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STI education for adolescents
No full textAdolescents make up the majority of STI cases in the United States; however, most STI education has not targeted them and their unique needs. This quality improvement project aimed to create an evidence-based educational tool for sexually transmitted diseases (STIs) for adolescents in a pediatric clinic. Next, we created a dynamic QR code to access the flyer digitally on a patient\u27s mobile device. The QR code was printed and placed in an accessible location in the office. The dynamic QR code allowed us to capture data on the total number of scans and provided the demographics of the scanners and the device they used. After the project\u27s implementation phase, we generated a report on the total number of scans. The report showed a total number of only three scans, which was insufficient to analyze data on utilization. Staffing changes, which included two nurse practitioners leaving and another reducing her status to working one day a week, affected the number of scans collected. Also, there was a mix-up about whether to give out the flier in printed form versus the QR code as the project intended. As a result, no printed-out flyers and QR codes were readily available in rooms to give to patients; these were some reasons that affected the number of scans
Foley Catheter Algorithm
Get PDFUrinary catheterization, indwelling and intermittent are simple and common procedures performed in hospitals, emergency rooms, nursing homes, and clinics to ensure adequate urinary output in patients who cannot void efficiently or closely monitor fluid intake and output. Though simple and straightforward in most cases, catheterization can become a challenging procedure with complications in the absence of a standardized protocol for difficult catheterization (Ghaffary et al., 2013). This Quality Improvement Project aimed to develop a standardized Foley catheter algorithm/ flow chart available in our institution\u27s intranet and laminated charts in nursing stations and procedure rooms with Foley catheter insertion indications, types, sizes, mindful patient history, and indications to consult with the urology team to decrease complications and morbidities due to catheterization in patients as well as to decrease healthcare financial burden. Data collection for the project was done in the level one emergency room through a pretest to identify the areas of knowledge deficit, followed by a 20-25 minutes educational PowerPoint presentation for the staff (nurses, advanced practice providers, and physicians) in the emergency department followed by a posttest questionnaire to evaluate the efficacy of the education. The data were analyzed using the Wilcoxon signed-rank test, which showed that the 20-25 -minute presentation on Foley Catheters elicited a statistically significant change in participants\u27 knowledge on catheter
Postoperative Pruritis from Neuraxial Anesthesia
Get PDFABSTRACT
Post-operative pruritus from the use of neuraxial opioids is a commonly overlooked issue among patients receiving neuraxial anesthesia for operations. A literature review was conducted comparing the use of dexmedetomidine in neuraxial anesthesia versus narcotics and the use of nalbuphine as a treatment for postoperative pruritus when narcotics are used in neuraxial anesthesia. After a review of the literature, a PowerPoint presentation was given to a group of anesthesia providers at a central Illinois hospital that discussed the evidence-based information. A pre- and post-survey were conducted to assess the change in knowledge, the willingness of providers to adapt to new changes in practice, and the willingness of providers to recommend these practice changes to colleagues. The results of the pre-and post-surveys showed willingness among the providers to implement the use of either dexmedetomidine instead of opioids in neuraxial anesthesia or the use of nalbuphine to treat post-operative pruritus in patients who received neuraxial opioids. A significant limitation of this study was the lack of rigorous research. Due to the lack of research, it is the hope that this topic will be further researched in the future to create a more widespread usage among anesthesia providers.
KEYWORDS
Opioid
Dexmedetomidine
Nalbuphine
Neuraxial anesthesia
Pruritus
Hypotensio
Diversity in Nurse Anesthesia Education: Understanding the Perspective of Racial-Ethnic Minority Nurse Anesthesia Students
Get PDFThe idea that race is not an issue, everyone is treated fairly, and the denial of racial differences is an act to refute that racism still perpetuates nursing education. Racial-ethnic minority student registered nurse anesthetists (SRNA) face unique challenges in their didactic and clinical training, including microaggressions, discrimination, and bias, all of which white students do not have to face during their educational experiences (Carter & McMillian-Bohler, 2020). Our project sought to highlight the lived experiences of ethnic minority student registered nurse anesthetists in the United States to bring awareness and effectuate change in nurse anesthesia education. Our Qualtrics survey link was emailed to nurse anesthesia faculty to forward to their students. The survey contained Likert style and open-ended questions. There were 371 respondents, and 130 racial-ethnic minority students completed 100% of the survey,101 racialethnic minority students did not complete the survey, and 140 students self-identified as Caucasian. Data were collected from participants who self-identified as racial-ethnic minority students and completed the entire survey (n=130). A total of 241 participants were excluded from the statistical analysis. Of the responses received, 61% of ethnic minority SRNAs felt isolated in clinical based on ethnicity, and 61% felt that preceptors judged their skills or intelligence based on race. Understanding the experiences of non-white SRNAs while navigating the educational system will allow the administration and faculty to understand the experiences that students of color have in the nurse anesthesia program and be able to better support them in the categories of mentorship and preceptor relationship
Perioperative corneal abrasion: An investigation into preventive practices and educational interventions that limit corneal abrasions in the perioperative setting
Get PDFCorneal abrasions are the most common ophthalmic injuries that occur in the perioperative period. Corneal abrasions that occur while the patient is under anesthesia are the result of either physical trauma, exposure, or patient related factors. Anesthesiology departments rarely develop continuing education focusing on the reduction of corneal abrasion incidence. Evidenced-based guidelines for corneal abrasion prevention techniques were reviewed while developing an educational program focused on corneal abrasion prevention amongst a group of Certified Registered Nurse Anesthetists (CRNAs). An educational presentation was given to twenty-eight CRNAs. The goal of the presentation is to reduce corneal abrasions in the perioperative setting, educate CRNAs the risk factors associated with increased occurrence of corneal abrasions, and practices reduce corneal abrasions. Pre-and post-tests were performed to evaluate the effectiveness of the educational presentation. After completion of the post-test, the results showed an improvement in the knowledge base related to corneal abrasions
Identifying Facilitators and Barriers for a Successful Student Registered Nurse Anesthetist’s Clinical Experience
Get PDFStudent registered nurse anesthetists experience a wide variety of barriers and facilitators to their clinical education; often rotating through several clinical sites during their nurse anesthesia educational program (NAEP) tenure. Existing evidence suggests SRNAs must be proficient in seeking, accepting, and utilizing feedback from clinical preceptors (Algiraigri, 2014). Accepting constructive criticism may be challenging for SRNAs as they are highly skilled, competent nurses who are now entering rigorous NAEPs as novices. Reverting from preceptor to preceptee can be a difficult transition for SRNAs. This project aimed to identify barriers and facilitators to a successful SRNA clinical education through a literature review and survey data obtained from SRNAs across the United States. The literature review and survey results revealed a need for continuing education on adult learning theory and improved communication skills in the clinical realm
Best Practice in the Perioperative Anesthetic Management of Infants with Gastroschisis
Get PDFGastroschisis, a severe abdominal wall defect, occurs in approximately 1 in every 2,000 fetuses. Despite care advancements, gastroschisis is associated with significant morbidity and mortality including prolonged time to tolerance of enteral feeds, prolonged ventilator support, and increased intensive care unit length of stay and hospital costs. A recent practice change in the care of infants with gastroschisis at a tertiary care facility in central Illinois lead to the request for an integrative review of the available literature and subsequent development of a comprehensive guideline discussing best-practice perioperative recommendations pertinent to the care of infants with gastroschisis. Through review of the available literature and development of a comprehensive guideline, this project aimed to facilitate the delivery of standardized, evidence-based care to infants with gastroschisis in the perioperative setting, potentially reducing the associated morbidity and mortality. An educational PowerPoint and comprehensive guideline were presented to the anesthesia providers at the project host facility, followed by a short survey. Results of the post-implementation survey were positive and revealed an increase in provider knowledge and overall approval and acceptance of the guideline. With the continued use of the knowledge and comprehensive guideline presented in this project, the potential to improve patient outcomes exists
Implementation of Childhood Trauma Questionnaire in a Primary Care Setting
Get PDFBackground
Childhood abuse, neglect and unusual stressful or traumatic conditions are common pediatric issues, with most Americans having experienced one kind of these adverse childhood experience (ACE) resulting in mental and physical issues in adulthood (Centers for Disease Control, 2010). Implementing a routine screening for patients will assist in identifying health concerns and can improve outcomes for the patient.
Aim
The aim of this project was to implement the use of a brief screening tool in a primary care medical office setting to assess for traumatic childhood experiences that have impact on a patient’s current morbidities.
Theoretical Framework
This quality improvement project was guided by the Biopsychosocial Model. The model demonstrates the complex interplay of the three major dimensions (biological, psychological, and social) in the development of psychiatric disorders.
Methods
The Childhood Trauma Questionnaire (CTQ) was administered to all patients seen at a rural central Illinois clinic. The office staff completed a brief questionnaire at the end of the initial implementation period. A 5-point Likert scale was used to evaluate the findings from the project.
Results
Implementation of the CTQ screening tool in primary practice demonstrated that a screening process could be successfully implemented. Participants agreed that the CTQ was easy to understand and administer and a feasible screening tool to use in practice.
Conclusions
Implementing the CTQ was considered feasible and quick to administer at no cost to the facility. Further research should include replicating this QI project to a larger scale to validate findings from this study
Peer Support Specialist Incorporation into Collaborative Patient Centered Care
Get PDFPeer support specialists (PSS) can deliver recovery care to those suffering with mental health and substance abuse issues; specifically, recuperative care is the fundamental principle in good practice for individuals with mental disease or substance abuse disorders. The goal of this quality improvement project was to improve the referral process to the in-house PSS at one Midwestern Veteran’s Administration Medical Center. Data from May and June 2021 was collected to determine the number of referrals prior to project implementation. The pre-implementation data showed twenty-four referrals from May and June 2021. Implementation occurred during the months of July and August 2021. Data was collected in the two-month period and although there was not an increase in the referrals as the project anticipated, the data did not show a large decrease in referrals either. Referrals were tracked from the initial consult by the provider and whether the patient made the follow up with the PSS. This may be due to multiple variables such the decreased patient visits during the intervention period, poor communication between primary care providers and the mental health team, as well as an influx of new providers to the clinic that did not receive pre-implementation education on the new process. Clinic staff, providers, and PSS provided feedback on the referral process and suggested continuing education to both new providers and LPNs that started in the clinic after implementation
Integrating Mental Health into Primary Care
Get PDFBACKGROUND: The purpose of this project was to examine the effects of a newly integrated collaborative mental health care model. The primary goal of the integrated behavioral health program was designed to increase the ability of primary care providers to provide mental health services with the support and expertise of a consulting psychiatrist and behavioral health specialist. Additional goals were to improve access to care and improve mental health outcomes.
AIMS: The aim of this project was to evaluate a new way of integrating mental health services in a rural health, primary care practice in central Illinois.
METHODS: Measures were established to assess quality improvement efforts (Institute for Healthcare Improvement, 2021). Outcome, process, and balancing measures were assessed. Access to care was identified as the primary outcome measure of the project. Qualitative and quantitative surveys were used to collect data. Trends in depression screening were also analyzed.
RESULTS: Early entry into care at the primary care practice was demonstrated by survey results of 0-2 days for entry into care as compared to over a week at two local health departments. Depression screening data shows the entire practice at 30.81% patients screened for depression. Frequency of screening for the behavioral health program was 86%.
CONCLUSIONS: The Integrated Behavioral Health Care Model addresses community health needs assessments: IPLAN and CHNA and the Healthy People 2030 goal to “increase the ability of primary care and behavioral health professionals to provide a more high-quality health care to patients who need it