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TikTok and Civic Activity among Young Adults
Get PDFTikTok is known for its lighthearted dance and lip-synch videos, yet videos with the hashtag #politics have garnered nearly 14 billion views. Does young adults’ politically oriented expression on TikTok lead to increased civic engagement offline? TikTok helps incorporate young adults into political social networks that may encourage additional civic activity. In addition, the playful, humorous nature of TikTok-based political expression encourages young adults to develop participatory, political selves. Using data from a 2020 survey of Americans between 18 and 25 years old, we find that posting political videos on TikTok connects with higher offline civic engagement. The results suggest that playful political expression is an important feature for promoting young adult civic engagement
Developing an Advocacy Campaign to Minimize Barriers to SRNA Political Awareness
Get PDFContinuous advocacy and political participation have secured better working conditions and recognition of certified registered nurse anesthetists (CRNAs), translating into better patient care. This project aimed to launch an advocacy campaign targeting student registered nurse anesthetists (SRNAs). A pre-lesson survey was designed to identify SRNAs’ political participation barriers and assess their political literacy. Additionally, a lesson was developed to help SRNAs’ understand CRNA advocacy. To evaluate the educational tool, a post-lesson survey was created. These materials were distributed via email to all SRNAs (n=320) enrolled in a CRNA program in Illinois. Only 51 students completed the pre-lesson survey, and 39 completed the post-lesson survey. Results showed that lack of free time (82.4%) and political literacy (54.9%) were the most reported barriers to participation. Although most SRNAs ranked slightly more aware of politics (74.5%, n=38), six SRNAs were classified as totally politically unaware (11.75%). Most of the SRNAs strongly agreed the lesson help them understand CRNA advocacy (84.6%). However, only some SRNAs (38%) strongly agreed to participate in the political process after graduation. This and the lack of participation suggest disinterest or preexisting negativity toward politics among SRNAs. Therefore, engagement facilitation should be the focus to increase SRNAs’ political astuteness.
Keywords: advocacy, student registered nurse anesthetist, political participation, political literacy, political astuteness, political process
Compassion Fatigue and Burnout In Mission Trip Providers
Get PDFCompassion fatigue (CF), burnout (BO), lack of compassion satisfaction, and impaired mental health have had catastrophic effects on nurses, providers, and support staff in the past few years due to COVID-19, labor shortage, an influx of critically ill patients, and long hours. Compassion fatigue was coined by Figley as a state of exhaustion and dysfunction biologically, psychologically, and socially because of prolonged exposure to compassion stress. Related concepts identified as burnout and secondary traumatic stress (STS) play an inclusive role in one’s ability to cope with daily environmental stressors causing physical, emotional, and mental breakdown. The link between volunteering and improved mental wellness and positive health benefits have been well documented. Participating in volunteer medical or nonmedical service can lower depression symptoms, improve mental and physical health, increase happiness, and improve life satisfaction. The setting of this project was both online and in person on the ground in Guatemala with members of a short-term medial mission trip team of health care and non-health care team members. This project utilized focused group interaction while in Guatemala with all eleven participants, there were pre and post self-administered self-care questionnaires, Professional Quality of Life Scale (ProQOL) Survey, handouts, PowerPoint presentation, mindfulness and selfcare intervention tools, and Q&A discussions. The purpose of the project was to have participants assess their level of CF and BO, pre-Guatemala as well as identify their selfcare routines. The goal was to identify pre and post burnout, CF, and compassion satisfaction as well as promote daily self-care interventions to achieve a reduction in CF and BO over thirty days post Guatemala Mission Trip. Results indicated poor feedback rate with only a 37% response rate of that one participant had an increased ProQOL score after returning from Guatemala. Limitations found included an initial small sample size, participants span across several states, inefficient post-feedback data collection, and lack of participation during the intervention phase to evaluate if self-care plays a role in decreasing or eliminating risk of CF or BO
Improving Student Registered Nurse Anesthesiologists’ Skills and Confidence Through High-fidelity Simulation
Get PDFPositive anesthetic outcomes require rapid and precise recognition and treatment of highly complex pathophysiologic states. Repeated exposure to low-frequency, high-stakes events in a realistic milieu facilitates timely and appropriate anesthetic interventions. Current evidence suggests high-fidelity simulation enhances anesthetic training and can improve patient outcomes by enhancing confidence, competence, and proficiency while removing the risk for patient harm during simulated events. This project’s aim was to improve student registered nurse anesthesiologists’ confidence and competence in routinely encountered anesthetic situations utilizing high-fidelity simulation. Prior to beginning clinical rotations, students participated in a high-fidelity routine anesthetic induction simulation and were challenged to diagnose and mitigate an esophageal or right-mainstem bronchus intubation. Overall, students self-reported improvements in confidence and competence with the anesthetic induction, endotracheal intubation, confirming appropriate endotracheal tube placement, and troubleshooting complications that may arise during an anesthetic induction
Tranexamic Acid Protocol for Lower Extremity Total Joint Arthroplasties
Get PDFAbstract
Bleeding is a risk associated with surgery, and complications, such as hypotension, anemia, and decreased oxygen-carrying capacity, can occur. Blood transfusions have been the mainstay treatment for excessive surgical blood loss; however, transfusion has associated risks including infection, volume overload, immunological reactions, and increased morbidity and mortality (Sahu et al., 2014). Interventions to decrease surgical blood loss are essential components to improving surgical outcomes. The antithrombolytic, tranexamic acid (TXA), decreases surgical blood loss and blood transfusion requirements, thereby decreasing transfusion-related complications (Gausden et al., 2017). Despite frequent use, variance exists surrounding the administration of TXA. Current evidence and guidelines regarding TXA administration were examined to decrease provider variance and optimize utilization. This quality improvement project aimed to improve outcomes for patients undergoing lower extremity total joint arthroplasty in a tertiary care facility in central Illinois by developing a TXA administration protocol. The protocol addressed contraindications and dosing guidelines. The results of the project indicated anesthesia providers at the host facility supported implementation of the evidenced-based TXA protocol into practice
Advanced Care Planning in Primary Care
Get PDFIn Illinois, the do-not-resuscitate (DNR) form that is legally binding in all healthcare facilities is known as the Practitioner Orders for Life-Sustaining Treatment (POLST) form. The Patient Self-Determination Act (PSDA) of 1991 mandates only certain facilities to discuss advanced care planning (ACP). Primary care offices are not included in this mandate. Therefore, no structured process exists for primary care providers to identify patients who may benefit from ACP discussions. The purpose of this Doctor of Nursing Practice (DNP) project was to initiate conversations about ACP with patients 55 years and older in a primary care office and complete POLST forms when appropriate. A screening form was implemented into the clinic’s electronic medical record (EMR) which would prompt the intake staff to ask any patient 55 years or older if they had any advanced directives. If a patient answered no, the provider was notified by placing ACP forms outside the patient’s room to signal the provider to have a discussion with the patient. This project was implemented over a period of two months and the data gathered was compared with ACP on file before and after implementation. Prior to implementation, 20% of patients had ACP on file, and 19.4% after implementation, which is a decrease of 0.6%. The future recommendation for this project is to implement it in multiple primary care offices over a year to gain a broader, larger, and more diverse population of patients for the purpose of outcome evaluation
Just Culture in Undergraduate Nursing Academia
Get PDFUnderstanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data to drive high-quality, safe evidence-based practices and will help to engrain a just culture in the undergraduate nursing program. The purpose of this project was to evaluate just culture knowledge in undergraduate nursing students in the 3rd-semester of school before and after the addition of just culture education at a community college. The education consisted of 30 minutes of formal in-classroom theory content provided via lecture and the use of a PowerPoint presentation to 29 undergraduate nursing students. The 3rd-semester nursing students were given the Just Culture Assessment Tool for Nursing Education (JCAT-NE) survey pre and post-formal classroom education. The JCAT-NE consisted of 27 questions divided into 6 subscales. Five questions in two subscales, fear of reporting and understanding of continuous improvement process, had a statistically significant improvement with a p-value of post-education calculated by performing a Mann-Whitney U test. The difference means in the five questions ranged from 1.66 to -2.00. The results indicate that formal education improves understanding of the importance of reporting errors and how it contributes to quality and safety improvement. Building a stronger curriculum focusing on the quality and safety aspect of reporting errors, near misses, and good catches could help future generations of nurses reduce errors resulting in improved healthcare and quality patient outcomes
Hyperoxemia Education to Nurses to Increase the Adherence to Oxygen Weaning Goals in Inpatient COPD Patients.
Get PDFHyperoxemia in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at risk for increased hospital stay, mechanical ventilation, and increased risk of death. Literature supports that establishing increased education to nursing staff on the risks of hypoxemia to increase adherence to oxygen weaning protocols has the potential to improve future practice. Oxygen weaning protocols are often not followed for concern of patient care. Nurses may believe to be helping patients when increasing oxygen, when they could actually be potentially harming them. Increased education on hypoxemia in COPD patients for the nursing staff will assist them to feeling more comfortable following oxygen weaning goals to achieve ordered O2 saturation for their patients. This DNP project focused on evidence based data for hyperoxemia in AECOPD patients with education for nurses to enhance their knowledge. The nurses were presented with an educational poster presentation and a post test to evaluate their hyperoxemia knowledge in AECOPD patients. The educational goal for improvement was to have the nurses to score 80% or higher on the post test. This goal was achieved, implying it was a successful strategy for improvement of knowledge. For future projects in this topic, it would be beneficial to have include a pre and post chart audit to evaluate if the education is being implemented into nursing practice
Introduction of a Spinal Care Pathway Triage Protocol in the Secondary Care Setting
Get PDFBackground: Back pain is considered the leading cause of disability worldwide. Providing effective multidisciplinary care for clients with chronic back pain (CBP) has been an ongoing issue globally. Improper care management of CBP creates personal, economic, and societal burdens that significantly affect patients, their families, and the healthcare system. Purpose: This quality improvement project aimed to successfully integrate a spinal care pathway (SCP) electronic decision support tool (e-tool) into a multidisciplinary spinal care program, to improve providers’ satisfaction with care delivery and their satisfaction with CBP patient outcomes. Methods: This DNP project used an evidence-based quality improvement (EBQI) design to introduce an SCP e-tool into a multidisciplinary spinal care program, a secondary healthcare setting. The Institute for Healthcare Improvements’ Plan-Do-Study-Act cycle was used as the pilot change process to evaluate the effects of an SCP use on CBP patients’ delivery of care and healthcare providers’ satisfaction rates. Results: Of the NSI staff who participated in the surveys, 57.14% agreed, and 42.86% highly agreed that the SCP e-tool is and will be helpful in collaboratively triaging their CBP patients to the most appropriate care modalities to decrease pain and increase functionality, which is a critical metric indicator. (N=7). Conclusion: The SCP e-tool is a novel electronic clinical decision support tool that will provide an evidence-based method to improve the quality and delivery of care for CBP patients. The results of this EBQI project revealed clinical relevance to support the integration of the SCP e-tool into the NSI’s secondary clinical practice setting
Utilizing Gastric Point-of-Care Ultrasound Assessment for Patients with Questionable NPO Status
Get PDFPerioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel the anesthetic and therefore the surgical procedure. Gastric point-of-care ultrasound (POCUS) can be used to assess the status of the patient’s gastric contents to objectively decide how to manage an anesthetic. The difficulty in the implementation of this tool lies in the level of confidence and efficiency of the anesthesia provider’s assessment to dictate decision-making. This project’s goal was to train anesthesia providers to feel more confident in their ability to utilize this tool to mitigate relevant risks. Short knowledge tests and opinion surveys were administered before and after training on gastric POCUS. Anesthesia providers improved in their willingness and confidence to continue usage of gastric POCUS in appropriate scenarios. This will provide cost savings and improve safety within our facility which ultimately adds value in our clinical setting