UBIR Repository (Univ. at Buffalo)
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The Development of an Anesthetic ERAS Protocol for Lumbar Spine Surgeries and Assessment of Current Usage Rates, Barriers to Implementation, and Provider Readiness to Change at a Western New York Hospital
No full textUB SON, DNP Research ProjectBackground & Significance: Enhanced Recovery After Surgery (ERAS) protocols are an effective alternative to traditional care. ERAS protocols can produce superior outcomes for patients undergoing lumbar spine surgeries, yet they are underutilized. Purpose, Aims & Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to generate an ERAS protocol to help standardize the anesthetic care patients undergoing lumbar spine surgeries receive. The aim of this project was to enhance provider knowledge of ERAS interventions and increase their use. Objectives were to 1) conduct an extensive review of current literature to produce an ERAS protocol, 2) to disseminate the produced ERAS protocol to providers specializing in anesthesia and 3) identify providers readiness to change current practice, current usage rates of interventions, and perceived barriers to their implementation. Theoretical Framework: The Change Theory of Nursing developed by Kurt Lewin. Methods & Design: This project employed a quantitative cross-sectional survey with descriptive design to administer an online based survey to anesthesia providers at a WNY hospital. Readiness to change was assessed by the University of Rhode Island Change Assessment (URICA) Scale. Data collected was analyzed using SPSS version 29. Results: Current usage rates of interventions suggested in this projects protocol vary and multiple barriers exist in enacting ERAS protocol anesthetic interventions. Conclusion: Data suggests providers are beginning to contemplate a change to their clinical practice or have begun to determine appropriate modifications. Future Implications & Recommendations: For implementation to be successful, all multidisciplinary parties need to be on board, review of evidence considered, and barriers that exist need to be addressed so that interventions can be executed in a timely and efficacious manner
Effects of Mindfulness on Psychological Well-being and Job-Related Outcomes Among Inpatient Psychiatry Staff
No full textUB SON, DNP Research ProjectBackground & Significance: Evidence supports the positive impact of mindfulness practices for improving psychological well-being and job-related outcomes among healthcare workers. However, lack of standardization and research are identified as challenges to their implementation in healthcare settings. Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to contribute empirical evidence regarding the effectiveness of mindfulness in improving the mental health, well-being, stress, and burnout among psychiatric care providers. Theoretical Framework: This project was guided by the Transactional Model of Stress and Coping (TMSC). Methods and Design: Quantitative, descriptive study with a post- intervention survey. Results: Survey responses indicated that the mindfulness practices resulted in overall decreases in anxiety among participants, with varied impacts on burnout, depression, job satisfaction and intent to leave their current job. Notably, nurses reported a decrease in their intent to leave the healthcare profession, and participants who engaged more frequently in the intervention had better responses related to the intervention’s impact on teamwork, work relationships, and job satisfaction.
Conclusion: The study results support the potential influence of mindfulness exercises in boosting mental health and job contentment among healthcare professionals, thereby addressing systemic challenges in the healthcare workforce. Findings suggest that incorporating brief mindfulness exercises into brief mindfulness exercises can be incorporated into inpatient psychiatric settings to enhance job-related outcomes and psychological well-being
Evaluating Current Knowledge of Chinese American Females in a Large Metropolitan Primary Care Clinic regarding Breast Cancer and Breast Cancer Screening
No full textUB SON, DNP Research ProjectBackground: Cancer has a major impact on society in the United States and across the world. In 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States (American Cancer Society, 2023). However, there is a gap between breast cancer screening among Chinese American females and the guidelines from ACS, NCCN and Healthy People 2020. Methods: This DNP project developed a culturally tailored education program to improve the breast cancer knowledge and intention for breast cancer screening among Chinese American female patients in a Chinese primary care clinic. Results: The purpose of this project was to explore if increased health literacy has a positive impact on breast cancer screening knowledge, and then lead to an increased intention to register for mammogram among Chinese American females aged between 40 to 74 years. The paired t-test showed a statistically significant results by comparing pre-and posttest. Conclusion: The culturally tailored education program can effectively address the needs of breast cancer knowledge and screening among minority patients. Future efforts should be directed toward personalized screening, prevention, and treatment programs to lower the health risks, and cancer screenings should become part of routine check-ups
Enhancing Accessibility: Knox Hall and Lockwood Library
No full text2023 Fall EAS 360 STEM Communications project poster: To understand and critique the accessibility of elevators in Knox Hall and Lockwood Memorial Library. Outlines the key principles of universal design and the Americans with Disabilities Act (ADA). Focuses on making Knox Hall and Lockwood Library accessible to all, including students with physical disabilities
Opposing CRT Bans in NYS K-12 Education: A Petition for Racial Consciousness in Education
No full textSpring 2023 HON 499 Independent Study: This brief focuses on New York State (NYS) Assembly Bill A8579, which proposed a prohibition on the teaching of CRT across state public schools. This brief outlines the bill’s eight prongs, all of which work to prohibit education about different races and/or sexes. Drawing from literature on CRT and reflecting on the importance of a race-conscious education, this brief closely analyzes CRT, its application in public education, as well as arguments for and against CRT education. Should this bill advances through the NYS Senate, this brief offers recommendations as to how community-based organizations (CBOs) can continue to uplift student groups of color, and advocates for legislatures to still reconsider their perspective of the necessity of race-conscious epistemology
Effects of Nursing Students’ Experiences of Incivility in Clinical Practice Environment on Teamwork and Collaboration
No full textUB SON, DNP Research ProjectTeamwork and Collaboration is an essential part of nursing practice, education, and research and is one of the core competencies set forth by the Quality and Safety Education for Nurses (QSEN). Incivility experienced by nursing students can negatively affect teamwork and collaboration. The purpose of this Doctor of Nursing Practice (DNP) project was to quantitatively examine the effects of students’ experiences of incivility on teamwork and collaboration, with the aim of understanding nursing students’ experiences of incivility and its’ impact on teamwork and collaboration. The primary objective was to examine the effects of incivility experienced by nursing students on their participation in teamwork and collaborative practices. This DNP project utilized a cross-sectional quantitative design consisting of survey methodology which was distributed using a listserv generated by the nursing department. Theory of Self Positioning and principles of phenomenology served as the theoretical foundation. The impact of incivility regardless of its form can be conceptualized, enabling students’ perceptions, attitudes, and behaviors to be influenced. A thorough review of the literature identified the following recurrent themes: Forms of Incivility in Clinical Practice Environment (CPE), Impact of Incivility on Teamwork and Collaboration, Psychological and Financial Cost of Incivility, and Strategies to Promote Civility. Synthesis of these themes uncover some vulnerabilities in the clinical practice environments that may perpetuate uncivil behaviors. Descriptive statistics, Independent Samples t-test and one way ANOVA testing was used to analyze the data. Further research is needed to examine the relationship between uncivil behaviors on students’ self-esteem, attrition rates, and burnout
Certified Registered Nurse Anesthetists’ (CRNA) Use of Remifentanil for Labor Analgesia When an Epidural is Contraindicated: A National Survey
No full textUB SON, DNP Research ProjectAlthough an epidural is considered the gold standard for labor analgesia, absolute or relative contraindications prevent some women from undergoing the neuraxial anesthetic technique. Anesthesia providers have responded to these concerns by incorporating remifentanil, an ultrashort-acting mu-opioid agonist, as a complementary analgesic. Despite strong evidence-based support for the use of remifentanil as a safe and effective means for labor pain management, some anesthesia providers remain hesitant to use this alternative opioid analgesic. The purpose of this Doctor of Nursing Practice (DNP) project was to survey and identify current clinical practice habits and perceived barriers to the utilization of remifentanil for laboring patients for whom an epidural is contraindicated among CRNAs practicing within the United States. The aim was to identify gaps in knowledge and data within the United States to increase the utilization of remifentanil in obstetrics. Lewin’s Change Theory was the theoretical framework guiding this project. A descriptive design with a structured online survey was used. CRNAs were recruited through a closed Facebook group, and a total of 57 CRNAs were recruited. Descriptive statistics were performed and demonstrated that remifentanil use is limited in obstetrics within the United States. Top facilitators associated with its use included education, clear policies, standard order sets, and pharmacy buy, and top barriers to its use included lack of one-to-one nurse staffing and resistance to change. Project findings provide further insight into our understanding of remifentanil utilization habits within the United States when an epidural is contraindicated. Further research may investigate educational endeavors to increase remifentanil utilization
Patients' Experiences with Collaborative Mental Health Care in a Nurse-Managed Rural Primary Care Practice
No full textUB SON, DNP Research ProjectBackground and Significance: Rural populations experience numerous barriers to accessing healthcare. The Collaborative Care Model (CCM) is an evidence-based integrated care model designed to increase access to mental health services. A primary care provider, behavioral health care manager, and consulting psychiatrist provide coordinated mental health services within primary care. The CCM's efficacy in improving mental health outcomes is well-established. However, little is known about patient experiences with CCM. Purpose: The purpose of this project was to understand rural, adult, primary care patients' experiences with CCM. Theoretical Framework: Reflexive Thematic Analysis Constructivist grounded theory guided this DNP project in its development, data collection, and data analysis processes. Methods: The project utilized a qualitative descriptive design. Semi-structured interviews were conducted with adult patients who received CCM in a nurse-managed primary care practice in rural New York. Interview data were transcribed verbatim and analyzed using Braun and Clarke's Thematic Analysis. Findings: We conducted 10 interviews. Participants were diagnosed with depression or anxiety. Six major themes emerged. Participants reported improved mental health with CCM. Participants valued feeling understood and having a voice in treatment plans. The CCM 's patient-centered, team-based approach was viewed favorably to address physical and mental health. Participants described the CCM as convenient and flexible with in-person and remote accessibility. Conclusion and Implications: The project addressed a critical knowledge gap regarding patient experiences with CCM. The CCM 's patient-centered approach promotes accessibility and patient engagement in treatment. Nurse practitioners can lead CCM implementation to improve access to mental health care in rural areas
Assessing Accessibility: The UB Stampede Bus System
No full text2024 Spring EAS 360 STEM Communications project poster: Transportation is critical for mobility across UB's campuses. Using a checklist based on universal design and ADA guidelines, we assessed the accessibility of Stampede transit. The objective of this study was to look beyond compliance and towards better accessibility
ADA Compliance and Site Accessibility Report For North Erie Basin Marina and Observation Tower
No full text2024 Summer EAS 360 STEM Communications project poster: The Erie Basin Marina located on Lake Erie in the City of Buffalo. Construction began in the 1950’s and completed in 1974. In the past 50 years the site has faced many challenges and undergone some updates. In this report we will do an evaluation on its ADA compliance and accessibility in hope of offering opinions for equal opportunity access for all residents