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Inequities in Healthcare and Health Outcomes for Racial, Gender, and Sex Minorities
No full textSpring 2024 HON 499 Independent Study: This paper will examine how implicit bias functions in the healthcare system and institutions of medical education and the strengths and weaknesses of existing initiatives to address physician bias. This analysis will culminate in guidelines for how the University at Buffalo Jacobs School of Medicine and Biomedical Sciences (UB JSMBS) can shape future implicit bias mitigation efforts to have the greatest efficacy
Inclusive Spaces, Inclusive Minds: A Policy Proposal for a Disability Cultural Center at the University at Buffalo
No full textSpring 2024 HON 499 Independent Study: The University at Buffalo (UB) is committed to cultivating an inclusive environment where everyone, from all backgrounds, feels embraced and welcomed. This paper proposes the establishment of a Disability Cultural Center at UB, aimed at enriching the educational and personal experiences of students with disabilities by celebrating their identities and facilitating community. The envisioned center seeks to address the gap in institutional support for students with disabilities and underscores the University at Buffalo's dedication to diversity, equity, and inclusivity
Accessibility of UB's Schedule Builder for Visual Impairments: Accessibility Research Poster
No full text2023 Fall EAS 360 STEM Communications project poster: We are researching the accessibility of the University at Buffalo's schedule builder tool for visually impaired people through the lens of W3C Accessibility Guidelines (WCAG) 2.1. This resource provides rigorous guidelines regarding the accessibility of websites
Punching Down: The Role of Hierarchy in Creating a Toxic Workplace Culture
No full textThis chapter will explore the abuse that travels through the hierarchy in what I call “punching down” model: workers lower in the organizational hierarchy may face neglect, exploitation, and bullying from those higher up, and in turn may abuse those lower still.1 This situation can exacerbate other preexisting divisions based on race, gender, (dis)ability, or other underrepresented identities. Through this chapter, I will review the literature on rank and hierarchy in workplace culture, while exploring an autoethnography of my experience of moving through the hierarchy, from student library worker to titled librarian. I’ll note that most of my focus will be on toxicity traveling down the hierarchy instead of flowing up. You can do more damage punching down from a secure position than trying to throw jabs into the air
Nurse Practitioners' Knowledge, Attitudes, and Beliefs Regarding the Management of Perimenopause in Primary Care
No full textUB SON, DNP Research ProjectMenopause signifies a momentous reproductive phase, marked by twelve consecutive months without menstruation. The perimenopausal phase spans the period leading up to menopause and the twelve months following. A healthcare gap exists for individuals navigating this transitional period, resulting in the under recognition and mismanagement of diverse symptoms. This oversight leads to delays in care, disruptions in daily life, and the potential development of chronic conditions. The Doctor of Nursing Practice (DNP) project's purpose is to create an executive summary for stakeholders, the faculty that prepares women's health content in the DNP program at the University at Buffalo (UB). The project aimed to evaluate nurse practitioners'(NPs) knowledge, attitudes, and beliefs in providing care to perimenopausal patients. DNP project objectives include 1) a review of literature on perimenopause management; 2) a survey of NPs in New York on perimenopause management knowledge; 3) creating an evidence-based educational executive summary, and 4) disseminating the project publicly. The Emancipated Decision-making (EDM) nursing model acknowledges gender influences on healthcare decisions due to social norms, a concern in women's healthcare. The DNP project employed a non-experimental, cross-sectional quantitative design with the distribution of a 30-item questionnaire, descriptive statistics were utilized for data analysis. Findings from the survey of twenty-eight NPs revealed knowledge gaps in symptomatic perimenopause management. The study advocates for the integration of comprehensive perimenopause management education within NP programs to address the diverse needs of perimenopausal and menopausal patients, fostering a holistic approach to care
Evaluating the Impact of an Educational Workshop in Teaching Ultrasound-Guided Techniques for Peripheral Intravenous Access to Nurse Anesthetists
No full textUB SON, DNP Research ProjectBackground and Significance: Peripheral intravenous (PIV) catheterization is frequently established in the perioperative setting as required for surgical anesthesia. When patients present with difficult vascular access, Certified Registered Nurse Anesthetists (CRNAs) are less likely to utilize ultrasound (US) guidance for PIV catheterization due to variances in US education. Purpose, Aims, and Objectives: The purpose of this project was to assess how a two-part educational workshop impacted CRNA confidence levels and willingness to utilize US guidance for PIV access in practice, with the secondary aim of enhancing CRNA knowledge and skills. Theoretical Framework: David Kolb 's Experiential Leaming Theory Methods and Design: A quantitative pre/post-study design was implemented at a large urban hospital. A two-part educational workshop was developed and administered to a group of CRNAs as a one-hour didactic session and a skills session in-service. Pre-survey and post-survey data were collected to evaluate changes in CRNA competencies. Results: Thirteen CRNAs attended both sessions of the educational workshop. Post-intervention, significant increases were noted in the number of CRNAs who reported feeling confident in their ability to obtain PIV access with US guidance (p < .001), and in those who reported the willingness to use US-guided techniques for PIV access in practice (p = .003). Conclusion: Administering a two-part educational workshop has made a positive impact on CRNA confidence and willingness to use US guidance for PIV access in practice. Future Implications and Recommendations: Surgical facilities that employ CRNAs should develop and administer a two-part educational workshop to teach US-guided PIV access
Perioperative Ketamine Administration for Analgesia in The Chronic Pain Population and Obstacles Accompanying Utilization
No full textUB SON, DNP Research ProjectPain management may be cumbersome in the patient with a medical diagnosis of chronic pain. Traditional opioid analgesics used in this population may lead to inadequate pain management further worsening outcomes. Ketamine possesses strong analgesic properties which can mitigate opioid consumption while providing pain relief. However, ketamine is seldomly used by anesthesia providers, placing patients with chronic pain at risk for inadequate pain management and worsening postoperative outcomes. The purpose of this project was to examine the obstacles which hinder ketamine utilization in practice and identify an administration method which promotes optimal analgesia without an increased risk of adverse effects. The study was conducted online through the New York Association of Nurse Anesthetists. Kurt Lewin's Theory of Planned Change acted as the framework for this project. Project approval was granted by the University at Buffalo Institutional Review Board. This study was a non-experimental, pilot study design. Data collection from participants was de-identified to allow for anonymity. Apart from scientific contribution and garnered knowledge, participants did not receive any direct benefits. The literature finds immense benefits to intraoperative ketamine use. The dissemination of findings pertaining to the use of ketamine as an analgesic agent in the chronic pain population fosters a scientific basis for practice, promotes a less harmful modality of analgesia, and addresses a gap in practice. Overall, findings of ketamine dosing are widespread with minimal consistency, and misaligned with current research, this is suggestive of the need for protocol to foster a scientific base for practice and address a visible gap in practice
Current Knowledge of Certified Registered Nurse Anesthetists Regarding Perioperative Care for Patients Prescribed a Glucagon-Like Peptide-I Receptor Agonist (GLP-1 RA)
No full textUB SON, DNP Research ProjectThe diabetes epidemic has increased the likelihood that anesthesia providers will regularly be responsible for perioperative management of patients prescribed a Glucagon-like Peptide-I Receptor Agonist (GLP-1 RA). Despite evidence to the contrary, patients are frequently instructed to continue GLP-1-based therapy prior to elective surgery. The lack of evidence-based research on patients who take a GLP-1 RA and undergo surgery has led anesthesia providers to rely solely on case studies and anecdotal evidence. The purpose of this Doctor of Nursing Practice (DNP) project was to explore existing literature on perioperative management of patients with Type 2 diabetes (T2D) who take a GLP-1 RA. Assessing attitudes, confidence, and current practices of Certified Registered Nurse Anesthetists (CRNAs) who provide anesthesia for this patient population is integral to the formulation of an educational module that will guide clinical decision-making, reduce intraoperative complications, and improve patient outcomes. Institutional Review Board (IRB) approval was obtained, and a survey questionnaire was electronically distributed to CRNAs who were members of a national CRNA Facebook group. Results revealed that 80.9% of respondents would have benefited from further training on perioperative management for patients who were currently taking a GLP-1 RA. Close to 60% of respondents stated that they did not feel confident providing deep sedation or general anesthetic for patients currently taking a GLP-1 RA, and 40% of respondents had no policy in place at their surgical center regarding the care of patients prescribed a GLP-1 RA. This study reveals that education regarding GLP-1 RA therapy and implementation of a protocol are vital
Impact of Provider Knowledge, Attitudes, and Skills on Treatment Plans of Patients with Borderline Personality Disorder
No full textUB SON, DNP Research ProjectThe purpose of this Doctor of Nursing Practice (DNP) project was to improve care of patients with Borderline Personality Disorder (BPD), by gaining an understanding of factors that influence how clinical recommendations and prescriptive decisions are made by prescribers of psychiatric medication. Although BPD occurs in relatively small percentages of the population, management of the disorder is complex, with high mortality rates and strong representation of patients seeking care in psychiatric inpatient and outpatient settings. The stigmatization of patients, poor understanding of psychopharmacological prescription practices, and lack of standardized clinical practice guidelines for use of psychotropics further complicates care management of patients with BPD. Research demonstrates stigma and providers report difficulty in managing patients with BPD. A quantitative, descriptive research design guided by Peplau's theory of interpersonal relations was used to examine the knowledge, attitudes, and skills of psychiatric providers in care management of patients with BPD. Twenty-seven prescribers of psychiatric medication completed the survey. Results revealed Factors impacting treatment plans were examined including knowledge, attitudes, and skills of providers in utilizing both medication and therapeutic interventions. Gaps in knowledge were identified. This project contributed to improvements in PMHNP practice as it was the first study to our knowledge which examined Psychiatric Nurse Practitioner attitudes towards BPD specifically
The Effects of a Tailored Brief Mindfulness-Based Intervention on Well-Being and Burnout Among Primary Care Staff
No full textUB SON, DNP Research ProjectBackground and Significance: Mindfulness-based interventions (MBis) are an effective strategy for mitigating the rising levels of burnout among healthcare workers (HCWs). However, unaddressed barriers and undesirable content can affect participation. Purpose, Aims, and Objectives: This Doctor of Nursing (DNP) project sought to quantitatively explore the effects of a brief MBI program on HCW's perceived well-being and burnout scores. The aim and objectives included highlighting the importance of designing and implementing an MBI program tailored to the preferences of HCWs and disseminating findings to pertinent stakeholders to guide future wellness initiatives. Theoretical Framework: Pender's Health Promotion Model (HPM) was used to guide the development of this project. Methods and Design: Eight full-time HCWs at a small primary care office were recruited for this project. Two web-based surveys were derived from standardized survey instruments and researcher-drafted questions. The first survey assessed the perceived barriers and preferences to an MBI. These responses were analyzed and interpreted to design and implement the brief MBI. The second survey was administered at baseline and two weeks post-intervention and assessed perceived well-being and burnout. Results: Average perceived resiliency, self-compassion, well-being, and stress scores improved post-intervention; however, these were not statistically significant. There was no improvement in the average perceived burnout score. Conclusion: Though the results were not statistically significant, all the participants engaged in the intervention and completed the surveys. Future Implications and Recommendations: Employers should consider implementing initiatives that address the barriers and preferences of their staff