UBIR Repository (Univ. at Buffalo)
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Decision-Making Process for Inpatient Treatment with Buprenorphine Microinduction: Adults with Opiate Use Disorder
No full textUB SON, DNP Research ProjectBuprenorphine microinductions are an emerging practice amongst prescribers that treat opioid use disorder [OUD] as a response to rising overdose death rates and the growing risk of precipitated withdrawal associated with fentanyl use. However, little is known about the process that patients use when making decisions related to buprenorphine treatment. The purpose of this DNP project was to formulate person-centered approaches when discussing treatment for OUD. This project was guided by Charmaz's methodology using Pender's health promotion model as a theoretical framework. Purposive sampling was used to recruit informants from an addiction treatment center in New York. Data collection and data analysis occurred simultaneously using constructivist grounded theory. Preliminary findings suggest a grounded theory of a daily balancing act as participants repeatedly reflected on their past experiences, expressed fears what would happen next, weighed options, played the tape through, considered timing, shunned dependency, and sought input & support while making decisions about the buprenorphine microinduction. Additionally, two phases specific to the recovery process were revealed: Accepting OUD and Maintaining Recovery. Preliminary findings revealed facilitators and barriers to buprenorphine microinduction treatment that can inform practices and policies
Safety and Efficacy of Endovascular Interventions in Preventing Post-thrombotic Syndrome
No full textUB SON, DNP Research ProjectBackground and Significance: The incidence of upper extremity deep venous thrombosis (UEDVT) is on the rise. Anticoagulation alone predisposes the patient to a high risk for post thrombotic syndrome (PTS) which severely impacts quality of life and associated healthcare costs. Purpose, Aims, and Objectives: The purpose of this project was to investigate the efficacy and safety of endovascular interventions in preventing PTS for patients presenting with an UEDVT to a health clinic. The aim of this project was to increase knowledge and understanding of the benefits and/or risks of endovascular interventions and their efficacy in restoring venous patency and preventing PTS without increasing bleeding complications. Theoretical Framework: The Donabedian framework will be used to guide this project. Methods and Design: A quantitative retrospective chart review was conducted at a local hospital investigating the incidence of post-thrombotic syndrome and adverse events relating to anticoagulation or endovascular treatments. Results: The lowest risk for PTS was seen in the pharmacomechanical thrombectomy group; the highest risk for bleeding was females older than age 60 on anticoagulants. Conclusion: The best course of treatment for UEDVT patients is pharmacomechanical thrombectomy, which can restore venous patency and prevent severe PTS without severe bleeding complications. Future Implications and Recommendations: There should be a qualitative needs assessment performed with providers at the facility on knowledge and implementation of endovascular interventions
Barriers and Facilitators to Hospice Utilization among Hispanic Adults Aged 18 Years and Older Living in Erie County New York as Perceived by Primary Care Providers and Community Leaders
No full textUB SON, DNP Research ProjectHispanics utilize hospice care less than any other patient population. The purpose of this Doctor of Nursing (DNP) project was to qualitatively explore hospice utilization barriers and facilitators among Hispanic adults living in Erie County, NY from the perspective of their primary care providers and community leaders. The project aimed to increase knowledge, insight and understanding regarding existing barriers to hospice utilization among Hispanic adults in Erie County, NY for Hospice & Palliative Care Buffalo (HPCB) stakeholders. Project objectives were to create an evidence-based PowerPoint to present project findings with evidence-based recommendations and educational resources for HPCB stakeholders. The Bioecological Model (BMD) guided this project and the development of the semi-structured interview questionnaire and evidence-based recommendations and educational resources. Institutional Review Board approval was granted. Braun and Clarke's reflexive thematic analysis method was utilized to analyze data. Five participants were included. One overarching theme, I Don 1 Necessarily Believe its Culture ... an Ethnic Thing ... It's a Lack of Knowledge and Understanding about Hospice Services and four key themes, The Feeling of Being in a Dark Room that You Cannot See Anything and Somebody Grabs Your Hand and Guides You; There's No Hospice Training, Especially in the Hispanic Community, Providers are Not Really Able to Support Hispanic Individuals with Accurate Hospice Information; and Educate the Hispanic Community about Hospice Services and Break Hospice Stigma with Someone from the Same Background emerged from the data analysis. Future research is critically needed examining hospice utilization among Hispanic individuals to promote increased quality of life and care
Creating, Implementing, and Evaluating an Evidence-Based Orientation Inservice on Peripheral Intravenous Catheter Insertion and Management for Newly Hired Registered Nurses and Graduate Nurses Employed in a Western New York Healthcare System
No full textUB SON, DNP Research ProjectPeripheral intravenous catheter (PIVC) insertion is the most common invasive procedure performed by healthcare providers on hospitalized patients worldwide. This skill requires great knowledge, clinical judgement, and confidence regarding insertion technique, management, and surveillance to prevent complications. Current research supports that a lack of PIVC training and education exists, contributing to low procedural self-confidence and skill levels that increase the risk for complications and patient harm. The purpose of this Doctor of Nursing Practice (DNP) project was to create, implement, and evaluate an evidence-based orientation inservice on PIVC insertion and management for newly hired RNs and graduate nurses employed in a Western New York non-profit healthcare system. Edward Deming's Plan-Do-Study-Act cycle was used as the theoretical framework to guide the development, implementation, and evaluation of this project. The project utilized a mixed-methods descriptive survey design that included demographic information, pre and post-inservice assessments, and four open-ended narrative response questions. The inservice showed a statistically significant (p=<0.001) improvement in PIVC knowledge and skill scores. Multiple confidence statements also showed a statistically significant improvement in post-inservice confidence assessment. Participants in this project had improved knowledge, skill, and self-perceived confidence pertaining to PIVC insertion and management after the educational inservice. Project findings support the need for opportunities to improve hospital-based nurses' knowledge, skill, and confidence for PIVC insertion and management using evidence-based educational inservices. Further research is needed to explore the long-term effects of PIVC educational efforts and evaluate their outcomes on patient satisfaction and cost effectiveness
Disposable vs Reusable Laryngoscopes: A Financial and Environmental Cost Analysis for Anesthesia Providers
No full textUB SON, DNP Research ProjectThe use of single-use medical devices has grown exponentially over the last decade in healthcare, including anesthesia. It is imperative to address how its use can impact our environment as our future health continues to be threatened by global warming and pollution. The purpose of this DNP project was to conduct a quantitative financial and environmental cost comparative analysis of reusable and single-use laryngoscopes for anesthesia providers at a Western New York Surgery Center and to increase knowledge and understanding of the Life Cycle Cost (LCC) analysis to make informed device procurement choices. The objectives were to review the literature exploring the LCC method, conduct a financial and environmental cost analysis of the laryngoscope varieties, provide evidence-based recommendations to the project site, and publicly disseminate the study findings. Bandura's Theory of Self-Efficacy served as the guiding theoretical framework. A retrospective review of the financial cost chart for direct laryngoscopy was carried out at the project site and quantitative cost comparison data between the reusable and disposable varieties was obtained. Factors specific to findings in this facility showed that maintaining reusable laryngoscope sets was more cost-effective than procuring the disposable variety. Knowledge of the actual lifecycle cost of a disposable model and how it compares to a reusable model assists practices in analyzing the risk-benefit balance when addressing sustainability. Future studies can focus on further knowledge dissemination on this topic to strengthen the literature on environmental economics to influence our profession and health practices
Comparing Thoughts Between Veterans and Non-Veterans on the Adverse Effects, Safety, and Hesitancy of COVID-19 Immunization Through a Survey
No full textUB SON, DNP Research ProjectBackground and Significance: The SARS-CoV-2 (COVID-19) pandemic cost the U.S. healthcare system $13. 8 billion. Primary care sites improve healthcare efficiency, lower health costs, have historically played a significant role in vaccine delivery, and have been a trusted source of health information for patients. Unfortunately, many primary care providers exhibit emotional distress when discussing vaccinations with those who are hesitant. Purpose, Aims, and Objectives: The purpose of this project was to quantitatively explore the thoughts of veterans and non-veterans pertaining to COVID-19 vaccine hesitancy. This project aims to allow providers to address vaccine hesitancy efficiently and comfortably concerning adverse effects and safety. Theoretical Framework: The Health Belief Model is a framework that explains why people may not adopt disease prevention strategies and will assist in the guidance of the study. Methods and Design: A Likert scale vaccine hesitancy survey assessed vaccine thoughts on the SurveyMonkey platform. Data was analyzed via the SPSS platform. Results: There was no statistically significant difference between veteran and nonveteran attitudes. There existed differences with specific question answers, between age groups, and when comparing the amount of education. Conclusion: COVID-19 is a deadly disease and there are varying attitudes regarding the currently available vaccinations for it. Future Implications and Recommendations: It is imperative that providers tailor their discussions of vaccines towards individuals rather than employing a "one-size-fits-all" approach. This includes population (veterans versus non-veterans) and age characteristics
Food for Most but Not for All: An Evaluation of Accessibility in One World Café
No full text2024 Spring EAS 360 STEM Communications project poster: We set out to evaluate the accessibility of One World Café on north campus. Employing Universal Design and Design Justice as our critical frameworks, we uncovered numerous issues and identified possible solutions through various research methods
Combating the Opioid Epidemic: Implementing a Safe Injection Site in Buffalo
No full textSpring 2024 HON 499 Independent Study: This policy paper explores the implementation of a safe injection site in Buffalo. Safe injection sites (SIS) are locations where individuals can safely consume pre-obtained drugs under the supervision of medical personnel who can respond in the case of an overdose. These sites are an underutilized harm-reduction method that has been shown in other countries and NYC to be effective. Associated benefits of these sites include fatal overdose prevention, cost-effectiveness, safe needle practices, and improved public safety. Despite the associated benefits that come with safe injection sites, several obstacles would need to be overcome to successfully implement this site. Obstacles include opposition from community members, uncertainty about the legality of safe injection sites, and logistical barriers
Perspectives on Scholarly Communication: Volume 6
No full text2024, FallPerspectives on Scholarly Communication: Volume Six, like its preceding volumes, is a student-created open monograph. Graduate students in the University at Buffalo's Department of Information Science authored this compilation for the LIS 577: Scholarly Communication course during the fall term of 2024. Each chapter is the culmination of a student's semester-long investigation into an aspect of scholarly communication for which he or she has established an informed position. The text was developed under the Creative Commons license CC BY-NC-SA 4.0 as an open educational resource, which can be adapted for future sections of the Scholarly Communication course or for similar courses offered at other institutions
A Knowledge Assessment of Registered Nurse Assistance in Emergency Airway Management Beyond the Operating Room
No full textUB SON, DNP Research ProjectEmergency endotracheal intubation performed outside the operating room is a high-risk, lifesaving procedure requiring interdisciplinary collaboration and effective teamwork to ensure quality patient outcomes. The team is led by the anesthesia provider, while registered nurses (RN) assume a crucial supportive role. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate RN knowledge, central to participation on the airway management (AM) team, aiming to quantify foundational knowledge that enabled nurses’ capacity to assist anesthesia providers. The objectives of this project were to perform a literature search and utilize the Social Cognitive Theory of Self-efficacy to develop a survey questionnaire to assess relevant aspects of nursing knowledge. Institutional review board approval was acquired, and a convenience sample recruited 70 respondents to participate in a cross-sectional electronic survey. Analysis revealed that there were no significant differences in knowledge among nurses according to employment history (see results), years of experience (p=0.070), or frequency of assisting with intubation (p=0.589). Nurses reported that they were aware of their role in AM and felt competent to participate. They also expressed that anesthesia provider leadership affected team dynamics and the overall quality of AM encounters and provided suggestions for future educational initiatives. These results were used to inform the development of the educational deliverable. This project was limited by the lack of representativeness of the sample which overrepresented critical care nurses. Future study should address this and should examine the relationship between training and knowledge