Nursing Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson

Doctor of Nursing Practice Scholarly Projects

Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers

Doctor of Nursing Practice Scholarly Projects

The nurse anesthesia specialty is highly stressful, with educational training being no exception. High didactic demands and intensive clinical experiences are placed on student registered nurse anesthetists (SRNAs), increasing stress and anxiety in their personal and professional lives. High levels of psychological distress can lead to inadvertent consequences in students’ mental, emotional, and physical health and can contribute to illness, burnout, substance use, and compromise in patient safety. Some degree of stress is necessary for motivation to succeed and perform at high levels, and encountering stress while enrolled in a doctoral nurse anesthesia program is expected and unavoidable. A search …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather Tatusko

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather M. Tatusko Phiri

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Final Scholarly Project: Clinical Guidelines For The Perioperative Management Of Patients With Opioid Use Disorder Requiring Anesthesia, Jessica Kayla Joos

Doctor of Nursing Practice Scholarly Projects

Opioids have highly addictive properties that allow for high levels of misuse. Since the early 1990s, the misuse and deaths rates related to narcotics have steadily risen in the United States. Efforts to identify individuals using opioids prior to surgery have proven difficult. The number of patients misusing opioids and reporting for surgery can only be estimated due to under-reporting related to fear and self-stigma. With 50 million surgeries in the U.S. annually and 3.32 million people misusing opioids monthly, the chances of a patient with Opioid Use Disorder (OUD) presenting for anesthesia are exceptionally high. Moreover, patients who rate …

Enhancing Srna Confidence: Simulation-Based Crm Training For The Management Of Intraoperative Cardiac Arrest, Melissa Lee

Doctor of Nursing Practice Scholarly Projects

Intraoperative emergencies in the operating room (OR) are rare but necessitate early recognition and intervention.

Enhancing Srna Confidence: Integrating Simulation-Based Crm Training With Didactic Education To Improve Intraoperative Recognition, Communication, And Management Of Intraoperative Cardiac Arrest, Melissa Lee

Doctor of Nursing Practice Scholarly Projects

Within the operating room (OR), the ability to identify deteriorating patient conditions and effectively communicate, is essential to delivering safe and efficient care. Although rare, the critical nature of emergent events necessitates early recognition and prompt intervention by an experienced anesthesia provider. The complexity of emergency management is often related to diagnostic ambiguity, individual provider experience, and disruptions of the fast-paced OR environment, requiring appropriate training methods for proficient execution. However, student registered nurse anesthetists (SRNAs) often lack sufficient exposure to emergent clinical scenarios, leading to delayed intervention and diminished confidence during crisis management. An evidence-based simulation education guideline for …

Evidence-Based Strategy To Improve Delirium Detection In Elderly Postsurgical Patients, Aimee Baker

Doctor of Nursing Practice Scholarly Projects

Postoperative delirium (POD) is a serious adverse outcome that frequently affects older adults. Patients experiencing POD are at greater risk for postoperative mortality, increased length of hospital stay, functional decline, and increased cost of care. Current global population trends indicate that the population of adults over the age of 60 years old will double over the next thirty years. Recent guidelines call for hospitals to implement routine delirium assessment to improve early intervention. Nursing delirium assessment tools are a critical resource for early delirium identification. Nursing delirium assessment tools are often highly sensitive and specific for delirium when used in …

Implementation And Evaluation Of A Structured Mentorship Program, Cary Bedinghaus, Caroline Hillman

Doctor of Nursing Practice Scholarly Projects

The project addresses mentorship in a graduate nursing anesthesia program. The goal is to improve the existing mentorship program and to implement a durable and consistent system that gathers and responds to feedback from the students. Two literature reviews form the underpinnings of the structure and evaluation components of the project. Three structural components were identified in the review as highly effective in multiple studies of diverse mentorship programs. The first component is establishing an effective dyad matching scheme. The second component is establishing clear goals. The third component is maintaining the relationship and achieving goals through frequent and consistent …

Implementation Of Evidence Based Practices To Reduce Postoperative Sore Throat, Anthony Brusadin

Doctor of Nursing Practice Scholarly Projects

An estimated 15 million endotracheal tube (ETT) intubations occur annually in the United States. In addition to pain and nausea, one of the leading complaints by patients after intubation is a sore throat. Postoperative sore throat (POST) is caused by increased pressure on the trachea from the ETT during intubation and after the ETT cuff has been inflated. To prevent the occurrences of POST many options were explored, including cuff material, shape, filling media, and ETT tube size. Through research one of the ways to reduce POST is by monitoring the cuff pressure of the ETT against the tracheal. Typically, …

Using Curriculum Mapping As A Tool To Align The Information Literacy And Evidence-Based Research Learning Outcomes In Nursing Curriculum, Jane Wu

Library Faculty & Staff Scholarship

This research investigated how to use curriculum mapping as a curriculum-integration tool to identify the components of information literacy (IL) and evidence-based practice (EBP) in the nursing curriculum for the future systematic incorporation of information literacy components in teaching EBP. The primary objective is to strengthen information literacy and evidence-based research competency. The ACRL information literacy framework in Higher Education, Information Literacy Competency Standards for Nursing, EBP Competencies, and the EBP research model were used to provide structure to create a map and crosswalk of information literacy and EBP student learning outcomes. We obtained 59 copies of the nursing undergraduate …

Evaluating Implementation Of Diabetes Screening In Family Practice, Makilah Furlan

Masters Theses/Capstone Projects

Poster presentation on implementing diabetes screening in family medicine practice.

Personal Health Questionnaire-9 And Interventions In Adults, Grace Alford

Masters Theses/Capstone Projects

This is an evaluation of the PHQ-9 depression screening and interventions in adults within an urban setting.

Communication Assessment Tools For Emergency Department Nurses Who Interact With Individuals With Intellectual And Developmental Disabilities, Holly Hunt

Doctor of Nursing Practice Scholarly Projects

Abstract/Executive Summary

Problem Statement: Communication is an essential part of every nurse-patient interaction. During the best of times the patient and nurse can clearly understand each other and engage in successful interaction with positive patient outcomes. Individuals with intellectual and developmental disabilities (IDD) often use nontraditional ways of communicating that can complicate the ideal nurse-patient interaction. When a patient presents with a different method of communicating, the nurse must possess tools available to facilitate a successful interaction. Identifying such a tool or if one cannot be found building a sample tool is vital for positive patient outcomes for individuals with …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When …

Development And Implementation Of An Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Program For Student Registered Nurse Anesthetists, Nicholas Colangelo, Zachary Wise

Doctor of Nursing Practice Scholarly Projects

The American Association of Nurse Anesthetists (AANA) has defined the scope of nurse anesthesia practice to include services in acute, chronic, and interventional pain management, as well as the use of ultrasound (U/S) and other diagnostic technologies. However, there are no standard curriculum requirements in place that mandate graduate programs to educate student nurse anesthetists in U/S-related modalities. In addition to the AANA, the use of U/S in nurse anesthesia practice has recently been adopted by The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which characterizes U/S use by its clinical impact on the reduction in complications, increased …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

2023 Nurse Anesthesia Graduation Awards Ceremony Program, Otterbein University

Commencement Programs

Program for the 2023 Otterbein University Nurse Anesthesia Graduation Awards Ceremony.

A Systematic Record Review Of A Local Quality Improvement Impacts On Anesthesia Provider Knowledge And Attitudes Following A Presentation Of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use In Total Joint Arthroplasty Surgical Patients, Kevin Mcclellan

Doctor of Nursing Practice Scholarly Projects

Abstract Patients undergoing spinal anesthesia for total joint arthroplasty (TJA) must urinate and ambulate within 1-hour before discharge from the post-anesthesia care unit to indicate a healthy return of lower body neuro-function after spinal administration. The most common spinal medication used is bupivacaine which has complications including postoperative urinary retention (POUR), altered proprioception, delayed ambulation, and prolonged motor block, resulting in increased cost and length of stay. One alternative solution is mepivacaine, an intermediate local anesthetic lasting 1.5 to 2.5 hours with comparative surgical blockade but a quicker motor and sensory function return. Research suggests mepivacaine is just as safe …

Examining The Need For Change By Describing The Attitudes And Perceptions Of Team Communications Related To Patient Care And Safety Among Ambulatory Clinic Healthcare Staff, Peter Seivers

Doctor of Nursing Practice Scholarly Projects

Medical errors account up to 250,000 patient deaths annually. Research suggests medical errors are attributable to poor healthcare team communications. The Institute of Medicine posits that communication and teamwork are essential components to safe and successful health care environments. According to the Joint Commission poor communication is considered the root cause of nearly 80% of all serious medical errors. Consequently, the Department of Defense and Agency for Healthcare Research and Research created a team-based training program, known as TeamSTEPPS®, which has shown to improve team communication, performance, effectiveness, patient safety, satisfaction, and health outcomes in healthcare settings. Despite evidence supporting …

Evidence-Based Practice Guidelines For The Optimal Assessment Of The Airway In Predicting Difficult Intubation, Meredith Louden

Doctor of Nursing Practice Scholarly Projects

Adverse respiratory events are the most common injuries in anesthesia; difficult intubation and ventilation contribute to most cases. Injuries following inadequate airway management include cerebral hypoxia, aspiration, and cardiac arrest. Despite the risk and consequences following inadequate airway management, most medical facilities lack standardized airway assessments for anesthesia providers. Current evidence implicates that ultrasound measurement of the hyomental distance demonstrates the highest specificity and accuracy in predicting difficult intubation. The traditional approach to conducting airway assessments includes Mallampati classification, which shows high specificity for predicting difficult airways only when combined with other airway assessments. The purpose of this evidence-based project …

Development Of Guidelines For Early Implementation Of Regional Anesthesia In United States Personnel With Peripheral Injuries, Matthew Baker

Doctor of Nursing Practice Scholarly Projects

Dating back to 3200 BC, military personnel routinely experience peripheral extremity wounds during combat. Traditionally, military anesthesia providers utilized general anesthesia and opioids to treat acute pain in the combat setting. Opioids can cause adverse effects such as respiratory depression, delirium, hemodynamic instability, nausea & vomiting, and addiction, which causes delays in care and requires more resources. Regional anesthesia is gaining favor during military operations due to its safety profile and effectiveness in controlling acute pain. Regional anesthesia is safer and more effective than opioids in the trauma/combat setting. Guidelines were provided based on current evidence in the literature and …

Developing A Pediatric Weight Management Program In Primary Care, Alyssa Bosse

Masters Theses/Capstone Projects

The practicum was completed at Central Ohio Primary Care Physicians (COPC), a large group of physician owned primary care practices. COPC would like to start a program for pediatric weight management utilizing their three pediatric Registered Dietitian Nutritionists (RDNs). The first step was collecting data to see any improvements that are needed from the current nutrition program. The second step was reviewing the literature on pediatric weight management to ensure the new program is evidenced-based. All steps were evaluated by COPC leadership and collaborated with internal company resources.