UBIR Repository (Univ. at Buffalo)
Not a member yet
5736 research outputs found
Sort by
Changing Perceptions of Palliative Care, One Lecture at a Time: A Pre-/Post-Test Survey Evaluating the Effectiveness of an Existing Educational Program on Perceived Knowledge of Palliative Care for New Hire Registered Nurses on Orientation at an Academic Medical Center
No full textUB SON, DNP Research ProjectNurses play an essential role in caring for patients with serious illnesses, yet tend to have received limited formal education on palliative care (PC), leading to poor management of patients with serious illnesses and the actively dying patient. The purpose of this Doctor of Nursing (DNP) project was to quantitatively explore the effectiveness of an existing educational program on new hire nurses’ knowledge of PC. The aim was to increase nurses’ knowledge test scores and improve the care that patients receive. The Palliative Care Quiz for Nursing ([PCQN] Ross et al., 1996) questionnaire is a valid tool that was utilized to assess nurses’ knowledge. Project objectives consisted of 1) conducting a literature search to identify current evidence-based literature on PC and nurses’ knowledge; 2) surveying nurses with a demographic survey and a pre-PCQN test; 3) performing a 1-hour lecture on the fundamentals of PC; 4) surveying nurses with a post-PCQN test; 5) analyzing collected data and interpret the results; and 6) providing evidence-based recommendations to institutional nursing leadership for ongoing PC education. Dr. Patricia Benner’s model, From Novice to Expert (1982) served as the theoretical framework for this project and descriptive statistics was utilized to analyze findings. Approval was obtained from University at Buffalo’s Institutional Review Board (IRB) and the Quality Improvement Committee at Westchester Medical Center, and data was collected and stored as per IRB protocol. Participation was voluntary and anonymous and informed consent was obtained from participants prior to initiating the study
Parent, Caregiver and Healthcare Worker Perceptions of Holistic Support Resources and Needs While Caring for a Child Undergoing Cancer Treatment or Hematopoietic Stem Cell Transplant in an Inpatient Setting
No full textUB SON, DNP Research ProjectPediatric cancer or hematopoietic stem cell transplant (HSCT) can destabilize family dynamics as parents and caregivers struggle to balance various responsibilities and time commitments. Inadequate holistic support resources for parents and caregivers often result in decreased family presence during their child’s inpatient hematology-oncology (heme-onc) treatment. The purpose of the Doctor of Nursing Practice (DNP) project was to explore parent, caregiver, and healthcare worker perceptions of holistic support needs and resources for families caring for a child undergoing inpatient cancer treatment or HSCT in a local hospital’s heme-onc unit. The project aim was to increase insight and awareness of parent and caregiver holistic support needs and resources to better support families caring for a child undergoing cancer treatment or HSCT on the hospital’s heme-onc unit. A qualitative descriptive design was utilized with semi-structured individual interviews. Orlando’s Nursing Process Discipline Theory guided development of the semi-structured interview questionnaire created for the purpose of this project. Braun and Clarke's Reflexive Thematic Analysis Method was used to analyze data. Findings revealed one overarching theme, It [Caring for a Child with Aplastic Anemia] is One of the Most Challenging Things and four supporting themes, Family Experiences Can Vary, Everything [Self-Care] has Fallen by the Wayside, Each [Existing] Resource has Been Helpful, and Just Make Some of the Ones [Support Resources] More Robust. Future research is needed exploring family needs and support resources on a larger scale including outpatient and bereaved family support resources and translation services for non-English speaking patients and families
Reducing Barriers to Cognitive Testing for Vulnerable Elders in an Urban Primary Care Setting
No full textUB SON, DNP Research ProjectBackground and Significance: In older adults, proper screening for dementia and mild cognitive impairment is necessary so that proper treatment can be started, as necessary. Purpose, Aims, and Objective: To assess the barriers to cognitive screening in several busy primary care practices and then find ways to overcome those barriers. The goal was to increase screenings while not burdening providers. Theoretical Framework: This study was guided by Bandura’s Social Cognitive Theory. Methods and Design: The study was a mixed methods design that started with an evaluation of screening rates at four NFMMC primary care offices, followed by provider and staff interviews with the objective to determine what the screening barriers are and the best ways to overcome them. Results: The research showed that lack of knowledge among providers regarding dementia screening is not a problem. The issues are more system wide and more complex: 1) there are varied methods to screen, 2) there is lack of role clarity, and 3) there are structural barriers to screening. Conclusion: Working with a racially and economically diverse inner-city population, screening for MCI is critically important. Providers recognize this and have incorporated their own methods to identify cases. Future Implications and Recommendations: Further investigation and discussion about possible solutions for structural barriers is needed. However, incorporation of screening tools into the current EMR and practice workflow could be implemented concurrently with the discussion
A Survey of Undergraduate Engineering Students’ Personal Information Management Practices
No full text85th Annual Meeting of the Association for Information Science & Technology, Oct. 29-Nov. 1, 2022, Pittsburgh, PA.Personal information management (PIM) includes the activities and preferences that support future information use. PIM is especially important in the context of engineering education, where learners are expected to engage with a substantial amount of information. This paper builds on the findings of a research project on the information practices of undergraduate engineering students, examined through multiple qualitative and quantitative methods (Dodson, 2021). This paper reports on one aspect of the project, an online questionnaire (n = 103). Findings suggest learners regularly engage in PIM activities, and experience different degrees of challenge when managing multiple types of information
Impact of Postoperative Nausea and Vomiting Education Towards Anesthesia Provider Compliance with Institutional Prophylaxis Protocols
No full textUB SON, DNP Research ProjectDespite advances in anesthetic techniques and interventions, postoperative nausea and vomiting (PONV) remains a highly prevalent surgical complication. Current literature supports the use of a preoperative screening tool (i.e. Apfel risk score) to guide the administration of multimodal antiemetics for patients with moderate to high risk factors. Unfortunately, a significant challenge to PONV management is the lack of anesthesia provider compliance to institutional protocols. The purpose of this Doctor of Nursing Practice (DNP) project was to develop a PONV prophylaxis guideline for anesthesia providers in a Western New York community hospital setting. The aim was to expand their proficiency in PONV prevention strategies. Objectives for this research included an evidenced-based literature review, a PONV survey distribution, an inservice presentation, a pre-and post-implementation evaluation, dissemination of the findings, and contribution of project deliverables (i.e. PONV protocol). This DNP project was guided by Roy's Adaption Model (RAM) which describes nursing behavioral changes in response to work stimuli, thereby undergoing a coping process and adaption as they adopt new institutional guidelines. The project utilized a cross-sectional survey design to evaluate the anesthesia providers' perspectives on institutional protocols, as well as retrospective patient chart reviews to measure PONV risk factors and antiemetic interventions in order to determine the rate of compliance. The survey findings showed that most of the participants culturally advocate for a PONV protocol to improve patient outcomes. Additionally, the quantitative analysis revealed an increased frequency in multimodal administration, but the results were not statically significant. The DNP project thus displayed an effective enhancement in anesthetic knowledge and discipline which can have future implications in pharmacogenetics and antiemetic efficacy
Perceptions of Radiation Safety and Subsequent Workplace Burnout
No full textUB SON, DNP Research ProjectBackground and Significance: Radiation safety in the operating room (OR) is necessary for protection against ionizing radiation exposure. Barriers to personal protection and increased use of fluoroscopy to guide safe surgical procedures, places operating room employees at high risk for negative health outcomes. Purpose, Aims and Objective(s): The purpose of this study was to determine operating room staff barriers to proper personal protective equipment including, lead aprons, thyroid shields, and dosimeter badges as it relates to burnout in the workplace. Theoretical Framework: The theoretical framework was the Health Belief Model which explains and predicts individuals’ health promoting behaviors. Understanding barriers to radiation safety compliance is needed to promote improvements in safety. Methods and Design: This quality improvement study surveyed 24 OR staff to determine their perceptions of radiation safety in their workplace, radiation knowledge, and perceptions of workplace burnout. The sample included RNs, technicians, CRNAs, and MDAs. Descriptive and text-based data revealed clinically significant safety concerns including, poor availability and cleanliness of lead. Staff reported willingness to wear dosimeters but noted problems with availability. No statistically significant relationships were found among staff, age, education, and years in practice with radiation knowledge or workplace satisfaction. The Mini Z survey revealed that participants were satisfied with their workplace, but it was stressful and lacking resources. Conclusion: Improvements in training, and availability of clean and comfortable lead shields, and use of dosimeters are needed. Future Implications: Revisions in QI should be re-evaluated annually for deficits
Barriers and Facilitators to Implementing an Enhanced Recovery After Surgery (ERAS) Total Knee Arthroplasty Protocol for Anesthesia Providers Working at a Teaching Hospital Practice Setting in Central New York
No full textUB SON, DNP Research ProjectA challenging component of the opioid crisis in the United States is the overuse of perioperative opioids for total knee arthroplasty (TKA). Considering variations in anesthetic techniques, opioid sparing, enhanced recovery after surgery (ERAS) pathways target enhancing patient outcomes via standardization of care. The purpose of this Doctor of Nursing Practice project was to evaluate the existing TKA protocol at a Central New York hospital, survey anesthesia providers, and develop a prototype ERAS TKA pathway. The objectives included conducting a literature review, devising a survey tool, identifying barriers and facilitators to implementing ERAS for TKA, creating an ERAS TKA pathway, and reporting the findings. Kurt Lewin's Change Theory guided this project as it remains the cornerstone for eliciting change. A cross-sectional survey was used and data was analyzed using descriptive and inferential statistics. Among the 25 respondents, 23 facilitators and eight barriers of implementing ERAS were identified. Regarding pharmacology these providers reported the most comfort with general anesthesia and administering opioids. Significant findings were revealed in peripheral nerve block (PNB) comfort scores for CRNAs (M=2.79, SD=l.475) and anesthesiologists (M=4.67, SD=0.516); t (22.488) =-4.709, p=<0.001. Provider burnout had no significant impact on the results; however, statistics showed that mid-career individuals were least burned out, with a decline in resiliency in later career years, [F (4,20) =4.015, p=0.015]. Considering this, anesthesia providers play a pivotal role in addressing the opioid crisis and education regarding opioid alternatives is warranted. Future implications include understanding practice variations between professions and breaking down barriers to widespread ERAS adoption
Perceived Teaching Barriers, Facilitators, and Needed Resources Among Nurse Practitioner Preceptors Teaching Advanced Practice Nursing Students in the Clinical Setting: A Qualitative Study
No full textUB SON, DNP Research ProjectAs a professional discipline experiencing rapid growth, it is imperative that systems are put in
place to promote quality education for Nurse Practitioners (NPs). Literature review findings
revealed that current barriers to NP precepting include a lack of standardized clinical education,
precepting incentives, and research supporting NP precepting best practice. The purpose of this
DNP project was to explore perceived teaching barriers, facilitators, and resource needs among
active NP preceptors associated with the University at Buffalo’s School of Nursing to guide
development and provision of an evidence-based, digital precepting resource toolkit. The aim of
this project was to gain greater insight into the NP preceptor role and what is needed to optimally
fulfill the role. Data were analyzed using Braun and Clarke’s Reflexive Thematic Analysis
method. The analysis of data generated one overarching theme, It’s Really Important to Be a
[NP] Preceptor, and four key themes, It’s [NP Precepting] a Positive Experience; Preceptors
Need to Prioritize, Be Organized, and Teach in a Way They’re [APRN Students] Going to
Understand; I’m Sure More People Would Be a Preceptor if There Was More Incentives to It;
and What’s DEI? Findings revealed that although participants viewed the NP preceptor role as
important, valuable, and enjoyable, formal NP preceptor role preparation was almost
nonexistent, a need for improved communication among preceptors, students, and schools exists,
and that education is needed regarding the role of diversity, equity, and inclusion in NP
precepting. Further research is needed exploring and examining NP preceptor resources and role
preparation
Nurse Anesthetists Perceived Attitudes and Knowledge of Amniotic Fluid Embolism Management and Utilization of a Novel A-OK Protocol in Clinical Practice
No full textUB SON, DNP Research ProjectBackground and Significance: Amniotic fluid embolism (AFE) is a rare, unpredicted, and life-threatening complication associated with childbirth. In the United States, AFE is the second leading cause of maternal death in obstetrics. A novel approach known astheA-OK protocol, consisting of Atropine, Ondansetron, and Ketorolac, used as an adjunct to traditional treatment has been shown effective in resuscitation from the syndrome. Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia during all phases of labor obstetric care. Prompt recognition and rapid intervention by the anesthesia provider is essential to optimize maternal and fetal outcomes. Still, accurate recognition of the syndrome remains difficult due to lack of universal diagnostic criteria and limited practitioner experience with the event. Purpose, Aims and Objective(s): To explore perceived competence of CRNAs currently practicing in obstetric setting, in recognizing and managing AFE, and to identify potential barriers to utilization of A-OK protocol in clinical practice. Theoretical Framework: Patricia Benner’s Novice to Expert Model. Methods and Design: Convenient sampling was used to recruit CRNAs nationwide, utilizing an online social media platform. A quantitative pre-and-post intervention design questionnaire was used to explore CRNA’s self-perceived knowledge of AFE management and A-OK protocol. Results: Descriptive statistics and paired sample T-tests were used for analysis using SPSS 26. Statistical significance was not achieved regarding CRNAs’ confidence levels of AFE management and A-OK protocol in the pre and post surveys (p=0.332). There was no statistical significance regarding CRNAs’ likelihood of implementing the protocol in clinical practice comparing the pre and post surveys scores (p=0.705)
Effectiveness of a Pilot Project to Measure the Efficacy Of a Practice-Based Latina Adolescent Pregnancy Prevention Program
No full textUB SON, DNP Research ProjectBirths to Latina teenagers between 13 and 18 outnumber those for adolescents of every other ethnic group in America. The literature suggests that in addition to birth control, sexually transmitted infections and pregnancy prevention programs should include parents and discussion of traditional Latino values. No practice-based program so far has combined all of these elements. The purpose of this project was to pilot a four-session ethnically relevant program for Latina teens and their parents led by a bilingual Nurse Practitioner. The objectives were to increase teen knowledge and intention to use effective prevention methods. The sample consisted of 14 adolescents between the ages of 16 and 18 and 14 parents. The study utilized a quasiexperimental one group pretest/posttest design. A paired sample t-test was used to measure the outcomes. Statistically significant pre and post-test improvements were present in the teen knowledge, attitudes and peer communication sections. Statistically significant improvements were also present in the parent knowledge and attitudes sections. However, in the peer communication section for the parents it was non-significant. The program was favorably reviewed by teens and their parents. These results suggest that a comprehensive practice-based Latina sexual education program can be effective at increasing teen/parent knowledge of
preventive measures and teens’ ability to communicate with parents. The program can be adapted for use in private practices, community centers, hospitals, clinics and schools. Future programs should include a follow-up period to test for long-term effects