Nursing Commons^™

Effectiveness Of A Postpartum Breastfeeding Protocol For Avoiding Pregnancy Data, Mary Schneider, Richard Fehring, Thomas Paul Bouchard

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

The uses of cervical mucus and basal body temperature as indicators of return to fertility postpartum have resulted in high unintended pregnancy rates. In 2013, a study found that when women used urine hormone signs in a postpartum/breastfeeding protocol this resulted in fewer pregnancies. To improve the original protocol's effectiveness, three revisions were made: (1) women were to increase the number of days tested with the Clearblue Fertility Monitor, (2) an optional second luteinizing hormone test could be done in the evening, and (3) instructions were given to manage the beginning of the fertile window for the first six cycles …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall

Journal of Wellness

Introduction: The Coronavirus Disease (COVID-19) introduced additional stress to the baseline occupational stressors of emergency care workers. The objectives of this study were to evaluate perceived stress and burnout and the utilization and perceived benefit of wellness practices among emergency healthcare workers (EHCWs), including: emergency physicians, advanced practice providers (APPs), nurses, and departmental administrative staff during the COVID-19 pandemic.

Methods: A cross-sectional 28-item electronic survey of EHCWs at three hospitals in a major United States city was used to measure participants’ utilization and perceived benefit of wellness practices, burnout (2-item measure), overall stress (perceived stress scale), and stress …

Another Good Reason Not To Pick Your Nose, Martin Schiavenato

Nursing Faculty Scholarship

No abstract provided.

Clearing The Smoke Around Marijuana Laws For Healthcare Organizations: Evaluating Certified Registered Nurse Anesthetists' Perceived Knowledge Of Their Organization’S Cannabis Use Policies, Jessica Aspan

College of Science and Health Theses and Dissertations

The legalization of marijuana in many U.S. states, despite its federal illegality, has resulted in an influx of positive marijuana drug screens across the healthcare sector.1 To better understand this problem, CRNAs in the Illinois Association of Nurse Anesthetists (IANA) were surveyed regarding their perceived knowledge of their organization’s policies regarding cannabis use using an online survey. The survey had a response rate of approximately 8.2% (n=148) and a majority (70%) of CRNAs disagreed or were neutral when asked if their organization’s policies were well-communicated regarding cannabis use. These results make clear that CRNAs lack clarity and communication from employers …

Pediatric Fiberoptic Intubation Education Utilizing Simulation: A Quality Improvement Study, Aladin Bihorac, Jonathan Mangan

College of Science and Health Theses and Dissertations

Fiberoptic intubation has been used as a secondary option to intubate pediatric patients with difficult airways. Failure to understand how to properly use a fiberoptic scope could have severe consequences, such as increased trauma or mortality. This is a quality improvement research study that examines the effect of simulation training utilizing a pediatric flexible fiberoptic scope on the confidence and competence of Nurse Anesthesia Trainees (NATs). Competence was measured using time to successful intubation. The authors developed a survey tool to assess the confidence of the participants in intubating pediatric patients’ airways with a fiberoptic scope after educational training and …

A Systematic Review Examining The Efficacy Of Existing Child Abuse Screening Tools Used In The Emergency Department, Kaitlan Meyers, Alyssa Strapko

College of Science and Health Theses and Dissertations

Child abuse and neglect is a major health problem in the United States and has lasting and detrimental effects. This review examines the screening instruments that are in existence today to detect child maltreatment. The instruments are compared and evaluated for their feasibility of use in an emergency department setting.

Four electronic databases were searched to identify screening instruments that assessed for child physical, emotional, and sexual abuse and neglect. The following subject heading keywords were used: ‘child abuse or child maltreatment or child mistreatment or child neglect or child sexual abuse or non-accidental trauma or head trauma or battered …

Tefra 7 Requirements: Assessment Of Education On Crna Knowledge, Erin Tienhaara

College of Science and Health Theses and Dissertations

Failure to follow the seven requirements of the Tax Equality and Fiscal Responsibility Act (TEFRA) when working in a medical direction model can place a CRNA at increased liability related to Medicare fraud. CRNAs and SRNAs often lack basic knowledge about the TEFRA 7 requirements which puts them at risk of committing inadvertent medical billing fraud. The purpose of this study was to determine if the investigator-developed educational flyer improved CRNA and SRNA knowledge regarding the TEFRA 7 requirements. A convenience sample of CRNAs and SRNAs (n=61) completed an online knowledge pre-test about TEFRA, reviewed the investigator-developed educational flyer about …

Increasing Anesthesia Bar Code Medication Administration Scanning Compliance, Andrew Calderon

College of Science and Health Theses and Dissertations

Purpose: This study aimed to determine whether the multimodal implementation of visual aids in anesthesia drug drawers, dissemination of virtual reminders through email and scheduling software, and alteration of the barcode scanner location to a more convenient location will improve barcode medication administration (BCMA) compliance.

Design: This study was a time series design study utilizing a retrospective chart review.

Methods: The data collection points included pre- vs. post-intervention, anesthesia provider type, medication type (ephedrine or phenylephrine), and whether the barcode was scanned or not. Chi-squared tests and logistic regression analysis were performed.

Findings: The Chi-squared tests indicated that the type …

Just-In-Time Training Videos For Specialty Operating Room Setups For Student Registered Nurse Anesthetists, Michelle Murray, Emily Miller

College of Science and Health Theses and Dissertations

Background: Just-in-time training (JITT) is an accepted training method in healthcare education that can be used for newer concepts or for procedures that are not performed often. JITT training is focused, brief, and intended to be used in the moment to address a knowledge or skill deficit. This makes JITT videos an appropriate solution for when the student registered nurse anesthetist (SRNA) needs a timely reminder on how to set up an operating room for a unique case, such as a pediatric case or a neonatal micrognathia case.

Purpose: The purpose of this study was to examine the efficacy of …

Just-In-Time Training Improves Knowledge And Confidence In Neuraxial Anesthesia In Student Registered Nurse Anesthetists, Amanda Arredondo, Victoria Willis

College of Science and Health Theses and Dissertations

Background: Student registered nurse anesthetists (SRNAs) are required by the Council on Accreditation to complete a minimum of ten spinal and ten epidural procedures. Neuraxial anesthesia, which includes spinal and epidural techniques, are challenging skills to master, requiring deliberate practice and active learning to achieve competency. There may be an extended period between when SRNAs learn the steps and implications of neuraxial procedures, and when they begin performing these skills in the clinical setting. Just-In-Time Training (JITT) is proven to be a successful teaching adjunct to bridge knowledge gaps for healthcare professionals. Purpose: To determine if using JITT, , as …

Airway Management Simulation With Ppe To Improve Nat Education And Comfort, Blake Butler, Marius Zymantas

College of Science and Health Theses and Dissertations

Guidelines for the use of proper personal protective equipment (PPE) were created by the Center of Disease Control and Prevention (CDC) half a century ago but PPE compliance remains low. To effectively protect healthcare workers from becoming infected and spreading infectious agents, PPE compliance must be improved. The purpose of this study was to assess the efficacy of an educational tool and simulation on improving NAT (nurse anesthesia trainee) knowledge of PPE protocols as well as perceived comfort performing airway management procedures while wearing PPE. This study used a pre- and post- survey design to assess both knowledge of proper …

Playing Darts Blindfolded: A Quasi-Experimental Study On Crnas And Srnas Knowledge On Pre-Procedural Ultrasound For Neuraxial Anesthesia, Drew Golden, Kristine Kim

College of Science and Health Theses and Dissertations

Pre-procedural ultrasound is an emerging technique among anesthesia providers to increase procedural efficiency and safety of neuraxial procedures on patients with increased technical difficulty. The use of pre-procedural ultrasound in neuraxial anesthesia among certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) has not been previously described. This study examined the efficacy of an educational intervention on CRNAs’ and SRNAs’ knowledge and future intent to use pre-procedural ultrasound to identify lumbar intervertebral spaces. We utilized a pre-and post-test design with convenience sampling. This study demonstrated a statistically significant improvement in the participants’ knowledge in four out of seven …

Sphenopalatine Ganglion Block For Post-Dural Puncture Headaches: A Video And Simulation For Nurse Anesthesia Trainees, Nicole Kwolek, Samantha Tarnoff

College of Science and Health Theses and Dissertations

Purpose: Dural punctures can cause debilitating headaches known as post-dural puncture headaches (PDPHs). The sphenopalatine ganglion (SPG) block can be used to treat PDPHs. This study aimed to determine if an educational video and simulation focused on the SPG block for PDPHs increased nurse anesthesia trainees’ (NAT) knowledge of the SPG block and confidence in performing the block for PDPHs. Design: The study design utilized a one-group quasi experimental study with a pre-test and posttest to assess NATs’ knowledge of the SPG block and their confidence in the placement of the block. Methods: The design consisted of a pre-test, an …

Evaluating The Effectiveness Of Simulation-Based Education Of Venous Gas Embolism On Novice Nurse Anesthesia Trainees, Angelica Rejczak, Jenna Fitzpatrick

College of Science and Health Theses and Dissertations

Background: Simulation-based education is a learning modality utilized in healthcare curriculum among nurse anesthesia trainees (NATs) for crisis management training. This learning modality may improve confidence and knowledge in novice NATs responding to a crisis scenario, such as a venous gas embolism (VGE).

Purpose: Evaluate the effectiveness of simulation-based education in effectively managing a crisis scenario, VGE, as measured by novice NATs confidence and knowledge levels.

Methods: An observational, cross-sectional study with a pretest-posttest design on a group of novice second-year NATs (NAT-2s) from NorthShore University HealthSystems (NorthShore) School of Nurse Anesthesia was utilized. A total of 15 NATs participated …

Examining Certified Registered Nurse Anesthetists’ Perspective On The Utilization Of Regional Anesthesia In Outpatient Orthopedic Surgery, Hannah M. Robert, Jessica O. Stasinski

College of Science and Health Theses and Dissertations

Regional anesthesia has played a significant role in the reduction of perioperative opioid consumption while still providing high-quality analgesia, making it a fundamental practice in outpatient orthopedic surgery. The purpose of this study was to qualitatively examine the experiences and perspectives of CRNAs surrounding the utilization of regional anesthesia in outpatient orthopedic surgery. A qualitative study design using semistructured interviews was conducted (N =14). Study participants described their current practices and experiences with regional anesthesia utilization in the outpatient orthopedic surgery setting. In particular, four themes describing factors that promote CRNAs’ utilization of regional anesthesia for outpatient orthopedic surgery emerged: …

Podcasting As An Education Modality On The Environmental Effect Of Desflurane, Jacob Bonnema

College of Science and Health Theses and Dissertations

Background: Climate crisis is well-documented as posing a major threat to the population. The provision of anesthesia utilizes gases that contribute to this problem. Podcasts may serve as a useful modality to educate anesthesia providers on best practices.

Purpose: The purpose of this study was to evaluate the effectiveness of an evidence-based educational intervention in the form of a podcast which focuses on the evaluation of knowledge, attitudes, and practice habits related to the use of desflurane among anesthesia providers.

Methods: An observational cross-section study using survey methodology was utilized in this pre-test post-test design. Knowledge, attitudes, and practice habits …

Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth

College of Science and Health Theses and Dissertations

Transgender individuals experience healthcare-related discrimination, resulting in significant disparities and negative health outcomes in comparison to the general population. Many CRNAs do not receive formal or adequate education before being expected to care for transgender patients that contributes to these negative health outcomes. To correct this problem, an educational intervention was created to improve anesthesia providers' knowledge of genderaffirming therapies and to survey anesthesia provider attitudes towards transgender patients and knowledge, beliefs, and preferences towards treating transgender patients. A sample of anesthesia providers was collected (n=27) that included SRNAs and CRNAs at varying levels of professional experience from diverse sociodemographic …

Isolated & Impulsive: A Quality Improvement Pilot Survey Of The Perceived Icu Nurse Workload Implementing The A2f Care Bundle For Isolated Covid-19 Patients With Delirium., Ranier Calimlim

College of Science and Health Theses and Dissertations

Background: Existing research focused on A2F Care Bundle efficacy to optimize patient care and improve patient outcomes among ICU patients. Perceived workflow evaluation has been validated for healthcare task analysis endorsed by the Agency for Healthcare Research and Quality. A needs assessment was identified to evaluate nursing challenges with the A2F Care Bundle interventions, inform allocation where support and resources may be necessary when providing patient care for isolated patients with COVID-19 delirium.

Purpose: The purpose of this study was to evaluate the perceived workload of ICU nurses when implementing the A2F Care Bundle among isolated COVID-19 patients with delirium. …

Multiple Myeloma: Validation Of The Values And Preferences Elicitation Questionnaire- Cure And Survival Preference Scale (Vpeq-Csps), Anastasiia Savchenko

College of Science and Health Theses and Dissertations

Background: With the emergence of many novel therapies, the treatment decisions for multiple myeloma (MM) are increasingly guided by concerns of quality of life, achievement of cancerfree remission, living a longer overall survival, and a relentless search for a cure; however, the impact of these various treatment options on patients’ choices and lives is mainly unknown. Oncology clinicians face the challenge of uncovering their patient’s preferences and values and putting them into the actual treatment decision-making. Purpose: This study examined the psychometric properties of the Values and Preferences Elicitation Questionnaire-Cure and Survival Preference Scale (VPEQ-CSPS) instrument. Methods: The VPEQ-CSPS instrument …

The Dnp Project Maze, Martin Schiavenato

Nursing Faculty Scholarship

No abstract provided.

Reducing 30-Day Psychiatric Inpatient Hospital Readmission Of Mentally Ill Homeless Men With Substance Use Disorder By Using A Discharge Checklist, Chibuogwu E. Ogbuka

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men with substance use disorder is greater than that of the non-use population. Substance use disorder co-occurs with high prevalence among patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health, behavior, and medication non-compliance, resulting in hospital readmission.

Problem: In acute psychiatric facilities in Northern California, the greatest readmission after inpatient hospitalization occurs at 53% in a week and 74.8% within two weeks of discharge. For homeless individuals, substance use disorder exacerbates personal problems and decreases the likelihood of …

Preoperative Hba1c And Postoperative Outcomes In Spine Surgery: A Systematic Review And Meta-Analysis, Tao, Abhijith V. Matur, Paolo Palmisciano, Fatu S. Conteh, Louisa Onyewadume, Henry Ofori Duah, Geet Shukla, Phillip Vorster, Sahil Gupta, Sai S. Chilakapati, Owoicho Adogwa

College of Nursing Faculty Research and Publications

Study Design. 

Systematic review and meta-analysis.

Objective. 

To perform a systematic review and meta-analysis of previous studies on HbA1c in preoperative risk stratification in patients undergoing spinal procedures and provide an overview of the consensus recommendations.

Summary of Background Data. 

Diabetes mellitus (DM) and hyperglycemia have been shown to be independent risk factors for increased surgical complications. Glycated Hemoglobin A1C (HbA1c), a surrogate for long term glycemic control, is an important preoperative parameter that may be optimized to reduce surgical complications and improve patient-reported outcomes. However, comprehensive systematic reviews on preoperative HbA1c and postoperative outcomes in spine surgery have been …

The Importance Of Family Presence At The Bedside Of Critically Ill Patients, Brenda K. Ramsey

MSN Capstone Projects

The purpose of this paper is to discuss the visitor restrictions on patients and their families during the COVID-19 pandemic. At the beginning of the pandemic, visitation was highly restricted with only telecommunication as a means of “visiting” with your loved one who were hospitalized, especially in the ICU settings. During my research of keeper studies for my capstone project, the articles discussed different forms of communication. The articles discussed interventions such as electronic (e-visits) for physician offices and diaries kept in the ICU for communication between family and staff. Some discussed the effects of visitor restrictions and how it …

Opioid Use Disorder (Oud) And Neonatal Abstinence Syndrome (Nas) Education In An Undergraduate Nursing Program, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

In 2018 the American Academy of Nursing urged all nursing schools to adopt curriculum to address the opioid epidemic, although few programs have begun this work.

Minimal background training in nursing school is focused on caring for patients with Opiate use disorder ( OUD) and Neonatal Abstinence Syndrome (NAS) leaving nurses to develop the necessary skills for optimal patient engagement to be formulated in practice. An undergraduate nursing program in an urban setting developed OUD and NAS education into their curriculum.

Undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Previous research indicates …

Addressing Inpatient Substance Use Stigma And Bias: An Examination To Support Training For Healthcare Professionals, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.

Acute Inpatient Stabilization Study Primary Stakeholders Evaluation, Tara Flood, Dnp, Rn, Cbc

College of Nursing Posters

Background

The current opioid crisis is a significant public health issue in the United States, especially amongst women of reproductive age. In the last two decades, the rate of opioid use disorder (OUD) in pregnant women has quadrupled. Women with substance use disorders (SUD) experience more sociodemographic and health disadvantages, pre-existing health conditions, and co-morbid psychiatric diagnoses than their counterparts without SUDs. They are also more likely to experience emergency department visits and hospitalizations during the antenatal period and less likely to utilize prenatal healthcare services.

Seeking Patient-Centered Care Through Bedside Handoff In The Postpartum Unit, Evelyn Ndaki

Master's Projects and Capstones

Problem: Patient discontent with nurse compassion and attentiveness prompted the implementation of standardized bedside shift handoff (BSH) for nurses in the postpartum unit of a Northern California teaching hospital.

Context: Pandemic stressors led to nurse practices not reflecting patient-centered care. Bedside handoff offers an opportunity to improve patient-centered nurse behaviors.

Intervention: To standardize BSH, a modified SBAR (Situation, Background, Assessment, Recommendation) tool was implemented.

Measures: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question on “Nurses kept you informed” was tracked, and nurse satisfaction with the handoff process was measured with a pre- and post-implementation survey.

Results: Final …

Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado

Doctor of Nursing Practice (DNP) Projects

Background: Globally, adverse health effects, including deaths and disabilities, occur from living or working in unhealthy domains where exposure to environmental and occupational hazards exists. A multitude of these hazards are present in clinical settings in the healthcare environment where nurses care for patients and risk ongoing exposures to toxic substances.

Problem: Environmental and occupational health education is rarely included in the standard undergraduate nursing curriculum, contributing to a deficit among nurses in environmental health awareness and knowledge.

Methods: The study design was a pre/post evaluation of a single cohort (n=32) of undergraduate nursing students to assess environmental and occupational …

Simplifying Qualitative Case Study Research Methodology: A Step-By-Step Guide Using A Palliative Care Example, Elizabeth M. Miller Mrs, Joanne E. Porter Professor, Michael S. Barbagallo Dr

The Qualitative Report

Qualitative case study research can be a helpful methodology when conducting health research. However, it can be overlooked or dismissed as a possible methodological choice due to different epistemological positionings by case study theorists and often confusing and contradictory definitions and terminology. Much has been written about case studies, but it takes time to wade through volumes of often philosophically and methodologically dense material to locate a theorist who presents case study research at a depth the novice researcher can understand. Case study research literature may offer a condensed summary of processes but often needs more theoretical detail. Therefore, discerning …