Bsn, Rn, Matthew Wilhaucks, Bsn, Rn, Ashton Weaver, Bsn, Rn, Christin Simpson, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

No abstract provided.

Food Insecurity Screening Of Families In A Level Iii Neonatal Intensive Care Unit, Katelyn P. Vawter Rn, Bsn, Rnc-Nic, Megan Ortiz Rn, Bsn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Full Study Title: Food Insecurity Screening of Families in a Level III Neonatal Intensive Care Unit

Background: Early infancy food insecurity (FI) is linked to poor health later in life, and Neonatal Intensive Care Units (NICUs) are often overlooked. Routine FI screening can help identify and assist the families suffering from FI seen in the NICU before being discharged home.

Purpose: The aim was to identify if families were assessed for FI by social workers or if they were more likely to report FI in a brief survey.

Method: A randomized chart review of social work notes for 30 NICU …