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Doctor of Nursing Practice Projects

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https://ir.ua.edu/handle/123456789/7250
The DNP is a practice doctorate in nursing which prepares graduates to function at the highest level of nursing practice. The DNP curriculum includes development of a clinical practice project. This “DNP project” is designed to synthesize scholarship in an advanced nursing practice specialty or an area of health care leadership. Practice immersion experiences provide the context within which the project is completed. Students develop the project under the direction of a team, including program faculty, the student, the clinical advisor, the faculty advisor, and alumni mentors.

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Browsing Doctor of Nursing Practice Projects by Subject "Anesthesia"

Now showing 1 - 3 of 3
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    Examining Obstructive Sleep Apnea Risk and Changes in Oxygen Saturation in an Outpatient Endoscopy Center
    Parrish, Joseph; Cody, Shameka; Matthews, Joanne
    The significant increase in obesity, which is classified as a body mass index (BMI) greater than 30 kg/m² presents potential challenges in the field of office-based anesthesia. As obesity has become more prevalent in our society, the incidence of undiagnosed or untreated obstructive sleep apnea (OSA) and the associated comorbidities have increased. Purpose: The purpose of this project was to examine the changes between pre-procedural and post-procedural oxygen saturations among patients with moderate to high OSA risk. Methods: Participants (N=316) in the pre-procedural area were screened using the STOP-BANG questionnaire prior to receiving anesthesia. The participant’s STOP-BANG score (SBS) and pre-post procedural oxygen saturations were obtained and documented. Final data was obtained using a retrospective chart review. Results: More than half of the participants’ (59.8%; n=189) were identified as having a moderate to severe risk of OSA (Mean SBS=4, SD=1.05). There was a statistically significant reduction in mean oxygen saturations for participants with moderate to severe OSA risk from pre-procedural (M=97.2%, SD=1.76%) to post-procedural (M=94.2%, SD=3.48%); t (4) = 10.45, p < .001. Discussion: The clinical significance of the findings of this study reinforces the importance of screening all patients in the pre-procedural area to identify those at increased risk of OSA. This will allow referral to sleep specialists and provide evidence-based data that can be utilized by the anesthesia providers to update exclusion criteria identifying patients that are not appropriate for office-based procedures, with the goal of limiting potential adverse events.
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    Obstetric Epidural Time-Outs: Will this Promote Patient Safety and Improve Staff Communication? A Quality Improvement Project
    Stone, Lori K.; Wood, Felecia; Mitchener, Julie; University of Alabama Tuscaloosa
    Introduction: Anesthesia providers face daily challenges when caring for patients in non-operating room anesthesia (NORA) sites that require non-surgical, invasive procedures. The Joint Commission (TJC) also requires all “surgical and non-surgical invasive procedures” to have a completed safety checklist prior to starting the procedure. Purpose: The goal of this project was to investigate if an obstetric epidural time-out tool would promote patient safety and increase pre-procedure staff communication. Method: A quantitative study that assessed safety time-outs and an obstetrical epidural time-out tool on the Labor and Delivery room (LDR) unit at a community hospital in the Midwest. Results: A pre-intervention questionnaire and information session to launch the study tool were used to obtain a baseline understanding of safety time-outs. A post-intervention questionnaire assessed the OB RNs’ increased knowledge at the end of the study. The mean score of the pre and post questionnaire improved from 74.6% to 80%. The 6-week study evaluated the overall completion percentage of the time-out tool. Of the 53 tools returned out of 113, there was an 87.812 mean compliance rate that had 100% of the 10-check boxes completed. Discussion: Non-surgical invasive procedures are performed in various areas of the hospital. The LDR unit should also adhere to TJC’s safety standards during epidural placement.
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    Pediatric Anesthesia Emergence Delirium Scale Quality Improvement Project and Retrospective Chart Review
    Bakker, Melissa Gayle; Owings, Clara; Langford, Patsy
    Pediatric anesthesia emergence delirium (PAED) is a prevalent postoperative occurrence in a complex patient population. Presentation can manifest in school-aged children as disorientation, confusion, agitation, hallucinations, hypersensitivity, irritability, inconsolability, hyperactive physical behavior, emotional lability, and inconsolable crying. The unpredictability and variable presentation require prompt recognition by staff. The PAED scale developed by Sikich, N. & Lerman (2004) is the most reliable in diagnosing pediatric emergence delirium (PED). Implementation is underutilized postoperatively. Application of the PAED scale in the perioperative setting is not considered standard of care; however, given the potentially harmful outcomes to patients, staff, and family members, utilization may be instrumental in postoperative management. Preventative measures and techniques continue to evolve in research; some have been successful but inconclusive. The aim of this project was a quality improvement pilot study to assess the probable rate of PED, provide recommendations on whether to implement an appropriate assessment scale and provide up-to-date anesthesia perioperative guidelines for PED. A retrospective chart review examined the probable rate of PAED over the last year. Further analysis and evaluation of the anesthetic techniques and potential triggers were assessed. Recommendations for scale implementation and preventative measures for anesthesia were constructed.