Dexmedetomidine Vs Fentanyl In Attenuating The Sympathetic Surge During Endotracheal Intubation: A Scoping Review, Alexandra Schwieger, Kaelee Shrewsbury, Paul Shaver, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 …

Postoperative Nausea And Vomiting Implications In Neostigmine Versus Sugammadex, Corey Lee Johnson, Colton Bradley James, Sarah Grace Traughber, Charles Anthony Walker, Dwayne Accardo Dnp, Aprn, Crna

Doctor of Nursing Practice Projects

Purpose/Background: Postoperative nausea and vomiting (PONV) is a frequent complaint in the postoperative period, which can delay discharge, result in readmission, and increase cost for patients and facilities. Inducing paralysis is common in anesthesia, as is utilizing the drugs neostigmine and sugammadex as reversal agents for non-depolarizing neuromuscular blockers. Many studies are available that compare these two drugs to determine if neostigmine increases the risk of PONV over sugammadex. Sugammadex has a more favorable pharmacologic profile and may improve patient outcomes by reducing PONV.

Methods: This review included screening a total of 39 studies and peer-reviewed articles that looked at …

Opioid Free Anesthesia To Prevent Post Operative Nausea/Vomiting, Aleksander Acred, Milena Devineni, Lindsey Blake, Cindi Dabney Dnp, Crna

Doctor of Nursing Practice Projects

Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice.

Methods In this scoping …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Availability And Nursing Implementation Of Measurement Tools In The Co-Occurrence Of Depression And Chronic Pain: An Integrative Literature Review, Ashley Thomas

Grace Peterson Nursing Research Colloquium

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Ashley Thomas

Faculty Sponsor: Barbara Harris

Background: There is high correlation between chronic pain and depression. They are seen throughout the literature to interact and feedback symptoms upon each other. However, there is not a comprehensive screening tool that assess both symptoms and not a clear indication of nursing responsibility in assessment of the co-occurrence.

Objectives: The purpose of this literature review is to create a comprehensive review of current research concerning the availability of screening tools that measure the co-occurrence …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

Efficacy Of Smart Infusion Pumps From A Nursing Perspective, Kassi B. Zaborowski

Applied Research Projects

In today’s healthcare, intravenous (IV) therapy-related errors have become rampant and are responsible for a substantial portion of hospital injuries and deaths. In the last decade, however, since the development and implementation of “smart” IV pumps, a significant number of these IV medication errors have allegedly been reduced. The purpose of this paper is to discuss research surrounding an evaluation of the efficacy of smart IV pumps from a nursing perspective.

Effects Of Energy-Based Therapies On Postoperative Recovery: An Integrative Review Of The Literature, Emily M. Wooten

Honors Undergraduate Theses

Associated with health care reform, there has been a growing interest among healthcare professionals regarding use of energy-based therapies as a complementary therapeutic intervention. The purpose of this integrative literature review was to examine the impact of energy-based therapies (i.e. healing touch, reiki, therapeutic touch) on patients’ postoperative recovery. The methodology included identifying appropriate peer-reviewed, English-language research articles on the topic area that were published between 2006 to 2018. Following a search in select data bases, articles focusing on the topic were critiqued, analyzed and synthesized by the researcher. Consistent and inconsistent findings along with gaps in the literature are …

The Impact Of The Nurse Practitioner In Pre-Admission Testing: A Comparative Review, Laurel A. Robinson

DNP Projects

Abstract

PURPOSE: The purpose of this study was to compare the efficiency of pre-admission testing (PAT) surgical clinic pre and post implementation of the APRN for patient assessment. Cancellation and delay occurrences for scheduled surgeries will be compared during two time periods on patients on the surgical schedule at Norton Women and Children’s Hospital (NWC).

METHODS: This study was a single-center, pre and post implementation retrospective comparative study of the impact of the NP led PAT unit at Norton Women and Children’s Hospital (NWC) in terms of delay and cancellation rates for day-of-surgery. The sample consisted of 411 patients for …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Rationale And Study Protocol For The Patient-Centered Outcome Aid (Pcoa) Randomized Controlled Trial: A Personalized Decision Tool For Newly Diagnosed Ovarian Cancer Patients, Lari Wenzel, Dana Mukamel, Kathryn Osann, Laura Havrilesky, Lisa Sparks, Joseph Lipscomb, Alexi A. Wright, Joan Walker, Ronald Alvarez, Linda Van Le, Katina Robison, Robert Bristow, Robert Morgan, Bobbie Rimel, Heather Ladd, Susie Hsieh, Aditi Wahi, David Cohn

Communication Faculty Articles and Research

"The purpose of this study was to develop and test the effectiveness of a Patient-Centered Outcome Aid (PCOA) compared to a control condition of usual care, as patients chose between IV or IP therapy for advanced ovarian cancer. We developed an internet-based decision aid to improve patient-centered outcomes and tested it within a randomized clinical trial. The purpose of this paper is to describe the clinical trial development and protocol."

An Expanded Role For Nurses In Laboratory Utilization, Marilyn S. Hamilton, Rangaraj Selvarangan, Michele Fix, Lynn E. Shriver

Posters

Introduction: The majority of laboratory testing errors occur in the pre-analytical stage, including specimen collection. Children provide special challenges including small blood volumes, small veins, and an inability to cooperate. We describe collaboration between laboratorians and nursing staff to improve specimen collection and the reliability of test results.

Methods: We identified three areas for improvement: 1) Volume of blood for culture, 2) Urine collection, and 3) Appropriate blood collection through a line. Base line data was established. Guidelines for specimen collection were updated. Nurse members of the Laboratory Utilization Committee developed educational tools.

Results: Nursing education was effective at improving …

Noise: Its Impact In The Operating Room, Brennon Wesley Sloan

Doctoral Projects

Orthopedic and neurologic cases routinely reach noise levels exceeding 120 decibels (Katz, 2014). Modern equipment and monitors used by anesthesia personnel only reach 85 decibels (Katz, 2014). These monitors can go undetected during peak noise levels creating a serious safety concern for patients that could lead to patient injury or death (Gawande, Zinner, Studdert, & Brennan, 2003). A clinical question was developed to determine if the education of noise levels in the operating room affects change in practice. For operating room managers and staff, does education of noise levels in the operating room compared to no education initiate a change …

The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen

Senior Honors Theses

Respiratory distress syndrome (RDS) is a common consequence of pulmonary immaturity in the lungs of neonates. RDS is the result of the deficient secretion of endogenous surfactant, causing increased surface tension in the alveolar sacs leading to respiratory compromise. RDS is more common in the preterm neonate but can be experienced by neonates at any gestational age. Treatment for RDS formerly consisted of mechanical ventilation and oxygen therapy to treat and relieve symptoms but not the cause. A new treatment method, developed largely in the 1980s and 90s is the use of exogenous surfactant to treat the deficiency exhibited in …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Lauren M. Hurley, Alexandra Smola

Williams Honors College, Honors Research Projects

The prevalence of developmental disabilities in children in the United States is a serious problem. Since children with developmental disabilities often show decreased self-efficacy and balance, researchers have studied the effects of interventions in this population. The purpose of this study is to determine the effect of a 10-week THR session on balance and task-specific self-efficacy in children with physical disabilities ages 6 to 18 years old. Bandura’s social cognitive theory and The Physical Stress Theory will guide the quasi-experimental study. A pre-test post-test design will be implemented over a 12 week span at 3 different riding centers in the …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

An Exploration Of Nurse Adherence To Ventilator-Associated Pneumonia Bundle Interventions: A Quantitative Study, Alexis Luna

Senior Theses

Ventilator-associated pneumonia (VAP) poses a significant health risk to patients on mechanical ventilation in hospital intensive care units (ICU). It is the responsibility of the nurse to implement VAP bundle interventions to decrease the prevalence of VAP in mechanically ventilated patients. The objective of the study was to measure nurse perception of adherence to VAP bundle interventions of oral hygiene, head-of-bed elevation, spontaneous breathing trials, daily sedation vacations, and peptic ulcer and deep vein thrombosis prophylaxis. A descriptive study involving a sample population of 28 ICU nurses at 3 hospitals in northern California was conducted. A 57-item questionnaire was developed …

The Effects Of Nursing Care On The Patient Experiencing A Stillborn Birth, Katherine Totten

Senior Honors Theses

Childbirth has the potential of being one of the most joyous and fulfilling experiences a woman goes through in her entire life. Being a mom, driving the kids to soccer practice, and sitting around the Christmas tree with the family can easily be seen as an ideal life. Conversely, the negative experiences with childbirth are rarely discussed. There is an overlooked category: moms who conceive but lose the baby in the womb. Not only are these women overlooked, but also the hospital care they receive proves inconsistent with the latest research. Nurses and doctors should be aware of the latest …

A Bland–Altman Comparison Of The Lead Care® System And Inductively Coupled Plasma Mass Spectrometry For Detecting Low-Level Lead In Child Whole Blood Samples, Christina Sobin, Tanner Schaub, Natali Parisi, Eva De La Riva

Selected Works Temporary Series

Chronic childhood lead exposure, yielding blood lead levels consistently below 10 μg/dL, remains a major public health concern. Low neurotoxic effect thresholds have not yet been established. Progress requires accurate, efficient, and cost-effective methods for testing large numbers of children. The LeadCare® System (LCS) may provide one ready option. The comparability of this system to the “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS) for the purpose of detecting blood lead levels below 10 μg/dL has not yet been examined. Paired blood samples from 177 children ages 5.2–12.8 years were tested with LCS and ICP-MS. Triplicate repeat tests …

Relationship Between Some Demographic Characteristics And Adverse Reactions Experienced By Women Undergoing A Therapeutic Abortion While Awake, Karen K. House

Loma Linda University Electronic Theses, Dissertations & Projects

With the liberalization of abortion laws by the Supreme Court in 1973, American women have been able to obtain therapeutic abortions in hospitals and out-patient clinics in ever increasing numbers. With the increased number of women seeking abortions the medical field has responded with abortion procedures that are safe and relatively quick. With the speed doctors use to perform the procedure, many women may wish to take advantage of the medically safer method of abortion under local anesthesia. However, some women are unable to withstand the psychological and physical stress associated with a therapeutic abortion while awake. It would be …