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Surgical Skills for the APRN Student: A Low-Fidelity Simulation Experience
Get PDFThere are many contemporary areas of practice available to the ACNP to date that encompass a surgical component of practice. Surgical specialty settings require a practitioner to be competent in a specialized base of knowledge as well as possess a fundamental set of psychomotor skills to practice competently. Unlike the training of the PA, ACNP programs do not typically address surgical theory or skills. The purpose of the program was to increase graduate nursing student confidence in basic surgical skills. The review of the literature examined the differences between the educational preparation of the PA and the NP, expansion of the NP role in surgery, as well as the use of simulation in graduate nursing education. The program incorporated a surgical skills lab concluding with a low-fidelity simulation experience. Skills addressed included the surgical hand scrub, donning surgical attire, and simple wound closure techniques. The sample comprised of 13 subjects representing 65% of the population meeting the inclusion criteria. The program was evaluated using a researcher designed and validated non-experimental Likert type survey measuring subject confidence both pre and post intervention. Responses to the nine Likert scale questions demonstrated a statistical increase from the pre-intervention to the post-intervention survey. Two participants reported utilized the new attained knowledge and skills during their final semester surgical clinical practicum. Incorporating surgical theory and skill training into graduate nursing education is vital if the ACNP would like to remain competitive with the PA in the surgical specialty job market
A Nurse-Driven, Exercise-Based Intervention for Patients with Cancer-Related Fatigue when Severe Fatigue Interferes with Daily Activity
Get PDFCancer affects more than 1 million people each year. Of all of the symptoms related to cancer, the most frequently experienced is fatigue. Cancer-related fatigue (CRF) is an extreme tiredness that contributes to morbidity and mortality due to resulting inactivity. Extreme inactivity related to CRF may cause severe complications affecting multiple body systems. The Oncology Nursing Society (ONS) recommends exercise as the only evidence-based intervention shown to be significant for CRF. The purpose of this project was to provide a nurse-driven, exercise-based intervention to combat severe CRF. The site was an oncology out-patient clinic of a 247 bed Magnet hospital in Providence, RI; no specific intervention for oncology patients with fatigue levels \u3e4/10 was in place. A program development project was developed that included creating a brochure for patients targeted at CRF, revising clinic treatment sheets for easy intervention documentation, and educating the nurses by means of in-services regarding the project. Nurses’ knowledge regarding CRF, when to use the brochure and how to document it improved after the in-service. Potentially, receiving the CRF brochure will enable patients to appropriately manage their fatigue at home. Long term follow up related to the impact of the CRF program on Press Ganey fatigue education scores is indicated
Critical Inquiry in Developmental Mathematics
Get PDFCritical mathematics literacy is a necessary but often overlooked portion of developmental mathematics. This exploratory study focuses on the experiences of students in a developmental algebra course at a community college in New England. The theoretical framework combined critical pedagogy, teacher research, and critical discourse analysis resulting in a qualitative analysis. The analysis found that students who completed a social-justice oriented developmental algebra course increased their perception of their ability to understand math. The analysis also indicated that developing a sense of solidarity within the classroom was beneficial to students. Other issues for future study that surfaced during the analysis are the problems of deeply engrained learner dependence on the instructor and students’ reliance on short term memorization rather than understanding
Eye on Ethics: Context Matters - Shifting Norms in Social Work Ethics
No full textIn some instances, context is irrelevant when social workers make ethical judgments. Sexual contact with clients is unethical regardless of setting and client population. The same is true of falsifying documents or billing for services that a social worker never provided. But in many other instances, context matters
Commencement Program 2014
Get PDFThis commencement program is for baccalaureate and advanced degrees.https://digitalcommons.ric.edu/commencement_programs/1126/thumbnail.jp
Exploring Women\u27s Empowerment Through Credit-Plus Microfinance in India
Get PDFTransnational feminist discourse has critiqued the pursuit of women’s empowerment through international development programs. Empowerment, when reduced to the provision of financial resources and services, is unlikely to lead to wider changes in gender inequality unless programs strategically combine credit with other vital services. We interviewed women participating in a multifaceted empowerment program in Mumbai, India, to explore the potential of the ‘‘Credit-Plus’’ model to facilitate pathways of individual and collective empowerment. Emergent themes of empowerment were enhanced socioemotional well-being, increased economic assets, and improved household gender equity. Interview responses demonstrate changes in individual, household, and collective agency dynamics
Alarm Fatigue: A Technology Hazard
Get PDFThis research project sought to investigate the impact of alarm fatigue on nurses in an inpatient adult acute care setting at an academic and magnet medical center in the Northeast. The project methodology included a 12-question survey containing 9- likert and 3 open ended questions, designed by the student researcher. The survey was administered to 48 registered nurses on two telemetry-monitoring units. The survey explored whether nurses are aware of alarm fatigue, and also how their daily workflow was impacted by alarm fatigue. Surveys were anonymous and confidential. Descriptive statistics were performed on the study variables, and responses from three open-ended questions analyzed. The questions did not lend themselves to determining themes. Several respondents did request further telemetry monitoring system review and education. The survey results established that nurses from both units were experiencing alarm fatigue as well as workflow disruption as a result of frequent nuisance alarms. Implications for nursing practice are complex and of great importance given the patient safety implication. Nurses must spearhead initiatives to tackle and mitigate alarm fatigue. Participation at a system level is necessary to review current practice standards and policies in order to drive changes necessary to improve the patient care environment. End users of monitoring systems are in a unique position to work with vendors in order to create monitoring devices with sophisticated capabilities for monitoring which decrease nuisance alarms
Engaging Students in Art Beyond the K-12 School Environment
Get PDFThis purpose of this thesis is to investigate a unit of instruction for a mural project with a community organization.
The question I sought to answer through this research was: How can I design a unit of instruction in collaboration with a local organization that will potentially engage students in a community-based work of art while also promoting a sense of community among the students?
Though this thesis research, I learned to collaborate with an organization to create a hypothetical unit of instruction. Also, I wanted to discover how I can create a learning experience that is engaging and personally meaningful to students. The unit of study that I created is inquiry-based towards sparking the interest of students through open-ended questioning. I designed lessons that involved cooperative group work where students would work towards a common goal. This thesis will show that cooperative group work has the potential to develop a sense of community among students while meeting the needs of a community organization
Preventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses
Get PDFVentilator-associated pneumonia (VAP) is the second most common hospital acquired infection and is primarily found in the intensive care units. The presence of an endotracheal tube is the primary risk factor for developing VAP. Many times the process of intubation occurs pre-hospital, in the emergency room (ER) or in the operating room. Ventilator associated pneumonia is associated with increased hospital stay and costs. Evidence-based guidelines have been developed to decrease the occurrence of VAP and decrease patient mortality. Preventative measures are initiated on the intensive care unit once the patient is transferred. The purpose of this study was to evaluate the impact of an educational program on ER nurses knowledge of VAP and preventative measures to decrease VAP.
The study took place at Rhode Island Hospital, a level 1 trauma center located in Providence, RI. Participants were ER nurses who worked in the critical care area of the ER. A pre-intervention-posttest design was used to evaluate emergency room nurses knowledge regarding VAP. The intervention consisted of a posterboard and study guide that provided information regarding evidence-based guidelines that could be implemented in the ER such as oral care, and head of bed elevation. The overall results on the pre and posttest demonstrated that ER nurses were unaware that oral care and the use of chlorhexidine were important interventions to reduce the incidence of developing VAP. Recommendations and implications for advanced practice nursing and the need for future research are discussed
TRFLP Analysis of the Effect of a Forest-to-Gap Ectone on Soil Microbial Diversity
Get PDFTo investigate how soil microbial diversity is influenced by the formation of an experimental edge-creating gap within a southern New England oak-hickory forest, I used a molecular fingerprinting technique known as terminal restriction fragment length polymorphism (TRFLP). Sequence variability in the 16S ribosomal RNA (rRNA) gene in soil bacterial communities is detected by differences in the length and abundance of fragments produced by digesting PCR products amplified from rRNA genes. The different patterns observed are assumed to represent unique phylotypes.
How does the forest-gap ecotone influence soil bacterial diversity? Based on other studies, I hypothesized that the edge would contain the most diverse bacterial community, followed by the gap, and as distance from the gap into the forest increased, bacterial diversity would decrease.
Soil samples were collected along 40m transects perpendicular to the northern edge of the gap. DNA was extracted from each sample, PCR was used to amplify the 16S rRNA gene, and DNA fragments were cut by restriction enzyme digestion and separated via electrophoresis. The DNA fragments were analyzed by TRFLP.
Environmental variables (soil pH, soil temperature and soil gravimetric moisture) were different in the gap compared to all other distances, but not significantly so. Phylotype richness and diversity (Simpson’s index) was greatest at the edge. Canonical Correspondence Analysis (CCA) produced a phylotype-by-distance ordination that supports my hypothesis and shows that the edge is an ecotone (transitional zone) between the gap and forest