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Examining Knowledge, Attitudes, and Educational Needs Regarding Caring for Adult Patients Aged 18 Years and Older Diagnosed with Schizophrenia Among Healthcare Professionals and Providers Referring Palliative Care Consultation Working in a Large Teaching Hospital
No full textUB SON, DNP Research ProjectBackground & Significance: Schizophrenia, a severe and persistent mental illness (SPMI), affects approximately 24 million people or 1 in 222 adults worldwide. There has been growing interest to integrate compassionate humanistic approaches into palliative care (PC) for individuals with SPMI, including schizophrenia. Purpose and Aims: To examine current knowledge, attitudes, and educational needs regarding caring for adult patients diagnosed with schizophrenia among healthcare professionals and providers in a large teaching hospital to promote compassionate humanistic care and quality of life for adult patients with schizophrenia. Theoretical Framework: Zalenski and Raspa's (2006) adaptation of Maslow’s Hierarchy of Needs acted as the project's theoretical framework. Methods and Design: A descriptive cross-sectional survey design was utilized. A 52-item survey was administered that included four open-ended questions to elicit narrative responses regarding perceived PC care needs for patients diagnosed with schizophrenia. Results: A total of 42 participants completed the survey. Participants demonstrated overall sufficient knowledge regarding schizophrenia and positive attitudes and beliefs towards individuals living with an SPMI. Narrative responses generated four main themes: Unmet Needs and Lack of Support; Relief of Physical and Emotional Distress; Uncertainty of Death; and Verbal Support. Conclusion: Mental health and PC experts need to collaborate to deliver education to healthcare professionals and providers caring for patients living with SPMI to promote compassionate and humanistic care. Future Implications & Recommendations: Future research is needed among healthcare professionals and providers examining and exploring comfortability of providing PC to individuals living with SPMI and overall PC knowledge, especially in Urban hospitals
Perceptions of Continuous Noninvasive Hemodynamic Monitors, A Pre-/Post-Test Survey Evaluating the Effectiveness of an Educational Program on Perceived Knowledge and Barriers Related to the Clear Sight Device among Certified Registered Nurse Anesthetists
No full textUB SON, DNP Research ProjectThe association between perioperative hemodynarnic (HD) instability and postoperative morbidity and mortality is supported by a considerable body of literature. Continuous noninvasive hemodynarnic monitors, including the ClearSight device, allow for beat-to-beat feedback that is comparable to that derived from invasive catheters. Access to continuous feedback facilitates the early diagnosis and timely intervention for HD instability and allows for the titration of fluids based on HD indicators of volume status. The purpose of this project was to evaluate the effectiveness of an educational program for certified registered nurse anesthetists (CRNAs) and close the gap between the availability of this device and its appropriate use in order to improve the standard of care at the project site. Using a pre-test post-test without control group study design, 29 CRNAs at a large academic institution completed surveys assessing selfperceived knowledge and barriers to use of the ClearSight device utilizing an online platform. Survey questions were developed based on the theoretical framework, the Technology Acceptance Model (TAM), which focused on the perceived ease of use (PEU) and the perceived usefulness (PU) of new technology. Participants attended a thirty-minute training seminar and then completed a post-education survey immediately following the information session. There was a statistically significant improvement in self-perceived knowledge and barriers to use. The educational intervention discussed in this proposal was the first step in challenging the status quo and ultimately improving the quality of anesthetic delivery at the project site
Advance Care Planning: A Survey of Adult Primary Care Patients Regarding Their Current Attitudes, Behaviors, and Beliefs, Surrounding Serious Illness Planning Preparation
No full textUB SON, DNP Research ProjectAccording to the world population estimates, there will be 2.1 billion people aged 60 and older by 2050 (Su et al., 2020). The number of advanced directives in the United States remains scarce despite various efforts to bolster advance care planning (ACP) (Ludwick et al., 2022). The magnitude of this issue was recently highlighted during the Covid-19 pandemic, when shared medical decision-making became a crucial component of triaging patients and resource utilization. The purpose of this Doctor of Nursing Practice (DNP) project was to develop and administer an ACP survey to healthy adult patients at a primary care clinic in Western New York. Donabedian’s conceptual model was utilized as the theoretical framework (Ayanian & Markel, 2016). The survey consisted of 11 sociodemographic questions, followed by 52 questions requiring responses in a 5-point Likert scale format. The UB Institutional Review Board (IRB) deemed this DNP project exempt. Convenience sampling was utilized, 30 participants completed the survey. Data was analyzed using descriptive statistics (frequencies, means, and cross-tabulations). Main findings included: patients would like to begin serious illness planning in their twenties, their proxies need additional information regarding their current health status and future wishes, and binary questions are not capturing the ACP needs of patients. Future research should focus on the educational needs of patients engaging in serious illness planning during different life stages, how providers should appropriately involve proxies in a patients’ care across a lifespan, and on formulating serious illness planning and preparation guidelines geared towards various age groups
Early Pennsylvania Tribes
No full text[p.13 is a photocopy of "Champlain's Map of New France 1632." Prominent place names on map: Nouvelle France, Mer Douce, Lac St. Louis, Virginia. Bottom left reads, "the Original in the State Library for Doc. Hist. of N.Y. Vol. 3." p.14 added by hand at the bottom. "Heidenreich's paper 'Mapping the Location of Native Groups 1600 - 1760.' Mapping History, Journal of Historical Atlas of Canada (2):81" p.15 is a photocopy of "A Map of the Eastern part of the Province of New York; with part of New Jersey, & c. Drawn from the best Authorities. By T. Kitchin Geog." p.16 is a photocopy of "Virginia Erforshet und Beschrieben Durch Capitain Johan Schmidt," a German rendition of John Smith's map of the Chesapeake Bay, dated to 1627.]"Early Pennsylvania Tribes" includes Michelson's research and notes, especially annotations and quotes related to various maps. There are photocopies of four maps at the end of the document
Oral History Indexing
No full textOral history indexing (OHI) is a set of practices for audio/video content management that emerged with computer-based media. Through thematically defined passages within recordings, OHI provides electronically linked, timecode-level access to online oral history interviews and collections. Several institutions have developed multimedia OHI interfaces that, like an indexed book, allow cross-referencing to specific points within media documents, describe content through natural language, and promote browsing and exploring modes rather than literal text searching. This article describes the OHI work of seven pioneering institutions through case studies, highlighting a range of methodological approaches and system attributes. It also examines the phenomena of OHI through the lens of oral history best practices, discusses how emerging technologies such as automatic speech recognition will likely change oral history transcription practices and OHI, and suggests that the concepts and skills involved in OHI are applicable well beyond oral history and its content
MLA Colleague Connection: A Transition to a Virtual Mentoring Program
No full textBackground: Since 2003, the MLA Membership Committee has facilitated an in-person mentoring program called Colleague Connection at the annual meeting. The program hinged on meeting attendance, so members who could not attend were excluded. The 2020 virtual meeting created an opportunity to rethink the Colleague Connection experience. Three members of the Membership Committee developed an expanded and virtual version of the mentoring program. Case Presentation: Colleague Connection was promoted via the MLA ’20 vConference Welcome Event, MLAConnect, and email lists. The 134 participants were matched based on same-chapter preference, library type, practice area interest, and years of experience. Mentees chose mentor-mentee or peer pairs, resulting in 4 peer matchings and 65 mentor-mentee matchings. Pairs were encouraged to meet monthly, and conversation prompts were provided. A Wrap-Up Event was held for participants to talk about their experiences and network. A survey evaluated the program and sought suggestions for improvement. Conclusion: The online format boosted participation, and the format change was well received. In the future, a formal orientation meeting and communication plan can ensure pairs make their initial connections and provide clarity about program details, expectations, timelines, and contact information. The type of pairings and size of the program are important considerations for the feasibility and sustainability of a virtual mentoring program
Barriers to utilization of employer-initiated mindfulness interventions identified by Certified Registered Nurse Anesthetists
No full textUB SON, DNP Research ProjectThe purpose of this cross-sectional study was to determine the barriers to utilization of employer initiated mindfulness interventions by CRNAs. Mindfulness is an effective coping strategy to decrease the emotional exhaustion aspect of burnout in healthcare providers. Burnout is important due to its impact on quality of life for the practitioner, quality of patient care and its effect on workplace relationships. Hospital systems suffer due to increased financial burden related to staff attrition, absenteeism, high costs to orient new staff and medical errors. Forty eight CRNAs, at a large cancer hospital located in the northeast United States, completed a web based survey determining the barriers to utilization of an employer-initiated mindfulness intervention program. The survey was derived from the DMPI as well as researcher drafted demographic and open-ended response questions. CRNA staff scored an average of 3 7 on the DMPI indicating a low number of barriers to mindfulness. Barriers most often displayed were perceived lack of time, lack of knowledge and preconceptions about mindfulness as well as cynicism towards employer-initiated solutions. CRNAs are interested in mindfulness however at times that are convenient to them. Virtual intervention appears to be the most acceptable. Two thirds of surveyed staff indicated they would be willing to attend, at minimum on a monthly basis. This project can be used by hospital-based stakeholders to determine if mindfulness programming, held at convenient times, location, and modality for anesthesia staff, is a feasible request
Inpatient Lung Cancer Length of Stay and 30-day Readmission Rates: The Impact of Palliative Care Consultations
No full textUB SON, DNP Research ProjectThe hospital length of stay (LOS) has an impact on hospitals' finances and patient quality of life. Although there are numerous medical conditions that require hospitalizations, lung cancer is the most common oncologic diagnosis requiring a hospitalization for various reasons. The purpose of this Doctor of Nursing (DNP) project was to quantitatively complete a retrospective chart review to determine if the use of palliative care consults with adult lung cancer patients decreases the hospital length of stay and 30-day readmission rates. The aim was to increase the knowledge and importance of early palliative care involvement and change the standard of practice by consulting palliative care earlier. Project objectives were to compare hospital length of stay, 30-day readmission rates, and various patient variables among adult lung cancer patients, over the age of 18, who are treated with palliative care versus no palliative care. The King's Theory of Goal Attainment indirectly was used to understand the relationship and communication between the palliative care team and patients, to assist with decreased length of stay. Institutional Review Board (IRB) approval was obtained and data was collected and stored in accordance with University at Buffalo's IRB protocol. Following data collection, it was found that length of stay was significantly shorter without a palliative care consult and the stage of cancer did impact if a palliative consult was placed. All other variables were not statistically significant. Various strengths and limits were present within the study. Future research would be needed to gain a better understanding
Perceived Barriers and Facilitators of the Utilization of the Transversus Abdominis Plane (TAP) Block for Patients Undergoing Abdominal Procedures Among Certified Registered Nurse Anesthetists (CRNAs) Practicing in New York State
No full textUB SON, DNP Research ProjectIn 2013, it was reported that prescription misuse and abuse were associated with an estimated $78.5 billion in United States healthcare costs. Anesthesia providers have responded to these concerns by incorporating opioid-free analgesia techniques, including the transversus abdominis plane (TAP) block. Despite strong evidence-based support for the use of TAP blocks, some anesthesia providers continue to remain hesitant in using this safe and effective opioid sparing technique. The purpose of this Doctor of Nursing Practice (DNP) project was to identify perceived barriers and facilitators to the utilization of the TAP block for patients undergoing abdominal procedures among Certified Registered Nurse Anesthetists (CRNAs) practicing in New York State (NYS). Kurt Lewin's Change Theory was the theoretical framework guiding this project. A cross-sectional design was used to survey NYS CRNAs via SurveyMonkey. A total of 41 CRNAs were recruited through the New York State Association of Nurse Anesthetists' (NYSANA) Facebook page and email server. Univariate statistics was utilized to analyze data. Results indicated that only 43.9% of participants have performed a TAP block. Top barriers to use included difficultly integrating TAP blocks into the norms of existing practice (mean score 4.15), the inability to frequently perform TAP blocks (mean score 4.10), and organizational resistance to change (mean score 4.00). Identification of these barriers and facilitators to TAP block usage provided valuable information that led to the development of evidence-based recommendations that will in tum increase the use of TAP blocks and improve surgical patient outcomes
Supplementary Notes 2: Word that appears in Iroquoian translation of Old Testament
No full textThis undated note is a list of words in an Iroquoian language. They appear to be variants. (One variant can be found in an 1890 translation of the Old Testament, somewhere in the book of Judges, in a paragraph about Jephthah. This translation was published by a missionary located in Caughnawaga, Rev. Pere N.V. Burtin.