Medicine and Health Sciences Commons^™

General Anesthetic Induction Sequence High Fidelity Simulation: Determining Efficacy Among Novice Student Registered Nurse Anesthetists, Alex Wilkie, Steven Urbick, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background High Fidelity Simulation (HFS) is used across multiple health professions. Despite the wide variety of clinical experiences that Student Registered Nurse Anesthetists (SRNA) possess prior to training, the induction sequence to a General Anesthetic (GA) is a daunting task. Although the efficacy of HFS has been widely studied within undergraduate nursing programs, there are no studies published determining the efficacy of HFS on SRNA training. The purpose of this study was to determine the efficacy of simulation training amongst entry-level SRNA’s and examine any individual participant factors that may influence clinical performance within HFS.

Methods • Human subjects were …

Comparisons Of Preoperative Blood Pressures In Surgical Patients, Brian Stacy, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Surgical patients expect anesthesia providers to provide high quality care. Blood pressure variability must be mitigated by establishing the patient’s blood pressure baseline and sustaining it through surgery. A consensus has not been established on which blood pressure measurement should be used as the patient’s baseline. Blood pressures before surgery in multiple care settings have been shown to vary. This may result in differences in drug and fluid administration, depending on the blood pressure considered baseline by the anesthesia provider. The purpose of this observational evidence-based practice project was to compare mean blood pressures leading up to surgery among …

Comparison Of Ondansetron, Dexamethasone, And Its Combination In The Prevention Of Postoperative Nausea And Vomiting, Alina Palanchuk, Kenn B Daratha

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Background Postoperative nausea and vomiting remains a common and unpleasant side effect for patients following surgery. Uncontrolled PONV can result in prolonged hospital stays, unanticipated hospital readmissions, and decreased patient satisfaction. The Apfel score identifies and counts independent risk factors for PONV; females, non-smokers, postoperative opioid use, and history of PONV or motion sickness. Rates of PONV increases as the number of risk factors increase. The primary intervention to decrease PONV is administration of prophylactic antiemetics. Research supports the use of combination antiemetic therapy for patients with a high number of risk factors. The purpose of this evidence based practice …

Intraoperative Hypotension In Non-Cardiac Surgery Patients At Providence Sacred Heart Medical Center, Genna Ledrew, Kenn B Daratha

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Background Intraoperative Hypotension (IOH) during non-cardiac surgery is a common side effect of anesthesia that is associated with acute kidney injury (AKI), myocardial injury (MI), mortality, and other adverse outcomes1,3,4. These risks increase as the duration and severity of IOH exposure increase3,4. Blood pressure is a modifiable risk factor of mortality and organ damage that can be readily treated by the anesthesia provider2 . Limiting IOH can improve patient outcomes and produce monetary savings5 . The objective of this project is to report the incidence of IOH at a large tertiary teaching hospital, and extrapolate the risks of mortality and …

Hyperoxia: Current Practice Of Oxygen Delivery During General Anesthesia, Christa Kirby, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background While supplemental oxygen is routinely administered during anesthesia to prevent oxygen desaturation and optimize tissue oxygenation, oxygen delivery practices after intubation are largely unknown. Compiled evidence suggests limiting intraoperative fraction of inspired oxygen (FiO2) to below 60%. The deleterious effects of hyperoxia and the mortality benefit of conservative oxygen administration are being demonstrated in contemporary critical care literature. The lack of consensus guidelines and high level evidence on the topic of intraoperative oxygen delivery begs the question to what degree are patients being exposed to hyperoxia during general anesthesia. The purpose of this evidence-based practice project was to better …

Ultrasound Simulation For Regional Anesthesia, Kayla Brown, Kenn B Daratha

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Background Regional anesthesia is an essential skill in the practice of Nurse Anesthesia, and future employment demands expertise. Literature supports the addition of simulation training to existing didactic and apprenticeship education to improve clinical expertise. The purpose of this project was to trial simulation training, focused on anatomical visualization with ultrasound for regional anesthesia, as a means to improve student performance and confidence.

Methods • Facility project approval and exemption determination by IRB. • Hands-On Test: Ultrasound to obtain visualization for axillary (cohort 1), interscalene (cohort 2) block on live-model. Expert CRNA observed performance to determine if image was clinically …

Intraoperative Opioid Administration Among Cancer Patients, Amanda Barrett, Kenn B Daratha

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Background Cancer prevalence continues to rise. In vitro and in vivo studies have demonstrated that opioid receptor agonists may be associated with poor outcomes for cancer patients. Laboratory studies have shown that opioids cause immunosuppression; tumor cell progression, recurrence and metastasis. The surgical environment further decreases immune function, causes an inflammatory response and promotes cancer cell mobilization. Anesthesia providers are in a unique position to influence postoperative outcomes. Opioid free anesthetic delivery is a growing trend amongst anesthesia providers and is supported by the literature. The purpose of this project is to compare intraoperative opioid administration rates for patients with …

Transfusion Ratios Following Activation Of A Massive Transfusion Protocol: An Evidence Based Practice Project, Cody Woodbury, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Accidental injury is one of the leading causes of death in the United States and worldwide. Severe hemorrhage from injury is the leading cause of preventable death. Effective management of hemorrhaging trauma patients has been evolving since the early 1900’s. Recent studies have demonstrated the benefits of using a balanced resuscitation technique, revolving around the goal of recreating whole blood. The purpose of this project was to identify what ratios of blood products are being transfused at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods A literature review was performed identifying seven high quality …

Sugammadex Versus Neostigmine: Operating Room Time And Cost, Annie Benscheidt, Kenn B Daratha

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Background The choice of neuromuscular blockade reversal agents impacts cost and operating room time. Currently, the two medications used to reverse neuromuscular blockade are Neostigmine and Sugammadex. These medications differ in both cost and pharmacologic profiles which effect the time and predictability of reversal (Carron, Zarantonello, Tellaroli, & Ori, 2016). Evaluating cost and time differences in reversal using Sugammadex and Neostigmine helps anesthesia providers select the appropriate medication. This evidence based practice project examined the difference in case length and operating room and reversal agent costs in cases using Sugammadex and Neostigmine at Providence Sacred Heart Medical Center.

Methods • …

Ibuprofen Does Not Increase Blood Pressure In Preeclampsia, Sofia Costas, Sherry Hutton, Cindy Kenyon

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Objective: The aim of this IRB approved study was to evaluate the impact of ibuprofen on Mean Arterial Pressure (MAP) in the immediate postpartum period of women with preeclampsia.

Design: A retrospective chart audit of 633 preeclampsia patients who had treated severe hypertension (BP > 160/105) during their hospital stay.

Setting: Metropolitan Level 3 facility in Portland OR.

Patients/Participants: 169 patients met criteria; received magnesium sulfate postpartum and had severe hypertension postpartum. 60 were randomly selected, 30 received ibuprofen, 30 did not.

Methods: Baseline was obtained at 2 hours postpartum. Each patients MAP for each 24 hour interval were …

The Force Of Magnetism: Nursing-Library Collaborations To Support Magnet, Barbara (Basia) Delawska-Elliott, Helene Anderson, Marla London

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Background: The ANCC Magnet model is built on 5 Model Components and 14 Forces of Magnetism. The Components and Forces, including Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, New Knowledge, Innovation & Improvement, and Empirical Quality Results (Models), and Professional Development, Quality Improvement, Nurses as Teachers, and Quality of Care (Forces) encourage and recognize professional growth, care improvement, and knowledge dissemination. Familiarity with searching professional literature and information literacy are key skills needed to grow Magnetism. This presentation will describe a collaboration between Magnet leadership and the library to build programs designed to support Magnet values and outcomes.

Description: Magnet …

Evaluating The Efficacy And Safety Of Transitioning Patients From Natalizumab To Ocrelizumab (Octave), Kyle E Smoot, Kiren Kresa-Reahl, Pavle Repovic, Jessica Craddock, Chiayi Chen, Lindsay Lucas, Tiffany Gervasi-Follmar, Stanley Cohan

Books, Presentations, Posters, Etc.

No abstract provided.

Nurses’ Experiences And Perceptions Of Using Online Resources For Patient And Family Education: A Qualitative Interview Study, Carrie Grinstead, Sarah Sumner, Julius Shakari, Martha Inofuentes

Books, Presentations, Posters, Etc.

No abstract provided.

Staying Well With Survivorship Wellness, Janni Buaiz

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No abstract provided.

Conversations Matter: Initiating A Serious Illness Conversation, Matthew J Gonzales, Suzanne Engelder

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No abstract provided.

Oncology Navigation: Improving The Patient Experience, Rhonda Hjelm

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No abstract provided.

What's New In Ovarian Cancer, Jessica L. Kozuki

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No abstract provided.

Cologuard: Stool Dna Testing For Colorectal Cancer Screening, Grace Hwang

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No abstract provided.

“-Itis & -Itis”: Immune Checkpoint Inhibitors Toxicity Management, Timothy E. Byun

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No abstract provided.

Renal Considerations In The Oncology Patient, Sridhar K. Reddy

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No abstract provided.

Mild Cognitive Deficits From Cancer Treatments, Jason Tse

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No abstract provided.

Advances In Radiation Oncology, Robert Ash

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No abstract provided.

Evaluating Bundle Adherence In Ventilated Patients: A Quality Improvement Project, Melanie Webb, Lindsay Iverson

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No abstract provided.

Efficacy Of Post-Hospital Follow-Up With A Heart Failure Nurse Practitioner In Older Adults, Gabrielle Bell

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No abstract provided.

Sodium Glucose Co-Transporters Inhibition And Diabetic Kidney Disease, Radica Alicic

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No abstract provided.

Using Ai And Nlp To Alleviate Physician Burnout, Aaron Martin

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Artificial Intelligence (AI) is widely recognized as a powerful tool with potential for many healthcare applications. One application gaining interest is using AI to help solve physician burnout – the state of disillusionment among doctors tired of repetitive data entry tasks, as well as administrative duties, and excessive time spent combing through patient data. In this session, one of healthcare’s top innovators will examine how the power of AI, when merged with natural language processing (NLP), can alleviate many physician burnout woes.

Aaron Martin, a former executive leader and innovator at Amazon before he moved to healthcare, will take a …

Identification And Treatment Of Sepsis In The Field, Jamie Roney

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No abstract provided.

Managing Severe Tbi In The Icu Setting Using A Three Tier Approach, Mary Kay Bader

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Objectives:

• Assess the effects of injury to the brain in the neurologic injured patient and implement a tiered approach to manage severe TBI
• Evaluate TBI patients using multimodality monitoring
• Apply interventions to manage brain injury & integrate the complex multi-system issues and manage these patients using an actual case study.

Temperature Management: All Shook Up! Managing Shivering In Normothermia, Mary Kay Bader

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Objectives:

• Identify key factors related to maintaining normothermia
• Describe the use of the Bedside Shivering Assessment Scale
• Provide interventions to manage shivering in the Neuro patient population

Practice With Purpose & Passion, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Integrate the components of clinical practice in an ICU environment including elements of team membership/performance, teamwork, shared decision making, communication and collaboration
• Demonstrate passion in delivering care in the ICU environment by reflecting on the meaning of nursing care and generating fuel to inspire the clinical team in the work environment