Medicine and Health Sciences Commons^™

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 …

Effect On Opioid Use Following The Implementation Of Evidence-Based Pain Management, Kathryn L. Ellens

Doctoral Projects

Pain is the most common reason people seek healthcare. Initiatives to prevent the undertreatment of pain have resulted in overreliance on opioids to treat pain. Despite significant increases in opioid use, pain is more prevalent than ever. Additionally, devastating consequences from opioid use have resulted, such as dependence, addiction, and increasing opioid-related deaths. Research demonstrates multimodal analgesic therapy is an effective alternative to the overreliance on opioids to treat pain. Multimodal analgesia is the synergistic use of two or more analgesics with different mechanisms of action. Multimodal analgesia produces significantly more effective and efficient pain management than opioid-only therapy. This …

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified registered nurse …

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 …

End Of Life Care Practices For Patients Who Die In Intensive Care Units (Icu), Jila Ghabeljoo

Doctoral Projects

Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

Fentanyl Administration On Emergence From Surgery And Post Anesthesia Care Unit Discharge Times And Pain Scores, Andrew Ernst Wetzel

Doctoral Projects

Problem: Pain has been historically mismanaged potentially leading to a host of negative physiological consequences. Today’s dynamic health care reform offers an opportunity to increase satisfaction with care. Utilizing the PICO question, in adults undergoing laparoscopic cholecystectomy over a 12 month period, does medication with fentanyl during emergence versus not medicating during emergence reduce the need for pain medications and discharge times? Evidence/Background: Two national studies surveyed patient perception of pain management following surgery. The first, conducted by Apfelbaum et.al (2003) showed that 80% of patients experienced acute pain after surgery with 86% rating that pain as moderate …