UBIR Repository (Univ. at Buffalo)
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Accessibility Evaluation of the University at Buffalo Online Campus Map
No full text2024 Spring EAS 360 STEM Communications project poster: UB's North Campus Map is not an accessible website, and does not work in an effective manner when attempting to navigate campus grounds
UB Ellicott Basketball Court Accessibility
No full text2024 Spring EAS 360 STEM Communications project poster: We want to provide recommendations that will improve the basketball court in a way that benefits all. Principals used: ADA Compliance and Universal Design
Structural and Institutional Implications for the School-to-Prison Pipeline in New York
No full textSpring 2024 HON 499 Independent Study: In the United States, the availability and accessibility of educational opportunities incurred by the public schooling system are stratified by both race and gender. These are factors which have maintained, perpetuated and developed alongside the school-to-prison pipeline, which in turn have acted to marginalize students from these groups. The school-to-prison pipeline is sustained by a stratification process where, “students, disproportionately racially marginalized students, and students with disabilities are funneled out of public education and toward the adult criminal justice system.” This educational phenomenon is perpetuated by implementing punitive disciplinary methods, removing students from an educational environment. The gender of a student also creates different classroom expectations that impact students differently. This reproducing pipeline is partially accomplished through gradual and pervasive waves of constant racial resegregation within and among school districts. This process also serves as a critical factor in determining educational outcomes as school resource allocation is directed, in part, based on the school district's ability to secure and divide resources
An Educational Module of Evidence Based Guidelines Regarding the Perioperative Pain Management of the Opioid Use Disorder Patient Prescribed Buprenorphine
No full textUB SON, DNP Research ProjectBackground and Significance: The opioid epidemic and rise in buprenorphine prescriptions has increased the likelihood anesthesia providers will be responsible for perioperative pain management of an opioid use disorder (OUD) patient prescribed buprenorphine. Purpose, Aim, and Objective(s): The purpose of this Doctoral of Nursing Practice (DNP) project was to explore existing literature on perioperative management of buprenorphine patients to facilitate the formation of an educational module. Theoretical Framework: Katherine Kolcaba’s Comfort Theory Methods and Design: Project design was a cross sectional Google Forms survey posted to closed Facebook pages for CRNAs and RRNAs. The survey identified the need for and the development of the project deliverable. Results: Descriptive statistics, one way ANOVA, and post hoc Tukey HSD tests were run using SPSS 29. Descriptive statistics identified a high frequency of buprenorphine patient encounters and a desire to receive additional training. The Tukey HSD tests indicated a statistically significant difference in confidence level when caring for this patient population when compared to years of experience. Providers with 1-10 years of experience were more confident than providers with 16-20 years of experience. Conclusion: Nearly 78% of surveyed providers reported being assigned to care for a buprenorphine patient. Only 29% of surveyed providers reported feeling confident in care. The increase in buprenorphine patients has not been matched with increased training. Providers desire training and evidence-based policies. Future Implications and Recommendations: Further implications include posttest administration to test the effectiveness of the deliverable and the development of hospital wide evidence-based policies
Effect of Clinical Scenarios in Simulation-Based Orientation for Nurses on Clinical Confidence and Self-Efficacy in Outpatient Settings
No full textUB SON, DNP Research ProjectCare in the ambulatory setting has grown tremendously as more healthcare institutions are expanding to increase access to care throughout the United States. Patients today are living longer and need trained clinicians to manage long-term conditions in the outpatient setting (Calma et al., 2019). The National Institute of Neurological Disorders and Stroke reports that in the United States, more than 800,000 strokes occur each year (Know Stroke, 2023). Reducing mortality and morbidity rates of this disease by early detection and treatment is vital. Simulation education is documented as a recommended training method by the Institute of Medicine to improve patient safety (Sherif et al., 2021). This Doctor of Nursing Practice project aimed to explore the effect of clinical scenarios in simulation-based education (SBE) for registered and licensed practical nurses and rates of clinical confidence and competence in the ambulatory setting. The National Patient Safety Education Framework was selected for this project due to its ability to guide and develop new educational training programs or measure existing programs (Walton et al., 2006). A questionnaire was given to each participant pre-implementation and post-implementation. Participants were recruited voluntarily, and responses were anonymous. The survey tool used was the Student Satisfaction and Self Confidence in Learning Scale developed by the National League for Nursing (NLN). Nurses reported increased confidence in their knowledge of stroke and high satisfaction with the simulation education experience. Future research implications include the frequency at which employees should receive simulation education to improve knowledge retention
Anesthesia Providers Use of Video Assisted Laryngoscopy in a Level 1 Trauma Center
No full textUB SON, DNP Research ProjectBackground and Significance: Advances in technology introduced video assisted laryngoscopes (VAL) that allow anesthesia providers to visualize airway anatomy when traditional direct laryngoscopy (DL) cannot. Recently a large academic hospital in Erie County, NY began equipping every operating room with its own VAL console. Minimal research has been done on the availability of VAL equipment and its influences anesthesia providers’ choice of intubation equipment. Purpose, Aims, and Objectives: The purpose of this DNP project will be to quantitatively analyze the impact of having a readily available VAL (Provu) equipment in every operating room. The aim will be to bridge to gap in research of how VAL influences anesthesia providers’ decisions. Project objectives are to: 1) conduct a survey of anesthesia providers choice of laryngoscopy equipment for endotracheal intubation prior to VAL equipment being supplied in every room and after; 2) determine any increase/decrease in the use of the previous VAL console (Glidescope) ; 3) analyze the specific reason(s) anesthesia chose to use VAL versus DL; and 4) determine if anesthesia providers prefer Miller blades of Macintosh blades.
Theoretical Framework: Lippitt’s seven stage model of change will serve as the theoretical framework for this DNP project. Methods and Design: A Likert scale survey was created in REDCap and distributed to anesthesia providers who have provided anesthesia at the project site before and after the arrival of the Provu. Statistical analysis will be performed.
Protection of Human Rights and Ethical Considerations: Institutional Review Board (IRB) approval was granted from University at Buffalo and additionally from the project site’s research committee. Results: 14 surveys were completed by CRNAs, physician anesthesia residents, and attending anesthesiologists. Descriptive statistics were performed with SPSS, but the low sample size did not allow for any statistical tests of significance. 14.3% of respondents reported to be more likely to use the Provu after it was stocked in every OR. 64.3% of respondents responded they were less likely to use a Glidescope after the arrival of the Provu. 71.4% of the providers are more likely to use a Miller blade for DL and 28.6% are more likely to use a Macintosh blade.
Conclusions: The presence of a Provu laryngoscopy console in every room did not meaningfully increase the use of VAL equipment. Providers are more likely to use a Miller blade for their DL approach, which has not been mentioned in other studies comparing DL to VAL.
Future Implications: Future recommendations would be to collect intubation equipment selection use via chart review. Performing a similar study at other sites in different parts of the country and/or different operation rooms settings would also be beneficial
Nurse Practitioners (NP) Perceived Effects of Patient Satisfaction Ratings on Clinical Decision Making, Job Satisfaction, Morale, and Burnout
No full textUB SON, DNP Research ProjectAlthough patient satisfaction ratings often drive positive changes, they have unintended consequences. The purpose of this Doctoral of Nursing Practice (DNP) pilot study was to examine the relationship between patient satisfaction ratings (PSR) and nurse practitioner well-being, including ethical considerations, burnout, and attrition from practice in New York State. Additionally, the impact of incentivized patient ratings on evidence-based practice was explored. With the growing healthcare provider-demand gap, this study examined if PSR has a negative effect on job satisfaction, morale, and burnout. It investigated the influence of incentivized patient satisfaction scores on clinical decision-making. The theoretical framework used was a combination of Maslow's hierarchy of needs and May’s Normative Process Theory (NPT). Maslow's theory highlights human needs, including safety, driving behavior, while May's NPT offers insights into the normalization process. A 44-item online survey tool, integrating NPT and the Burnout Assessment Tool, was distributed to active nurse practitioners through a state-wide nursing association, urban community-based organization, and social media. Data collection utilizes a cross-sectional design with de-identified responses analyzed via descriptive statistics. Ethical safeguards involve Institutional Review Board (IRB) approval from the University at Buffalo (UB). Result suggested that NP subjected to PSR have the perception of increased risk of burnout however there was no difference in burnout scores compared NP who were not subjected to PSR. There is a strong correlation between PSR and evidence-based practice decisions. The relationship between PSR and anxiety needs further investigation. Overall results of the relationship between PSR and clinical practice is complex
The Impact of Mobile Technology on COPD Readmissions
No full textUB SON, DNP Research ProjectThe burden of chronic obstructive pulmonary disease (COPD) on patients and healthcare institutions is steadily increasing. Gaps in COPD care are evident upon hospital discharge and outpatient follow-up. The purpose of this Doctor of Nursing Practice (DNP) project is to conduct a quantitative research study to bridge the gap and improve care transitions from inpatient to outpatient care using a free mobile app (COPD Manager) designed to educate and assist patients in the daily monitoring of their COPD symptoms. The project aims to implement a mobile app to the patient's daily routine, as an adjunct therapy to their current care plan, upon discharge from St. Peter's Health Partners Hospital to help improve education, self-care, and behavior management of their COPD. Project objectives included conducting a comprehensive literature review, administering a pre-and post-intervention survey, analyzing the data, and developing recommendations for further use. Pender' s Health Promotion Model will be the guiding framework for this project. Methods and Design: This project analyzed a 23-question pre-and post-intervention survey delivered to participants while hospitalized and then via telephone two weeks after the mobile app was implemented. Results: The participants (n= 40) showed a positive perception overall concerning the COPD mobile app, self-care behaviors, empowerment, and education about COPD. T-tests and Chi-square tests were used for data analysis. Institutional Review Board (IRB) approval was granted, and data will be collected and stored per IRB protocol. Participation in this study was completely voluntary and consent was obtained before beginning the study
A Quantitative Survey to Assess Factors Certified Registered Nurse Anesthetists Utilize when Determining if a Labor Epidural is Appropriate to Use for Surgical Anesthesia in a Cesarean Section
No full textUB SON, DNP Research ProjectLabor epidurals (LE) are considered gold standard for labor analgesia and are able to be converted to surgical anesthesia for a cesarean section (c/s). Neuraxial anesthesia is preferential due to the risks and complications that are associated with general anesthesia in this patient population. Failure to have a successful labor epidural conversion for cesarean section can be influenced by a variety of factors and risks for failed conversion should be minimized. The purpose of the Doctor of Nursing Practice (DNP) project was to quantitatively investigate factors that CRNAs nationwide consider when determining if a LE is appropriate for the conversion to surgical anesthesia for a cesarean section. The aim of the DNP project was to identify factors that are impactful in the clinical decision-making practices of nurse anesthetists when faced with having to convert a LE to a surgical anesthetic for cesarean section, along with alternative anesthetics utilized if the LE failed to convert. Melanie Jasper’s Experience, Reflection, and Action Framework acted as the basis for the DNP project. The project used a quantitative design with a demographic and descriptive survey administered through an online survey platform, REDCap. The results indicated that the number of boluses, bilateral LE block, and length of epidural catheter placement >24 hours were crucial in determining if the LE was appropriate to convert. The data will ultimately aid in the development of clinical guidelines to guide clinical decision-making surrounding the practice of extending a labor epidural for a cesarean section
Courtside Access: A Dive into Alumni Arena's Accessibility
No full text2023 Fall EAS 360 STEM Communications project poster: To understand and critique the accessibility of Alumni Arena, a building constructed in 1982 and located on UB's North Campus