13468 research outputs found
Sort by
9 to 5 (2024)
No full texthttps://digitalcommons.otterbein.edu/theatre_dance_gallery/5768/thumbnail.jp
Beehive: The \u2760s Musical
Get PDFhttps://digitalcommons.otterbein.edu/summer_production_2024/1000/thumbnail.jp
Final Scholarly Project: Clinical Guidelines for the Perioperative Management of Patients with Opioid Use Disorder Requiring Anesthesia
Get PDFOpioids have highly addictive properties that allow for high levels of misuse. Since the early 1990s, the misuse and deaths rates related to narcotics have steadily risen in the United States. Efforts to identify individuals using opioids prior to surgery have proven difficult. The number of patients misusing opioids and reporting for surgery can only be estimated due to under-reporting related to fear and self-stigma. With 50 million surgeries in the U.S. annually and 3.32 million people misusing opioids monthly, the chances of a patient with Opioid Use Disorder (OUD) presenting for anesthesia are exceptionally high. Moreover, patients who rate pain higher throughout their hospital stay are more likely to have longer stays and be readmitted for pain issues. Notably, the average readmission cost is $15,200 for the patient. Issues with anesthetizing patients who chronically misuse opioids include cardiac dysrhythmias, respiratory complications, death from acute intoxication, higher opioid requirements postoperatively, prolonged hospital stays and increased readmission rates. The project serves to evaluate current literature to provide direct guidelines for implementation for OUD. The providers will be given a set of guidelines for adaption into practice. The success of the project will be measured by the outcomes of amount of opioids used, the length of stay, and readmission rates
Evidence-Based Practice Guidelines: Anesthesia for Total Knee and Hip Arthroplasty
Get PDFAbstract
Total knee and hip arthroplasty are the two most common orthopedic surgeries in the United States. Traditional perioperative practice is multidisciplinary, with each professional, including anesthesia, making decisions based on their current knowledge or past experience. Postoperative complications pose a threat to any patient undergoing a surgical procedure. Enhanced Recovery After Surgery (ERAS) protocols were developed to streamline best practice guidelines during the perioperative period. ERAS pathways aim to decrease postoperative complications, accelerate recovery after surgery, decrease narcotic use and promote early mobilization and discharge from the hospital. The aim of this project is the development of evidence-based practice (EBP) guidelines using recommendations from ERAS protocols. The EBP guidelines include preoperative education, patient optimization and euvolemic fluid management. During the intraoperative period, the EBP guideline includes opioid-sparing anesthetic, spinal anesthesia, and/or intraarticular block. The EBP guideline recommends scheduled medications preoperatively and postoperatively. In the postoperative period, the EBP guideline recommends early mobilization. Project managers will implement the EBP guideline at an urban mid-western level one hospital. Progress of implementation and staff adherence to guidelines will be tracked electronically. Data will be collected in excel spreadsheets and evaluated.
Keywords: ERAS, TKA/THA, Evidence-based practice guideline
Routine Evaluation with Gastric Ultrasound to Reduce Gastric Aspiration (REGURGA)
Get PDFWhen a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this project was to develop evidence-based practice (EBP) guidelines for using point-of-care ultrasound (POCUS) of the stomach as a preoperative aspiration risk stratification tool. In addition to the primary aim, secondary objectives included developing a comprehensive plan to implement the guidelines as established, a comprehensive plan to monitor and measure the guidelines\u27 effect, and a comprehensive plan to adjust the guidelines if the outcomes are less than desirable. A literature search, review, and synthesis were conducted to establish the background of gastric ultrasound in anesthesia and to determine if the measurements were accurate. Guidelines were developed for theoretical implementation at a level-one trauma center in the midwestern United States. Following the implementation of the guidelines, a retrospective review will be conducted with measurement and analysis of outcomes, and adjustments will be made, if necessary, as described by the comprehensive adjustment plan. By using POCUS preoperatively, the risk of perioperative aspiration is reduced
14. Still Life without Fish (Fish Reappearing with Woman)
No full texthttps://digitalcommons.otterbein.edu/stichweh_fish/1013/thumbnail.jp
11. Doorways Opening into Mountain Landscape
No full texthttps://digitalcommons.otterbein.edu/stichweh_landscapes/1010/thumbnail.jp
12. Exotic Garden with Parrots and Moons
No full texthttps://digitalcommons.otterbein.edu/stichweh_landscapes/1011/thumbnail.jp
08. A Place for Aunt Jennifer\u27s Tigers to Prowl
No full texthttps://digitalcommons.otterbein.edu/stichweh_landscapes/1007/thumbnail.jp