Nursing Commons^™

Patient Care Advocacy Through Electronic Communication, Jared T. Holton, Scott A. Kahre

Doctor of Nursing Practice Projects

Patient advocacy is a primary role of the Certified Registered Nurse Anesthetist (CRNA). While engaged in the legislative process, CRNAs have failed to materialize significant gains in political potency on a national scale. This project involved the development of prototype software for mobile communication devices to augment the CRNA community’s ability to advocate for patients in the healthcare policy arenas. After a demonstration of the software to key leaders of the American Association of Nurse Anesthetists (AANA), an anonymous survey was distributed to the AANA executive administrators. All six executives in attendance for the demonstration of the software completed and …

Local Anesthetic Systemic Toxicity Management: An Assessment Of Simulation-Based Staff Education, Kevin L. Kanallakan

Doctor of Nursing Practice Projects

When local anesthetics are administered at toxic doses or when certain local anesthetics are directly injected into the patient’s circulation, excessive plasma concentrations of the drug will produce a systemic cascade of events known as local anesthetic systemic toxicity (LAST). LAST is a rare, potentially life-threatening complication, which affects both the central nervous and cardiovascular systems. Anesthesia providers and perioperative healthcare professionals must remain current on best practice LAST management in order to reduce morbidity and mortality.

This quality improvement project utilized high fidelity simulation paired with LAST education to improve stakeholder knowledge and management of a LAST scenario. With …

Diabetes Education, Audra Trump

Doctor of Nursing Practice Projects

Background: Diabetes Self-Management Education (DSME) has been shown to improve diabetes management. However, a Midwest academic clinic does not offer formal diabetes education. The health department offers formal diabetes education classes twice a year. However, the classes are not flexible, long, and offered infrequently. Objective: The purpose of this project is to improve access to and standardize DSME for patients newly diagnosed with type II diabetes. Methods: The project design includes a one group pre-test/post-test convenience sample of adult patients who are newly diagnosed with type II diabetes in an academic outpatient setting. Results: At the time of diagnosis, the …

Postoperative Delirium Education, Aaron Wede

Doctor of Nursing Practice Projects

Surgical patients, aged 65 and older, comprise the largest surgical population. Increased age correlates with an increased incidence of postoperative delirium. Postoperative delirium (POD) can drastically increase healthcare costs, length of hospital stay, and overall morbidity and mortality. A clinical reference tool was created to have available for perioperative staff members at a 200-bed community hospital in the Midwest. The tool describes risk factors, prevention methods, and treatment options for POD. The initial implementation of the project was achieved with a PowerPoint presentation which was created to summarize the information found in the literature review and to instruct perioperative staff …

Sugammadex Protocol, Brenna M. Thomas

Doctor of Nursing Practice Projects

Sugammadex is a new medication used for the reversal of muscle relaxation induced by rocuronium, vecuronium, and pancuronium. Sugammadex is available for use at St. Anthony’s Memorial Hospital in Effingham, IL. However, they did not have a protocol regarding the use of this medication. A sugammadex protocol was written for the operating room (OR) staff after a thorough, evidence based literature review was completed. The OR staff included certified registered nurse anesthetists, anesthesiologists, registered nurses, and pharmacy. The protocol was implemented and evaluated with a pretest, an educational PowerPoint regarding sugammadex, and a posttest. A paired samples t test was …

Diabetic Foot Screening Tool: Utility In A Busy Primary Care Setting, Crystal A. Cusanelli

Doctor of Nursing Practice Projects

Abstract

Problem: Providers in a Midwest rural clinic identified that foot care is often overlooked due to the complexity of diabetic patients and limited time available during office visits.

Purpose: This project examined the utility of an evidence-based, diabetic foot screening tool, provider satisfaction with the tool, and provider perceptions regarding foot care in a busy primary care practice.

Methodology: Providers were instructed on using the screening tool. The tool was utilized on all diabetic patients during office visits over a two-month period. Anonymous surveys were distributed and a focus group was conducted to gather post-implementation outcomes.

Results: Two providers …

Obstructive Sleep Apnea: A Staff Educational Program And Protocol, Aaron Michael Quach

Doctor of Nursing Practice Projects

Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Despite its prevalence, OSA often goes undiagnosed. This can result in negative sequelae. By educating healthcare providers about OSA, screening patients, and altering the plan of care, better outcomes will arise and complications can be minimized.

The purpose of this project was to develop an obstructive sleep apnea educational program and protocol based on available current literature for anesthesia providers at a community hospital. The educational project and protocol consisted of an informational PowerPoint, pretest and posttest surveys, an OSA screening tool and identification of a high risk OSA patient …

Fascia Iliaca Compartment Block Protocol For Hip Fracture, M. Ray Nordyke

Doctor of Nursing Practice Projects

Fascia iliaca compartment block (FICB) is a volume based block used to treat pain associated with hip fractures. An anesthesia group at a central Illinois hospital expressed interest in the creation of an evidenced-based protocol for FICB. After an extensive literature search an evidence-based protocol was designed. The initial implementation of the protocol was a presentation of an informational PowerPoint which discussed the aspects of the protocol presented to the anesthesia staff and the registered nursing staff who assist the anesthesia providers. The protocol was then evaluated with a Likert scale survey completed by the staff. The results from the …

Improving Acute Postoperative Pain Management For Opioid-Tolerant Patients: Development Of A Postoperative Ketamine Infusion Protocol, Jeri Dockins

Doctor of Nursing Practice Projects

Anesthesia providers are encountering a growing number of opioid-tolerant patients. To date, the treatment for acute pain has been the administration of opioids. The administration of opioids leads to postsurgical complications. This project’s purpose was to improve acute pain management for opioid-tolerant patients by creating a postoperative ketamine infusion protocol. Ketamine is a noncompetitive antagonist at N-methyl-D-aspartate receptor sites involved in nociceptive and inflammatory pain transmission (Radvansky et al., 2015; Vandivelu et al., 2016). Research has demonstrated ketamine administered as a bolus dose or a continuous low-dose infusion for 24 to 48 hours postoperatively often results in a decrease in …

Introduction Of Enhanced Recovery After Surgery For Colorectal Surgical Patients: A Quality Improvement Project, Amanda R. Mcvey

Doctor of Nursing Practice Projects

The purpose of this practice project was to develop and introduce an enhanced recovery after surgery (ERAS) protocol for colorectal surgical patients at a tertiary care center in southern Illinois. Project aims included reviewing available literature and study outcomes to develop an evidenced-based ERAS protocol for colorectal surgery and educating anesthesia providers about ERAS to introduce the evidenced-based ERAS protocol for colorectal surgery. An educational presentation and learning assessment tool were developed and subsequently presented to the anesthesia providers at the host facility. The first step toward implementing the protocol is education, as such, the results of the assessment questions …

The Implementation Of A Health Blog At A Community College, Colin M. Solomon, Roxanne Strohbeck

Doctor of Nursing Practice Projects

This projects details the implementation of a health blog at a Midwestern community college family health clinic. The literature review examines issues regarding benefits of college health clinics to students, health dangers college students face, social media usage for health education, how enhanced awareness of college health clinics can lead to increased usage, social media intervention design, and ethics of social media use for health promotion. A theoretical nursing framework is applied to the project of designing the blog. Clinical relevance for nurse practitioner practice is established with supporting literature review. Methods of project implementation are delineated including possible improvements, …

Protocol Development In The Or: Lessons Learned, Megan Sims

Doctor of Nursing Practice Projects

The management of pain in those undergoing a laparoscopic cholecystectomy is complex and challenging. There have been advances in the understanding of the physiology of pain and a wide variety of treatment options are now available. Establishing a preventative multi-modal protocol with different types of pain medications that work on a variety of receptors along the pain pathway is imperative. Through an exhaustive literature review, a preventative multi-modal approach was established and introduced at a small hospital in Central Illinois available for all laparoscopic cholecystectomy patients undergoing surgery over a 10 week implementation period. There was only one completed case …

Improving Perioperative Management Of Patients Experiencing Local Anesthetic Systemic Toxicity: An Assessment Of A Staff Educational Program, Sarah O'Leary

Doctor of Nursing Practice Projects

Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication occurring after administration of local anesthetics. With the increasingly widespread use of local anesthetics (LAs), healthcare providers must be educated on safe administration, as well as recognition and treatment of LAST. This project involved the development of a computer-based learning (CBL) module for staff at a tertiary care center in central Illinois with a focus on the definition, characteristics, prevention, symptoms, and treatment of LAST.

Knowles’ adult learning theory served as the primary foundation and theoretical framework for the development of the CBL. A comprehensive review of the literature …

Training Plan For Anesthesia Information Management Systems (Aims), Omololu Kaffy Kafisanwo

Doctor of Nursing Practice Projects

The federal government has set a mandate for healthcare facilities to adopt electronic health records (EHR) or be penalized through reimbursement cut. A SIH has plans to install Epic in November 2017, a survey completed by anesthesia providers at SIH revealed staff resistance to the Epic transition. Since this resistance has the potential to disrupt patient care and anesthesia workflow, the chief anesthesiologist at SIH and the author devised a training plan to reduce resistance and facilitate smooth transition. The author utilized the results from the completed survey to coordinate with the chief anesthesiologist and IT training specialist to develop …