Via Sapientiae: The Institutional Repository at DePaul University
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Playing Darts Blindfolded: A Quasi-Experimental Study on CRNAs and SRNAs Knowledge on Pre-Procedural Ultrasound for Neuraxial Anesthesia
No full textPre-procedural ultrasound is an emerging technique among anesthesia providers to increase procedural efficiency and safety of neuraxial procedures on patients with increased technical difficulty. The use of pre-procedural ultrasound in neuraxial anesthesia among certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) has not been previously described. This study examined the efficacy of an educational intervention on CRNAs’ and SRNAs’ knowledge and future intent to use pre-procedural ultrasound to identify lumbar intervertebral spaces. We utilized a pre-and post-test design with convenience sampling. This study demonstrated a statistically significant improvement in the participants’ knowledge in four out of seven question pairs. One question pair had the majority of the participants answer correctly on both pre and post- tests thus no statistical improvement was observed. Two question pairs did not show enough statistical improvement between pre-and post-test scores. A McNemar test (p\u3c0.05) was performed on all knowledge-based questions, which indicated that our educational video improved the participants’ knowledge. Seventy-six percent of the participants indicated that they intend to use this technique after viewing the educational video. One of the most prominent barriers to implementation among CRNAs and SRNAs was the lack of knowledge of ultrasound use. Most of the participants did not have formal ultrasound training during their anesthesia education. Many obtained their ultrasound knowledge and skills through other resources. Approximately half of the participants found pre-procedural ultrasound useful in their neuraxial practices. It is recommended that nurse anesthesia programs develop more robust ultrasound training to ensure that nurse anesthesia residents are graduating with this emerging critical skill
Examining Certified Registered Nurse Anesthetists’ Perspective on the Utilization of Regional Anesthesia in Outpatient Orthopedic Surgery
No full textRegional anesthesia has played a significant role in the reduction of perioperative opioid consumption while still providing high-quality analgesia, making it a fundamental practice in outpatient orthopedic surgery. The purpose of this study was to qualitatively examine the experiences and perspectives of CRNAs surrounding the utilization of regional anesthesia in outpatient orthopedic surgery. A qualitative study design using semistructured interviews was conducted (N =14). Study participants described their current practices and experiences with regional anesthesia utilization in the outpatient orthopedic surgery setting. In particular, four themes describing factors that promote CRNAs’ utilization of regional anesthesia for outpatient orthopedic surgery emerged: 1) employment selection, 2) institutional factors, 3) practice variation, and 4) policy change. Overall, CRNAs felt strongly about implementing regional anesthesia techniques in this patient population due to consistent experiences with its positive impact on patient outcomes. CRNAs expressed the desire to perform regional anesthesia, allowing them to practice to the full scope of their education and training, which ultimately impacted their choice of employment. However, there are several barriers on an institutional, organizational, and systemic level that prevent the universal utilization of regional anesthesia by CRNAs, leading to practice variations that inhibit equitable, efficient care delivery. This study highlights the importance of the universal utilization of regional anesthesia by CRNAs and the necessity for advocacy efforts to alter unnecessary restrictive policies and barriers, ultimately improving inequities in healthcare
A Systematic Review Examining the Efficacy of Existing Child Abuse Screening Tools Used in the Emergency Department
No full textChild abuse and neglect is a major health problem in the United States and has lasting and detrimental effects. This review examines the screening instruments that are in existence today to detect child maltreatment. The instruments are compared and evaluated for their feasibility of use in an emergency department setting.
Four electronic databases were searched to identify screening instruments that assessed for child physical, emotional, and sexual abuse and neglect. The following subject heading keywords were used: ‘child abuse or child maltreatment or child mistreatment or child neglect or child sexual abuse or non-accidental trauma or head trauma or battered child syndrome or shaken baby syndrome or Munchausen syndrome’ and ‘screening or instrument or tool or questionnaire’ and ‘emergency department or emergency room’.
Six instruments (one with multiple versions) met the inclusion criteria. Variation among the instruments included the number of questions, scoring method, target demographics, and type of injury/abuse. The psychometrics of each screening instrument were examined and included the study that tested each tool, study setting, the instrument name, type of study design, sample size, sensitivity and specificity (if calculated), and whether or not a reference standard was used.
It can be concluded that there is not one standardized, validated, and comprehensive screening tool that exists to accurately detect child maltreatment in a United States ED. Although a screening tool that can successfully screen for all types of abuse does not exist, there is something to be learned from each tool. A new screening tool needs to be created in order to most accurately diagnose child maltreatment
Invisible in Plain Sight: A Qualitative Analysis of The U.S. Public Health Service Syphilis Study and Contemporary Issues of Iatrophobia in Black Women
Get PDFThe U.S. Public Health Service Syphilis Study (USPHSSS) is the nation’s most infamous example of biomedical misconduct in the United States. Using the wives and the descendants of the USPHSSS as a case study, this project examines and conceptualizes how the lack of healthcare access and secondhand healthcare the wives and descendants received has had a cumulative impact on Black women and contemporary iatrophobia, using a Black feminist ethical and constructivist theoretical framework. Findings reflect two major themes for contemporary iatrophobia: systemic racism and what Muhjah Shakir terms the cultural constellation of silence
She Was There Too: Enslaved Black Women, Agency, and Community
Get PDFRarely are the experiences of enslaved women prioritized in studying the history of enslavement in the United States. This is particularly true in relation to how black women experienced, survived, and carved out agency in the face of sexual violence. Rather than acknowledge the strength demonstrated by these women, contemporary historiography relegates them to the position of victims. This research intervenes in this practice and argues that enslaved women worked hard to create agency for themselves in the face of sexual violence from those that enslaved them. More specifically, it argues that the presence of a community of other enslaved women determined the ways in which a woman was able to demonstrate sexual agency, retaliate against a sexual aggressor, and the way in which moral codes were constructed.
This research is done through a black feminist theoretical framework for the purpose of prioritizing black women’s voices and the centrality of relationships to other black women in navigating oppressive systems. A textual content analysis is utilized to approach the primary texts that are relied on within the research. Phenomenological methodology is utilized within the research in order to capture the reality of black women’s experiences with sexual violence and creating agency
Calladita No Te Ves Más Bonita: Cultural Practices within Latina Women’s Advocacy
No full textHistorically, Latina women-led advocacy groups have faced significant underrepresentation within academia, leading to an erasure of their experiences and contributions. For this reason, it is imperative to take on a thorough analysis that respects the nuances of Latina women\u27s advocacy. In recognizing how their identities enable them to bring about meaningful change, we see the Latina woman\u27s role as an agent of advocacy. Therefore, this exploratory research study investigates the incorporation of cultural practices within two Latina-led organizations in Chicago, Amigas Latinas, and Mujeres Latinas En Acción, from the mid-20th century to the present. I employ Anita Tijerina Revilla\u27s Muxerista framework to perform a culturally sensitive textual analysis of oral histories, ephemera, photographs, and other material culture to highlight areas of advocacy that appear instructive for other contemporary social justice causes. In the end, it is within the realm of social justice and reclamation of cultural practices that Latinas oppose systemic discrimination in a civic conscious, inclusive, supportive manner that works to reshape who and what we consider in our conception of advocacy
Athletics
Get PDFDePaul University women’s tennis player Yuliya Kizelbasheva participates in Be The Match, an organization that finds stem cell and marrow donors for people with life-threatening blood cancers. DePaul senior Noelle Malkamaki wins gold in the Paralympic shot put competition. DePaul Athletics reframes its mission
Time-Inconsistent Preference in Booking Hotels: Role of Quasi-Hyperbolic Discounting in Booking Timing and Price Options Change Over Time
Get PDFIn hotel booking decision-making, consumers must incorporate booking timing and cancellation policy with different price options to deal with uncertainty in the upcoming travel and their utilities that aggregate spending and enjoying on the hotel booking. To fill the gap in the literature that omitted the consumers’ time-inconsistent booking behavior over time and the mechanisms behind booking decisions and timing decisions, this study investigates consumers’ preference between two price options related to cancellation over time and their preferred booking timing. Quasi-hyperbolic discounting model in behavioral economics is applied to explain time-inconsistent behavior by lab experiment