Nursing Commons^™

Improving Oncofertility Discussions And Referrals: Implementation Of A Formal Fertility Preservation Program, Mackenzie Danielle Browning, Melissa Marie Hessock

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Impaired fertility is a risk of life-saving cancer treatment in adolescents and young adults (AYAs). Despite this known risk and clinical practice guidelines that stress their importance, treatment-associated fertility risk education and preservation referrals are often neglected in this population.

LOCAL PROBLEM: The site of this evidence-based practice improvement project is an outpatient hematology-oncology clinic serving adults with varying cancer diagnoses. The site did not have a standardized approach to ensure treatment-associated fertility risk education and fertility preservation referrals were provided to AYAs with newly diagnosed cancer. The purpose of this project was to implement a formal fertility preservation …

Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).

LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.

METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …

Implementation Of A Single-Patient-Use Airway Taping Product In The Operating Room, Savannah Sierra Nicole Craig, Kaitlin D. Burrell, Jennifer Patrick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Anesthesia providers use adhesive tape to secure advanced airway devices. Rolls of adhesive tape serve as reservoirs for pathogens. Rolls of tape do not have instructions on how they are to be reused, cannot be disinfected, and should not be repurposed. The re-use of rolls of tape poses a risk to patient safety.

LOCAL PROBLEM: The project facility was an academic medical center in the Southeast region of the United States. The facility does not have taping practice guidelines in place. Rolls of tape are handled without gloves, used by several providers, placed on multiple patients’ faces, and stored …

Implementation Of Standardized Handoff Report In The Post Anesthesia Care Unit, Christie Faye Cox, Godsy Raju, Alyssa Garcia, Nicole Odom, Jennifer Patrick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Handoff communication is a critical event as it involves the transfer of patient details, authority, and responsibility from one clinician to another. The variations in handoff can lead to increased opportunities for clinician error due to the distinct possibility of the anesthesia providers omitting critical patient information.

LOCAL PROBLEM: The site for this quality improvement project is an academic medical center in the Southeastern region. The purpose of this quality improvement project was to implement a standardized anesthesia handoff tool for anesthesia providers. The aim of this project was after one month of implementation, the mean anesthesia …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Non-Opioid Pain Relief: Use Of Vitamin D In Central Appalachia, Christina Brown, Karen Lasater, Teresa Tyson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Overdose deaths have exceeded US war fatalities since WWII. Central Appalachia faces high substance use rates and poor health determinants. The opioid epidemic costs $740 billion annually. Providing 100 million chronic pain sufferers alternative pain control is efficacious, equitable, and reduces opioids. The author collaborated with a nurse-led mobile clinic in Central Appalachia to identify evidence-based non-opioid pain relief options for practice translation. In patients with hypovitaminosis D, the body will increase parathyroid hormone production to absorb calcium resulting in skeletal or muscular pain. Vitamin D’s steroid properties reduce inflammation by dampening proinflammatory cytokines. Framework: The Johns Hopkins Nursing …

Assessing Preinjury Frailty In The Elderly Hip Fracture Patient To Promote Palliative Care Referral In Those At Risk For High Morbidity And Mortality, Alicia N. Walker, Jewyl Gibson, Sara Dunham

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

The objective of this project is to assess preinjury frailty in hip fracture patients aged 65 and older as a predictor for postsurgical morbidity and mortality, prompting early referral to palliative care services in patients deemed high-risk for postoperative complications. Including palliative care in the multidisciplinary care of the high-risk patient has been shown to improve quality of life, increase patient and caregiver satisfaction, and reduce healthcare costs. The design is a quality improvement initiative. The setting is an academic medical center, serving as the region’s Level 1 Trauma Center. There is no current process for measuring frailty as a …

The Practice Environment For Nurse Anesthetists In Tennessee, Taylor Cathey, Jessica Hobbs, Matthew Owen, Alexis Varney, James Alberding, Tausha Alexander

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Potential consequences of anesthesia provider shortages may include a reduction in health care access, poor patient outcomes, and increased costs to government funded agencies. Current leaders in the anesthesia profession need to establish a work environment that is embracing, supportive, and safe so that certified registered nurse anesthetists (CRNA) can remain healthy and productive. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to provide an overview of the current CRNA practice environment in Tennessee and advocate for policies to promote CRNA retention and enhance patient access to care. The overarching goal included gathering sufficient evidence regarding …

Instituting An Educational Module To Improve Knowledge Of Local Anesthetic Systemic Toxicity Among Anesthesia Providers, Alisha Marie Linehan, Chad Andrew Mcclure, Steven Taylor Moon, Shukhratilla Ibragimov Shamshitdinov, Julie Newton Bonom, Jason Michael Buehler

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Local anesthetic use in the perioperative period is increasing in the United States as healthcare providers seek alternatives to opioid-based pain management. While increased use of local anesthetics has many benefits, their use also increases the risk of Local Anesthetic Systemic Toxicity (LAST), which is a serious and potentially life-threatening complication. A search of the literature indicates there is a considerable gap in knowledge of LAST among healthcare providers, including Certified Registered Nurse Anesthetists (CRNAs) and anesthesia residents. This knowledge gap is combined with a lack of standardized approaches to identifying and treating this complication. Identifying and treating LAST is …