Nurse Anesthesia
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Item Open Access Academic Self-Efficacy in Student Registered Nurse Anesthetists(2024-02-18) Hueneke, Sara; Rademaker, Alex; Smith, EllenAdvanced learning strategies can help augment academic success in graduate-level academia. The level of synthesis and metacognition required by graduate education is generally not learned at the undergraduate level and presents a need to shift learning styles. While many studies exist on this topic, few directly relate to Doctor of Nurse Anesthesia Practice (DNAP) program students. This scholarly project aimed to determine if education on learning techniques early in a program is associated with improved academic self-efficacy (ASE). Interviews with key players have identified three topics that are particularly useful for building ASE: discovering new study strategies, managing procrastination, and strengthening time management. This scholarly project used a quasi-experimental design with convenience sampling with a maximum sample size of 30 to identify learning strategies suited for the DNAP population. A validated instrument, the Motivated Strategies for Learning Questionnaire (MSLQ) was utilized to assess perceptions of ASE before and after reviewing the module during the first didactic DNAP trimester (see appendix D). Utilizing the Statistical Package for Social Sciences software version 21, the results provide strong evidence (α=0.05) to reject the null hypothesis, indicating a statistically significant increase in participants' ASE before and after the intervention, as supported by the Wilcoxon Signed-Rank test results for both the MSLQ control of learning beliefs component and total scores (p=0.0412 and p=0.0431, respectively). Given the findings, correcting maladaptive educational behaviors and introducing new learning techniques early in the program could have a significant impact on DNAP learning methods.Item Open Access Adhesive Tape Cross-Contamination in the Operating Room(2024-02-17) Jimenez, Izamar; Reames, Danielle; Verbal, JurneeThe use of adhesive tape in the operating room serves multiple purposes for the anesthesia provider. Most importantly, is its use in securing the patient's airway, specifically the endotracheal tube. There are a lack of policies and procedures to prevent the cross-contamination of adhesive tape rolls during those critical moments, leading to the tape's exposure to bodily fluids and blood. The inability to properly clean and sterilize tape makes it a reservoir for pathogens and blood to spread, placing patients at risk during airway securement. The primary aim of this scholarly project was to reveal the need to initiate cleaner handling and storage of tape rolls, as evidenced by the presence of bacteria and blood on tape utilized for securing the endotracheal tube in the operating room. To support this innovation, a data compilation was performed after collecting samples of three different types of adhesive tape used by anesthesia providers in the operating room, along with a control group of packaged, clean tape. A total of 33 samples were obtained from ten different operating rooms in a large hospital located in the Southeastern United States. Furthermore, P levels <0.05 were considered significant, which demonstrated the need for cleaner practices of tape storage and utilization to ensure patient safety and protection against nosocomial infections.Item Open Access The Direct Administration of Isopropyl Alcohol to Rat Astrocytes(2024-04-02) McGee, Grant; Lozano, Jovanny; Cavalli, StephenAnesthesia providers have been cautious when applying isopropyl alcohol (IPA) prep pads specifically as an antiseptic for ports on neuraxial catheters. After re-bolusing a neuraxial catheter with medication, there has been concern that a residual amount of IPA travels to the patient and causes neurolysis. The literature review analyzed various neurolytic agents and their purposes when applied to clinical practice. IPA is not used as a neurolytic agent in clinical practice or even reported as an accidental agent in the literature. There is a need for continued research of IPA and its effects on cells. The purpose of this study was to determine if there is neurolysis caused by a direct application of 70% IPA to rat astrocyte cells at varying time intervals running from 5-60 minutes following trypan blue exclusions and hemocytometer analysis. The outcome was that alcohol concentration decreased as dry time increased after scrubbing the epidural catheter port with an IPA pad. The project resulted incomplete as it did not reach the steps of administering the found alcohol concentrations onto rat astrocytes for neurolysis. The results of this scholarly project provided evidence needed to assess the safety of scrubbing an epidural catheter port with a 70% IPA prep pad and possibly allow health organizations to develop policies based on the results and for further research.Item Open Access Maternal Cannabis Use and Childhood Development(2024-02) Visser, Harlie E.; Smith, Danielle O.; Crum, Taylor B.Fallacies surrounding gestational cannabis use are a growing concern throughout the obstetric population. Societal factors play a major role in influencing cannabis use as a method to alleviate symptoms such as nausea in early pregnancy. There is a gap in the literature regarding perinatal education and the psychological and physiological effects of in-utero exposure to cannabis. These identified risks ranged from behavioral transgressions to physical anomalies such as small for gestational age, ultimately supporting the need for enhanced education regarding gestational cannabis use. This social habit can significantly affect anesthetic management during the intrapartum phase and negatively impact pain and postoperative nausea and vomiting management. The purpose of this innovation was to assess maternal knowledge on gestational cannabis use and the effects on childhood development in parturient participants attending an inperson educational class at the Osceola Pregnancy Center in Kissimmee, Florida (FL). Implementation of a 20-minute PowerPoint educational session was conducted for parturient participants, and a face-validated pretest and posttest were electronically distributed. A nonidentifying online platform, Microsoft Forms, was utilized to facilitate data collection. Data analysis utilized the Wilcoxon signed-rank test, yielding a p-value of 0.0002079 (α = 0.05). These findings suggest a positive correlation between a community-based perinatal educational course and improved maternal knowledge. Evidence-based recommendations can be made for continued community educational outreach initiatives to raise patient and provider awareness on the growing topic.Item Open Access Increasing the Doctorate of Nurse Anesthesia Pipeline(2024-02-09) Gotay, Cassandra; Moran, BrittaniMentorship in the medical community can positively influence professional growth (Chan et al., 2016; Giannone et al., 2018; Stanfill et al., 2019). The objective of this research project was to increase AdventHealth University (AHU) undergraduate nursing students’ intent to apply to a nurse anesthesia program (NAP) by implementation of a mentorship program. There exists evidence to support that peer mentorship promotes positive outcomes, such as career growth, academic success, and increased exposure to advanced healthcare degrees. The study examined how peer mentorship of an undergraduate Bachelor of Science in Nursing (BSN) affects intent to apply to a NAP. The design of the study followed a quality improvement and quality assurance design that took place on AHU’s Orlando campus. Peer mentorship has been supported by literature to provide mental health benefits (Akinla et al., 2018; Kim et al., 2013; Maniam et al., 2020; Scott et al., 2019; Yuksel & Bahadir-Yilmaz, 2019). Research in determining the effectiveness of mentorship programs on subspecialty choice in undergraduate programs is currently being evaluated as well (Salerno et al. 2017; Stanfill et al., 2019). There is an increased demand for certified registered nurse anesthetists (CRNAs) and a need to examine how to increase the pipeline to NAPs. Factors that limit BSN students is a lack of knowledge of the role of a CRNA and the requirements of NAPs. The project aim was to set up a mentorship with a student registered nurse anesthetists (SRNAs) to close the knowledge gap and provide a support system to improve intent to apply to a NAP.Item Open Access Point of Care Ultrasound Gastric Assessment(2024-02-18) Cox, Stephanie Kay; Hintze, Whitney; Sanchez, ChristinaAspiration pneumonia is one of the most prevalent causes of morbidity and mortality in anesthesia, responsible for almost half of all airway-related anesthesia complications (Perlas et al., 2018; Sharma et al., 2018; Warner et al., 2021). Current practice utilizes nil per os (NPO) guidelines to determine the patient’s stomach content; however, a review of the literature reveals that maintaining rigid fasting guidelines has little correlation with gastric volumes, leading to misdiagnosis of aspiration risk (Miller et al., 2021; Ohashi et al., 2018). Compared to current NPO guidelines, point-of-care ultrasound (POCUS) gastric assessment identifies high-risk patients, enhancing sensitivity and specificity. Mainstreaming POCUS gastric assessment as a standard tool to identify high-risk aspiration patients in the preoperative phase may allow the anesthesia team to modify the plan of care. This can help providers tailor the anesthesia plan to individual patient status and comorbidities, allowing for decreased risk of aspiration and subsequent consequences. The literature promotes POCUS gastric assessment as the new standard of care, potentiating a safer anesthesia plan in up to 50% of procedures (Delamarre et al., 2021; Shorbagy et al., 2021; Van de Putte et al., 2018). This project aims to create a continuing education (CE) module on utilizing POCUS gastric assessment and submission for approval by Echelon and the American Association of Nurse Anesthesiology (AANA) accreditation.Item Open Access Virtual Reality Simulation and Self-Efficacy(2023-11-12) Keegan, Theresa; Mueller, Maribel; Winters, BaleeVirtual reality (VR) has long been utilized to enhance learning opportunities among trainees in a multitude of medical professions. Implementation of VR has grown in popularity over the years due to the ability of students to immerse themselves in real-world clinical environments that provide safe and effective experiences to enhance clinical skills. In contrast to human patient simulators or mannequin-based training, VR offers student registered nurse anesthetists (SRNAs) the ability to visualize a more anatomically correct representation of the human body. The aim of this QA/QI study at AdventHealth University was to incorporate Anatomage tables in learning the airway and respiratory tract, an understanding that is critical to the skill of intubation in the education of SRNAs. The goal was to determine if exposure to this technology increased feelings of preparedness in the 2026 cohort regarding their ability to appropriately identify airway anatomy and successfully intubate before approaching real-life clinical scenarios. Outcomes were measured through a single post-test for all participants utilizing the Self-Efficacy Scale (SES) modeled after the Learning Self-Efficacy Scale. The results determined that Anatomage tables provided a statistically significant enhancement to the novice SRNAs training in airway anatomy, suggesting their integration into the DNAP program at AHU for future cohorts. Recommendations based on the results were communicated to AdventHealth University faculty regarding the benefit of VR, specifically Anatomage tables, for the overall preparedness or self-efficacy students perceive before starting clinical rotations within the Doctor of Nurse Anesthesia Practice program.Item Open Access Online Continuing Education Module Transthoracic Echocardiogram(2024-02-18) Gallagher, Angelina; Joseph, Arun; Davis, MichaelA Transthoracic Echocardiogram (TTE) is the utilization of an ultrasound probe to obtain five different views of the heart (Aurora Health Care, 2022). A TTE allows the anesthesia provider to assess a patient’s cardiac ventricles and valves in real-time to elicit information about fluid status, ejection fraction, and rhythm abnormalities. Several observational, pilot, and case studies have shown both hands-on and computer-based training for TTE have been implemented in healthcare education (Anderson et al., 2021; Bhatia et al., 2017; Elison et al., 2020; Goldstein et al., 2020; Goldstein et al., 2021; Haskins et al., 2017; Hempel et al., 2020; Kline et al., 2021; Sanders et al., 2019; Shields & Gentry, 2020). The studies demonstrate how effectively these methods improve TTE skills and knowledge in nurse anesthesia and physician residency programs. Applying this information allows the provider to determine fluid requirements and hemodynamic condition and assess changing cardiac rhythm during the perioperative care period. Certified registered nurse anesthetists (CRNAs) are required to complete continuing education (CE) modules to maintain their licensure through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). CE is critical to developing skills and gaining knowledge for all anesthesia providers. This project developed a CE module to teach student registered nurse anesthetists (SRNAs) and CRNAs how to perform a basic TTE to obtain the five views of the heart. AdventHealth University (AHU) SRNAs developed an evidence-based educational module regarding TTE assessment for publication in AHU Echelon and received CE credit approval from the American Association of Nurse Anesthetists (AANA) in September 2023.Item Open Access The Transgender Patient and Perioperative Complications(2024-03-15) Cima, Abilio; Dobes, Kelsey; Ta, BaoThere are an estimated 1.4 million adults in the United States that currently identify as transgender. As the social acceptance of the transgender population continues to increase, it is expected that this number will continue to rise. There are a reported 61% of transgender individuals who have pharmaceutically transitioned with Hormone Replacement Therapy and 25% having undergone Gender Affirming Surgery. As health insurance coverage encompasses treatment options and surgical services for this population, anesthesia providers must be aware of potential perioperative complications. Potential risks include cardiovascular complications, altered respiratory physiology, and distorted airway anatomy. Currently, there is a gap in knowledge in the care of transgender patients among anesthesia providers as well as a lack of a standardized curriculum in anesthesia education addressing transgender patients during the perioperative period and related anesthetic considerations. Therefore, a continuing education (CE) module via the Echelon platform was created to reduce the gap in knowledge among anesthesia providers related to the care of the transgender population in the perioperative setting.Item Open Access Correlation of Variables for Program Success and First Time SEE Scores of the Doctor of Nurse Anesthesia Practice Program Student Registered Nurse Anesthetists at AdventHealth University(2023-03-23) Anderson, Brian; Gotay, DerikNurse anesthesia is considered one of the most rigorous fields in advanced practice nursing, and many graduate nurse anesthesia programs have limited availability. Due to the academic rigor of graduate nurse anesthesia programs, selection and admission requirements are established to assist program directors and faculty in selecting candidates with the highest probability of completing the program and passing the National Certification Examination (NCE). The Self-Evaluation Examination (SEE) is taken by student registered nurse anesthetists (SRNAs) to prepare for the NCE, and SEE scores strongly correlate to NCE scores. Evaluation of specific pre-admission variables may assist in identifying applicants most likely to succeed. Methods for this project included the Spearman’s Rho Correlation test of de-identified retrospective data collected by the nurse anesthesia department at AdventHealth University (AHU) to identify statistically significant correlations between the independent and dependent variables, followed by a linear regression analysis of any statistically significant correlations. This study determined the correlations of pre-admission cumulative grade point average (cGPA), science grade point average (sGPA), total Graduate Record Examination (GRE) score, and Health Sciences Reasoning Test (HSRT) overall score with nurse anesthesia program grade point average (NAPGPA) at the end of the fourth trimester and with the SEE total score during the fifth trimester for students who matriculated to AHU’s DNAP Program from 2018 to 2020. This study found the following four statistically significant correlations: cGPA with NAPGPA, cGPA with SEE total score, sGPA with SEE total score, and NAPGPA with SEE total score. This study made four recommendations to the program’s leadership for pre-admission requirements and three recommendations regarding program progression.Item Open Access A Review of the Existing Evidence-based Protocols/guidelines on Oxytocin Dosing during Elective Cesarean Section to Prevent Post-partum Hemorrhage--A Creation of a Class A Pharmacology Continuing Educational Module for Certified Registered Nurse Anesthetist(2023-01-15) Lyons, Khadijah; Martinez, EuniceOxytocin is an endogenous hormone, and Pitocin is its synthetic analog often administered in the parturient patient to induce labor and further dilate the cervix. Per the American College of Obstetricians and Gynecologists (ACOG) and American Society of Anesthesiologists (ASA), there are standard dosage and administration guidelines to ensure safe delivery and decrease postpartum hemorrhage (PPH) (2020). Anesthesia providers must understand these administration guidelines to ensure more favorable health outcomes in the laboring woman. Globally, PPH is the leading cause of maternal mortality. A literature review suggests Pitocin via intravenous administration during active labor can significantly reduce postpartum hemorrhage, thus leading to more favorable health outcomes in the parturient patient (Salati et al., 2019). Education is a method of affecting change. A 60-minute evidenced-based Class A pharmacology continuing education (CE) module on the appropriate use of Pitocin to prevent PPH during elective cesarean section was developed for Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs). The goal of the module is to discuss the role of oxytocin in the parturient patient, to provide evidence-based recommendations for intravenous Pitocin dosing during elective cesarean section to prevent PPH, and to understand the physiological changes associated with increased levels of oxytocin.Item Open Access Anesthesia Provider’s Preception on Preserving Asepsis at the Epidural Catheter Hub(2023-04-06) Barcelow, Travis; Dominique, KindraEpidural catheter infections occur despite best practice guidance. The incidence of positive infectious cultures obtained from epidural catheters is approximately 23%. While most infections are superficial, the incidence of infection within the deeper epidural space can result in permanent and irriversable neurologic damage. The epidural catheter hub is a potential route of contamination that can occur with repeated injections. There is very little literature focusing on the epidural catheter hub and the contamination with repeated injections. The objectives of this scholarly project is to examine the current practice of anesthesia providers and to evaluate whether the current evidence-based best-practice standards, regarding epidural hub mainenance are being applied consistently. Further investigation is needed and will be conducted by surveying providers to determine if there are inconsistencies among practice. The survey findings may suggest the need for further education regarding need for consistent evidence-based best-practice standards to help reduce the risks for epidural catheter infections.Item Open Access Effect of Airway Management Education on Knowledge, Skill, and Confidence Levels(2023-02-19) Reyes, Jessenia; Cadet, SabineAirway assessment and management are crucial skills for nurses managing patients during critical situations; nurses are usually the first healthcare providers to identify a deterioration in patients’ health status. Proper airway management skills increase the chance of survival for a critical patient. Nursing students, however, may have limited exposure to clinical situations in which it is necessary to identify and manage a deteriorating patient leading to a lack of confidence in airway management. The purpose of this scholarly project was to evaluate the effect of an airway management educational module and low fidelity simulation experience on the knowledge, skill, and confidence level of senior student nurses attending AdventHealth (AHU) University Orlando. The design of this evidence-based practice initiative was quasi-experimental with convenience sampling. All 21 AdventHealth University senior nursing students in the Summer 2022 cohort were allowed access if they chose to view the educational content in Canvas prior to attending a simulation lab. This project used convenience sampling and all students were required to participate in a 20-minute pre-simulation educational module and a 30- minute low fidelity airway management simulation lab. However, assessments, such as a pre-test/ post-test, a skills checklist and a satisfaction and confidence questionnaire used to evaluate knowledge, skills, and confidence levels were voluntary and did not impact student grades.Item Open Access The Effect of Smartphone Applications on Graduate Student Stress Levels(2023-04-24) McDuffie, Jacob; Spence, AmandaNurse anesthesia students encounter stress in academics, clinical, and personal life. Excessive stress can be a product of poor emotional intelligence (EI) and decreased self-efficacy (Chipas et al. 2012; Molero Jurado et al., 2019). Appropriate use of smartphone applications (app/apps), such as medical resource apps, decreases the stress of decision-making in the clinical setting and increases positive patient outcomes, as well as increases self-efficacy (Molero Jurado, 2019; Green et al., 2017; Ross & Myers, 2017). The aim of this scholarly project is to evaluate the appropriate utilization of the smartphone app UpToDate and its effect on stress among graduate students currently enrolled at AdventHealth University (AHU). This scholarly project will consist of a pretest assessing participants' baseline knowledge of the UpToDate app, how often per week they use the app, and their perceived stress. Following the pretest, a 60-minute educational presentation on the appropriate uses of smartphones and the UpToDate app will be presented. Following the intervention, a post-test will be administered to assess the participant's retained knowledge of the topic. Four weeks following the intervention, a post-test will be administered to assess the participant's perceived stress levels and how often UpToDate was utilized. The objectives of this scholarly project will be for graduate healthcare students who are in clinical trimesters to identify the appropriate utilization of the app UpToDate, increase knowledge of navigation within the app UpToDate, increase the use of the app UpToDate and reduce stress during the student’s clinical rotation at the end of the 4-week period. The anticipated outcome of this project is to have a positive impact on student health, productivity, and clinical and academic performance by reducing the stress of graduate students through the utilization of UpToDate.Item Open Access Anesthesia Workstations as Intensive Care Ventilators During a COVID-19 Surge(2023-02-07) Jordan, Jasmin; Estima, BellySARS-CoV-2 is an extremely transmittable virus that causes coronavirus disease 2019 (COVID-19). In the last 20 years, COVID-19 is the third coronavirus pandemic to occur. The SARS virus of 2002, while highly virulent, was not rapidly transmitted and thus did not create a significant strain on healthcare infrastructure. In early 2009, Influenza A (H1N1) like COVID-19 transmitted rapidly throughout the world and increased hospitalizations at an exponential rate but was still treatable with available medical resources. The surge created by COVID-19, however, resulted in an increase in hospitalizations that created such a strain on hospital infrastructure, it became necessary to implement alternative patient care solutions to treat the surge of critically ill patients. As COVID-19 spread, patients showed rapid decline with many requiring respiratory support via mechanical ventilation. This rise in intensive care ventilator use, outstripped available resources and generated an imminent need for unconventional solutions. Anesthesia workstations were rapidly identified as a viable alternative to address the demand for mechanical ventilation devices created by COVID-19. The use of anesthesia workstations within the intensive care environment however, resulted in a knowledge gap for critical care nurses who had no prior exposure to the equipment. Thus, creation of an evidence based online continuing education module in collaboration with Echelon, AdventHealth University's (AHU) professional education division will help decrease critical care nurse knowledge gap regarding the use of anesthesia machines as intensive care ventilators. With a secondary aim of constructing an SRNA guidance protocol that clarifies and improves the CE module development at AHU.Item Open Access Anesthesia Preceptorship and Standardized Methods(2023-03-27) Walton, Caval; Bennett, ZacharyClinical learning is critical for developing students and graduate advanced practice nurses. Clinical education affects self-awareness, critical thinking, and hands-on skills. Graduate students develop their practice by being precepted by advanced practice preceptors. Clinical learning, however, is negatively impacted by preceptors who may lack appropriate, evidenced based training. Thus, preceptors and their knowledge base play a significant role in this development and could potentially influence future patient outcomes. This scholarly project aimed to address knowledge gaps of advanced practice preceptors by creating an online continuing education module regarding evidence-based precepting approaches for certified registered nurse anesthetists and attempted to submit to the American Association of Nurse Anesthesiology (AANA) for approval which was denied. While developing this module, the current process for creating Continuing Education (CE) modules at AdventHealth University (AHU) was optimized through the application of a Find Organize Clarify Understand Select (FOCUS) Plan-Do-Check-Act (PDCA) cycle to create a protocol that outlines requirements, optimize facilitators and minimize barriers. The FOCUS PDCA cycle is a quality improvement model that will provide a structure for problem-solving. The FOCUS portion of this cycle was addressed in this project and future improvements could be made by future cohorts through implementing the PDCA portion. This project aimed to create a CE module but was denied for lack of evidence to support its creation. A protocol was developed for improving the process of CE module creation with the AdventHealth University’s continuing education division, Echelon.Item Open Access Type Two Diabetes Management in the Latino Community(2023-03-31) Cherry, Valerie; Cooper, BrendaThe Latino community makes up 31.1% of the population in the Central Florida region, and is disproportionately affected by diabetes mellitus (DM) (U. S. Census Bureau, 2019). Proper glycemic control is pivotal to the surgical management of this patient population. Poorly controlled glycemic levels impact the perioperative state and are associated with an increased risk of surgical site infection, embolic events, poor wound healing, postoperative nausea and vomiting, sepsis, and death. There is also an increased risk of further organ damage, such as end-stage renal disease, affecting medication metabolism and excretion (Dreisbach et al., 2009). Type 2 diabetes mellitus (T2DM) patients have shown to have similar surgical outcomes as their non-diabetic counterparts with proper glycemic management (Dagogo-Jack & Alberti, 2002; Tidy & Cox, 2016; Wukich, 2015). Previous quantitative improvement initiatives show a direct correlation between culturally tailored diabetes self-management education (DSME) and a reduction in hemoglobin A1C (HbA1C) (Brown et al., 2011; Chrvala et al., 2016; Fortmann et al., 2017; Garcia et al., 2015; Hildebrand et al., 2020; Hu et al., 2016; Palmas et al., 2014; Pérez-Escamilla et al., 2014; Rosal et al., 2011; Rotberg et al., 2016; Spencer et al., 2018; Weinstock et al., 2011). While this correlation has been proven, no improvement projects found utilized education primarily through an online format nor include an educational focus on disease management's long-term impact. Due to stated deficits, a quantitative improvement project was formulated to address the shortcomings and assess the correlation between DSME and HbA1C.Item Open Access The Effects of Music on Anxiety Levels in Surgical Waiting Rooms for Family and Friends(2023-03-19) Bowen, BrittneyPreoperative anxiety has been proven to cause complications both during and after the procedure. These complications range from aggressive behavior to hemodynamic instability. One factor that may impact preoperative patient anxiety is the anxiety of the family members and friends who accompany the patient. Current literature shows a strong correlation between music and decreased anxiety in family members and friends. Therefore, this project is a quality improvement project to provide potential benefits of using music in waiting rooms and by measuring the different anxiety levels between the two groups. Advanced Aesthetics was chosen as the site for the scholarly project data collection. Working with the key players to identify possible limitations helped the researchers understand the background of the business and the environment involved in observation. Data was collected on 8 days, 4 days with music playing and 4 days without music playing. Each participant was asked to fill out a State Trait Anxiety Inventory (STAI). An independent two sample t-test was used for data analysis to compare the difference between the music group and the non-music group. Statistical analysis was completed on both the state anxiety scores and the trait anxiety scores between the music group and the non-music group. Low participation yielded results that were not statistically significant in the state anxiety scores when music was played versus when music was not played. Overall, the project was well received by both the facility where the study occurred as well as those that did participate. This study can be used for an evaluation of evidence-based recommendations on the use of music in waiting room and its effect on anxiety.Item Open Access Effects of Cleaning an Epidural Catheter Hub with Alcohol and Determination of Neurotoxicity on Rat Astrocyte Cells(2023-01-15) Minton, Brandon; Yamber, CourtneyPatient safety must always be the first concern for anesthesia providers and aligning with evidence-based research provides best practice standards. The standard for cleansing the epidural catheter hub is rudimentary and poorly established as shown by the variations in current practice. Difference in opinions exists between cleansing the epidural catheter hubs with alcohol for bolusing administrations and the risk of causing adhesive arachnoiditis and/or neurolysis/apoptosis in the epidural space. A literature review revealed research concerning skin cleansing prior to placement of neuraxial anesthesia; however, the evidence was absent regarding best practice for epidural catheter hub access. Commentary and guidelines were made based on poor outcomes of two case studies, but no research has focused on epidural catheter hub aseptic techniques and risks to date. The intention of this scholarly project was to conduct an experimental study design with five epidural catheters and pumps infusing onto commercially available rat astrocyte cells after cleansing the epidural hubs with 70% isopropyl alcohol to test the potential presence of alcohol introduced into the epidural space and the risk of adhesive arachnoiditis and neurolysis/apoptosis. Each epidural pump would run an infusion into a sample size of five commercially available rat astrocyte cells. At completion of infusion, the commercially available rat astrocyte cells would be analyzed to determine the presence of alcohol in the cells. Data would be gathered by student co-investigators and sent for analysis using a statistical analysis software package. These results are intended to provide evidence-based recommendations for cleansing epidural catheter hubs with alcohol in anesthesia practice. Due to the nature of this scholarly project and unforeseen limitations the completion of proposed methods was not possible.Item Open Access Mentoring Undergraduate Nursing Students into Graduate Level Nurse Anesthesia Education(2023-03-16) Derringer, Melissa; McIntyre, GabriellaThere is minimal evidence to support or discourage the use of a mentorship program to increase the number of baccalaureate nursing students with the intent to apply to graduate level nurse anesthesia education at the time of graduation. The scholarly project aimed to evaluate the effect of a mentorship program on senior baccalaureate nursing students’ intent to pursue graduate level nurse anesthesia education. The causal relationship between the mentorship program and baccalaureate nursing student intent to apply was evaluated by analyzing results from a survey at the end of the mentorship period. An 8-week mentorship program with an integrated skills lab was completed by the senior baccalaureate nursing students before the survey was completed. This scholarly project sought to provide AHU baccalaureate nursing students and faculty with a one-to-one SRNA led mentorship program. Survey results from this scholarly project are minimally significant due to a small sample size. However, due a small level of increased intent to pursue graduate level nurse anesthesia education, the project results support the need for additional implementation with an increased sample size. Positive results from future studies may prove that implementing mentorship programs can assist in growing the profession of nurse anesthesia.