Nursing Commons^™

A Qualitative Examination Of Opioid Sparing Anesthesia Practices Among Crnas, Stephanie Knell

College of Science and Health Theses and Dissertations

The opioid epidemic has had significant consequences across the healthcare system in the United States. While anesthesia providers have historically provided quality intraoperative analgesia utilizing opioids, research to date suggests that these care experiences may have lasting implications on patients’ long term health outcomes. In contrast, opioid sparing anesthesia can provide patients superb analgesic coverage without the noxious side effects of opioids or the risk of misuse. As an emerging topic, no known study to date has described anesthesia providers’ qualitative experiences with opioid sparing anesthesia. Therefore, the purpose of this qualitative descriptive study was to conduct semi-structured interviews to …

Implementation Of An Emergency Reflex Action Drill To Improve Perceived Knowledge And Confidence In Intubation Skills Of Nurse Anesthesia Trainees, Amanda Lamacki

College of Science and Health Theses and Dissertations

Direct laryngoscopy remains the primary method for achieving intubation of the airway in general anesthesia. Novice laryngoscopists may encounter high stress and cognitive load when unexpectedly faced with a Cormack-Lehane Grade III or IV view in an unfamiliar and time-pressured environment. An Emergency Reflex Action Drill (ERAD) is a specifically designed action sequence intended to execute clinical interventions with minimal cognitive load in the setting of marked time pressure. The purpose of this study was to examine the implementation of the ERAD “Head-Neck-Reset” to improve perceived knowledge and confidence in intubation skills of nurse anesthesia trainees. A convenience sample of …

Simulation Education For Ultrasound Guided Peripheral Intravenous Catheter Insertion, Ronald Mack

College of Science and Health Theses and Dissertations

The purpose of this study was to evaluate student registered nurse anesthetist (SRNA) knowledge and confidence of ultrasound guided peripheral intravenous catheter insertion (UGPIV) before and after viewing an educational video. As a basis for developing a single group pre-test and post-test study, the dual coding theory was used. The authors hypothesize that SRNA knowledge and confidence would improve after an educational video intervention. A convenience sample of first, second, and third year SRNAs was used (N=31). The study participants completed a pre-survey to evaluate UGPIV knowledge and confidence, along with demographic questions. Participants were then instructed to view a …

Perioperative Non-Opioid Modalities (Pnom) Questionnaire Implementation And Validation Of Its Psychometric Properties, Liliya Sprisovskiy

College of Science and Health Theses and Dissertations

Introduction: The opioid epidemic and prescription opioid related deaths continue to grow in the US. Contributing factors to this epidemic include nonrestrictive opioid administration in the perioperative period. Though solutions to the epidemic has been discussed by anesthesia providers, there is no tool to quantiatively evaluate of their beliefs and practices for the perioperative management of pain. Over the past three years, there has been advancement in the science of nurse anesthesia on this front and in 2020 Tucker and Wong completed the development of a quantitative tool aimed at assessing CRNA beliefs and practices with regard to their use …

A Qualitative Examination Of Opioid Sparing Anesthesia Practices Among Crnas, Stephanie Knell

College of Science and Health Theses and Dissertations

The opioid epidemic has had significant consequences across the healthcare system in the United States. While anesthesia providers have historically provided quality intraoperative analgesia utilizing opioids, research to date suggests that these care experiences may have lasting implications on patients’ long term health outcomes. In contrast, opioid sparing anesthesia can provide patients superb analgesic coverage without the noxious side effects of opioids or the risk of misuse. As an emerging topic, no known study to date has described anesthesia providers’ qualitative experiences with opioid sparing anesthesia. Therefore, the purpose of this qualitative descriptive study was to conduct semi-structured interviews to …

Implications Of An Education Tool As A Noise Reduction Strategy In The Operating Room, Sona Wardius, Amanda Parker

College of Science and Health Theses and Dissertations

Noise in the operating room (OR) can be from many sources, including personnel and medical equipment. Excessive noise is prevalent in the OR and can lead to distractions, interruptions, stress, and medical errors. These distractions have been well-documented in the literature and can reduce the quality of patient care. Awareness and education have proven to be solutions to noise reduction, but there is little evidence in the literature regarding the adoption of a clinical guideline. The goal of this study is to bring awareness of noise levels in the OR, the most common noise distractions, and how these relate to …

Aspects Of The Physical Work Environment And Nursing Work, Yolanda Keys

Nursing Theses and Dissertations

Objective: The purpose of this body of work is to inform nurse leaders and design professionals of opportunities to leverage the physical environment to enhance the overall work environment for nurses.

Background: The environments in which nursing work takes place need to support the staff who work within them. Healthy work environments have been shown to improve outcomes for patients, nurses, and organizations; however, the contribution of the built environment to the overall work environment for nurses is not fully understood.

Methods: Included in this portfolio are three studies: 1) a descriptive study exploring the experiences of …

Development And Implementation Of An Evidence-Based Guideline For Spinal Cord Injury/Disorder Patients Requiring Colonoscopy, Tanya D. Young

Student Scholarly Projects

Practice Problem: Colorectal cancer is one of the leading causes of preventable cancer death in the United States. Spinal cord injury/disorder (SCI/D) patients present with unique challenges for maximizing bowel prep and successful attainment of screening and therapeutic colonoscopy procedures. Current practice for bowel prep regimens does not take into consideration the specific needs of the SCI/D population resulting in significant patient dissatisfaction.

PICOT: The PICOT question that guided this project was in adult patients with spinal cord injuries/disorders requiring colonoscopy (P), how does the development and implementation of evidence-based guidelines for the care of the spinal cord injury/disorder patient …

Evidence-Based Follow-Up Care For The Cardiac Patient: A Benchmark Project, Natalie E. Kelley

MSN Capstone Projects

Since the implementation of the Affordable Care Act (ACA) in 2012 and the Hospital Readmission Reduction Program (HRRP), hospitals and organizations have been encouraged to improve care coordination to reduce the number of avoidable readmissions (CMS, 2020). Three of the six publicly reported condition or procedure-specific 30-day risk-standardized unplanned readmission measures in the HRRP are cardiac-related: heart failure, acute myocardial infarction, and coronary artery bypass grafting (CMS, 2020). Although guidelines call for structured follow-up in patients with cardiac diagnoses after a hospital admission, just over half of admitted patients are being scheduled for follow-up (Goyal et al., 2016; Heidenreich et …

Overcoming The Covid-19 Pandemic For Dementia Research: Engaging Rural, Older, Racially And Ethnically Diverse Church Attendees In Remote Recruitment, Intervention And Assessment, Lisa Kirk Wiese, Ishan C. Williams, Nancy E. Schoenberg, James E. Galvin, Jennifer Lingler

Behavioral Science Faculty Publications

Background: Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals.

Method: Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening.

Results: Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average …

Evaluation Of Lifestyle Modification Program For Polycystic Ovary Syndrome In Infertile Women, Kelly Batton

Dissertations

Abstract

Problem: Polycystic Ovary Syndrome (PCOS) affects a large proportion of the female population worldwide. PCOS can have a wide variety of health implications for the woman including difficulty achieving pregnancy.

Methods: A retrospective chart review of 368 patient records were assessed for inclusion criteria yielding 163 patients with PCOS suffering from infertility. Demographic and health data were gathered for each patient to provide a baseline comparison between the first two quarters of 2019 and the first two quarters of 2020.

Results: The results of the study were mixed. Patients who lost weight did have a higher positive pregnancy rate. …

Education Effectiveness Of Recognizing Asymptomatic Bacteriuria In A Long-Term Care Facility, Xie Zhonghua, Lisa Ertman, Carole Jenson, Kimberly Langer, Kristi Petersen

Nursing DNP Projects

This article presents the educational effectiveness of recognizing asymptomatic bacteriuria (ASB) in a long-term care facility using presentations and clinical pathways. Results indicate interventions are effective in identifying ASB but inconclusive of the number of inappropriate UA reductions.

New Graduate Nurse Retention Strategies: An Integrative Literature Review, Amy Fiala

Nursing Masters Papers

Decreasing nurse retention rates, particularly of new graduate nurses, is a costly issue for health care organizations across the country. Turnover rates for new nurses average around 20% in the first year following graduation (Kovner, et al., 2014). Low retention rates also create staff burnout, orientation fatigue for preceptors, poor morale, and safety concerns. The purpose of this integrative literature review is to identify best practice strategies and interventions to increase new graduate nurse retention in the acute care setting. Ten articles were selected for this review, including three high-level systematic reviews. Bandura’s Self-Efficacy Theory was chosen as the conceptual …

Development And Implementation Of An Opioid Risk-Reduction Strategy, Heather Darmetko

Student Scholarly Projects

Practice Problem: Accidental overdose is a continued concern for those who are prescribed opioids, and it is essential that healthcare members intensify prevention and response measures in order to prevent death or misuse from this medication.

PICOT: The PICOT question that guided this project was: “In adult patients at an outpatient chronic pain management clinic (P), how does development and implementation of a safe opioid risk-reduction office policy (I), compared to usual practice (C), improve patient rates of naloxone availability and health literacy (O) over eight weeks (T)?”

Evidence: The CDC’s Guideline for Prescribing Opioids for Chronic Pain, the …

Understanding The Relationship Between Kangaroo Care And Neurodevelopment In Infants With Congenital Heart Disease: A Systematic Review, Natalie Geralde, Alexis Antoci, Anne Aca, Kamrin Burdell

Symposium of Student Scholars

Background: Infants with congenital heart disease (CHD) are predisposed to significant neurodevelopmental delays related to disrupted parent-infant bonding, stress caused by invasive cardiac interventions, and overstimulating environments, such as the cardiac intensive care unit. Early promotion of neurodevelopment in infants with CHD is essential to support their overall health and quality of life, and to diminish the extent of neurocognitive delays. However, there is limited research examining the relationship between neurodevelopment in infants with CHD and the benefits of kangaroo care.

Objective: The purpose of the systematic review was to evaluate the effectiveness of kangaroo care and touch on optimal …

Prolonged Hospitalization Effects On Psychosocial Development In Chronic Illness Pediatric Patients, Zoe Quarles, Courtney Cumberland, Megan Pringle, Sophie Kinrade

Symposium of Student Scholars

Prolonged hospitalization effects on psychosocial development in chronic illness pediatric populations

Abstract

Courtney Cumberland, Sophie Kinrade, Megan Pringle, and Zoe Quarles

Background/Objective: Frequent and extensive hospitalizations have a negative impact on the psychosocial development of children in the most formative years of their lives. This problem is most evident in children who have chronic disease or health conditions that require multiple hospital stays and interventions. This topic can be considered broad because of the extensive variety of chronic conditions and how that determines a child's length of stay. This study aims to identify whether patient-to-patient interaction impacts the psychosocial development …

Hand Hygiene And Covid Education At Women’S Shelter, Anastasiya Yerina, Cristal Garibay, Henok Tewolde, Muskan Priya, Jeannie Lee

Nursing Leadership in Community Engagement Projects

Introduction

In 2020, there were around 580,000 people experiencing homelessness in the US with about 39% of them in unsheltered locations (Montgomery et al., 2021). Many homeless women experience safety issues and have severely impacted physical and mental health, so finding shelter is crucial in efforts to improve their well being (Sarla, 2020). Women’s Shelter is a shelter for single homeless women in downtown Seattle that provides daily meals, laundry services, and overnight shelter. After assessing the women by visiting Angeline’s, the group found that hand hygiene was an issue among the women. Then, the group decided to focus on …

Mental Health Training, Adrienne Leonard, Seanghai Lim, Emma Booth, Jaeger Mccaulou, Saori Fukuoka

Nursing Leadership in Community Engagement Projects

Introduction

New Horizons is a Seattle-based non-profit organization that serves to aid homeless youth in the greater Seattle area, with an end goal of ending youth homelessness in Seattle and King County. New Horizons has been operating since 1978 and has reached out to homeless youth of all different backgrounds in order to meet their basic needs and help transition them into a stable living environment. (New Horizons, 2016). This type of work requires staff and volunteers to be able to accommodate a wide range of cultural backgrounds, lifestyle habits, and crucially, individuals with differing mental health states and disabilities. …

Promoting Health Independence Through Accessible Health Resources, Haylee R. Gilman, Lucy Carrasco Flores, Keenan Haack, Hui Jean Liew, Gebrehiwot Abrha

Nursing Leadership in Community Engagement Projects

Introduction

The U.S. Department of Housing and Urban Development (HUD, 2018) defines an individual or family as homeless, as someone who lacks “fixed, regular, and adequate nighttime residence”. As of January 2020, there were an estimated 11,751 individuals experiencing homelessness in Seattle/King County (King County Regional Homelessness Authority, 2020). National Alliance to End Homelessness (2020) explains that health and homelessness are inextricably linked, where an acute physical or behavioral health crisis or any long-term disabling condition may lead to homelessness; homelessness itself can exacerbate chronic medical conditions. To reduce the number of homeless families on the streets in King County, …

Improving Patient Flow In The Urgent Care Setting, Stephanie Carpenter

Student Scholarly Projects

Practice Problem: Urgent care clinics provide care to patients with non-life-threatening illnesses or injuries and are found to be less expensive and more convenient than emergency departments. As urgent care clinics are growing in popularity so are the patient wait times and overall length of stay times.

PICOT: The PICOT question that guided this project was in urgent care clinic patients (P), how does utilizing the Emergency Severity Index (ESI) as a patient triage tool (I) compared to using no patient triage tool (C) affect the patient flow and patient wait times (O) within 13 weeks.

Evidence: Evidence search with …

Resuscitation Quality Improvement Mortality Rates, Jordan Priest

Dissertations

This paper explores and answers the question: What is the impact of Resuscitation Quality Improvement on survival at discharge rates after suffering an IHCA when compared to every two-year BLS/ACLS training? Articles are explored that identify positive patients’ outcomes when resuscitation training is repetitively learned. The design consists of a BLS/ACLS and RQI evaluation of quarterly survival to discharge rates prior to the initiation of the new RQI program and after the initiation of the new RQI program. The setting of the study is the east region of a midwestern faith-based health care system, that includes four hospitals in one …

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.

Emotional Intelligence: Improving The Delivery Of Quality Patient Care, Genesis Serrano, Angela Putt

Journal of Interdisciplinary Undergraduate Research

Emotional intelligence (EI) is the ability to recognize one’s own emotions and that of others when responding to a situation. It has a long-standing reputation for predicting positive outcomes in many fields and occupations. Emotional intelligence has also had a long-standing reputation for taking the backseat in education. Nursing is no exception. With many nurses having little to no knowledge of anticipating patient needs or what it means to be empathetic, it can impact the patient’s perception of patient care. Often, the skill of being emotionally intelligent is either learned on the job through experience, innately in the character of …

The Impact Of A 12-Hour Shift Compared To An 8-Hour Shift On Nurse Health And Safety, Matthew Kramer, Andrea Howell, Kayla Kloes, Emmy Lam, Brittney Levy

Symposium of Student Scholars

Abstract

Background: An international healthcare concern is extensive shift length among registered nurses and the negative factors associated with nurse burnout. Cognitive impairment, medical errors, sleep deprivation, job dissatisfaction, and overall declined health and safety of nurses have been associated to long shift work hours among registered nurses globally. However, there is limited published evidence about the difference between 8-hour and 12-hour shift work.

Objective: This systematic review summarized evidence on the impact that 12-hour shifts compared to 8-hour shifts has on the health and safety of registered nurses.

Methods: PubMed, SCOPUS, EBSCOHost, NCBI, Google Scholar, and …

A Good Life: Palliative Care In The World Of Dementia, Nicola Farmer

Journal of Interdisciplinary Graduate Research

Objective: The World Health Organization (2019) reports that dementia is the seventh leading cause of death with an estimated 50 million people worldwide with this disease. In the United States out of one and a half million Medicare patients on hospice in 2016, only 18% had dementia (The National Hospice and Palliative Care Organization, 2017). McAteer and Wellbery (2013) identified that while referrals to services seem to be on the rise, many are not made until the patient is close to death in the last weeks of an illness. The purpose of this project was to review the literature to …

Best Practices For Preventing Delirium In Critically-Ill Patients, Madi Williams, Hailey Trexler Price, Natalie Hosman

Scholars Week

Abstract:

Utilizing and integrating best evidence-based research to improve nursing care is a core responsibility of a nurse. Implementing best nursing practices leads to better patient outcomes and patient experiences. Through research, specific interventions that can reduce the incidence of delirium in critically ill patients were uncovered. Through utilization of theoretical framework, and multiple evidence-based research articles, a protocol was formed to initiate in the intensive care unit (ICU) at Murray-Calloway County Hospital in Murray, KY. This protocol consists of a multi-component intervention plan to hopefully decrease incidence of ICU delirium.

Impact Of Language Barriers In Nursing And The Need For Intervention, Emilee Cole, Tiarra L. Arant

Scholars Week

Health care is growing ever diverse and linguistically challenging. Language barriers in healthcare are an important issue that has a need for change. The question to be researched is, How do nurses and other healthcare providers overcome the growing barrier preventing efficient patient care for those who are non-English speaking? This was explored through the participation of Murray Calloway County Hospital (MCCH) offering their current policies on the topic. The method used for this Evidence Based Practice research included analyzing previous research performed over language barriers in healthcare, with findings including that online interpretation tools are the most cost-effective and …

Culturally Sensitive Care For Hispanic Americans, Christopher Dodson, Courtney Hall

Scholars Week

The number of individuals that speak another language that is not English as their primary language is at an all time high in the United States, and this can make healthcare harder to access for this portion of the population. This research examines what barriers are present for those who do not speak English as their primary language, such as miscommunications, reduced trust in their provider related to being unable to speak directly with them, parts of their cultural practices and alternative medicines being ignored or misunderstood by healthcare providers, and not feeling secure enough to reveal sensitive information to …

Evidence Based Pressure Ulcer Prevention, Rachel Payne, Jessica Rowe

Scholars Week

Pressure Injuries are problematic for patients and hospitals. We sought to research the best prevention methods for patients in health care facilities. Current Evidence Based Practice supports the use of the Braden Scale in addition to a method called the T3 program, which consists of turn, touch, and tidy.

Preventing Ventilator Associated Pneumonia, Ally Samuel, Anna Grace Terry

Scholars Week

Ventilator Associated Pneumonia is a serious infection in the lungs that affects individuals who are being mechanically ventilated. These patients, who are already critically ill, have decreased defense mechanisms that allow pathogens such as bacteria to invade the sterile respiratory tract (Cooper, 2021). Many of the risk factors for the development of VAP may be preventable, and it is up to the ICU nurses, who care for these mechanically ventilated patients, to play a role in the implementation of certain guidelines and/or bundles that may help with the prevention of ventilator associated pneumonia ( Aysegul et al., 2020). Although ventilator …