UBIR Repository (Univ. at Buffalo)
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Assisted Suicide: The Case for Legalization of Physician Assisted Suicide in New York State
No full textSpring 2024 HON 499 Independent Study: Terminally ill patients with less than 6 months to live do not have access to adequate end-of-life options in New York State. The importance of this shortcoming becomes apparent in recognizing that the lack of access to these options significantly limits a terminally ill patient's authority over their final moments. Despite the state of New York being a prime advocate for bodily autonomy—as proven by its steadfast support for access to abortion in the midst of Roe v. Wade's overturn—due to political pressures, the bill never makes it to the floor. Direct quotes from Assemblywoman Amy Paulin's office confirm just that. Her office relays that "[the updated bill] A.995a has over 60 assembly members that [have] signed onto the bill in support" but that "despite the support from other members, the bill has not made it to the floor for a vote...due to a hesitancy from the legislature to move the bill [on account of its controversy]." Such critiques usually arise from politicians with religious justifications or lack thereof. This in itself is indicative of the fundamental problem with popular counterarguments to physician assisted suicide. Many critics of the process present reasons and qualms originating from religious values rather than objective legal ones. The separation of church and state within the nation's establishment was written to prevent this very occurrence. The First Amendment of the Constitution reads that "Congress shall make no law(s) respecting any religious establishment," and yet Congress blocks the enactment of one here, in reverence of religious concerns. This clearly highlights the hypocrisy of the state..
Park Hall Bathroom 102 Accessibility Recommendation
No full text2024 Fall EAS 360 STEM Communications project poster: Our Accessibility report focuses on Park Hall Bathroom no.102 to evaluate whether it fits the ADA standards and Universal Design, ensuring that it is accessible to all users
Addressing Mental Health in Prisons: Improving the Well Being of Inmates and Promoting Public Good
No full textSpring 2024 HON 499 Independent Study: New York State prison conditions are disgraceful. “Today, in New York state nearly 59,000 people are incarcerated, warehoused in cramped spaces that lack fresh air, healthy food, natural light, proper health care, and connection to loved ones” (Vera Institute of Justice, n.d.). Of course, some people believe that this is deserved; their theory of punishment simply involves the removal of criminals from society. Oftentimes, people have a challenging time comprehending that criminals are still human beings with emotions, struggles, and loved ones. Our main goals are to evaluate the current state of prison mental health programs and make sure that already implemented policies are being executed efficiently. Also, we hope to find gaps in the services provided to prisoners regarding mental health, and we hope to ensure that every member of the prison population is being treated effectively for their respective conditions. Lastly, we plan to engage with different stakeholders and learn from their perspectives
Improved Quality of Life in Heart Failure with Mobile Health Applications
No full textUB SON, DNP Research ProjectMobile health applications demonstrate promise to improve heart failure (HF) patients' quality of life. The purpose of this Doctor of Nursing Practice (DNP) project is to quantitatively evaluate HF patients' willingness to use mobile health applications (mHealth apps) and cardiology providers ' recommendations for mHealth app use in HF. The DNP project objectives were to : 1) perform a literature review on heart failure quality of life and research gaps in mHealth app use;
2) consult with the Quantitative Methods and Design Research Expert to identify patient and provider surveys to evaluate willingness and recommendations to use mHealth apps; 3) apply for and obtain Institutional Board Review (IRB) approval; 4) survey stakeholder HF patients using a paper patient survey; 5) survey stakeholder providers using an electronic survey; 6) consult with the Quantitative Methods and Design Research Expert to analyze, synthesize, and report the data; 7) submit data analysis to the stakeholder practice for consideration of incorporating mHealth apps into standard care; and 8) disseminate the project through the University at Buffalo (UB). Orem's Self-Care Deficit Nursing Theory was the foundation of this study, and the Donabedian Model was utilized for survey design. The IRB approval was obtained before the initiation of the study with collected data stored per IRB protocols. Participation was voluntary, and withdrawal from the study was permitted at any time. This study demonstrates the potential positive impact of mHealth apps in HF management and patient quality of life
Knowledge, Attitudes, Practices, Beliefs, and Barriers Among Healthcare Providers When Discussing Emergency Contraception with Women of Reproductive Age
No full textUB SON, DNP Research ProjectThe Centers for Disease Control reports women aged 18 to 24 years are affected by low socioeconomic status and education levels, and Social Determinants of Health (SDOH) have higher rates of unintended pregnancies. The World Health Organization recommends emergency contraception (EC) access and education as it relates to family planning, and professional societies, including the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American Academy of Pediatrics, recommend women of reproductive age should also receive advanced prescriptions of EC for use as needed. Despite a variety of EC options and recommendations from reputable professional organizations, gaps in health care providers' knowledge, attitudes, practices, beliefs, and barriers towards EC exist. These gaps result in a lack of awareness of potential use and access in patients. The purpose of this Doctor of Nursing Practice (DNP) project was to improve provider practices related to discussing EC with women of reproductive age, ultimately reducing the number of unintended pregnancies. A quantitative cross-sectional survey examined the knowledge, attitudes, practices, beliefs, and barriers among healthcare providers discussing EC with women of reproductive age. The relationship between number of years in clinical practice and beliefs regarding having an EC prescription available before an episode of unprotected sexual intercourse was statistically significant (p 0.031 ). Healthcare provider demonstrated positive attitudes towards EC discussion and providers with extensive training were more likely to prescribe EC. Given providers' generally positive attitudes about ECPs and their willingness to prescribe, developing training surrounding IUD insertion might help to increase this form of EC
Perceived Barriers to Routine Utilization of Dexmedetomidine Among Certified Registered Nurse Anesthetists
No full textUB SON, DNP Research ProjectCertified Registered Nurse Anesthetists (CRNA) and Student Registered Nurse Anesthetists (SRNA) routinely utilize opioids for analgesic management throughout the perioperative period. However, opioid related side effects are consequently linked to increases in patient morbidity and mortality. Literature reviews indicate that dexmedetomidine (precedex) may reduce opioid consumption. Therefore, the purpose of this Doctor of Nursing Practice (DNP) Project was to identify perceived barriers to the routine utilization of dexmedetomidine among CRNAs and SRNAs during the perioperative period through electronically surveying New York State Association of Nurse Anesthetists (NYSANA) members. The six project objectives were 1) conduct an extensive literature review of perioperative dexmedetomidine administration 2) following approval by the University at Buffalo Institutional Review Board, send out electronic surveys to NYSANA members 3) analyze survey results and identify perceived barriers to routine dexmedetomidine use 4) provide deliverables as they pertained to identified survey barriers 5) dissemination of deliverables and survey findings to NYSANA 6) publicly disseminating DNP project. Virginia Henderson’s Nursing Need Theory was used as the framework in guiding and developing this DNP project. A quantitative cross-sectional survey design of 124 NYSANA members was used to identify barriers to routine dexmedetomidine utilization. The results were statistically analyzed using Chi-square, demonstrating statistically significant correlations between years of clinical practice and willingness to utilize dexmedetomidine. These findings suggest that years of provider experience correlate with willingness to utilize dexmedetomidine. Recommendations for future research include surveying a greater sample size and identifying whether specific practice settings impact routine utilization
Time Pressure and its Perceived Impact on Clinical Staff in a Primary Care Setting
No full textUB SON, DNP Research ProjectIn the primary care setting, an imbalance between available time and number of tasks creates a phenomenon known as time pressure. Multiple factors are linked to this phenomenon, which can negatively impact clinical staff and patients alike. Outcomes may include increased rates of burnout and perceptions of delivery of a lower quality of care, to an unfavorable patient experience and missed critical assessment data. This DNP project intended to corroborate and enrich existing data regarding time pressures through the perceptions of clinical staff in a primary care setting, as well as shed light on actions they felt may alleviate those pressures to inform policy or systemic changes. Betty Neuman’s Systems Model was used as a theoretical framework to guide this qualitative study. Purposive sampling and open-ended survey questions elicited the perceptions of providers, medical support staff, and clerical staff regarding time pressures and their impacts on them across multiple domains. The time pressures which staff experienced were derived from an ever-increasing patient load. Those time pressures caused staff to feel negative emotional impacts, impacts outside of work, loss of quality patient interaction, and in certain instances, a lowered sense of personal accomplishment at work. Additional staffing or improved patient encounter mechanics were pinned as potential alleviating factors. Overall, the findings were consistent with prior research and help to underscore the need for changes at the systemic level and what may help locally
Examining Sexual Health Knowledge, Behaviors, Educational Experiences and Needs among Young Adult Patients Aged 18-26 Years in a Rural Western New York Federally Qualified Health Center
No full textUB SON, DNP Research ProjectBackground and Significance: Sexual health education and healthcare resources are limited among adolescent and young adult populations and their providers in rural areas across New York State resulting in poor sexual health outcomes. Purpose, Aims, and Objectives: The purpose of this Doctor of Nursing Practice project was to examine sexual health knowledge, behaviors, educational experiences and needs among young adult patients aged 18-26 years in a rural Western New York Federally Qualified Health Center to promote sexual health knowledge, education, and safe sexual behaviors through best practice and policy recommendations based on project findings. Theoretical Framework: Pender’s Health Promotion Model was used as the guiding framework. Methods and Design: A cross-sectional survey design was utilized. Results: A total of 44 patients completed the survey. Findings revealed high-risk sexual behaviors and activity with varied precautions, limited sexual health knowledge, and desire for improved patient-provider engagement regarding sexual health education. Conclusion: A need exists at the project site for improved policy and provider engagement and education regarding young adult sexual health to promote best practice and quality patient care. Future Recommendations and Implications: Provider education, development of sexual health policies and patient assessment questionnaires and establishing clinical practice and rural community partnerships are needed. Future studies should include recruitment of young adult Spanish-speaking patients, evaluating the effects of COVID-19 on sexual health among young adults, and evaluation of telehealth services to promote young adult sexual health in rural areas
Assessment of Primary Care Provider Knowledge, Attitudes, and Practices Regarding Polycystic Ovarian Syndrome Diagnosis and Management
No full textUB SON, DNP Research ProjectPolycystic ovarian syndrome (PCOS), one of the most common endocrine conditions, affects about six to 12 percent of women. Despite its prevalence, PCOS is underdiagnosed and mismanaged, predisposing women to various comorbidities. The purpose of this Doctor of Nursing Practice (DNP) project was to assess primary care providers' (PCPs) knowledge, attitudes, and practices of PCOS and determine barriers to care. Objectives were to conduct a literature search, develop and distribute a survey, analyze results, and disseminate findings. Hildegard Peplau's Theory of interpersonal Relations guided this project. Due to external barriers, the study utilized convenience sampling at only one primary care office. Institutional Review Board (IRB) approval was obtained through the University at Buffalo (UB) prior to project implementation. Medical doctors (MDs) and nurse practitioners (NPs) responded to the survey which showed seven out of 11 providers regularly screen for PCOS and are aware of the diagnostic criteria. Implications for future practice include increasing staff knowledge, more evidence-based education to providers, and increasing quality, cost effective patient care
Impact of an Educational Experience to Promote Anesthesia Provider Comfort Level and Confidence in Utilizing the Upper Lip Bite Test among Adult Patients for Perioperative Difficult Airway Screening and Identification
No full textUB SON, DNP Research ProjectWhile General Anesthesia (GA) is relatively safe, respiratory complications are the second leading cause of anesthesia related closed claims. To mitigate patient complications associated with an unanticipated difficult airway during GA and endotracheal intubation, providers should be informed of sensitive and timely methods to help better predict potential challenging airways. Compared with more commonly used assessment tools, recent studies have shown the Upper Lip Bite Test (ULBT) to be superior in predicting difficult patient airways. The purpose of this DNP project was to examine the impact of an educational presentation on the usability, predictability, and knowledge of the practice implications associated with the ULBT to decrease potential patient complications associated with unanticipated difficult airways. Specific aims for this project were to support evidence-based education among anesthesia providers, increase provider awareness of the ULBT, its usability, and its practice implications, and to increase confidence and comfortability with utilizing and interpreting the ULBT and its results. Kurt Lewin's Change Model Theory guided this project's design and implementation. Project approval was granted by the University at Buffalo Institutional Review Board prior to implementation. The study was conducted at Roswell Park Cancer Institute using a pre-educational survey, an in-person educational presentation, followed by a post-educational survey. Providers reported an increased willingness to utilize the ULBT to assess patient airways. There was a statistically significant increase in provider willingness to use a VAL for patients with a Class 3 ULBT. Development of evidence-based airway assessment guidelines and further research on this topic is needed