Evidence-based Peer Support Guidelines for Second Victim Nurse Anesthetists

A critical event or critical incident is an unexpected situation that results in a negative patient event or poor patient outcome. The patient is the primary victim. However, the healthcare worker involved in this patient’s care becomes the second victim. Second victims are negatively impacted mentally and physically by adverse events that can further compromise patient safety. These events can precipitate feelings of guilt, depression, and physical ailments that can result in higher hospital rate turnover. Many certified registered nurse anesthetists have become second victims in the United States. Despite how such critical incidents negatively affect healthcare providers, patients, families, and institutions, there remains a gap in resources available to help these second victims. This Doctor of Nursing (DNP) practice project focuses on the development of a quality improvement project such as evidence-based guidelines related to peer support for helping second victims during recovery

The Civil War Diary of Sarah Butler Wister

From April 15, 1861, to September 4, 1861, Sarah Butler Wister, daughter of actress Fanny Kemble and member of the Wister family, kept a diary that detailed the events of the Civil War and her views on the matter. Over the course of the five-month long diary, Sarah introduces a multitude of people connected to both her personal life and the ongoing war while keeping track of the war’s events and the news cycles that soon followed. While the diary ends abruptly, we know that years later excerpts from it were published with the diarist’s permission by her mother.https://digitalcommons.lasalle.edu/people_places/1018/thumbnail.jp

Evidence-Based Teaching Plan on Implementing LAST (Local Anesthetic Systemic Toxicity) Response Protocol

Local anesthetics are widely used in practice to control patients’ pain; however, local anesthetic systemic toxicity (LAST) is a potentially fatal risk factor that may occur after local anesthetic administration. Evidence-based education for providers could prevent the deaths of patients by increasing knowledge of pathophysiology, identifying varying signs and symptoms of local anesthetic toxicity, and implementing timely treatment. This doctoral project created an evidence-based teaching plan to educate perioperative providers on how to identify and more effectively respond to LAST

Evidence-Based Educational Module on Management of Multi-Modal Analgesia for Perioperative Providers

Inadequate perioperative pain management and reliance on opioids postoperatively has been associated with poor short- and long-term patient outcomes. A focus on provider education related to effective multimodal therapy preoperatively is essential to direct care for optimal postoperative patient outcomes

Creation Of An Evidence-Based Cognitive Aid To Decrease Anesthesia-Related Adverse Respiratory Events In Non-Operating Room Areas Within Hospital Settings

The administration of anesthesia outside traditional operating room settings is a rapidly expanding practice that enables various procedures to be performed in non-operating room environments. Despite this growth, anesthesia providers face challenges due to the increasing complexity of cases, diverse patient comorbidities, production pressures, unfamiliar environments, and limited resources in emergencies, all of which greatly compromise patient safety. This Doctor of Nursing Practice project aims to identify essential components for a cognitive aid to support anesthesia providers in these non-operating room settings

Development of a Resilience Program to Combat Burnout in Nursing Practice

Burnout has been identified as a national health crisis, with implications for the retention and health of critical healthcare workers. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the United States. Understanding resilience and how to foster it in nurses will contribute to burnout prevention and consequently improve the quality of health care provided Americans. Resilience training has been identified as a valuable approach to retention of the workforce. This scholarly project developed a resilience training program for newly licensed registered nurses (NLRN) to promote awareness of self-care behaviors and healthy responses to counteract stress and promote a culture of safety. The program teaching plan\u27s content was evaluated by a panel of experts to establish individual and scale level validity. The program was introduced into the curriculum of an existing Nurse Residency Program seminar and training was completed by twenty-five participants. Using the Connor-Davidson Resilience Scale, a statistically significant difference in reported resilience was evident after participation in resilience training. Introduction of resilience training in a nurse residency program positively impacts resilience development with potential to promote burnout prevention

Effectiveness of an Instructional Program on Decreasing Fall Incidents in Geriatric Patients with Psychiatric Disorders

Falls occur in 25% of older adults, resulting in over 8 million fatal and nonfatal injuries. In addition to the human suffering, associated medical and legal costs amount to over 50 billion dollars a year. This study examines the impact on fall rates of an evidence-based fall prevention program provided to a multidisciplinary staff on a psycho geriatric unit in Philadelphia, Pennsylvania. Staff knowledge of effective fall prevention interventions was measured before and after their participation in an evidence-based instructional workshop provided by the Project Director using the Falls Prevention Knowledge Test by Dykes et al. (2019). While there were not statistically significant differences in levels of knowledge about fall prevention, the actual number of falls decreased. Implications of findings for discipline-specific and future fall prevention efforts are discussed

Performance Improvement Project Implementing Rapid Cycle Deliberate Practice Simulation to Improve Team Performance During Administration of Moderate Sedation by Non-Anesthesia Providers in the Interventional Platform

A steady increase in procedures in interventional platforms has required the administration of moderate sedation and analgesia by non-anesthesia providers. Of concern is managing the delicate balance between different levels of sedation on a continuum to ensure safe and effective care. Moderate sedation achieves suppression of consciousness while maintaining a patent airway and intrinsic respiratory drive compared to deep sedation where airway patency and respiratory function can be compromised. Administration of moderate sedation by non-anesthesia providers in interventional platforms leads to a higher rate of procedural complications. Rapid Cycle Deliberate Practice (RCDP) simulation will be utilized to educate non-anesthesia providers and to develop their crisis resource management (CRM) skills. The purpose of this performance improvement project is to implement a rapid cycle deliberate practice simulation training for non-anesthesia providers administering moderate sedation in interventional platforms to improve crisis resource management skills as determined by current evidence-based practice (EBP)