Medical Education Commons^™

Gastric Tube Placement Verification Using Rightspot Gastric Ph Testing, Belinda N. Leos, Msn, Rn, Cen, Elizabeth Winokur, Christiane Pepitone, Bsn, Rn, Cen, C.J. Pfeiffer, Msn, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

The Effectiveness Of Electrocardiogram Tip Confirmation System As Compared To Chest Radiography In Peripherally Inserted Central Catheter (Picc) Placements., Joey Guinto, Diane Dimarco Davis, Chynna Vu, Sabela Barrios, Summer Cortinas, Lynda Fenton, Jeremy Tan, Vinh Le

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Ratings Of Performance In Multisource Feedback: Comparing Performance Theories Of Residents And Nurses, Muhammed Tariq, Marjan Govaerts, Azam Afzal, Syed Ahsan Ali, Tabassum Zehra

Department for Educational Development

Background: Multisource feedback (MSF) is increasingly being used to assess trainee performance, with different assessor groups fulfilling a crucial role in utility of assessment data. However, in health professions education, research on assessor behaviors in MSF is limited. When assessing trainee performance in work settings, assessors use multidimensional conceptualizations of what constitutes effective performance, also called personal performance theories, to distinguish between various behaviors and sub competencies., This may not only explain assessor variability in Multi Source Feedback, but also result in differing acceptance (and use) of assessment data for developmental purposes. The purpose of this study was to explore …

Communicating Confidently: Skills For Nursing Student Clinical Success, Cari Granier

Journal of Interprofessional Practice and Collaboration

Background: Ineffective communication in healthcare has been tied to medical errors and provider stress (Chaharsoughi et al., 2014). Many nursing students struggle when communicating in the clinical setting because they lack confidence. When left unaddressed, this issue can follow students as they begin their nursing careers. Purpose: The study focused on measuring how confident undergraduate nursing students felt communicating with patients, visitors, nurses, and faculty in the clinical setting prior to and after instructor-led interventions. Methods: 17 first-year baccalaureate nursing students from Nicholls State University volunteered to participate. Participants were asked to anonymously complete a survey prior …

H. Advancing Your Education To The Doctoral Level: Dnp, Phd, Edd: Dr. Sheli Hicks Cain, Sheli Hicks Cain

Year of the Nurse: Clinical Scholarship Presentations

No abstract provided.

F. Advancing Your Education To The Doctoral Level: Doctor Of Nursing Practice (Dnp), Marilyn Steinberg

Year of the Nurse: Clinical Scholarship Presentations

No abstract provided.

A. Where Are We Now? Nursing Research In Southern California, Jan L. Keller-Unger

Year of the Nurse: Clinical Scholarship Presentations

No abstract provided.

Utilizing On-Line, Interactive, Adaptive Technology In Nursing Education, Zilola Khashimova

Physician Assistant Studies | Faculty Conference Presentations

The COVID-19 pandemic is affecting health care institutions and is disrupting the training of future nurses. It is more important than ever to ensure that the educators and students have access to high-quality educational materials and technologies to ensure trainee preparedness for clinical and global health challenges. To help meet this challenge, online tools have become a viable option with the recent development of information technology. E-learning can be used to enhance a classroom course, or as a stand-alone course. These online tools include online labs, videos, high resolution images (X-ray, CT-scan, histology), cadaver labs and adaptive, interactive technology such …

Ppe Compliance And Knowledge Among Healthcare Staff, Beatrice Hagert, Nicole Krummel

Nursing DNP Projects

Abstract

Problem: One of the most important steps in infection prevention is the use of personal protective equipment (PPE) to protect patients and staff from infectious agents; yet, research indicates that PPE compliance remains suboptimal in many healthcare institutions.

Purpose: To identify the effect of a multidisciplinary education campaign on PPE compliance and knowledge among healthcare workers (HCWs) on a rehabilitation unit of a large, midwestern teaching hospital.

Methods: This project utilized pre-intervention observational audits and a survey to determine baseline PPE compliance and knowledge on the piloted units. A post-intervention survey was sent to HCW to assess for a …

Decreasing Bias And Improving Education On Non-Invasive Colorectal Screening Methods, Sara H. Hughes

MSN Capstone Projects

It is estimated that in 2020, nearly 148,000 Americans will be diagnosed with colorectal cancer and 53,200 Americans will die from colorectal cancer (Siegel et al., 2020). One- half of all cases and deaths are due to modifiable risk factors such as diet and smoking and it has been shown that early screening and detection can greatly decrease the morbidity and mortality of colorectal cancer yet colorectal cancer related deaths still ranks among the leading causes of cancer-related deaths in the United States and the world. Early detection of colorectal cancer is crucial to reducing mortality and although this is …

Medical Cannabis: Knowledge, Beliefs And Attitudes Of Certified Registered Nurse Anesthetists, Adam Conlon

Grace Peterson Nursing Research Colloquium

Medical Cannabis: Knowledge, Beliefs and Attitudes of Certified Registered Nurse Anesthetists

Student:Adam Conlon RN, BSN

Faculty Sponsor: Kathryn Coletto DNP, CRNA, APN

Abstract Patients who require anesthesia may have a history of using medical cannabis (MC). Illinois has had a MC program since 2013 and legalized recreational use on January 1, 2020. Certified Registered Nurse Anesthetists (CRNA) and Student Registered Nurse Anesthetists (SRNAs) in Illinois need to be adept at discussing MC with their patients and understand how this class of medication affects anesthesia. Multi-modal approaches to control pain are becoming the standard of care inside and outside of the …

Neostigmine Versus Sugammadex And The Relationship To Reintubation Rates In The Pacu, Delanie Urrutia, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Findings Discussion Reintubation in the post-anesthesia care unit (PACU) is a complication that may be related to residual neuromuscular blockade. Neostigmine and sugammadex have different pharmacokinetics that effect speed and completeness of reversal of paralysis. According to Tillquist et al. (2016) reintubation following general anesthesia in the PACU is associated with a 50% increased risk of mortality. Few studies have investigated the incidence rate of PACU reintubation and its possible relationship and choice of reversal medication.

Methods • Retrospective Observational Research Study. • This project was approved by the PSHMC Clinical Innovation and Research Council and deemed human subjects …

Intraoperative Hypotension And Acute Kidney Injury In Non-Cardiac Surgery At Providence Sacred Heart Medical Center, Elizabeth Davison, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Acute kidney injury (AKI) is a serious postoperative complication that increases a patient’s risk for both long and short-term morbidity and mortality.¹ Intraoperative hypotension (IOH) is an independent risk factor for AKI,^2-5 which can be readily modified by anesthesia providers. This project aims to describe the risk factors and rates of AKI following IOH at various absolute mean arterial blood pressure (MAP) thresholds for specified durations of time among adults undergoing non-cardiac surgery at Providence Sacred Heart Medical Center (PSHMC).

Methods PSHMC approved this retrospective, observational evidence-based project and deemed the project exempt by the Institutional Review …

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …

Opioid Consumption After Scheduled Cesarean Delivery Following Implementation Of Enhanced Recovery After Surgery, Mindy Woodruff, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background With 47,600 opioid overdose related deaths in the U.S. in 2017, the opioid crisis is of national concern.1 Cesarean delivery is the most common surgery worldwide, with over 1.2 million in the U.S. in 2018 alone.2,3 As cesarean delivery is a highly prevalent surgery it has a large capacity to influence the opioid epidemic. Literature is showing that Enhanced Recovery after Surgery (ERAS) and multimodal analgesia are effective means of managing postoperative pain while minimizing opioid use.4,5,6,7,8 This project aims to help discover if introduction of ERAS, and more specifically it’s multimodal analgesia aspect, has helped decrease oral morphine …

Prophylactic Phenylephrine Infusion To Mitigate Intraoperative Hypotension After Spinal Anesthesia Among Orthopedic Patients, David Nelson, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background

Intraoperative Hypotension (IOH) is common after spinal anesthesia (SA) and is associated with an increased risk of end organ damage.1 2 3 The treatment regimen for IOH after SA varies in the orthopedic population. However, the current research literature suggests that a prophylactic infusion of phenylephrine significantly reduces the number of episodes and duration of hypotension.1 This EBP project aims to report the proportion of patients receiving prophylactic phenylephrine infusions and the incidence of hypotension following SA among orthopedic surgery patients at Providence Sacred Heart Medical Center (PSHMC) in Spokane, WA.

Methods

• A retrospective, observational EBP project was …

Intraoperative Dexmedetomidine Use On Adult Surgical Patients At Providence Sacred Heart Medical Center, Christina Rose, Scot Pettey, Norel Smith, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Opioids are considered the standard of practice for intraoperative and postoperative pain management but yield unfavorable outcomes.6 The research evidence demonstrates reductions in post-operative opioid use following intraoperative administration of dexmedetomidine.1,3,4,5,6 Due to the prospective nature of literature surrounding dexmedetomidine, the rate of implementation remains largely unknown. The aim of this retrospective, observational project was to identify the rate of adoption of intraoperative dexmedetomidine administration among adult surgical patients at Providence Sacred Heart Medical Center (PSHMC) from January 1, 2015 to December 31, 2019. Accordingly, investigation into dexmedetomidine administration at PSHMC may shed light on this strategy aimed to …

Rate Of Unscheduled Administration Of An Epidural Bolus Among Pregnant Women Receiving Labor Epidurals, Aleksandr A. Lyakhov, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The labor and delivery process is a painful experience that pregnant women undergo and while various medical options are available for managing labor pain, labor epidurals are the most common.1,3 Breakthrough pain, or inadequate analgesia, is a significant complication of labor epidurals that is typically managed with the administration of an unscheduled epidural bolus. The purpose of this evidence-based practice (EBP) project is to describe the rate of unscheduled epidural bolus administration in pregnant women receiving continuous labor epidurals (CLE) at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods • Design: Retrospective, observational, EBP …

Intratracheal Lidocaine And Postoperative Sore Throat At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Jennifer Cowgill, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative sore throat (POST) is a common side effect from general anesthesia (GA) and has a prevalence of 14.4-50%.1 The experience of POST contributes to patient discomfort during recovery from surgery. The etiology of this is thought to be from tracheal mucosal erosion from the cuff of the endotracheal tube (ETT), trauma from intubation, coughing and bucking, and friction between the ETT and the tracheal mucosa during general anesthesia.2 Risk factors shown to contribute to the development of POST include, but are not limited to, elderly age, smoking history, patient positioning, ETT cuff pressure, and movement of ETT during …

Rates Of Ondansetron Administration Prior To Spinal Anesthesia: Evaluating The Practice Of Prophylactic Attenuation Of Spinal-Induced Hypotension And Bradycardia, Clare Santana, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Hypotension and bradycardia are common complications of spinal anesthesia. Intraoperative hypotension and bradycardia may lead to complications that require additional treatment and increase cost. The literature identifies intervention strategies to attenuate spinalinduced hypotension (SIH) and bradycardia.1 Prophylactic administration of ondansetron, a serotonin 5-hydroxytryptamine receptor antagonist, prior to spinal anesthesia is associated with reduced SIH and bradycardia.1,2,3,4,6 The objective of this scholarly project was to report the practice of ondansetron prophylaxis for SIH and bradycardia and the rate of rescue interventions in patients who received ondansetron prior to spinal anesthesia.

Methods Retrospective, multi-center observational evidence-based practice project conducted at Providence …

Correlation Of Ondansetron Timing In Postoperative Nausea And Vomiting: A Retrospective Evaluation Amongst Adult Patients Receiving General Anesthesia, Jeff Tanguay, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Addressed as a national quality initiative by the Centers for Medicare and Medicaid Services (CMS), postoperative nausea and vomiting (PONV) is a vexing complication requiring further attention by anesthesia providers.3 Medication optimization is an area of focus to address this complication.4 Ondansetron, a selective 5- hydroxytryptophan subtype 3 (5-HT3 ) receptor antagonist, is effective and considered the “gold standard” in the prevention of PONV.4 GlaxoSmithKline™ suggests administering Zofran® (ondansetron) before the induction of anesthesia.5 These directions are in contrast to the synthesis of the research evidence, which supports increased effectiveness of ondansetron when administered 30 minutes before emergence from …

Postoperative Nausea And Vomiting With Low-Dose Propofol Infusions In Patients Undergoing Gynecological Surgeries With Volatile Anesthetics At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Adrianna Silva, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative nausea and vomiting (PONV) is a common complication following surgery. It remains the most important determinant of length of stay and leading cause of dissatisfaction in anesthesia.4 Females undergoing gynecological laparoscopic surgery have the highest rates.8 Apfel’s baseline risk factors for PONV include female gender, history of motion sickness and/or PONV, non-smoking status and administration of postoperative opioids.1 Propofol has antiemetic properties and Gan’s evidence supports the use of an intraoperative low-dose infusion to reduce baseline risk factors for PONV.6 This project aims to describe the rates of intraoperative low-dose propofol infusions in female patients undergoing gynecological surgery …

Solutions To Address Frequent Hospital Attendance, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

In this editorial, practical solutions and considerations in helping the most complex and at-risk patients in our health systems are discussed. These patients, sometimes referred to as health care “super-utilizers” in the literature, tend to be frequently seen and cared for in costly hospital and emergency department settings. Innovative care models that aim to bridge system gaps, achieve better health outcomes, and improve the well-being of both patients and providers are needed and should continue to be explored.

Sepsis Screening Education, Brittany R. Horn

Doctor of Nursing Practice Scholarly Project

Sepsis is a significant burden to the healthcare field with 1.7 million Americans annually diagnosed with this condition. Earlier diagnosis and treatment are the most effective ways of reducing morbidity and mortality related to sepsis. The current sepsis screening tool in place at Stormont-Vail Hospital, in Topeka, Kansas, is the systemic inflammatory response (SIRS) criteria; however, this screening tool has proven to be less effective than other screening tools available. The screening tools proven more effective than the SIRS criteria, are the quick sequential organ failure assessment (qSOFA) and the sequential organ failure assessment (SOFA). For this project, nursing staff …

Nursing In The 21st Century: A Conversation With The New President Of The Illinois American Nurses Association

DePaul Magazine

In an interview, Assistant Professor of Nursing Elizabeth Aquino, president of the Illinois American Nurses Association (ANA) and associate director of the School of Nursing’s Master’s Entry to Nursing Practice program, talks about the future of nursing. She discusses the nursing shortage, the need for more school nurses, diversity in the nursing profession and retention issues related to burnout. She outlines what DePaul's School of Nursing, the ANA and other nursing associations are doing to strengthen and diversify the nursing profession.

Factors Predicting Sustainability: A Correlational Study Of One Multi-Site Program, Meredith L. King Jensen

Dissertations, Theses, and Capstone Projects

Healthcare organizations invest significant economic, physical, and human resources to implement changes and expect sustained benefits for their investments in the long term. Yet, few studies have examined long-term sustainability and factors contributingto sustainability. The primary aim of the study was to gain a better understanding of sustainability and five factors (champions, leadership support, policy, resources, and training and education) that might predict long-term sustainability within the context of one Safe Patient Handling and Mobility (SPHM) program implemented in a large, nationwide system more than 7 years ago. The secondary aim was to examine the number of nursing staff injuries, …

Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti

Doctor of Nursing Practice Final Manuscripts

Abstract

Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Trauma Informed Care: Paving The Way To Better Patient Outcomes, Sarah Halsey, Amy L. Armstrong

Doctor of Nursing Practice Projects

Trauma-informed care (TIC) is an approach that enables healthcare clinicians to understand the effects of trauma and create a safer environment. Providers acknowledge the pervasive nature of trauma but lack proper tools and training to implement. It has been suggested that trauma is the prime determinant of health outcomes. Therefore, providing training and cultivating a change towards a trauma-informed organization, has the capability to change health outcomes.

The purpose of this project was to establish a program at SIU Medicine in which new employees are trained on the importance of TIC. Working closely with the Director of Population and Community …

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice …