Discharge Lounge Utilization

Efficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative findings reveal various operational barriers and staff perspectives influencing hospital throughput. This project contributes to a better understanding of the complex factors impacting hospital throughput and provides insights for improving healthcare delivery processes to enhance patient flow and alleviate overcrowding in emergency departments

Emotional Intelligence and SRNA Success Utilizing a SIM Experience

Student registered nurse anesthetists (SRNAs) face many challenges in meeting the rigorous demands of their doctoral-level training. Research demonstrates that high levels of emotional intelligence (EI) contribute to SRNAs’ academic and clinical success and improve patient safety and quality of care. Simulation is emerging as an educational tool to enhance the EI skills of students training in highly stressful professions and demonstrates promising benefits for SRNAs, such as improved decision-making, critical thinking, self-awareness, and self-regulation (Moriber & Beauvais, 2017; Dix et al., 2021). This doctoral project aimed to determine the efficacy of a high-fidelity simulation for strengthening the EI skills of first-year SRNAs at a mid-sized university in the Midwestern United States in preparation for their first clinical rotation. The students completed an introductory session presented by an EI expert and four active learning sessions presented by two second-year SRNAs. The students then divided into groups and participated in a clinically relevant high-fidelity simulation designed to elicit authentic emotions, followed by debriefing. EI levels were evaluated by comparing pre- and post-intervention Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) scores, and surveys collecting subjective data were distributed after the students completed the simulation and their first clinical rotation. MSCEIT results did not reveal any measurable, statistically significant increases in EI abilities; however, survey feedback was positive overall and indicated that the simulation improved students\u27 self-perceived abilities to respond to challenging clinical situations

Melting Premenstrual Dysphoric Disorder/ Premenstrual Exacerbation Symptoms with Metalsmithing: A Group Process

People experiencing Premenstrual Dysphoric Disorder/Premenstrual Exacerbation, PMDD/PME, frequently live with debilitating symptoms that can arrest their daily life functions (Barker-Smith, 2020). Finding art to process and transform painful emotions that align with PMDD/PME hormonal depression/anxiety, may assist in supporting people to keep choosing life, especially when these art practices involve group settings and community artmaking (Phillips & Rosal, 1989; Robb, 2022). Metalsmithing requires significant cognitive awareness and promotes mind/body connections in its elemental art form (Carlson, 2015). This proposal outlines a group process involving 8-12 people who will receive a beginner’s metalsmithing, 12-week studio art program at Hyde Park Arts Center in Chicago, IL. The total cost (including the final film: $2,500) =$27,797. Video documentation and artist journals will collect data from group participants. A final film edited by the researcher will be shared with a broader online community, to inspire hope for people with PMDD/PME who may be surviving alone. This project desires to carry an impact in that the physical light of fire refines the metal and symbolically one’s heart/mind through human connection

Increasing OB/GYN Clinic Nursing Staff Knowledge and Comfort Level in Providing Breastfeeding Education

There are well known benefits of breastfeeding for both mother and child, yet the educational support from providers during prenatal visits is not consistent or well-documented. An educational presentation discussing guidelines of breastfeeding education, common breastfeeding problems and barriers to breastfeeding was developed and presented to a “Baby Friendly” hospital-based OB/GYN clinic staff at an urban St. Louis hospital. The goal was to increase staff knowledge and comfort providing education and resources surrounding breastfeeding to be used to increase discussion of breastfeeding during prenatal and postpartum visits. Evaluation of pre and posttest data showed an increase in knowledge regarding managing breastfeeding concerns and level of comfort providing education. The project succeeded in showing a need for increasing OB appointment time slots at implementation site to allow adequate time for breastfeeding education opportunities

Hepatitis C Management for Individuals in Custody

The hepatitis C virus (HCV) is a pathogen that spreads through blood and causes hepatitis C disease, a liver infection. Early infection symptoms are rare, making it a silent killer. HCV, the chronic liver disease accounts for half of all hepatocellular carcinoma cases and is the leading cause of liver transplantation in the US. This quality improvement project aimed to create an educational toolkit for the Department of Correction staff working with individuals in custody refusing HCV treatment. The education tools comprised an infographic flyer (English and Spanish) to teach individuals in custody about HCV treatment and a PowerPoint presentation to educate staff who work with this population on how to deal with HCV treatment refusals. The total number of nurses who participated in the intervention was 15, and 100% of them completed the post-survey. Statistical analysis showed that 86.6% of the participants (n=13) strongly agreed that the presentation provided a clear understanding of risks associated with incarceration and HCV, including the impact of untreated HCV. Participants were asked to score their confidence level to assess the effect of the presentation based on the knowledge received; 73.3% of the participants (n=11) felt confident in their knowledge of strategies to address HCV treatment refusals in this population, although only 46.6% (n=7) reported they would be making changes to their current practices as a result of the presentation

Promoting the Incorporation of Regional Anesthesia to Improve Pain Management for Lower Extremity Surgeries

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint presentation was provided for the surgical perioperative personnel and anesthesia providers in July 2023. Pre- and post-presentation surveys were distributed to evaluate knowledge gained from the educational presentation. It was noted that there was a significant improvement between the pretest and posttest scores, indicating an increased understanding of the benefits of popliteal nerve blocks and the resultant reduction of opioid use and improved pain control. The results positively impacted the implementation of a popliteal block protocol and provided education for its use. Utilization of the popliteal block protocol could potentially reduce opioid administration for pain control of patients undergoing foot and ankle surgeries. As a result, it improves patient satisfaction, reduces the length of hospital stays, and reduces patient and institutional costs

Implementing an Insomnia Assessment and Management Algorithm in a Rural Pirmary Care Clinic

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in a rural primary care clinic in central Illinois. The project was implemented starting with a CME provider presentation surrounding researched-based treatment guidelines for insomnia management. An Epic “smart phrase” was created to be utilized in provider notes to guide management. Additionally, patient/provider resources were developed to support the algorithm. A direct referral was facilitated to a clinical psychologist for CBTi for patients with chronic insomnia. There was a 15% increase in Sleep Medicine referrals from the previous year during the same time interval and four direct referrals for CBTi for patients with severe insomnia. Providers noted that they found the education meaningful and adapted recommendations to their practice. The project benefited both providers and patients by delivering safe and efficient care for the substantial number of patients who experience chronic insomnia

Ca2+ binding shifts dimeric dual oxidase\u27s truncated EF-hand domain to monomer

Hydrogen peroxide, produced by Dual Oxidase (Duox), is essential for thyroid hormone synthesis. Duox activation involves Ca2+ binding to its EF-hand Domain (EFD), which contains two EF-hands (EFs). In this study, we characterized a truncated EFD using spectrometry, calorimetry, electrophoretic mobility, and gel filtration to obtain its Ca2+ binding thermodynamic and kinetics, as well as to assess the associated conformational changes. Our results revealed that its 2nd EF-hand (EF2) exhibits a strong exothermic Ca2+ binding (Ka = 107 M−1) while EF1 shows a weaker binding (Ka = 105 M−1), resulting in the burial of its negatively charged residues. The Ca2+ binding to EFD results in a stable structure with a melting temperature shifting from 67 to 99 °C and induces a structural transition from a dimeric to monomeric form. EF2 appears to play a role in dimer formation in its apo form, while the hydrophobic exposure of Ca2+-bound-EF1 is crucial for dimer formation in its holo form. The result is consistent with structures obtained from Cryo-EM, indicating that a stable structure of EFD with hydrophobic patches upon Ca2+ binding is vital for its Duox\u27s domain-domain interaction for electron transfer

Mentorship Program Including Alumni

The landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program\u27s impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and a mandatory interaction schedule