Nursing Commons^™

Decreasing Post-Operative Ventilator Time In The Cardiovascular Surgical Patient: A Nursing Education Quality Initiative, Amanda J. Bruno Roberts

DNP Scholarly Projects

Extended mechanical ventilation times after open heart surgery can contribute to complications prolonging recovery and length of stay, as well as increasing mortality. Standardized staff education of immediate post-open-heart recovery and ventilator weaning protocols, combined with the use of ABCDE and VAP bundles can reduce these complications. At Hospital X during summer of 2022, the average length of time patients remained mechanically ventilated after open heart surgery increased. After an initial needs survey was distributed to nursing staff, a set of novel QR codes was created to simplify and centralize training for staff in the ICU to facilitate early extubation …

An Evidence-Based Teaching Plan To Increase Awareness Of Certified Registered Nurse Anesthetists To Patient Safety Threats Due To Provider Fatigue And To Offer Effective Strategies To Mitigate Fatigue, Tieneasha Hines, Lisa Alexander

DNP Scholarly Projects

The mental, physical, and emotional effects of stress and fatigue pose significant patient safety risks resulting from impaired concentration, coordination, and overall productivity in certified registered nurse anesthetists. Fatigue is commonly experienced by nurse anesthetists. Fatigue is an occupational hazard that affects not only nurse anesthetists but also patients, colleagues, and other healthcare stakeholders. Certified registered nurse anesthetists are most affected by fatigue due to the prolonged duration of extensive patient monitoring during surgical and complex medical procedures. Due to their central role in ensuring patient safety and comfort during surgery and other procedures requiring anesthesia, certified registered nurse anesthetists …

Educational Modules On Pediatric Cardiac Care For Host Nurse Training During Surgical Mission Trips: A Quality Improvement Project, Maria Arlene Gapac Lemin

DNP Scholarly Projects

Numerous health care organizations conduct international surgical mission trips to treat pediatric patients with congenital cardiac disorders in countries unable to provide complex surgical interventions locally without support. This doctoral student’s experience on numerous mission trips provided the opportunity to evaluate the expertise of circulating and scrub nurses in host countries. Based on this assessment, a knowledge and skill gap was identified and suggested that an educational intervention might benefit host nurses. The purpose of this doctoral project was to develop evidence- and theoretically-based educational modules for local nurses to improve perioperative nursing practice in meeting the needs of their …

The Creation Of An Evidence-Based Educational Intervention For Preceptor Development Of The Novice Certified Registered Nurse Anesthetist, Kathleen Yoka, Nathalie Anderson

DNP Scholarly Projects

Novice certified registered nurse anesthetists (CRNA) are responsible for precepting student registered nurse anesthetists (SRNA) while simultaneously caring for patients in the operating room (OR). SRNAs rely on CRNAs for the majority of clinical training by preceptorship. Well-defined best precepting practices do not exist. The ability to teach others is a learned skill, and the lack of such skill can lead to undue stress for both the novice CRNA and the SRNA. This may lead to reduced job satisfaction of the CRNA and diminished educational experience of the SRNA. The primary purpose of this Doctor of Nursing Practice (DNP) project …

Multimodal Analgesia: Educating Postoperative Nursing, Ira Woodruff, James Keenan

DNP Scholarly Projects

Abstract

Background: Although anesthesia professionals are familiar with this multimodal analgesia, a need remains in educating nurses who will take care of the patients postoperatively so that multimodal techniques may be continued while minimizing opioid use.

Purpose: The purpose of this scholarly doctorate of nursing practice (DNP) project is to validate components of an educational program detailing multimodal analgesia so that postoperatively, nurses may continue to utilize similar techniques for patients to minimize opioid exposure.

Design: A quality improvement project using cross sectional data collection with a focus on provider education was conducted.

Instrumentation: Survey quantitative …

Use Of A Simplified Protocol For The Prevention Of Postoperative Nausea And Vomiting In Adult Ambulatory Surgical Patients, Roger Horne

DNP Scholarly Projects

Postoperative nausea and vomiting (PONV) remains a common complication affecting surgical patients after receiving anesthesia. Prevention of PONV is important in an ambulatory surgical setting where patient access to rescue treatment is limited after discharge. A quality improvement (QI) project introduced a simplified PONV prevention strategy to decrease the incidence of PONV at a Veterans Health Administration ambulatory surgery center. A retrospective chart audit of all facility surgical patients receiving anesthesia care (n = 94), excluding ophthalmology patients, was conducted prior to COVID-19 restrictions to establish baseline PONV incidence. An evidence-based, simplified PONV prevention protocol was developed and implemented. …

Implementation Of Safe Patient Toileting To Decrease Patient Falls On Medical-Surgical Unit, Kimberly A. Goldsborough

DNP Scholarly Projects

BACKGROUND: Patient falls are a serious safety concern in the hospital setting throughout the country. Falls are one of the most challenging patient safety events to prevent, as there are many contributing factors with toileting activities producing the highest incidence. Fall prevention bundles are used to minimize and reduce these such events although multifaceted. The project was conducted with an academic medical center on an acute inpatient medical-surgical unit primarily housing burn wound patients. Nursing leaders and front-line nursing staff participated.

METHODS: Literature review to determine the gap in knowledge of interventions to prevent acute inpatient falls was completed. Concepts …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley

DNP Scholarly Projects

Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013) …