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The Relationship Between Eating Disorders, Attachment Styles and the Uses of Art Materials
Get PDFPrevious studies showed that both eating disorder (ED) behaviors and attachment styles (ASs) could reflect on individuals’ uses of art materials. This mixed methods study aimed to explore the correlation between ED diagnoses and ASs, investigate clients’ selection of and familiarity with art materials, as well as understand how clients’ self-reports of media interactions match clinical observations. Participants were adults receiving residential care in an ED facility in Midwestern United States. Data were collected through surveys, chart reviews, and discussions with the participants’ therapist. The results of this study found a high prevalence (85%) of insecure attachment in the population. Participants with different ED diagnoses and ASs demonstrated distinct ways of using art materials and experienced separate modes of information processing. Discrepancies among subjective experiences, the therapist’s observations, and literature were discussed. Clinical applications include designing informed treatment plans to meet clients’ need and gaining a holistic view of the population
Mentorship Program Including Alumni
Get PDFThe landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program\u27s impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and a mandatory interaction schedule
Educating Anesthesia Providers on the Physiological Effects and Anesthesia Implications of Cannabis
Get PDFIn the U.S., currently 37 states have legalized cannabis for medicinal use prescribed by qualified medical professionals (National Conference of State Legislatures [NCSL], 2022). In 2012, the legalization of recreational cannabis began; as of 2022, 19 states have legalized the recreational use of marijuana (NCSL, 2022). This project aimed to optimize care for patients using cannabis by increasing anesthesia provider knowledge about cannabis. The project\u27s aim was accomplished through a thorough review of the current medical literature and implementation of education to anesthesia providers about the physiological effects and anesthesia implications of cannabis. Thirteen CRNAs took a pre- and post-quiz to test their knowledge about cannabis before and after an educational PowerPoint presentation was provided. Results demonstrated most providers have a knowledge deficit about cannabis. Comparative analysis of the pre and post-quiz results revealed significant improvement, indicating education to anesthesia providers can improve their knowledge about the physiological effects and anesthesia implications of cannabis. Using these results, one can hypothesize that with improved knowledge, providers can offer a safer anesthetic to patients presenting for surgery using cannabis
Local Anesthetic Systemic Toxicity: LAST Protocol Development, Implementation, and Evaluation for Healthcare Providers
Get PDFLAST is an uncommon but deadly complication of local anesthetic administration. Healthcare facilities benefit from protocol implementation to help streamline best evidence-based practice. The American Society of Regional Anesthesia and Pain Medicine warrants a LAST emergency protocol for any healthcare facility practicing regional anesthesia. Healthcare personnel encountering patients at risk for LAST must understand the symptoms and treatment of LAST to improve response time and patient outcomes. The project implemented a LAST protocol at a rural hospital in Southern Illinois in July 2023. The investigator held an educational service to discuss the new LAST protocol and implementation. The educational service included a PowerPoint presentation highlighting essential local anesthetic systemic toxicity and protocol information. Education provided healthcare personnel with information regarding LAST identification and treatment, which is paramount for improving patient outcomes. This project educated staff on where to find the necessary equipment to treat LAST, including a grab-and-go LAST emergency response bag with intralipids and a step-by-step treatment guide. Participants were asked to complete a pretest before the educational service and a post-test after to assess the efficacy of the presentation. There was significant improvement between the pretest and post-test scores, indicating increased LAST knowledge and provider comfort in responding to a LAST emergency. These results support the positive impact of implementing a LAST protocol and providing education for this rare emergency. The results of this project suggest an improvement in provider knowledge and comfort levels when responding to a LAST emergency, which may result in improved patient outcomes
Discharge Lounge Utilization
Get PDFEfficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative findings reveal various operational barriers and staff perspectives influencing hospital throughput. This project contributes to a better understanding of the complex factors impacting hospital throughput and provides insights for improving healthcare delivery processes to enhance patient flow and alleviate overcrowding in emergency departments
Identifying SRNAs individual learning preferences utilizing the VARK Learning Inventory Tool
Get PDFAbstract
All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. Thirty-eight Military personnel enrolled in the U.S. Army Graduate Program in Anesthesia Nursing were administered the VARK (Visual, Auditory, Reading, Kinesthetics) learning inventory tool in the beginning of their first year in the program. The VARK learning inventory tool is a sixteen questionnaire that identifies an individual’s learning preference based on the answers that he/she selects. After identifying the individual learning preference, everyone was given a 10-page performance template that outlined the various techniques that incorporated the individual learning preference to the daily learning and retaining of educational materials. The passage rate of the group involved in the project will be compared with the national average after taking the NCE.
Keywords: metacognition, VARK learning theory, doctoral education, nurse anesthesiology, self-regulated learnin
Blunt Cerebrovascular Injury (BCVI): Universal CTA Neck Screening at Level 2 Trauma Center
Get PDFBlunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years old with significant blunt-force trauma activations from March 2023-January 2024 will receive CTA neck with a 128-slice computed tomography scanner during initial trauma workup. During the study period, 395 patients had level I and level II trauma activations, 210 (53.16%) of which met the criteria for BCVI screening. CTA neck was completed on 156 individuals (74.29%),11 (7.05%) of which exhibited evidence of BCVI. The variables BCVI Followed and “Positive BCVI displayed a significant correlation (r=0.97 and p\u3c0.001). A strong positive linear relationship between the two variables was observed. The implementation of universal screening with CTA neck for BCVI detection holds promise for advancing trauma care practices. This doctoral project provides evidence-based recommendations and insights to guide similar initiatives in trauma centers, improving patient outcomes and reinforcing the commitment to excellence in trauma care
Implementing Pain Management Policies and Procedures at a Rural Pain Clinic
Get PDFThe United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural pain clinic which placed patients at higher risk of developing opioid use disorder. Multiple interventions were implemented at this clinic which included the opioid risk tool (ORT) to screen patients for their level of risk for developing opioid use disorder, increasing the number of random drug screens, pain management contracts, and consistent use of the prescription drug monitoring system (PDMS). During the project implementation phase 218 ORTs were completed, the PDMS was accessed 288 times, 80 pain contracts were signed, 25 random drug screens, and 10 yearly urine drug screens were completed. Pain clinic staff quickly adopted the interventions of administering the ORT and checking the PDMS. Pain contract administration was slowly accepted but completing random and yearly drug screens was not fully implemented by clinic staff
Enhanced Recovery After Surgery (ERAS) Protocol for Bariatric Surgery
Get PDFBariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). To address this burden, enhanced recovery after surgery (ERAS) protocols have been implemented at institutions. These protocols are designed to improve surgical outcomes, decrease postoperative complications, decrease hospital length of stay, and reduce healthcare costs. The objectives of this quality improvement project were to research current evidence-based literature on ERAS protocol for bariatric surgery, synthesize the recommendations, and present the gathered information to perioperative team members. After viewing the presentation, participants completed a post-presentation survey. Results of the post-presentation survey demonstrated that nurse anesthetists strongly understood ERAS protocol. Participants also believed that a customized ERAS protocol could be implemented into practice at their facility. The evidence displayed the remarkable impact ERAS protocols can have on practice
Evaporating Metacognitive Talk: School Inclusion, Power, and the Interplay of Structure and Agency
No full textThis paper addresses Lukes’ and Hayward’s arguments that power should be conceived as agential versus structural. My fieldwork at Mitchell Primary School demonstrated that educators and students at Mitchell were structurally constrained and enabled but also exercised agency in navigating these institutional boundaries. Not only are both structural and agential conceptions of power valid, considering their interplay moves social analyses forward—at Mitchell, teachers’ otherwise-frequent metacognitive talk evaporated when their inclusion-oriented practices were more distant from institutional norms. Understanding power requires including its sources (from the individual actor to social structure) as one key dimension. Using this understanding could help educators more intentionally make conscious choices about their inclusion practices as they navigate their school environment