Browsing by Title

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    Active Learning in Nurse Anesthesia Didactic Education
    ( 2022) Giffin, Rice ; Sweet, Caala
    Active learning is an innovative pedagogical approach to teaching where instructional methods other than lecture allow students to become active participants in their education during didactic sessions. Many disciplines within graduate-level medical and healthcare education report positive outcomes with active learning implementation; however, a gap in the literature exists regarding nurse anesthesia educators' understanding and use of active learning in the didactic setting. An online anonymous survey, including demographics, qualitative questions, and ordinal quantitative questions, was performed by the American Association of Nurse Anesthetists. Data analysis revealed how nurse anesthesia didactic faculty were implementing active learning prior to and after the COVID-19 pandemic began, with frequency distribution for the pre-pandemic period, and an assessment for pandemic-induced modifications to active learning strategies/implementation. Study findings included quantitative evidence on the implementation of question and answer, computer-based interaction systems, peer-teaching, formative quizzes and surveys, cooperative learning, case studies, application activities, and cooperative case work. Qualitative analysis demonstrated methods prior to the pandemic closely aligned with this evidence, while exhibiting varying degrees of student involvement. Continued analysis showed many nurse anesthesia educators had attempted to adapt active learning techniques/implementation due to pandemic-induced teaching restrictions and that most of those educators did not previously have methods in place to ease the transition. The implications of this study are profound when the concept of engagement is considered, where engaging students is constructing knowledge, allowing for further discussion and exploration, enhanced implementation, and future innovations in active learning within nurse anesthesia didactic education.
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    Adriatic Sea
    (Yale University Press, 1992) Stefanović, Zdravko
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    Advancement of the Nursing Honor Society and Development of Sigma Theta Tau Internatioinal Chapter at Adventist University of Health Sciences
    ( 2015) Tucker, Ffion ; Silas, Blessy
    The Honor Society of Nursing, Sigma Theta Tau International (STTI), was founded by six nurses from Indiana School of Nursing, Indiana, in 1922. The purpose or mission of the STTI is to assist the learning, knowledge and professional advancement of nurses devoted to making a difference in global healthcare. The Adventist University of Health Sciences (ADU) established the Nursing Honor Society (NHS) in 2013 and is in the process of becoming a chapter of STTI. The ADU honor society has already completed the first two phases of STTI chapter development and is now operating in the third phase. The process of establishing an STTI chapter at ADU was started in 2012 by two nurse anesthesia students from the class of 2013 and was followed by another student from the class of 2014 who helped the chapter to proceed into the third phase. The goal of this project was to advance this chapter to its next phase and recruit needed members (50) to apply for the STTI chapter. This project needed to be done in order to help promote the NHS and to build membership so that the goal of achieving STTI status can come to fruition. This was necessary so that the mission of ADU and the STTI to build healthcare and advance nursing professional excellence can continue to be met, not only in the Florida Hospital community and its environs, but also globally. Advancing the ADU NHS to STTI chapter would be a great achievement and would provide for inter professional collaboration on an international level. This project has implications for nurse anesthesia practice in that membership by the nurse anesthesia students will deepen the roots of education by providing continuing education in the form of conferences, meetings, and online or in journal articles, and encourages growth by improving the leadership skills. These organizations will help nurses learn the refined values and priorities that are not learned from the classroom. It is of vital importance to help cultivate in these nursing professionals, soon to be CRNA’s, the drive to always strive for excellence and to align themselves with certain organizations that can help to facilitate this growth and development. This growth and development of leadership skills along with the continued drive for excellence by these student nurse anesthetists can also transcend into the work place and affect anesthesia practice.
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    Anesthesia Care Implications of Paragangliomas and Pheochromocytomas
    ( 2017) Pak, Soomee ; Nielsen, Mignon
    Pheochromocytomas (PHEO) and paragangliomas (PGL) are rare conditions that an anesthesia provider may or may not encounter in his or her career. However, due to the life-threatening nature of these conditions and the critical anesthetic implications in the perioperative periods, the authors deemed it a must to present a lecture to the group of student registered nurse anesthetists (SRNAs) at Adventist University of Health Sciences. The educational lecture was provided with the goal of bridging the SRNAs’ knowledge gaps regarding PHEO and PGL in general, and of helping them to be more familiar with PGL in particular. A convenience sample of 34 SRNAs was utilized after informed consents were obtained. For the purpose of analyzing the effectiveness of the PowerPoint lecture, the pre-test and post-test scores were compared. A paired t test revealed p value of < 0.05, affirming the statistical significance. The pre-test scores had shown the lack of knowledge in general, as evidenced by the low average test scores (3.47/11). The mean post-test scores (6.32/11) were definitely improved after the lecture, albeit the average was still less than optimally anticipated.
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    Anesthesia Requirements for Redheads
    ( 2016) Classon, Nathan
    As the melanocortin-1 receptor gene was not discovered until 1995, only anecdotal observation supported that redheads had an increased anesthetic requirement. Utilizing relatively recent research, this project aimed to enhance the knowledge regarding the anesthetic requirements for redheads among student registered nurse anesthetists (SRNAs). Interestingly, there was a decided perspectival shift in the opinion of literature reviewed between 2004 and 2015. Earlier studies were supportive of an increased anesthetic requirement of redheads, while more recent studies discouraged such an approach. It is possible that the later studies relied on self-reported hair phenotype, rather than analysis of genetic makeup of the MC1R genotype. Given this, it is plausible that there is a significant difference in the anesthetic requirements of redheads, depending on whether they are homozygous, heterozygous, or compound heterozygous. Therefore, current literature was reviewed, synthesized, and presented simultaneously to two cohorts of SRNAs at Adventist University (ADU). The project’s efficacy was determined by comparing the scores of an identical pre- and post-test.
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    Anesthetic Implications for Implanted Cardiac Devices in Patients Undergoing Non-Cardiac Surgery
    ( 2018) Saladino, Brittni ; Tulenko, Valerie
    A scholarly project presentation for Anesthetic Implications for Implanted Cardiac Devices in Patients Undergoing Non-Cardiac Surgery was executed to the Adventist University of Health Sciences Nurse Anesthesia Program Student Registered Nurse Anesthetist (SRNA) cohorts of 2018 and 2019. This particular project and topic was of interest because there was a noticeable deficit in understanding regarding anesthetic management of implantable cardiac device education in the Nurse Anesthesia Program. The objective of this project was to enhance the knowledge base for future clinical encounters. After obtaining informed consent, a completely anonymous pre-test was administered to the research subjects. The researchers then provided a research-based PowerPoint presentation. After the presentation, an anonymous post-test was given. The researchers aimed to see evidence of enhanced baseline knowledge by observing an increase in mean scores from the pre-test to the post-test. The presentation, was, in fact, effective, as there was in increase in mean scores of 34.18% on the pre-test, to an average of 76.83% on the post-test. The conclusion can be drawn that the researchers were successful in their aim to increase knowledge base in this population, and the method of a PowerPoint presentation was effective at achieving the goal.
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    Anesthetic Implications of Obstructive Sleep Apnea (OSA) in the Adult Population
    ( 2018) Burrington, Jeffery ; Stanga, Joseph
    The intent of this project was to assess the student nurse anesthetist’s level of understanding on the anesthetic implications of patients with obstructive sleep apnea (OSA). The researchers aimed to educate this cohort on the best evidence-based practice in managing patients with OSA. There is a very high correlation between OSA and increased body mass index (BMI). As the prevalence of obesity rapidly rises in the United States, health care clinicians find themselves caring for more patients with OSA. Due to the increased prevalence of OSA, it is imperative that new clinicians have a sound knowledge of the comorbidities and the anesthetic implications that are directly related to this disease. The literature review revealed that OSA is largely under diagnosed. The literature also revealed common strategies that should be implemented perioperatively to reduce post-op complications in this specific group of patients. Research indicates that patients with OSA may be more sensitive to opioids, thus should be used sparingly. Another focus of this project was to improve screening for OSA and to better manage their anesthetic care. A pretest was administered to the participants before an educational presentation, then a posttest after the presentation was completed to measure the increase in knowledge. The pre-and posttests were graded and the statistics were analyzed utilizing a paired t-test. From the data, the researchers determined the t value is -13.347 (p < .001) which is statistically significant. Therefore, it can be concluded that there is a significant increase in the mean percentage values between pre-test and post-test.
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    Another Plan for Daniel’s Book: A Proposal
    (Universidad Peruana Union, 2015) Stefanović, Zdravko
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    The Aramaic of Daniel in the light of Old Aramaic
    (JOST Press, 1992) Stefanović, Zdravko
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    Are Cannabinoids Effective in Treating Non-Malignant Chronic Pain in Adult Patients
    ( 2018) Luk, Kenneth W. ; Tokash, Terry L.
    A large component of anesthetic practice incorporates pain management, and a growing contingency of patients whom anesthesia providers encounter each day have chronic pain. Multimodal pain regiments and their use in the management of chronic pain in adults have increased as a result. One alternative that has shown potential for pain management is cannabinoids, which work through the endocannabinoid system (ECS). With the legalization of medicinal marijuana in Florida, an increased knowledge base is needed to better drive care. A literature search of CINAHL, PubMed, Cochrane Databases, MEDLINE, and Google Scholar was done to discover the current knowledge of cannabinoids in treating chronic, non-malignant pain. There have been mixed results as to the efficacy of cannabinoids in this population, but they are well tolerated with rare serious adverse effects. A 30-minute presentation was created to better familiarize the master’s level Nurse Anesthesia Program’s students enrolled at AdventHealth University (AHU) with the current findings. A ten-question evaluation was conducted before and after the PowerPoint presentation. The results were analyzed using a paired sample t-test with a predetermined significance level of p<.05 using Statistical Package for the Social Sciences (SPSS). The pre-test mean was 26.19% and post-test was 55.24%. With a pvalue < 0.001, statistical significance was achieved, demonstrating the efficacy of the educational module in expanding the knowledge base of current AHU student nurse anesthetists regarding the use of cannabinoids in the treatment of chronic, non-malignant pain.
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    Assessing Information Literacy Skills and Library Anxiety of First-year Occupational Therapy Graduate Students
    ( 2021) Moghimi, Christine ; Rickelman, Mary C.
    In today’s academic environment, students equipped with self-regulated learning and information literacy (IL) skills have an excellent opportunity for professional success given the current information-based practices in health care. Purposefully providing IL instruction to students early in their coursework will help them develop competent research skills applicable to their remaining studies and scholarly projects. Along with IL challenges, students can experience “library anxiety,” which the literature identifies as a contributing factor to poor academic performance. This study explored components of library anxiety in Master of Occupational Therapy (MOT) students and identified opportunities for IL training that could help students become more confident and proficient in analyzing research publications. The study was embedded in a class assignment, that had the students, in small groups, connect with a university librarian for a one-hour research consultation and review of library resources. Participants in the study completed a pre- and post-survey of 17 questions utilizing a 4-point Likert scale. The results indicated that the students experienced significant positive change in their confidence level with utilization of research tools. Results also showed that students had increased comfort in seeking help while using the university library. The study suggests that the students’ ability to find and assess quality research material will only improve with practice. Despite the availability of new technology that does not necessitate human contact to facilitate research, face-to-face interactions are the most effective mode of communication for questions that are involved and complex, such as graduate students’ scholarly projects.
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    Assessing the Spatial Pattern of Iron in Well Water from a Small Central Florida Community
    (Journal of water and health, 2018-02) Hudgins, Jason ; Lambert, Nicholas ; Duranceau, Steven ; Butler, J. Russell
    Iron is one of the most common elements in the Earth's crust, which corresponds to it being a common constituent in drinking water supplies. Residents of Bithlo, an unincorporated community in east-central Florida, have observed that their drinking water tastes like metal and stains clothing and teeth. An evaluation of water samples collected from over 200 private drinking water wells revealed iron concentrations that exceeded the US Environmental Protection Agency's (EPA's) secondary standard of 0.3 mg/L. Households with and without point-of-entry treatment were found to have over three times (0.92 mg/L) and ten times (3.86 mg/L) more iron than the EPA's secondary standard, respectively. The human health-based threshold of 4.2 mg/L established by the Centers for Disease Control and Prevention was exceeded in 38.6% of untreated residences. Community-wide statistical and spatial water-quality trends were developed by combining the collected well water quality data with historically available water quality reports. Spatial analyses revealed that greater than 99% of the Bithlo community's private household supplies would exceed the EPA's drinking water secondary standard.
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    Assessing therapeutic communication during rehabilitation: The Clinical Assessment of Modes
    ( 2016) Fan, Chia-Wei ; Taylor, Renee R.
    OBJECTIVE. This study applied Rasch analysis to test four versions of the Clinical Assessment of Modes (CAM), an assessment based on Taylor’s Intentional Relationship Model: CAM–P, which assesses clients’ pretreatment preferences; CAM–E, clients’ treatment experience; CAM–T, therapists’ self-reported perspective; and CAM–O, an observer rating scale. METHOD. The CAM–P was administered to 63 inpatients. The CAM–E was administered to 110 inpatients and outpatients. Trained raters rated therapists’ modes with 59 inpatients and outpatients on the CAM–O. The CAM–T was administered to 38 therapists. Analyses of reliability and validity were conducted. RESULTS. The CAM demonstrated adequate construct validity. All versions showed acceptable internal consistency and unidimensionality within each of the subscales. Disorder between the 5 points on the ordinal rating scale was found for the client measures (CAM–P, CAM–E) and was resolved by modifying the ratings to encompass a 4-point scale. CONCLUSION. The four CAM versions are reliable and valid measures of therapeutic communication in rehabilitation.
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    Assessment and Management of the Opioid Tolerant Patient During the Perioperative Period
    ( 2015) Rauch, Karla ; Bautista, Claire
    Currently, management of chronic pain patients in a perioperative setting continues to be a challenge for every anesthesia provider. The challenges faced include opioid-induced hyperalgesia, patient satisfaction with their pain control, prevention of long-term disability, and issues of delayed mobilization due to uncontrolled pain. These challenges may occur due to under medication or lack of balanced analgesia techniques. Conversely, overmedication can lead to postoperative respiratory insufficiency with prolonged ventilator dependence and associated complications increasing length of hospital stay. These challenges are complicated for experienced providers; therefore, student registered nurse anesthetists (SRNAs) beginning their clinical rotations will find managing these patients an even greater challenge. The goal of this project was to provide tools for use in the care of patients with chronic pain. Tools that were provided included introducing the new SRNA to an in-depth preoperative pain assessment, a thorough understanding of the pathophysiology of acute and chronic pain development, dosing and regimens of analgesic adjuncts to be utilized concomitantly with opioids, and the use of equi-analgesic opioid dosing to plan appropriate interventions to improve the future health of their patients. Case scenarios were discussed to emphasize multimodal analgesia techniques to reduce the negative side effects of a pure opioid analgesia technique.
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    Atypical Mitogen-activated Protein Kinase Phosphatase Implicated in Regulating Transition from Pre-S-Phase Asexual Intraerythrocytic Development of Plasmodium falciparum
    (Eukaryotic Cell, 2013) Balu, Bharath ; Campbell, Christopher ; Sedillo, Jennifer ; Maher, Steven ; Singh, Naresh ; Thomas, Phaedra ; Zhang, Min ; Pance, Alena ; Otto, Thomas D. ; Rayner, Julian C. ; Adams, John H.
    Intraerythrocytic development of the human malaria parasite Plasmodium falciparum appears as a continuous flow through growth and proliferation. To develop a greater understanding of the critical regulatory events, we utilized piggyBac insertional mutagenesis to randomly disrupt genes. Screening a collection of piggyBac mutants for slow growth, we isolated the attenuated parasite C9, which carried a single insertion disrupting the open reading frame (ORF) of PF3D7_1305500. This gene encodes a protein structurally similar to a mitogen-activated protein kinase (MAPK) phosphatase, except for two notable characteristics that alter the signature motif of the dual-specificity phosphatase domain, suggesting that it may be a low-activity phosphatase or pseudophosphatase. C9 parasites demonstrated a significantly lower growth rate with delayed entry into the S/M phase of the cell cycle, which follows the stage of maximum PF3D7_1305500 expression in intact parasites. Genetic complementation with the full-length PF3D7_1305500 rescued the wild-type phenotype of C9, validating the importance of the putative protein phosphatase PF3D7_1305500 as a regulator of pre-S-phase cell cycle progression in P. falciparum.
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    Barriers and Determinants that Influence Membership in the American Association of Nurse Anesthetists
    ( 2021) Samons, David ; Samons, Jissel
    The American Association of Nurse Anesthetists (AANA) have a significant role in providing various benefits to their members and advancing the profession. However, membership percentages have decreased within the last 10 years. A review of the literature was conducted to identify the determinants that influence decision making regarding professional association membership. It was discovered that Florida was among the states with the highest percentages of non-members. For that reason, a scholarly project was developed and implemented to examine the factors that influence decision making regarding professional association membership among Florida’s licensed nurse anesthetists. An online survey was developed and sent to all Florida Certified Registered Nurse Anesthetists (CRNAs) with the help of the Florida Association of Nurse Anesthetists (FANA). The results of the survey revealed barriers to membership included dissatisfaction with the new National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) Continued Professional Certification (CPC) requirements, cost of membership, and a lack of education about the AANA. Determinants to membership identified included the benefit of CEUs and tracking, professional promotion, and the political advocacy the AANA provides. There was insufficient power to compare responses between FANA members and non-members due to a low non-member response rate. However, sufficient information was derived to suggest implications and recommendations to help improve future research efforts and better understand the issue.
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    Behavior of Model Ionic Compounds under Thermospray Liquid/Liquid Extraction Conditions
    ( 1997) Farrell, E. Sebastian ; Pacey, Gilbert E.
    Our previously reported procedure for the extraction of semivolatile and nonvolatile organic compounds from aqueous samples by thermospray liquid/liquid extraction was extended to the extraction of charged organic compounds from water. By thermally disrupting or extricating the solvation shell of hydrated ions, the thermospray process facilitates the extraction of these analytes from the aqueous matrix. The effects of probe temperature, probe flow rate, and sample pH on the extraction efficiency of model compounds such as phenylalanine, benzoate ion, p-toluenesulfonate ion, and naphthalenetrisulfonic acid trisodium salt were investigated. Under optimized conditions, the percent recoveries for these compounds were 95, 97, 91, and 13%, respectively.
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    Best Practice for Anesthesia for ECT: Quality Improvement Review and Guideline Development for ADU SRNAs at Florida Hospital
    ( 2017) Nguyen, Thu-Hien ; Calcetto, Patricia
    Electroconvulsive Therapy (ECT) is a safe and effective treatment for various psychiatric disorders. ECT treatment entailed the delivery of an electrical current via electrodes applied to the scalp that produce a generalized therapeutic seizure. Due to the nature of the procedure and for patient safety and comfort, the anesthetic of choice is general anesthesia. Unlike other general anesthesia cases, the anesthetic goals for ECT are a rapid induction, deep muscle relaxation without interference with seizure quality and length, and a rapid emergence. Due to the fast pace, multiple providers, and a multitude of distractions during ECT procedures, new providers, such as Student Registered Nurse Anesthetists (SRNAs), are at an increased risk for committing a medication error. This lack of knowledge and understanding of the ECT procedure and clinical setting can potentially impact patient care. Henceforth, the primary purpose of this project was to design a protocol intended to establish a safe process for preparing and labeling high-risk medications commonly used during ECT treatments by SRNAs. The sample population utilized in this project was the Adventist University of Health Sciences’ Nurse Anesthetist Program SRNAs class of 2018. The intervention used to address the problem is through a pre-test, a 30 to 45 minute PowerPoint presentation, and a post-test. The anticipated outcome of the PowerPoint presentation was an increase in the level of knowledge and understanding of the participants as demonstrated by improved post-test scores, indicating an effective PowerPoint presentation. The statistical analysis results of the pre- and post-test indicated significant increase in the level of knowledge of SRNAs after the PowerPoint presentation.
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    Best Practices for Prevention of Perioperative Ocular Injuries
    ( 2018) Best, Amy ; Englehardt, Amy
    Anesthesia providers are entrusted with the responsibility of providing competent health care and maintaining patient safety. This includes minimizing potential injury a patient may face during the perioperative period. Safe standards of practice may be derived from the most current body of research data. A literature review regarding preventative measures of perioperative ocular injury (POI) has demonstrated that, while having a low incidence, these occurrences may inflict devastating and possibly permanent vision impairment and discomfort upon patients. Research varies on which method of ocular protection is superior. Student registered nurse anesthetists (SRNA) have limited experience with management of POIs. The intent of this scholarly project was to increase the knowledge base of a sample size of 48 SRNAs at one nurse anesthesia program about POIs. The fundamental goal of this study was to increase the SRNAs’ awareness of evidence-based practice to assist with prevention of future POIs. SRNAs completed a pre-test consisting of 10 questions regarding pertinent POI information immediately prior to receiving education about POIs via a PowerPoint presentation. SRNAs then completed a post-test consisting of the same 10 questions presented in the pre-test. A correlation between scores utilizing statistical software determined an increase in the knowledge base of the SRNAs was achieved. POI education was successfully implemented and resulted in an increase in SRNA knowledge base. POI is relevant to the anesthesia profession. Therefore, a thorough understanding of POI incidence, prevalence, etiology, risk factors, evidence-based prevention and treatment, may be advantageous in possibly reducing its occurrence.
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    Black Art Posters, an Incentive to Increase Study Enrollment Among Blacks in a Large Cohort Study
    ( 2008) Yancey, Antronette K. ; Herring, Patti ; Fraser, Gary E. ; Yan, Ru ; Baker, Phyllip ; Lampkin, Andy ; Kyle, James
    Objective: Black art posters were offered to replace or augment the established $10 incentive for questionnaire completion in a longitudinal cohort study. Method: Eighty-one churches located in the US southern region were divided between two intervention groups, with a control group of 24 churches from the same region. Primary outcome measures were study enrollment rates and questionnaire return rates between December 2003 and July 2004 as a proportion of church goal. Results: 9.3% of participants returning questionnaires selected a poster in preference to $10. Half of participants offered both monetary and art incentives indicated a poster selection. Crude questionnaire return rates were 57.4% for the pooled intervention churches and 38.2% for the control churches. Enrollment rates among those offered both incentives were significantly higher (p < 0.01) than when monetary incentives alone were offered after adjustment for church size, promotional dates, and average income of church members. Survey return rates were also higher in the churches offered both incentives (p = 0.04). Conclusion: These data suggest that the black art posters improved study enrollment and survey return rates. The relatively low rate of poster selection suggests that the art primarily influenced participation indirectly, by creating a more culturally inclusive image of the study.