Medicine and Health Sciences Commons^™

Preoperative Non-Opioid Medications For The Management Of Postoperative Pain: Creation Of An Educational Module Based On The Knowledge And Attitudes, Pooja N. Mehta

College of Science and Health Theses and Dissertations

Background: Current clinical studies have shown that preoperative non-opioid medications are an effective method to reduce moderate to severe pain in the postoperative settings, but are not commonly utilized in laparoscopic cholecystectomy patients.

Purpose of this study: The purpose of this study was to evaluate the knowledge and attitudes of anesthesia providers about the preoperative use of three different non-opioid medications: clonidine, acetaminophen and gabapentin for the treatment of postoperative pain in laparoscopic cholecystectomy patients.

Design: A descriptive survey research design was used to determine anesthesia providers’ knowledge and attitudes regarding preoperative non-opioid medications. A modified evidence based knowledge and …

Dnp Project: Reversal Of Neuromuscular Blockade With Neostigmine: Development Of An Evidence-Based Practice Protocol, Kyle L. Mayer

College of Science and Health Theses and Dissertations

Background/Significance: A large population of patients entering the post-operative anesthesia care unit (PACU) with residual neuromuscular blockade (NMB), as defined by a Train-of-Four ratio < 0.9, has been reported in the literature. Patients with residual NMB have a higher likelihood of respiratory insufficiency and failure, and many others experience uncomfortable feelings of muscle weakness. Neostigmine is a commonly used agent to reverse NMB, but little is known about factors which affect use and dosing.

Purpose/Objectives: The purpose of this Scholarly Leadership Project was to identify the factors being considered by anesthesia providers when using neostigmine as a reversal agent for NMB. The findings from this study and current evidence were utilized in the formulation of a set of evidence-based practice guidelines for the reversal of NMB with neostigmine.

Design: This study utilized a descriptive, online survey design.

Methods: A survey was sent through the email LISTSERV of the Illinois Association …

Dnp Project: Effectiveness Of Video Simulation Training To Increase Knowledge And Confidence In The Student Registered Nurse Anesthetist, Erica Anna Kubis

College of Science and Health Theses and Dissertations

Background: Video instruction as a form of education has steadily increased over the past two decades (Whatley & Ahmad, 2007). Current research supports the use of web-based video learning as an adjunct to traditional education to increase knowledge and competency of skills. Despite the many studies showing the effectiveness of video based learning into traditional based learning methods, there are few web-based anesthesia specific platforms with reviewable audio-visual outlets for student registered nurse anesthetists (SRNA) to increase clinical skill competency and confidence.

Purpose: The purpose of this study was to assess the effectiveness of a newly developed web-based clinical simulation …

Evaluating Situation Awareness In The Nurse Anesthesia Trainee During High Fidelity Simulation, Jamie Natale

College of Science and Health Theses and Dissertations

Nurse anesthetists provide anesthesia care for patients within a complex and dynamic environment. Errors and adverse events during anesthesia have declined greatly over the decades, yet when errors occur they are devastating. Anesthesia providers must train for adverse events and develop skills to provide excellent care to patients. Situation awareness skills are proven to advance safety in other complex, dynamic professions, whereas situation awareness training and research is newly evolving in anesthesia.

A situation awareness seminar was developed from a review of relevant literature. A mixed methods research design was utilized for this pilot study. Nurse anesthesia trainees (NATs) were …

Dnp Project: Effect Of Convenience On Participation In Recycling By Anesthesia Providers In The Operating Room: A Pilot Study, Brittany A. Schuler

College of Science and Health Theses and Dissertations

Anesthesia providers are in a position to contribute to the financial and environmental health of their institution through recycling. One of the barriers to participation in recycling by anesthesia staff as identified by the researchers of this study is a lack of convenience. Researchers sought to measure the effect of convenience on participation in recycling by anesthesia providers working in the seventeen operating room suites at NorthShore University HealthSystem Evanston Hospital. The researchers conducted a pilot study implementing a program to enhance the convenience of recycling. Participation, measured by weight in kilograms (kg) of recycled material, was compared pre- and …

Dnp Project: Anesthesia Cost Awareness Project: Price List Of Common Anesthetic Drugs, Betty L. Mestousis

College of Science and Health Theses and Dissertations

Background: Anesthesia providers have full access to medications to administer anesthesia, yet many providers are not aware of the costs of the medications that are administered.

Objective: To examine the effects of providing a price list for the common anesthetic drugs in the operating room, to determine if a price list will change cost awareness among anesthesia providers, and to assess provider’s attitude toward price list intervention.

Methods: This is a descriptive comparative research study that uses a pre-intervention survey to assess if the anesthesia providers have a knowledge base of the cost for the anesthetic medications. A price list …

Evaluation Of Perioperative Intravenous Fluid Administration And Development Of A Goal-Directed Therapy Protocol In Adult Total Hip Arthroplasty Procedures, Amannda Casper

College of Science and Health Theses and Dissertations

Background: Variations in intravenous fluid (IVF) administration practice can result in unwarranted intraoperative volume replacement and suboptimal patient outcomes. This is especially important in patients undergoing moderate risk surgery, such as total hip arthroplasty (THA). 2 Study Purpose: The objective of this study was to evaluate current IVF administration practices during adult THA procedures, and to develop a goal-directed therapy (GDT) protocol in order to better standardize and optimize future fluid administration practices at the University of Illinois Chicago Hospital and Health Sciences System (UIC). Methods: A retrospective chart review was conducted. Intraoperative clinical data was extracted from electronic medical …

Development Of An Educational Seminar On Coping With Stress For Nurse Anesthesia Trainees, Becky Belk

College of Science and Health Theses and Dissertations

Stress is the body’s way of responding to something out of the norm, or a stressor. Stressors affect nurse anesthesia trainees (NATs) to unpredictable levels of stress. The purpose of this study was to explore stressors experienced; ways to cope with stressors as perceived by NATs, if there was any association between socio-demographic variables to the various ways of coping with stress, and development of a one-hour seminar on different ways to cope with stress during a nurse anesthesia program.

A survey was distributed to members of the Illinois Association of Nurse Anesthetists (IANA), which identified demographic information, stressors, and …

Dnp Project: Effectiveness Of Video Simulation Training To Increase Knowledge And Confidence In The Student Registered Nurse Anesthetist, Mishawna K. Bohner

College of Science and Health Theses and Dissertations

Background: Video instruction as a form of education has steadily increased over the past two decades (Whatley & Ahmad, 2007). Current research supports the use of web-based video learning as an adjunct to traditional education to increase knowledge and competency of skills. Despite the many studies showing the effectiveness of video based learning into traditional based learning methods, there are few web-based anesthesia specific platforms with reviewable audio-visual outlets for student registered nurse anesthetists (SRNA) to increase clinical skill competency and confidence.

Purpose: The purpose of this study was to assess the effectiveness of a newly developed web-based clinical simulation …

Dnp Project: Knowledge And Attitudes Regarding Current Technology To Prevent Drug Diversion, Grant T. Balbarin

College of Science and Health Theses and Dissertations

The purpose of this project was to assess Student Registered Nurse Anesthetists (SRNA) and Certified Registered Nurse Anesthetists (CRNA) knowledge and attitudes about current interventions using technology to prevent drug diversion. A descriptive survey was sent to current Illinois Association of Nurse Anesthetists members that included SRNAs and CRNAs. The survey was a modified version of the Evidence-based nursing tool originally developed by Upton and Upton (2006) and was coded utilizing a Likert scale. Data were collected from a sample of 145 SRNAs and CRNAs. Knowledge regarding drug diversion was in the neutral range with a mean = 2.64 - …

Dnp Project: Knowledge And Attitudes Regarding Current Technology To Prevent Drug Diversion, Cheryl Botsford

College of Science and Health Theses and Dissertations

The purpose of this project was to assess Student Registered Nurse Anesthetists (SRNA) and Certified Registered Nurse Anesthetists (CRNA) knowledge and attitudes about current interventions using technology to prevent drug diversion. A descriptive survey was sent to current Illinois Association of Nurse Anesthetists members that included SRNAs and CRNAs. The survey was a modified version of the Evidence-based nursing tool originally developed by Upton and Upton (2006) and was coded utilizing a Likert scale. Data were collected from a sample of 145 SRNAs and CRNAs. Knowledge regarding drug diversion was in the neutral range with a mean = 2.64 - …

Effects Of Convenience On Participation In Recycling By Anesthesia In The Operating Room: A Pilot Study, Alaina S. Murley

College of Science and Health Theses and Dissertations

Anesthesia providers are in a position to contribute to the financial and environmental health of their institution through recycling. One of the barriers to participation in recycling by anesthesia staff as identified by the researchers of this study is a lack of convenience. Researchers sought to measure the effect of convenience on participation in recycling by anesthesia providers working in the seventeen operating room suites at NorthShore University HealthSystem Evanston Hospital. The researchers conducted a pilot study implementing a program to enhance the convenience of recycling. Participation, measured by weight in kilograms (kg) of recycled material, was compared pre- and …

A Needs Assessment For The Development Of The Time Anesthesia Handoff Tool, Courtney K. Gibney

College of Science and Health Theses and Dissertations

Standardized handoff is critical to providing safe and effective patient care. Limited studies assess the need for developing a handoff tool for anesthesia providers.

The purpose of this descriptive study was to assess the need for a standardized anesthesia handoff tool and to identify the most essential components to develop an anesthesia handoff tool.

Descriptive survey design was utilized. Anesthesia providers were asked to complete an online survey.

Fifty-three of 82 (64%) respondents did not currently use a systematic process during anesthesia handoff. Most (73%) felt they were given inadequate information and forty (48.8%) sometimes discovered information that was not …

Anesthesia Providers' Knowledge And Attitudes On Fire Risk Assessment During Time-Out In The Operating Room, Kathryn D. Coletto

College of Science and Health Theses and Dissertations

Background/Significance: Operating room fire is included in a category of “never-events” which are preventable and often result in poor patient outcomes. However, there is currently no standard policy amongst industry organizations regarding the inclusion of fire risk in the operative time out, though all organizations recognize that the risk exists.

Purpose: The purpose of this descriptive study was to examine the knowledge and attitudes of anesthesia providers on fire risk assessment during time-out in current clinical practice.

Design: A descriptive, cross-sectional design was used.

Methods: Active members of the Illinois Association of Nurse Anesthetists were asked to participate in an …

Evaluating Situation Awareness In The Nurse Anesthesia Trainee During High Fidelity Simulation, Caitilin C. Pierchala

College of Science and Health Theses and Dissertations

Nurse anesthetists provide anesthesia care for patients within a complex and dynamic environment. Errors and adverse events during anesthesia have declined greatly over the decades, yet when errors occur they are devastating. Anesthesia providers must train for adverse events and develop skills to provide excellent care to patients. Situation awareness skills are proven to advance safety in other complex, dynamic professions, whereas situation awareness training and research is newly evolving in anesthesia.

A situation awareness seminar was developed from a review of relevant literature. A mixed methods research design was utilized for this pilot study. Nurse anesthesia trainees (NATs) were …

Anesthesia Cost Awareness Project: Price List Of Common Anesthetic Drugs, Minnie C. Zhou

College of Science and Health Theses and Dissertations

Anesthesia providers have full access to medications to administer anesthesia, yet many providers are not aware of the costs of the medications that are administered.

Objective: To examine the effects of providing a price list for the common anesthetic drugs in the operating room, to determine if a price list will change cost awareness among anesthesia providers, and to assess provider’s attitude toward price list intervention.

Methods: This is a descriptive comparative research study that uses a pre-intervention survey to assess if the anesthesia providers have a knowledge base of the cost for the anesthetic medications. A price list is …

Regulation Of Nachrs And Stemness By Nicotine And E-Cigarettes In Nsclc, Courtney Schaal

USF Tampa Graduate Theses and Dissertations

Lung cancer is the leading cause of cancer-related death in both men and women, nationally and internationally and kills more people each year than breast, prostate, and colon cancers combined. Non-small cell lung carcinoma (NSCLC) is the most common histological subtype of lung cancer, and accounts for 85% of all cases. Cigarette smoking is the single greatest risk factor for lung cancer, and is correlated with 80-90% of all lung cancer deaths. Nicotine, the addictive component of tobacco smoke, is not a carcinogen and cannot initiate tumors itself; however, it is known to act as a tumor promoter, by enhancing …

Dementia In Prison: An Argument For Training Correctional Officers, Rachele Vogel

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Dementia is a significant public health problem that is occurring behind bars. However, the number of inmates suffering from this disease is unknown (Feczko, 2014). Current research has exposed a serious gap in correctional health care for older adults, and correctional institutions are being encouraged to make changes to better address the needs of this population (Fellner, 2012; OIG, 2016; Williams, Stern, Mellow, Safer, & Greifinger, 2012b). The purpose of this paper is to bring awareness to the aging problem behind bars and respond to the identified need for additional training for custodial staff (correctional, parole, and probation officers). Training …

A Case Study Using The Biopsychosocial Vulnerability-Stress Model As A Framework To Understand The Incarceration Experience, Annette T. Maruca

Journal for Evidence-based Practice in Correctional Health

In the United States, the Center for Disease Control estimates that about 80% of incarcerated inmates have a substance abuse problem. More than one fourth of inmates are in prisons because of drug related arrests. Additionally, many inmates have cooccurring mental illness disorders as well as health related issues. A multiple (four) case study design was used to explore the association between co-occurring diagnoses, antisocial traits and challenging behaviors within the incarcerated population. The analysis revealed that the four co-occurring diagnoses studied did contribute to poor health outcomes. Study findings suggest that there is a great need to create services …

Biopsychosocial Vulnerability-Stress Modeling For An Incarcerated Population, Deborah Shelton, Bill Barta, Robert Trestman, Sara Wakai

Journal for Evidence-based Practice in Correctional Health

This paper discusses individual constructs that form diathesis-stress models and formulates an adapted model for a corrections population. Diathesis-stress models are familiar within psychiatric nursing, but rarely discussed in the literature in their application to correctional population, or for their potential in guiding nursing practice in correctional settings. Of particular interest to this paper is the coping response of inmates to the stressors of incarceration and the implications for clinical care management.

Rediscovery Of Self-Care For Incarcerated Persons With Diabetes, Louise Reagan, Deborah Shelton, Elizabeth Anderson

Journal for Evidence-based Practice in Correctional Health

Purpose: To examine self-care for diabetes in the incarcerated population within the framework of the Rediscovery of Self-Care (RSC), a newly developed care model for persons with incarceration experience

Organizing Construct: Diabetes is a chronic illness that requires the development and use complex self-care management skills. The RSC is a strengths-based model promoting the belief that inmate- patients are capable of re-discovering their own strengths for self-care.

Findings: Persons with an incarceration experience have person and environment exposures that reduce their self-care capabilities for diabetes. Using a clinical case management approach, clinicians can assist incarcerated persons with re-entry …

Role Of Spinophilin In Group I Metabotropic Glutamate Receptor Endocytosis, Signaling, And Synaptic Plasticity, Andrea R. Di Sebastiano, Sandra Fahim, Henry A. Dunn, Cornelia Walther, Fabiola M. Ribeiro, Sean P. Cregan, Stephane Angers, Susanne Schmid, Stephen S. G. Ferguson

Anatomy and Cell Biology Publications

Activation of Group I metabotropic glutamate receptors (mGluRs) activates signaling cascades, resulting in calcium release from intracellular stores, ERK1/2 activation, and long term changes in synaptic activity that are implicated in learning, memory, and neurodegenerative diseases. As such, elucidating the molecular mechanisms underlying Group I mGluR signaling is important for understanding physiological responses initiated by the activation of these receptors. In the current study, we identify the multifunctional scaffolding protein spinophilin as a novel Group I mGluR-interacting protein. We demonstrate that spinophilin interacts with the C-terminal tail and second intracellular loop of Group I mGluRs. Furthermore, we show that interaction …

The Role Of Inflammatory Monocytes In Post-Influenza Methicillin-Resistant Staphylococcus Aureus Pneumonia, Karl J. Fischer

Theses & Dissertations

Secondary bacterial infections following influenza can lead to poor clinical outcomes and mortality. It is widely accepted that susceptibility to secondary bacterial infections is attributable to a suppressed innate antibacterial immunity. In contrast, a dysregulated host inflammatory response may also contribute to disease severity. Inflammation induced by viral infection alone significantly affects lung pathology, potentially exacerbating the destruction of the respiratory tract. Interestingly, the role of inflammatory mediators such as inflammatory monocytes have been extensively studied during influenza infection alone; however, their role during secondary bacterial infection are still not fully established. The objective of this study was to analyze …

The Pathogenesis Of Natural Killer/T Cell Lymphoma, Bei Jiang

Theses & Dissertations

Extranodal natural killer/T-cell lymphomas (NKTCL) are uncommon lymphomas with poor prognosis. In order to gain a better understanding of the molecular pathogenesis of NKTCL, we obtained and compared the global gene expression profile, global somatic mutation profile, and global methylation profile of normal NK cells, malignant NK cell lines, and NKTCL patient samples. We showed that the JAK-STAT pathway was constitutively activated in NKTCL through the cooperation between activation of signal transducer and activator of transcription proteins (STATs) via activating mutations and inactivation of STAT suppressor protein suppressor of cytokine signaling 6 (SOCS6) through promoter hypermethylation. Activating STAT3 and STAT5B …

Assessing Change In Baseline Preparedness Knowledge In Long-Term Care Facilities, Heidi L. Wheeler

Theses & Dissertations

With much of the focus and federal resources in recent history going to support hospital preparedness, long-term care facilities have been left behind even though they house one of our most vulnerable populations. Few regulations and standards have required these facilities to keep pace with preparing for an increasingly volatile environment and aging society. This is changing with the proposal of new federal standards and regulations requiring more thorough and robust preparedness planning. These new requirements do not have to be overwhelming or burdensome to facilities but can be included quite simply into routine planning and training. This study looks …

Local Minocycline To Reduce Future Inflammation And Bone Loss In Periodontal Maintenance Patients, Jeffery S. Jensen

Theses & Dissertations

The objectives of this study were to compare the effect of SRP+MM versus SRP alone on inflammatory cytokines, interleukin (IL)-1β and IL-1 receptor antagonist (ra), found in gingival crevicular fluid (GCF) and saliva, and correlate IL-1 values with clinical outcomes over a 2-year period of PMT. Fifty-five patients with an initial posterior pocket ≥5 mm and history of bleeding on probing (BOP) were randomized to test (SRP+MM, n=27) and control (SRP, n=28) groups. Clinical measurements and GCF samples were done at baseline and 24 months. SRP+MM or SRP were provided at 6-month intervals. IL-1β and IL-1ra were measured in GCF …

Long-Acting Antiretroviral Nanoformulation Development And Subcellular Trafficking, Dongwei Guo

Theses & Dissertations

The introduction of nanoformulated antiretroviral therapeutic regimens is a promising alternative to standard once a day oral treatment of HIV infection. Our lab has pioneered this effort and was successful in harnessing mononuclear phagocytes (monocytes, dendritic cells and macrophages) as nanoformulated drug carriers. The approach was developed as Trojan horses for drug transport, delivery and distribution to sites of viral replication in order to facilitate microbial elimination in HIV sanctuaries. However, the remaining challenges for current antiretroviral nanoformulations include to formulate a broad range of hydrophilic short-acting drugs, and to elucidate the mechanism of sequestered nanoparticles in macrophages at the …

Antioxidant And Anti-Inflammatory Nutrients On Lung Function In Chronic Obstructive Pulmonary Disease, Jessica M. Hinds

Theses & Dissertations

Introduction Veterans are three times more likely to develop chronic obstructive pulmonary disease (COPD) than the general population. This is likely due to increased use of tobacco and exposure to environmental risk factors. Nutritional intake has been linked to COPD, and veterans report unique barriers to improving their eating habits.

Purpose The primary outcome of this study was to examine the relationship between antioxidant and anti-inflammatory nutrient intake and lung function in veterans with COPD. It was hypothesized that a higher intake of lutein + zeaxanthin, ß-cryptoxanthin, lycopene, retinol, ɑ-carotene, ß-carotene, vitamin C, vitamin D, ɑ-tocopherol, omega-3, zinc and selenium …

Changes To Echocardiography-Derived Left Ventricular Filling Pressures And Cardiac Output In Response To Fluid Boluses In Elderly Patients With Left Ventricular Diastolic Dysfunction Undergoing Vascular Surgery, Sasha K. Shillcutt

Theses & Dissertations

Left ventricular diastolic dysfunction (LVDD) of the heart is a condition where the heart does not relax properly. This condition is important during times of stress, as LVDD is associated with significant morbidity of elderly surgical patients. LVDD is often asymptomatic and unrecognized as many of these patients have normal ejection fractions. However, LVDD may lead to heart failure in patients with preserved systolic function, with the incidence being as high as 50% in hospitalized elderly patients. The diagnosis of LVDD is an independent risk factor for postoperative major adverse cardiac events (MACE) and negatively impacts post-surgery readmission rates. Anesthesiologists …

Stability And Kinetics Of Dna Pseudoknots: Formation Of T∗A•T Base-Triplets And Their Targeting Reactions, Calliste Steffensmeier

Theses & Dissertations

Pseudoknots have been found to play important roles in the biology of RNA. These stem-loop motifs are considered to be very compact and the targeting of their loops with complementary strands is accompanied with lower favorable free energy terms. We used a combination of spectroscopic (UV, CD and fluorescence), calorimetric (DSC, PPC and ITC) and kinetic (SPR) techniques to investigate: 1) Local base-triplet formation in pseudoknots; 2) energetic contributions for the association of pseudoknots with their complementary strands; and 3) the kinetic rates as a function of targeting strand length.

We investigated a set of DNA pseudoknots with sequence: d(TCTCT …