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Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students
Get PDFDevelopment of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates deep learning. Data shows that access to procedural videos enhances student physical examination performance compared to traditional teaching methods. Educational videos on performing neuraxial anesthesia were created according to best-practice recommendations. First-year nurse anesthesia students were given a pre-test to assess their baseline knowledge of neuraxial anesthesia. They were then given access to the educational videos and attended a hands-on lab. After students watched the video and practiced the procedures during lab, they were given a post-test with the same ten questions as the pre-test and a survey to gauge their thoughts and perceptions of the educational resources. The goal was to show an increase in scores and, thus, an increase in knowledge after the intervention. This quality improvement project implementation successfully enhanced student knowledge of neuraxial anesthesia and allowed for a refined approach to the education module, utilizing multimodal techniques
Art Bibliotherapy: An Integrative Approach to Art Therapy and Bibliotherapy
Get PDFArt Therapy and Bibliotherapy are both subfields in the creative/expressive arts world of therapeutic practice. Individually, art therapy and bibliotherapy have unique attributes that have the potential to improve a client’s overall therapeutic outcome. However, in pursuit of evidence-based practice, art therapy and bibliotherapy could benefit from further high-quality replicable studies. An exploration of the current research and emergent shared themes were undertaken. A single participant case study demonstrated Art Bibliotherapy in practice. Participant outcomes were increased emotional regulation, increased positive experience in therapy sessions, and increased positive self-esteem
Second-victimhood Among Anesthesia Providers & the Effects on Patient Outcomes
Get PDFAnesthesia providers work in environments promoting productivity with tremendous pressure to begin the next case regardless of any recent adverse events that may have occurred (Wands, 2021). Certified nurse anesthesiologists (CRNAs) potentially struggle with a lack of recognition, a high number of hours, inadequate work-life balance, and limited professional advancement, which all contribute to high stress levels within the field (Andrade & Dantas, 2015). A healthcare professional involved in an unexpected adverse event, medical error, or patient-related injury is labeled as a second victim. Thirty anesthesia providers from a central Illinois hospital viewed a PowerPoint presentation, completed a survey, and ranked scenarios on a 5-point Likert scale. All participants state the presentation increased second victimhood knowledge, and the majority (60%, n=18) admit to having experienced second victimhood. Regarding the most beneficial support, 96.7% of respondents chose talking to a trusted peer. Second Victim Experience and Support Tool (SVEST) results detailed the severity of second victimhood experienced by CRNAs. Inadequately resolving chronic stressors can have negative implications, such as leaving the career or even suicide. However, studies show that supportive management and trustworthy peers improve outcomes for healthcare providers experiencing second victimhood symptoms.
Keywords: second victimhood, anesthesia, patient outcomes, CRNA, nurse anesthetist, post-traumatic stress disorder, mental health
Increasing Education and Awareness of Patients who Identify as Transgender in Primary Care
Get PDFBackground. Lesbian, gay, bisexual, and individuals who identify as transgender and queer (LGBTQ) often experience negative healthcare encounters (Parameshwaran et al., 2017). According to the Williams Institute of Law (2022), there are 1.3 million adults who self-identify as transgender. This education project utilized a pre/post-test design to explore attitudes, practices, and knowledge of primary care providers when interfacing with individuals who identify as transgender in primary health care settings.
Theoretical Framework. This project was guided by Lewin’s Change Theory.
Methods. Primary care providers in an urban community health clinic received a pre and post-education survey. A teaching session was delivered to the primary care providers to increase knowledge and awareness of treatment modalities needed to improve health care for this population.
Results: Surveys were sent to 10 providers. Pre-test surveys were received from 100% of providers (n=10), and post-test surveys were received from 80% of providers (n=8). Post-test scores revealed substantial differences on some survey items. Participants on the post-test indicated a higher average agreement with the statement “I have sufficient training to provide primary care to patients who identify as transgender” compared to pre-test data (mean = 4.25; mean = 3.5, respectively).
Implications for Practice. Future work in this area should include teaching and educational programs in the healthcare curriculum to increase the knowledge and awareness of primary care providers when interacting with individuals who identify as transgender
Expansion of Heart Failure Education from Hospital to Clinic
Get PDFHeart failure education is vital to the long-term management of this condition. Education recommendations for heart failure are given by the American Heart Association (AHA) and the American College of Cardiology (ACC). Recommendations include verbal instruction and written materials regarding the patient’s medication plan, recognition of symptoms, what to do when symptoms occur, and the importance of daily weights.
This project aimed to provide outpatient clinic providers and staff with resources and education necessary to educate heart failure patients. The project expanded use of an inpatient heart failure education packet for outpatient use. This was accomplished by conducting educational sessions for outpatient providers and staff about the contents of the educational packet. Staff understanding of the educational packet was evaluated using pre-tests and post-tests. The overall score on the post-test was 99%, an increase of 19% from pre-test scores. In this rural clinic, providers will now distribute educational packets to those newly diagnosed with heart failure. Medical assistants and nurses will distribute educational packets to patients previously diagnosed with heart failure for continued reinforcement from the inpatient setting. All patients diagnosed with heart failure, who present to the outpatient clinics within this rural hospital system, will now be properly educated about heart failure, be able to self-manage their care, and reduce hospitalizations
Postdural Puncture Headaches and the Development of a Treatment Protocol
Get PDFRoughly 1% of patients receiving an epidural for analgesia will experience an accidental dural puncture (ADP). Of that 1%, half will go on to develop a postdural puncture headache (PDPH) (Apfel, 2010). PDPH presents 24-48 hours after neuraxial anesthesia as a dull, bilateral, throbbing, postural headache that is often accompanied by nausea (Patel et al., 2020). Although PDPH is a fairly common complication associated with neuraxial anesthesia, many facilities offering obstetric services lack a written protocol addressing ADP and PDPH treatment. The purpose of this project was to design and introduce a PDPH evidence-based treatment protocol for a hospital in the St. Louis metro-east region to combat the impact PDPH has on maternal-newborn bonding, patient satisfaction, and length of hospitalization. Through a comprehensive review of the literature, the most recent evidence of PDPH risk factors, prevention strategies, and treatment options were discovered and compiled into an educational presentation for the host facility anesthesia staff. This project utilized a non-experimental design and aimed at quality improvement. A pre and post educational presentation questionnaire were anonymously and voluntarily completed by staff in attendance to gauge the effectiveness of the educational presentation. Overall, questionnaire scores improved following the educational presentation. Anesthesia staff reported that they planned to adopt the proposed treatment protocol into their daily practice
Translating the Untranslatable: Cosmopolitan Oscar Wilde on Soviet Television
Get PDFThis article explores TV adaptations of Oscar Wilde’s plays and prose on the Soviet television of the so-called “stagnation” era of the late 1960s-early1980s. Though seemingly ideologically alien to the USSR, Wilde was a widely read and popular young-adult writer for the duration of the Soviet period. I will point to possible reasons for this unlikely popularity and look at two made-for-TV adaptations: The Importance of Being Earnest (1976) and The Picture of Dorian Gray (1968). As a queer cosmopolitan author, Wilde translates into, and undermines, a virulently anti-cosmopolitan culture. The adaptations in question use the guise of addressing and educating a young-adult audience to transmute queerness and the art-for-art’s-sake philosophy (both of which I identify with cosmopolitanism) into an ideologically hostile environment that delegitimizes them. Such adaptations both embody and pave the way for the more worldly and individualistic (in the Western sense of the word) art of the 1970, which, in turn, helped along the anti-totalitarian arc of the 1980s
Implementation of the Adult ADHD Self-Report Scale in a Mental Health Clinic
Get PDFLess than 20% of adults with attention deficit hyperactivity disorder (ADHD) are adequately treated due to overlapping symptomology of comorbid psychiatric conditions. Anxiety and depression are the most common comorbid psychiatric conditions in adults with ADHD. Diagnosis, treatment, and outcomes of adults with ADHD are impacted due to inadequate screening. The setting for this project occurred in a Veteran Affairs mental health outpatient clinic in central Illinois. The process was implemented by screening adults diagnosed with depression or anxiety using the adult ADHD self-report scale (ASRS). Of the 150 participants, 90 scored higher than 17 on the self-report scale, indicating further ADHD evaluation. Incorporating screening for ADHD in adults with comorbid psychiatric conditions will improve diagnosis and treatment, leading to improved mental health outcomes
Development of a Nurse Anesthesia Program Point-of-Care Ultrasound Airway Examination Curriculum
Get PDFAirway management is a critical and fundamental skill for anesthesia providers. Point-of-care ultrasound (POCUS) is an up-and-coming assessment technique that can provide critical information about a patient’s airway anatomy and may increase patient safety during anesthesia care. As a result, understanding the appropriate POCUS equipment, techniques, findings, and clinical implications for airway examination can become essential for safe and effective anesthesia practice. This project aimed to develop a clinical airway POCUS examination curriculum with detailed instructions on all aspects of appropriate examination equipment, set-up, technique, and implications for findings. The team designed the curriculum to incorporate it into the host Nurse Anesthesia program and to utilize it in future anesthesia coursework. It included an educational PowerPoint presentation with a voiceover lecture and a hands-on skills development lab conducted for third-year Nurse Anesthesia students at Southern Illinois University Edwardsville (SIUE). Pre-lab and post-lab surveys were collected to enable a comparative analysis of the curriculum\u27s effectiveness. The post-lab data showed that most students began with limited knowledge of the necessary elements of airway POCUS examination but ended the lab session with significantly increased confidence in their ability to perform an airway POCUS examination
Fantastic Four
Get PDFClinical IssueHeart failure claims one in four lives of those diagnosed each year. The term Guideline Directed Medication Therapy (GDMT) represents optimal medication therapy as defined by the American College of Cardiology Foundation and American Heart Association. Appropriate quadruple therapy results in an estimated 73% relative reduction in mortality over a two-year time span (Greene & Khan, 2021). However, there is a gap in proper GDMT stemming from suboptimal initiation and/or titration in the outpatient setting.
Project Implementation Nursing staff in a rural midwestern cardiology clinic were provided with an in-service presentation discussing current guidelines and recommendations of GDMT through visual, auditory and kinesthetic adaptations.
Outcomes A pre- and post-educational survey was given to the nurses. The pre-test questionnaire had an average score of78.3%. The post-educational questionnaire showed an average of 90.6%. Nursing staff then ranked their confidence and understanding on a scale of one to five. These scores reflected that the nursing staff felt more confident in their knowledge of GDMT medications and their mechanism of action along with their knowledge of the statistical benefit GDMT offers this patient population.
Clinical ImplicationsProject results revealed increased knowledge of GDMT therapy by 18%. The immediate impact on practice is an increase in knowledge for the nurses, which will promote the evaluation of GDMT through staff. Long term impact of this quality improvement project would be an anticipated reduction in mortality, cardiovascular risk, overall hospitalizations, and hospitalization for heart failure as proper treatment is implemented