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Establishing Guidelines for Certified Registered Nurse Anesthetists to Increase Confidence, Knowledge, and Use of Pre-Procedural Zofran Prior to Cesarean Section
No full textUB SON, DNP Research ProjectBackground and Significance: Spinal arachnoid blocks are a common anesthetic technique used for patients undergoing elective cesarean section. Spinal anesthesia is preferred over general anesthesia due its' adverse effects; however, negative consequences such as hypotension can be seen with spinal anesthetics. It is important for certified registered nurse anesthetists to use current evidence-based practice when caring for obstetric patients so they can provide safe and high-quality care. Purpose, Aims, and Objectives: The purpose of this Doctor of Nursing Practice Project was to establish if implementing guidelines and educational lecture at Highland Hospital would increase providers confidence, knowledge, and use of pre-procedural Ondansetron prior to cesarean section. Aims for this project included increasing providers willingness to administer preprocedural ondansetron by addressing perceived barriers and increasing obstetric CRNAs confidence. Theoretical Framework: Porter and Lawler's Theory of Motivation was used as a theoretical framework to guide and implement this DNP project. Methods and Design: The design of this study included a pre-survey questionnaire through REDCap, educational guidelines for provider implementation, and a three-week post-survey questionnaire through REDCap. The study was conducted at Highland Hospital in Rochester, New York and recruited all of the certified registered nurse anesthetists were currently performing spinal anesthesia for obstetric patients undergoing elective cesarean section. Results: Survey data revealed that providers felt that giving a prophylactic dose of preprocedural ondansetron did attenuate adverse outcomes of spinal anesthesia including hypotension, bradycardia, and nausea prior to elective cesarean section. Future Implications: Future implications for nursing practice include utilizing educational guidelines into everyday practice when providing care to obstetric patients undergoing elective cesarean section
Examining Clinician Multi-Dimensional Pain Assessment Among Post-Operative Adult Inpatients
No full textUB SON, DNP Research ProjectAcute postoperative pain has significant impacts on patient recovery, patient satisfaction, and healthcare costs. Therefore, mishandling of this pain leads to dire health consequences. To properly manage acute postoperative pain, accurate pain assessment is crucial. Current literature dictates using multidimensional pain scales (MDPS) to effectively capture the complexities of the pain experience. Yet, unidimensional pain scales (UDPS) are primarily used to assess acute postoperative pain. This Doctor of Nursing (DNP) project qualitatively examined current acute postoperative pain assessment among clinicians, primarily nurses. Kolcaba's Comfort Theory served as the framework for this study as it aids assessment of pain on multiple dimensions in harmony with MDPS and evidenced-based practice. The aim was to determine if clinicians are augmenting UDPS with other dimensions of MDPS to ensure effective pain therapy and true comfort. Study objectives were to 1) conduct a comprehensive literature review examining MDPS and UDPS and their respective pain domains; 2) construct a standardized survey incorporating the different pain domains and methods applied when treating and assessing pain;
3) analyze data and summarize findings; 4) present study results to administration and provide evidenced-based recommendations. Reflexive thematic analysis and a quantitative descriptive approach was used to analyze data. Survey results proved that clinicians assess pain on multiple dimensions, but not equally. Thus, there is a need for standardized and reliable MDPS for acute pain for improved pain management
The Efficacy of Surgical and Medical Methods in the Palliative Management of Malignant Bowel Obstruction
No full textUB SON, DNP Research ProjectPeople with cancer are living longer due to advances in cancer care and this has led to a prevalence of people with terminal end-stage complications. Malignant bowel obstructions (MBOs) are a terminal complication of end-stage cancer. MBOs are characterized by uncontrollable symptoms of nausea, vomiting, abdominal pain, and constipation. The disease process is recurrent includes treatment with anti-emetics and gastrointestinal drugs to palliate symptoms and facilitate de-obstruction. Palliative surgical management includes: debulking surgery, stent placement, stoma formation, and drainage percutaneous endoscopy gastrostomy (PEG) tubes. The purpose of this study was to conduct a retrospective study of inpatients with MBO, on the difference between surgical and medical treatment outcomes in admitted patients with MBO (hospital length of stay, readmissions, discharge disposition, survival length, and symptom burden). The aim of this project is to help nurse practitioners have evidence-based data to refer to when setting expectations and discuss palliative care options in patients with MBOs. The Donabedian model for assessment of quality of care was used as the theoretical framework for this study. Approximately 294 inpatients with MBO were identified over a time period of two years. Most patients who were diagnosed with MBO were older adults, female at birth, and patients with gastrointestinal or gynecologic malignancies. There was no significant effect of patient's functional status pre-intervention on treatment intervention F(3, 288)=1.14,p=.332, 172 =.012. Patients who received surgical intervention or conservative intervention had a shorter length of stay. A shorter length of stay was associated with longer survival
Kahnawake Mohawk Personal Names, with grammatical notes
No full textMichelson lists "Kahnawake Mohawk Personal Names" and follows with grammatical notes and linguistic analysis of noun and verb roots
Louise Blanchard Bethune: Every Woman Her Own Architect
No full textIncludes bibliographical references and index.This book is freely available in an open access edition thanks to TOME (Toward an Open Monograph Ecosystem)—a collaboration of the Association of American Universities, the Association of University Presses, and the Association of Research Libraries—and the generous support of the University at Buffalo Libraries. Learn more at the TOME website, available at: openmonographs.org.The trailblazing story of the life and career of Louise Blanchard Bethune, America's first professional woman architect. (Cover image: Original image by Michael Galen of Inkwell Studios. © Michael Galen.
Examining Barriers, Facilitators, and Needs Regarding Participating in a Doctor of Nursing Practice Adult/Gerontology Educational Program among Baccalaureate Prepared Registered Nurses Practicing in Rural Settings in the Southern Tier of New York State
No full textUB SON, DNP Research ProjectIn the United States (U.S.), Adult-Gerontology Nurse Practitioners (AGNPs) are in high demand because of the projected increase in absolute number and proportion of adults aged 65 and older living in rural areas. This Doctor of Nursing Practice (DNP) project used a cross-sectional study design to examine barriers, facilitators, and needs regarding participating in a DNP AGNP educational program among rural baccalaureate-prepared registered nurses (RNs) in the Southern Tier of New York State (NYS)-specifically, those who are not yet certified for advanced practice. The Plan-Do-Study-Act guided this project as the theoretical framework. Institutional Review Board approval was granted by the University at Buffalo prior to project implementation. A total of 17 responses were collected via an anonymous online survey. Results indicated that among participating RNs, there was low interest in becoming a doctoral-prepared AGNP. Barriers to participating in a DNP AGNP program included a lack of awareness regarding local programs, lack of employer support, lack of time for studying, tuition costs, and unspecified school requirements. The findings strongly support the need for ongoing and multifaceted long-term approaches that engage governments, communities, healthcare employers, and organizations, as well as facilitate close and deepening collaborations between urban and rural educational institutions. These approaches should encourage RNs working in rural areas with older adult populations to obtain a DNP AGNP degree. Further research is needed regarding what is necessary to encourage rural RNs to pursue a DNP AGNP degree and strengthen the existing workforce that cares for older adults
Supplementary Notes 5: Indian village on west branch of Susquehannah
No full textThis undated note lists Iroquioan variants for a village name starting with the letter "O," citing various linguists
Open Access Week Panel Discussion: Open for Climate Justice
No full text"Open for Climate Justice" was the theme for 2022 Open Access Week (October 24-30). This annual event promotes opportunities for open sharing of knowledge with the advancement of policy changes and the importance of social issues affecting people around the world. On Oct. 27, 2022, the UB Libraries hosted this panel discussion on climate justice. Scholarly Publishing Librarian Jonathan Grunert, PhD, was the event organizer and panel moderator
Identified Practices, Barriers, and Facilitators to the Utilization of Aromatherapy for Post-operative Nausea and Vomiting
No full textUB SON, DNP Research ProjectBackground & Significance: Aromatherapy has demonstrated to be an effective adjunct in the treatment of post-operative nausea and vomiting (PONV), yet it is under-utilized in practice. Purpose & Aims: The purpose of this Doctor of Nursing Practice (DNP) project was to improve treatment of PONV through holistic, multi-modal, evidenced-based care. The aims of this DNP project were to identify 1) current utilization of aromatherapy in the management of PONV in the Post Anesthesia Care Unit (PACU), 2) knowledge levels of providers related to use of aromatherapy for PONV, 3) comfort levels of providers related to use of aromatherapy for PONV, and 4) barriers and facilitators to the use of aromatherapy in the treatment of PONV. Theoretical Framework: Kurt Lewin's Theory of Planned Change served as the theoretical framework for this project. Methods & Design: This project used a cross-sectional, descriptive design using an online survey administered to anesthesia providers, Registered Nurses, and hospital administrators. Results: Two thirds of clinical respondents reported never using aromatherapy in the clinical setting. Those reporting use rated aromatherapy as somewhat effective. Although most respondents agreed aromatherapy should be made available, reported barriers to use include lack of knowledge and product availability. Education, evidenced-based research, and ease of use were reported as primary facilitators. Conclusion: Aromatherapy is not broadly utilized or available in Western New York. Aromatherapy utilization may be increased through evidence-based education on its use in PONV management
Evaluation of the Prevalence of HIV and HCV Screening and Results Among Patients in a Substance Abuse Residential Rehabilitation Treatment Program (SARRTP): A Retrospective Chart Analysis
No full textUB SON, DNP Research ProjectIndividuals with substance use disorders (SUD) have specific health needs for which prevention and screening for HIV and HCV are an important part of health promotion as this population is at increased risk due to drug equipment sharing or risky sexual behaviors related to drug use. While people who use drugs (PWUD), especially people who inject drugs (PWID), are at higher risk for HIV and HCV infection, screening practices remain low. This project explored the prevalence of HIV and HCV screening among patients in a substance abuse residential rehabilitation treatment program (SARRTP) in a Western New York (WNY) hospital and offered practice recommendations based on study findings. Jean Watson's Theory of Human Caring (THC) was utilized as the theoretical framework to guide this project as caring is a moral ideal to be upheld in both nursing theory and practice. A quantitative retrospective chart review analysis was conducted on rates of HIV and HCV screening and results among patients with SUD admitted into SARRTP at a WNY hospital. The University at Buffalo Institutional Review Board (UB IRB) issued a not-human research determination letter and the WNY hospital provided a determination letter before project implementation. Results showed overall extremely low rates of both HIV and HCV screening within SARRTP patients. Practice recommendations to implement unit policy change and strengthen patient education were provided to address the identified clinical gap and improve HIV and HCV screening rates in SARRTP