Nursing Commons^™

The Use Of An Intraoperative Forced Air Warming Device Alone Versus Warmed Intravenous Fluid Infusion And Forced Air Warming Versus Warmed Intravenous Fluid Alone In Patients Undergoing Open Intra-Abdominal Surgery, Charlie Adderley

Doctoral Projects

Patients undergoing open abdominal surgery with general anesthesia are at increased risk for adverse outcomes associated with disturbances in thermoregulation during the intraoperative phase of the surgical experience. The purpose of this quantitative capstone project was to examine and compare the differences between the use of an intraoperative forced air-warming device and a forced air warming device plus warmed intravenous fluid (IVF) in the management of postoperative hypothermia, as measured by the postoperative temperatures of patients undergoing open abdominal surgery. A comparative retrospective chart review was performed using two groups to assess the effectiveness of preventing postoperative hypothermia in this …

Utilization Of A Focus Group To Evaluate The Perceived Stress Levels And Coping Mechanisms Of Student Registered Nurse Anesthetists, Cillora Hicks

Doctoral Projects

Each year, thousands of Student Registered Nurse Anesthetists (SRNAs) matriculate into a nurse anesthesia educational program, confronted with unforeseen challenges and stressors. Although a certain amount of stress is essential to stimulate learning, excessive stress can have dire consequences in delaying a students’ academic and clinical progression. The purpose of this Capstone Project was to explore and describe the perceptions of 12 SRNAs relevant to their stress levels and coping behaviors in the management of academic and personal stress. The clinical research questions guiding the study examined the stress levels and coping behaviors of the SRNAs as measured by the …

Phenylephrine Versus Ephedrine: Safest Vasopressor For The Neonate During Caesarean Section, James S. Hale Jr.

Doctoral Projects

One of the most common side effects of spinal anesthesia is the development of hypotension. Data collected has determined that 80% of parturients that undergo spinal anesthesia for this mode of delivery experience hypotension (Chestnut et al., 2014).

Hypotension, if sustained and severe, can lead to fetal hypoxia, neonatal depression or injury, and decreased uteroplacental perfusion. Hypotension can also cause severe health issues for the parturient including apnea, altered level of consciousness, cardiac arrest, and pulmonary aspiration. This systematic review of the literature was conducted to determine whether the administration of phenylephrine or ephedrine was safer for the neonate to …

In The Surgical Patient Requiring Neuromuscular Blockade, Is There An Increased Incidence Of Postoperative Adverse Respiratory Events With Rocuronium Or Vecuronium?, Martha Claudine Boos

Doctoral Projects

It is estimated that up to 45% of surgical patients will have postoperative residual neuromuscular blockade (NMB) upon arrival to the postanesthesia care unit (PACU), and incomplete recovery can impair upper airway function and contribute to adverse respiratory events (Nagelhout & Plaus, 2014). This retrospective cohort study examined whether there was an increased incidence of postoperative adverse respiratory events with the neuromuscular blocking agents Rocuronium or Vecuronium. Inclusion criteria included any surgical patient ages 18-65 receiving NMB agents Rocuronium or Vecuronium during the procedure. Exclusion criteria included any surgical patient ages 18-65 with ASA classification > 4, any emergent cases, any …

Comparison Of Outcomes In Heart Bypass Patients Undergoing Insertion Of An Internal Jugular Vein Central Line By Ultrasound Compared To Traditional Landmark Technique, Sayha Ol Ma

Doctoral Projects

Patients that undergo heart bypass surgery require central line placement from a healthcare provider. To place this device one must use either ultrasound guided or landmark technique. Using ultrasound guided compared to landmark technique may reduce complications. The goal of this project was to determine if ultrasound use of central line placement is a safer practice compared to using the traditional technique.

A retrospective chart review was performed to compare internal jugular central line placement by ultrasound with the traditional landmark placement to evaluate results related to patient outcomes. Data from fifty health records were analyzed using chi-square. The complications …

The Regional Study Of Sleep-Related Behaviors Of Nurse Anesthetists: Personal And Professional Implications: A Replication Study, Jarrod Fontenelle

Doctoral Projects

Universally, anesthesia providers are expected to be knowledgeable, astutely responding to clinical challenges while maintaining a prolonged vigilance for administration of safe anesthesia and critical care. A fatigued anesthetist is the consequence of cumulative acuity manifesting as decreased motor and cognitive powers. This results in patient harm, impaired judgement, late and inadequate responses to clinical changes, poor communications, and medical errors. With increased expectations and medical-legal claims, anesthesiologists work to provide efficient and timely services, but are rendered sleep deprived themselves. It is the right time to address the issue of the health of anesthesia providers and the profession. The …

Does The Use Of A Regional Nerve Block Decrease The Incidence Of Post Operative Nausea And Vomiting, Decrease Pain Scores, Or Decrease Discharge Time Compared To General Anesthesia Alone?, Donald Lane Whitney

Doctoral Projects

Problem Statement: The use of regional anesthesia in orthopedic surgeries has been shown to decrease the rate of postoperative nausea and vomiting (PONV), postoperative pain, and decrease postoperative discharge time. However, some healthcare facilities continue to provide anesthesia for these procedures without the use of regional anesthesia techniques.

Purpose: The purpose of this capstone project was to determine if the addition of a regional anesthetic technique would be beneficial to the patient and cost efficient to the healthcare facility.

Methods: A retrospective chart review was conducted and data collected on the population of interest. Inclusion criteria were patients undergoing orthopedic …

Evaluation Of Vaccination Policies Among Outpatient Oncology Clinics In Utah: A Pilot Study, Karlen Beth Luthy, Sarah L. Stocksdale, Janelle L B Macintosh, Lacey M. Eden, Renea L. Beckstrand, Katherine Edmonds

Faculty Publications

Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown.

Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees.

Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic’s employee vaccination policy and the consequences for refusing the policy.

Findings: Most vaccination policies applied to employees primarily assigned to work in …

Preventing Surgical Site Infections By Utilizing Chg Wipes For Preoperative Skin Preparation, Jini K. Paek

Master's Projects and Capstones

Abstract

The Clinical Nurse Leader project took place at a 106-bed community hospital in Washington. The microsystem has five operating rooms where they provide outpatient, and inpatient surgical procedures. The goal of this project is to reduce and sustain a near zero number of surgical site infections by implementing the use of a no rinse 2% CHG cloth in the surgical patient. The specific aim of the project is to reduce the rate of SSIs by 80% by December 31^st, 2015. Due to a lack of a standardized care, specifically designed for the prevention of SSIs, the microsystem …

A Pilot Study Of Propofol As An Anti-Emetic In Laparoscopic, Gynecologic Surgery Patients, Flem-Flam Aaron Flemister

Doctoral Projects

The goal of this project was to use sub-hypnotic doses of propofol to decrease post operative nausea and vomiting (PONV) rates in the immediate post-operative period in females, ages 18-65, undergoing laparoscopic gynecologic surgery.

PONV is one of the largest complications of anesthesia affecting 20-30% of all surgical patients. Risk factors associated with PONV are female gender, laparoscopy, general anesthesia, opioids, volatile agents, and post-operative pain; all of which are frequently encountered. The incidence of PONV can prolong recovery time, delay discharge, increase patient cost, decrease patient satisfaction, and can cause significant medical complications. Propofol has previously demonstrated anti-emetic properties; …

The Effectiveness Of A Preoperative Multimodal Antiemetic Regimen On Reducing Early Postoperative Nausea And Vomiting In Total Joint Arthroplasty Patients, Jerry Mosley

Doctoral Projects

Postoperative nausea and vomiting (PONV) occurs frequently in all types of surgeries including after total joint orthopedic procedures. The resulting PONV can lead to many unwanted occurrences including immobilization, distress, and many serious adverse health complications. These unwanted occurrences may then lead to increased cost to the patient and healthcare facility. Administration of a preoperative multimodal regimen known to reduce PONV has the potential to reduce such unwanted anesthetic side effects influencing a reduction in overall healthcare cost. The purpose of this study is to determine the effectiveness of the preoperative kit which includes the administration of metoclopramide, famotidine, ondansetron, …

The Effects Of Consistent Exercise On Work Productivity Among Anesthesia Providers, Samuel K. Self

Doctoral Projects

Studies have been done that link various measurements of workplace productivity with varying levels of individual health. A thorough literature review examined the research to find any significant relation between regular exercise (as defined by the American Heart Association) and an improvement in workplace productivity among anesthesia providers. A Qualtrics survey was used to measure specific results regarding exercise activity and work productivity from anesthesia providers. This group included 53 certified registered nurse anesthetists and anesthesiologists. Descriptive analysis, Chi-square test of Independence, Fisher’s Exact test, and Cramer’s V test were all used to analyze the data. One significant correlation was …

Family Centered Care In Icu Settings, Victoria Kingsinger

Honors Theses

More than 5 million patients are admitted each year to Intensive Care Units (ICUs) in the US, and approximately 55,000 critically ill patients are cared for each day. ICU patients are a diverse population that has a need for an increased level of care. These patients often require ventilatory or cardiovascular support, invasive monitoring, and intense nursing and physician observation (Society of Critical Care Medicine, 2015). There are five primary admitting diagnoses for adults, which include respiratory failure, postoperative management, ischemic heart disorders, and sepsis. The mean age of patients is rising, particularly due to the baby boom generation, and …

Rn-Bsn Program: On-Demand, Online, Competency-Based Modules, Ladonna Michelle Mcclave

Morehead State Theses and Dissertations

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the College of Education at Morehead State University by Ladonna Michelle McClave on December 10, 2015.

A Critical Hermeneutic Analysis Of Presence In Nursing Practice, Alicia L. Bright

Collected Faculty Scholarship

Nursing presence, although it involves action at times, is a humanitarian quality of relating to a patient that is known to have powerful and positive implications for both nurse and patient. However, this phenomenon has not been well understood. Three theories, drawn from the work of Paul Ricoeur and Hans-Georg Gadamer, served as the boundaries for both data collection and analysis. The theories were narrative identity, play and solicitude. This study follows a critical hermeneutic approach to field research and data analysis. Literature regarding nursing presence is reviewed and discussed, and in-depth conversations with eleven participants are recorded. Examining the …

Restoring Digestive Health, Kristin M. Corbin, Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose: The purpose of this translational research project was to outline the healthcare problems associated with Functional Gastrointestinal Disorders and to explore the effectiveness of a gastrointestinal protocol utilized at Atlanta Center for Holistic and Integrative Medicine. The goal of this protocol is to restore digestive health with probiotics, digestive enzymes, and glutamine.

Background: Functional Gastrointestinal Disorders affect one in every four adults in the United States. These disorders encompass a variety of symptoms including diarrhea, constipation, cramping, abdominal pain, flatulence, reflux, and bloating without an identified physiological cause. There is currently no cure for Functional Gastrointestinal Disorders and treatment …

Comparison Of Older Urologic Patients' Perceptions And Nurses' Assessments Of Discharge Readiness, Elizabeth Dodge

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to explore older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness. In addition, this study examined the difference among older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness.

Design: A descriptive, comparative, cross-sectional design was used.

Methods: Convenience samples of older urological patients and clinical nurses were recruited from three surgical units. Data were collected using The Patient Readiness for Hospital Discharge and Nurse Readiness for Hospital Discharge questionnaires.

Results: Patients perceived low total discharge and personal status readiness for discharge. This was in contrast to 93.9% of …

Retrospective Study To Evaluate Nausea, Vomiting, And Hypersensitivity Reactions In Patients Receiving Folfox For Colorectal Cancer At An Infusion Center Not Routinely Administering Prophylactic Dexamethasone, Marissa Csovelak Pharmd, Melissa Kratz Rn, Msn, Aocn, Janine Barnaby Rph, Bcop

Department of Pharmacy

No abstract provided.

Prevalance Of Waterpipe Tobacco Smoking Among University Student Athletes In The United States, Liza Raymond, Cheryl Riley-Doucet

DNP Forum

Purpose: The purpose of this study was to determine the 30-day, previous year, and lifetime usage of waterpipe tobacco use among athletes within a Midwestern university. The prevalence of waterpipe smoking suggests that this form of tobacco use is becoming an epidemic in the United States.

Data Sources: This study used a convenience sample of 59 college students who were English-speaking and 18 years or older. These students were enrolled in the Winter 2013 semester athletic program. The athletes completed a survey that was previously used and created by Brian Primack and reprinted with the author's written consent. The following …

The Epigenetics Of Post-Traumatic Stress Disorder In Women And Ptsd In Women Veterans: Implications For Health Policy, Cheryl R. Brubaker Msn, Sdnp, Fnp-Bc, Judith Milner Psyd

DNP Forum

Women have long served in the military during war whether recognized or unrecognized, whether praised or unpraised, whether there by choice or not there by choice. Men and women both feel the wounds of war. So many times those wounds are very hard to ignore, and often those wounds are not so visible yet take their toll. Post-traumatic stress disorder (PTSD) is commonly associated with combat, with war, and with being a veteran (Fischer, 2014). Our understanding of women formally deployed as soldiers into combat and the consequences for these women is less well defined. Through a meta-synthesis of published …