Nursing Commons^™

Innovative Pain Management Of The Post-Operative Patient, Debra Perry

Theses and Graduate Projects

Medical/surgical patients post-operatively report significant pain and are not always satisfied with their pain management. Nurses on medical/surgical units frequently find themselves in a cycle of chasing after their patients' pain. Medical/surgical units historically rely heavily on pharmacological interventions to manage post-operative pain with little focus on non-pharmacological interventions. With the integration of complementary and alternative medicine (CAM) as an additional tool for care for medical/surgical nurses, they will be empowered to be proactive rather than reactive in post-operative pain management. This project develops an innovative post-operative pain management educational program that integrates Western medicine and CAM into the care …

Quiet Please: Our Patients Are Healing!, Evie Pochardt

Theses and Graduate Projects

Patients are under a significant amount of stress during their hospitalization. Noise is an environmental stressor which is found at increasing levels in hospitals and is a primary annoyance for patients. This environmental pollutant can impair a patient's rest, sleep, and ultimately affect healing. Unwanted noise has been shown to cause sleep disturbance, impair wound healing, trigger hormones affecting the cardiovascular system, immune system, and metabolism as well as perception of pain. Intermittent noises such as those from infusion pumps, monitor alarms, and pagers are the most disturbing. Nightingale believed that unnecessary noise was harmful to the patient's healing; it …

Intentional Rounding On A General Surgical Unit, Lisa M. Patterson

Theses and Graduate Projects

Patient safety for the hospitalized patient is a coneern. Hospitalized patients are affected by pain management issues, a risk of falling, and the potential to develop pressure ulcers. Research has shown that by reducing these events, patients report increased satisfaction which ultimately increases hospital reimbursements, not to mention cost avoidance. Intentional rounding is a nursing best practice designed to anticipate patient care needs and improve patient safety. A project to implement intentional rounding on a general surgical unit provided a leadership opportunity for a Masters of Nursing student to plan, implement, and evaluate a nursing unit quality initiative using Watson's …

Advocacy For The Perioperative Patient, Patricia R. Ballinger

Theses and Graduate Projects

Thousands of surgeries and procedures happen daily. Patients place their lives and well-being in the hands of the surgical team. The operating room is a high risk environment and unfortunately, errors can occur resulting in harm and even death. Each surgical team member has a role and responsibilities during the surgical case. One main role of the perioperative nurse is patient advocacy and patient safety. However, this role can be impeded due to hierarchy and the operating room culture. Identifying the perioperative nurse's role and responsibility relating to patient advocacy will provide directions in the perioperative nurse's daily practice. An …

Creating A Healing Environment In The Operating Room By Reducing Noise, Emily Grimshaw

Theses and Graduate Projects

The operating room can be a very noisy environment. Noise in this setting can affect patient's physiologically as well as psychologically and it can also affect operating room staff. The review of the literafure shows the effects noise in the operating room has on patients and staff. Patients can become tachycardic and hypertensive due to the exposure to increased noise in the operating room while staff concentration can be impeded as well. The creation of a noise reduction program for the operating room will create a healing environment. The healing environment will help both patients and operating room staff, Patients …

Roadmap: Setting The Course For Family And Patient Involvement In Their Plan Of Care, Kristina Holleran Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

We Rock – You Roll: Surgical Staging Unit Propels On-Time First Case Start Initiative, Marlene Mayza Bsn, Rn, Janice Magliane Adn, Rn

Patient Care Services / Nursing

No abstract provided.

Continuous Renal Replacement Therapy, Gulzar Salman Amlani

School of Nursing & Midwifery

Acute renal failure refers to sudden deterioration in biochemical and physiological functioning of kidneys and often associated with multi organ failure. Continuous renal replacement therapy (CRRT) holds special significance for the treatment of renal failure due to a variety of factors. It is believed that CRRT helps in restoration of acid-base imbalances and electrolyte abnormalities. Along with that, with gradual solute removal, it ensures haemodynamic stability and prevents the risk of cerebral oedema in neurosurgery patients. Besides this, several studies have supported that CRRT enables practitioners to adjust drug dosages and prevent drug accumulation and overdose. In addition, gradual removal …

Attitudes And Practices Of Perioperative Nurses Effecting The Election Of Wearing Protection From Occupational Radiation Exposure, Jane Leonard

Nursing Theses and Capstone Projects

Health effects from exposure to radiation are unpredictable. On a daily bases, nurses working in the perioperative setting are exposed to medical x-rays (ionizing radiation) and are vulnerable to its carcinogenic effects. Regardless of the potential health consequences, the use of protective equipment remains inconsistent among perioperative nurses. Most research studies regarding nurses' occupational health risks either failed to include or separate radiation exposure from chemicals and blood borne pathogens. The purpose of this study was to examine the relationship between the attitudes and practices of perioperative nurses that influence their decisions to wear or not wear radiation protection equipment …

Evaluating The Knowledge And Attitudes Regarding Pain Management Among Nurses In A Surgical Setting At An Acute Care Facility, Barbara Turner

Nursing Theses and Capstone Projects

It is estimated that seventy-three million patients undergo surgical procedures each year in the United States. Of these, 80% experience acute post-operative pain, and approximately 20% experience severe pain (Hutchinson, 2007). Benner's Theory from Novice to Expert was used to guide the study, "Evaluating the Knowledge and Attitudes Regarding Pain Management Among Nurses in a Surgical Setting at an Acute Care Facility". A convenience sample of twenty-one nurses in an acute care hospital in Southwestern North Carolina participated in the Knowledge and Attitudes Survey Regarding Pain. Results showed a weak correlation between knowledge and attitudes of pain management and years …

Preoperative Education: How Effective Teaching Impacts Knowledge With The Surgical Patient, Heidi Grossweiler

Nursing Theses and Capstone Projects

This research study involved questions identifying the perception of nursing staff related to preoperative teaching. Does initiating teaching, built through relationships and learning during the preadmission visit, have a positive effect on outcomes? The study design included a survey based on the Likert scale, evaluating nurses who conduct preadmission testing visits with patients in the outpatient surgical setting. The evaluation provided information about the correlation of information given between the nurse and the patient, which provides teaching guidelines for educating a patient preoperatively. A cover letter was given to the participant that detailed the purpose of the study and included …

Implementation Of A Beta Blocker Protocol, Jody L. Heriot

UNF Graduate Theses and Dissertations

Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction.

Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and …

Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour

UNF Graduate Theses and Dissertations

The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness …

How To Effectively Reduce Costs Associated With Robotic Surgery: Is This Even Possible?, Martin A. Martino Md, Jocelyn Shubella, Wesly Menard, Jeremy Patriarco, Brian Leader, Rachel Miller Pa-C, Megan Allen Rn, M Bijoy Thomas Md, Richard Boulay Md

Department of Obstetrics & Gynecology

No abstract provided.

Program...Validate...Infuse: Developing An Iv Infusion Validation Tool, Nancy Humes Bsn, Rn, Nicole Zimmerman Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

14 Irrefutable Reasons To Eliminate Surgical Smoke, Kay Ball

Nursing Faculty Scholarship

Next time a surgeon challenges your mandatory smoke evacuation policy, have these 14 fast facts at the ready. They’re a mix of evidence- based reasons as well as practical and financial incentives that make eliminating electrosurgery plume from your ORs tough to argue against.

Sleeping In Safety: A Study Of Nurse Anesthetists In Ghana, Lauren Kasparian

Inquiry Journal 2011

No abstract provided.

Effects Of Early Initiation Of Induced Therapeutic Hypothermia, Frank Castelblanco

Nursing Theses and Capstone Projects

Cardiac arrests are responsible for about 325,000 deaths annually in the United States (Heart Rhythm Foundation, 2010). The majority of these cardiac arrests occur outside the hospital setting, with a dismal national survival rate of 8% (American Heart Association, 2010). The Bernard (2002) and HACA (2002) studies demonstrated that by initiating therapeutic hypothermia as a treatment modality for cardiac arrests the survival rate could be as high as 49% and 55% respectively. Therapeutic hypothermia can be initiated in many different settings. The question remains, does the setting of the initiation of therapeutic hypothermia effect patient outcomes? The purpose of this …

Teamstepps Communication And In Situ Simulation Training To Improve Individual And Team Performance During Handoff Of The Immediate Post-Operative Cardiovascular Surgical Patient, Stacy Lynn Jepsen

All Graduate Theses, Dissertations, and Other Capstone Projects

The aim of this pilot study was to identify if establishing a reliable framework for consistent use of TeamSTEPPS communication would improve the team communication and performance during the critical handoff of the cardiac surgical patient from the OR team to the ICU team. Breakdown in handoff communication has been attributed as the cause of adverse health events, delays in treatment, inappropriate treatment, increased length of stay, and increased costs and inefficiencies from rework. Standardizing handoff communication is a Joint Commission National Patient Safety Goal, and immediate postoperative cardiac surgical patients are a high-risk population needing consistently high quality communication …

Emerging Evidence In Infection Control Effecting Change, Melissa Dawn Machan

UNF Graduate Theses and Dissertations

Current procedures for cleaning anesthesia airway equipment have been reported to be ineffective. The potential for cross-contamination from some airway equipment to a patient has been documented in several studies. In order to prevent potential infections, it should be ascertained as to why all anesthesia providers are not using disposable laryngoscope blades. The purpose of this evidence based project is to determine the perceptions of anesthesia providers regarding the use of disposable laryngoscope blades. Their frequency of use, their evaluation of ease of use, and any complications encountered when using the disposable blade before and after an in-service program designed …

Stamping Out Electrosurgery Smoke, Kay Ball

Nursing Faculty Scholarship

Did you know that perioperative nurses have twice the incidence of some respiratory problems as compared to the general population? This information surprised me too when the data from my doctoral research revealed this startling and unsettling fact.....What are we breathing in the OR?

Reorientation Of The Experienced General Medical/Surgical Nurse To A Progressive Care Medical/Surgical Nurse Utilizing Benner's Novice To Expert Theory, Barbara Radford

Nursing Theses and Capstone Projects

The decisive factor for this project was the Health Care Organization's decision to combine the medical/surgical units from two campuses into one department. This process required the Registered Nurses to reapply for their positions, merge into one unit, and transition to a different physical location. The next major process to occur will be the changing of patient acuity-levels from general medical/surgical to medical/surgical progressive care.

This project will provide a cost effective educational plan based on Benner's novice to expert theory which will ensure efficient transition for the expert medical/surgical nurse to an expert progressive care nurse. A structured orientation …

Are Your Ors Smoke Free?, Kay Ball

Nursing Faculty Scholarship

Are your ORs smoke free? They should be. Here's expert advice to overcome the 3 obstacles you're likely to encounter.

Evaluation Of Laparoscopic Appendectomy Vs. Open Appendectomy: A Retrospective Study At Aga Khan University Hospital, Karachi, Pakistan, Yasmin Vellani, Shaheena Bhatti, Ghina Shamsi, Yasmin Parpio, Tazeen Saeed Ali

School of Nursing & Midwifery

OBJECTIVE: To compare open and laparoscopic appendectomies and to evaluate the level of efficacy of both types of appendectomy performed at Aga Khan University Hospital (AKUH).

METHODS: Based on this strong study rationale, a clinical audit of patient's records was performed to evaluate the significance of this technique as a treatment modality. The study population comprised of patients with appendicitis admitted in the Department of Surgery from January 2004 to December 2004. The patients' charts were reviewed to ascertain whether the procedure was done as an acute case or as an elective procedure. The predictor variables explored in this study …

Ob-Pdcds English, Marianne E. Weiss

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Ob-Pdcds English, Marianne E. Weiss

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Ob-Pdcds English, Marianne E. Weiss

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Post Discharge Nausea And Vomiting In Ambulatory Surgical Patients: Incidence And Management Strategies, Jan Odom Forren

University of Kentucky Doctoral Dissertations

Approximately 65% of all surgeries are conducted in the outpatient surgery setting involving more than 35 million patients. Thirty-five to fifty percent of these outpatients will experience post discharge nausea and vomiting (PDNV), nausea and vomiting that occurs after discharge from the health care facility after surgery. A dearth of literature details the problems associated with nausea and vomiting experienced by patients after discharge home from outpatient surgery.

The purposes of this dissertation were to (1) review the current knowledge in the area of post discharge nausea and vomiting; (2) present results of an integrative review of the research literature …

Toward A Smoke-Free Or, Kay Ball

Nursing Faculty Scholarship

The hazards of surgical smoke are well documented. So why are many smoke evacuation systems going unused?

You can write all the surgical smoke evacuation policies in the world, spell out exactly what you expect to be done and provide the resources needed for compliance, but if you ignore the human element — the surgeons and staff who populate your ORs — then you aren't going to change behavior. Here's how you can educate your teams about the hazards of surgical smoke and get them to use evacuators when necessary.