11549 research outputs found
Sort by
Nourishing Change: Guiding postmenopausal women with lifestyle modifications to improve metabolism, aid in weight loss, and promote healthy aging
No full textNutrition Today is peer reviewed.This article was published in Nutrition Today and addresses issues in counseling women going through menopause. It (1) critiques diet-related recommendations generated by artificial intelligence for lifestyle changes that may positively impact women's metabolism, (2) discusses how a key metabolic change impacts health outcomes of women and describes appropriate dietary interventions to deal with it, and (3) describes the role of the registered dietitian nutritionist in caring for patients with diet-related metabolic changes
Anesthesia Providers’ Perceptions of a Cognitive Aid for the Management of Amniotic Fluid Embolism: A Doctor of Nursing Practice Project
No full textAmniotic fluid embolisms (AFE) are a rare but life-threatening obstetrical emergency associated with high maternal mortality. The purpose of this quality improvement project was to assess anesthesia providers’ perceptions of a cognitive aid to aid in identifying and managing AFE. The cognitive aid was developed following a synthesis of literature and distributed during an informational session to Certified Registered Nurse Anesthetists (CRNAs) at a partnering facility. The CRNAs responded to pre- and post-implementation surveys regarding their perceptions of the usefulness of the cognitive aid. Results indicated that the anesthesia providers felt that the CA was well-designed and easy to use. CRNAs reported increased confidence in AFE identification and management following the presentation and CA dissemination. Finally, the CA also increased the speed of locating information regarding the identification and management of a suspected AFE. By enhancing CRNA confidence and reducing the time required to access critical information, the cognitive aid may contribute to earlier intervention, more coordinated team responses, and ultimately, improved patient outcomes during one of the most time-sensitive emergencies in obstetric anesthesia. Recommendations for future versions of this project include the development of a multidisciplinary simulation program incorporating the cognitive aid into AFE emergency management scenarios.D.N.P
Certified Registered Nurse Anesthetist Perception of the Usefulness of a Standardized Reference Guide for the Management of Amniotic Fluid Embolism: A DNP Quality Improvement Project
No full textNoneAFE is a life-threatening complication of pregnancy with a high mortality rate that currently has no standardized or nationally agreed-upon protocols for treatment based on current best practices. Reference guides or cognitive aids are used in a wide array of emergencies. They can play an important role in helping the provider with a step-by-step approach to managing emergencies, such as amniotic fluid embolism. Evidence shows that a team-based approach to emergencies improved with the use of a(CA) or reference guide, and the rate of errors during emergencies was reduced by 50%. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the perception of usefulness of a new reference guide among CRNA participants for improving the management of amniotic fluid embolism via an in-person presentation. This quality improvement project occurred at a small outlying facility in eastern North Carolina with all participants in attendance at the presentation. Data was collected via pre- and post-implementation surveys using Qualtrics and analyzed using Microsoft Excel. The results showed an overall acceptance of the reference guide, a plan to implement the reference guide into their management of amniotic fluid embolism, and an increase in confidence when managing an amniotic fluid embolism event. Limitations to this project included the small number of participants available for implementation in a single facility. Future projects expanding on the work of this DNP project could include a simulation scenario allowing participants to practice using the reference tool in an amniotic fluid embolism event.Non
Assessing CRNA Perceptions of a Cognitive Aid Focused on Aspiration Pneumonitis: A DNP Project
No full textPerioperative aspiration pneumonitis is an uncommon yet potentially devastating complication of
anesthesia associated with significant morbidity and mortality. This Doctor of Nursing Practice
(DNP) quality improvement project evaluated Certified Registered Nurse Anesthetists’ (CRNAs)
perceptions of a newly developed quick reference guide (QRG) designed to support the
identification of at-risk patients and provide evidence-based prevention and management
strategies. Guided by the plan-do-study-act (PDSA) framework, the project was implemented in
a Level 1 trauma center and assessed through pre- and post-implementation surveys. Findings
indicated improved alignment with current practice recommendations, increased confidence in
recognizing aspiration risk factors, and positive perceptions of the QRG’s accessibility and
utility. Despite limited participation, results suggest that integrating a QRG into anesthesia
practice at this facility may enhance provider preparedness, improve patient outcomes, and
reduce perioperative complications. Future research with larger samples and extended timelines
is recommended to strengthen these findings.D.N.P
Increasing Confidence of Certified Registered Nurse Anesthetists in Managing an Amniotic Fluid Embolism – A Quality Improvement Project
No full textAmniotic fluid embolisms (AFE) are a rare obstetrical emergency with high mortality in the gravid patient and fetus, increasing both healthcare costs and stress for the patient, their family, and the provider. Data regarding AFE events are inconclusive, leaving CRNAs to rely on clinical judgment during this obstetrical emergency. The purpose of this quality improvement project is to assess whether the creation of a newly developed cognitive aid increased the confidence of CRNAs in identifying and managing an AFE event. A literature review was conducted to gather current recommendations on AFE events and the use of cognitive aids in anesthetic practice. A cognitive aid was then developed to illustrate the recommended steps for identifying and managing AFE events. The cognitive aid and current literature were presented to the CRNAs before their shift at a critical access hospital in Northeastern North Carolina. The participants (n = 3) completed both a pre- and post-presentation survey to gauge their thoughts on the tool and determine whether they perceived an increase in confidence. During data comparison, the use of a cognitive aid increased CRNA confidence in identifying and managing AFE events. An increase in CRNA confidence when using the tool will help reduce the likelihood of missing critical steps during an AFE event. However, due to the small sample size, further research is needed on the topic. Future research on AFE events can increase CRNA confidence while decreasing mortality for the fetus and parturient.D.N.P
A Grounded Theory Study of Birthing People’s Decision-Making on Labor Pain Management
No full textUsing a Constructivist Grounded Theory (CGT) approach, this study addressed the following research questions: 1) What sociocultural factors contribute to decision-making about labor pain management among nulliparous birthing people? and 2) How does the pain management decision develop or change from antepartum to delivery among nulliparous birthing people? Data to address the research questions was collected through semi-structured interviews. Seventeen nulliparous participants, at least 37 weeks pregnant, partook in initial interviews following their antepartum outpatient visit. Nine participants were retained for follow-up interviews that took place either at the hospital or over the phone between one day and four months postpartum. The overarching theme, Navigating Decision-making amid Uncertainty, was supported by two theoretical categories: 1) Shaping decisions, which involved receiving advice from social networks, engaging with social media, and awaiting provider-led education, and 2) Shifting decisions, which involved responding to labor realities and considering support system guidance. Of the follow-up participants, seven initially intended to avoid an epidural. However, only two of the seven did so. This shift was often a result of unanticipated pain intensity exacerbated by medical interventions such as the foley balloon and IV Pitocin. Policy and practice changes that promote person-centered care and informed decision-making should be considered. These findings offer a novel perspective on decision-making among nulliparous birthing people. They can serve as a step toward evaluating the potential for an intervention to promote informed decision-making about pain management during labor
Progress Made: A Records Management Year in Review
No full textThis presentation will discuss the challenges the presenters have addressed in their records management program during the last year. Specifically, they will discuss how they are improving dispersal of procedural information, being more responsible stewards of their physical spaces, and building digital records infrastructure. They will reflect on successes and lessons learned
Executive Summary: Digital Chest Drainage Systems in the CVIU
No full textAn executive summary for the completion of a DNP degree.D.N.P
Resiliency of Adverse Childhood Experiences in North Carolina
No full textResiliency of adverse childhood experiences in the North Carolina community aims to address adverse childhood experiences (ACEs) and trauma. Many decisions, outcomes, and experiences in life come from childhood events and can have long-term effects through one’s time. These traumatic events can include, but are not limited to, violence, abuse, deaths, mental issues, and substance use within households. From these events, many may find adulthood can be more challenging. Understanding collective impact and the different interventions such as community programs, resilience building, and trauma-informed care are significant. The goal of this project is to work with the community through research, local agencies and specialized departments to create a stronger and more resilient municipal through an accessible community resource guide and continuation of collaboration
Minding the Intergenerational Gap: The Role of Age on Knowledge Hiding and Constructive/Destructive Behaviors
No full textGiven employee’s increased time in the workforce and average lifespans, intergenerational workplaces are more prevalent, and many benefits of age-diverse workplaces have been substantiated (e.g., increased creativity, Backes-Gellner et al., 2011; increased decision-making capabilities, Wegge et al., 2008). Knowledge management research has considered knowledge sharing within intergenerational teams, suggesting that age may be an important factor to how employees share knowledge (Fasbender et al., 2021), but not explicitly knowledge hiding. There has yet to be a study to consider the relationship between intergenerational contact and knowledge hiding even as age influences many other workplace processes. Survey data collected through Cloud Research’s Connect from 401 working employees were analyzed using path analysis. Older employees were found to engage in more evasive hiding and rationalized hiding. However, when older workers are in environments with intergenerational contact, evasive hiding and rationalized hiding was less likely. Further, employees that engage in rationalized hiding were more likely to consider constructive behaviors like loyalty or considerate voice, while those who play dumb/hide evasively are more likely to utilize destructive behaviors like assertive voice, neglect, and employee exit. Mediations provide further context to how age impacts these behaviors showing how age influences constructive/destructive behaviors through differing facets of knowledge hiding. Theoretically, these relationships could be motivated by lifespan development and social exchange processes, which future research should explore