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Apneic Oxygenation: A Method to Prolong the Period of Safe Apnea
Title
Apneic Oxygenation: A Method to Prolong the Period of Safe Apnea.
Creator
Pratt, Matt, Research Day
Abstract / Description
A difficult intubation poses one of the most challenging tasks for anesthesia professionals, representing 27% of all adverse respiratory events, 93% of which are unanticipated. Unanticipated difficult mask ventilation and intubation may result in serious complications. Safe airway management requires a proper and thorough preoperative airway evaluation and a plan to secure the airway, with alternate plans available when the initial plan fails. Pediatric, obese, and obstetric patients...
Show moreA difficult intubation poses one of the most challenging tasks for anesthesia professionals, representing 27% of all adverse respiratory events, 93% of which are unanticipated. Unanticipated difficult mask ventilation and intubation may result in serious complications. Safe airway management requires a proper and thorough preoperative airway evaluation and a plan to secure the airway, with alternate plans available when the initial plan fails. Pediatric, obese, and obstetric patients undergoing general anesthesia with endotracheal intubation are considered to be at risk of rapid desaturation. As an adjunct to conventional preoxygenation techniques, continuous oxygen administration during the apneic period, termed apneic oxygenation, assists in the maintenance of oxygenation when tracheal intubation is attempted. Nine articles were selected for appraisal in this literature review: 6 randomized control trials, 2 prospective studies, and 1 retrospective study. Multiple apneic oxygenation techniques, including nasopharyngeal catheter, nasal prongs, endotracheal tube, intratracheal catheter, and high-flow transnasal humidified oxygen, demonstrated effectiveness at delaying the onset of hypoxemia during the apnea period. Prolonging the apneic window changes the nature of airway management in patients at high risk of desaturation and when an unanticipated difficult airway arises.
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Date Issued
2017
Identifier
fgcu_UGR_0009
Format
Document (PDF)
Cultural Competency for Student Registered Nurse Anesthetists Combatting Health Disparities
Title
Cultural Competency for Student Registered Nurse Anesthetists Combatting Health Disparities.
Creator
Belizaire, Daniel, Research Day
Abstract / Description
Health care disparities occur due to cultural and linguistic barriers, subtle bias, and prejudice. Enhancing cultural competency of future clinicians is essential in combatting health disparities. Research indicates that minorities in the United States are plagued by health care disparities. Therefore, certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) should become cultural competent to decrease health disparities and improve health outcomes. A...
Show moreHealth care disparities occur due to cultural and linguistic barriers, subtle bias, and prejudice. Enhancing cultural competency of future clinicians is essential in combatting health disparities. Research indicates that minorities in the United States are plagued by health care disparities. Therefore, certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) should become cultural competent to decrease health disparities and improve health outcomes. A secondary data analysis indicates that minority parturients are at higher odds of receiving general anesthesia in comparison to whites despite general anesthesia’s higher rates of maternal mortality. Three articles underline the importance of incorporating cultural competence into nursing education. One article revealed how Kaiser Permanente School of Anesthesia introduced cultural competency into its program curriculum. One article delineates high-fidelity simulation to show its effectiveness in preparing SRNAs to provide congruent, efficient, and culturally competent care. Nurse anesthesia programs require attainment of knowledge and necessary skills for patient safety, critical thinking, communication, and anesthetic management. CRNAs and SRNAs should be capable of providing individualized anesthetic management and culturally competent anesthetic care. Accomplishing these goals include having well developed modules intertwined into the program’s curriculum. Cultural competency training modules should allow students the opportunity to apply learned cultural knowledge to enhance cultural competent communication skills. After an in-depth review of the literature, cultural competence emerged as a social solution that has the promise and capacity to help reduce health disparities affecting minorities in the United States. Causes of current health care disparities include failures in the health care system, cultural and linguistic barriers, and subtle bias and prejudice during the clinical encounter. Among methods that must be implemented to reduce health care disparities, enhancing the cultural competence of future clinicians such as SRNAs is a major proponent of these tactics.
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Date Issued
2017
Identifier
fgcu_UGR_0013
Format
Document (PDF)
Delirium Prevention in the ICU: A Literature Review
Title
Delirium Prevention in the ICU: A Literature Review.
Creator
Chakonas, Stephanie, Mandell, Aubree, German, Brianna, Regan, Ana, Rosa, Yesenia, Research Day
Abstract / Description
Patients admitted to the intensive care unit have been identified as having a predisposition to states of delirium, placing them at high risk for negative outcomes. Delirium within this setting has a direct correlation with adverse occurrences such as prolonged duration of mechanical ventilation, increased length of hospital stays, higher mortality rates, and greater overall cost. Additionally, delirium has both short and long-term effects on patients’ levels of functioning and cognition,...
Show morePatients admitted to the intensive care unit have been identified as having a predisposition to states of delirium, placing them at high risk for negative outcomes. Delirium within this setting has a direct correlation with adverse occurrences such as prolonged duration of mechanical ventilation, increased length of hospital stays, higher mortality rates, and greater overall cost. Additionally, delirium has both short and long-term effects on patients’ levels of functioning and cognition, deleterious effects that may or may not ever fully resolve. Poor outcomes such as these should be avoided at all costs considering that delirium is indeed a preventable condition. It is the duty of those working in health care to provide both safe and patient-centered care practices. Nurses, in particular, spend a great amount of time with their patients and have the utmost advantage in their position at the bedside to both detect and prevent delirium in the ICU. For this literature review, a pursuit of knowledge and interventions surrounding delirium prevention have been sought after and recommended to be incorporated into practice in order to better care for these patient populations during this vulnerable time. Upon review, the following prevention strategies have been identified: early mobilization, physical therapy, reorientation, cognitive stimulation, drug reviews, awakening and breathing coordination, environmental stimulation and avoidance of sensory deprivation, pain control, restraint use avoidance, family participation, early participation of the health care team, shared leadership, providing adequate nutrition, fluid and electrolyte monitoring, use of the patient’s glasses or hearing aids, prevention of infection, promotion of family visits, use of the “THINK” pneumonic, minimizing the use of sedative medications, avoiding benzodiazepines, adequate oxygenation, sleep promotion, use of observational screening tools, and frequent status checks. We should also remain cognizant of the predisposing and non-modifiable risk factors of delirium such as alcohol or substance abuse, smoking, hypertension, dementia, mental illness, severity of illness, and older age. It has been concluded that by raising awareness through education and implementation of the items discussed, nurses can in fact better prevent delirium through quality improvement and patient-centered care practices in order to decrease mortality rates, reduce incidences of long term cognitive impairment, avoid prolonged length of stays, and mitigate sustained mechanical ventilation.
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Date Issued
2018
Identifier
fgcu_UGR_0014
Format
Document (PDF)
Jason McGuire
Format
Institutional Scholar
Scholar's name
Jason McGuire
Department
Nursing
Email
jmmcguire@fgcu.edu
Imke Casey
Format
Institutional Scholar
Scholar's name
Imke Casey
Department
Nursing
Email
icasey@fgcu.edu
Kelly Goebel
Format
Institutional Scholar
Scholar's name
Kelly Goebel
Department
Nursing
Email
kgoebel@fgcu.edu
Lolita Melhado
Format
Institutional Scholar
Scholar's name
Lolita Melhado
Department
Nursing
Email
lmelhado@fgcu.edu
Lynne Portnoy
Format
Institutional Scholar
Scholar's name
Lynne Portnoy
Department
Nursing
Email
lportnoy@fgcu.edu
Susan Hook
Format
Institutional Scholar
Scholar's name
Susan Hook
Department
Nursing
Email
shook@fgcu.edu
Sabrina Ronco
Format
Institutional Scholar
Scholar's name
Sabrina Ronco
Department
Nursing
Email
sronco@fgcu.edu
Shirley Ruder
Format
Institutional Scholar
Scholar's name
Shirley Ruder
Department
Nursing
Email
sruder@fgcu.edu
Rickey King
Format
Institutional Scholar
Scholar's name
Rickey King
Department
Nursing
Email
rking@fgcu.edu
Tammy Sadighi
Format
Institutional Scholar
Scholar's name
Tammy Sadighi
Department
Nursing
Email
tsadighi@fgcu.edu
Virginia Londahl-Ramsey
Format
Institutional Scholar
Scholar's name
Virginia Londahl-Ramsey
Department
Nursing
Email
vlondahl-ramsey@fgcu.edu
Paula Davis-Huffman
Format
Institutional Scholar
Scholar's name
Paula Davis-Huffman
Department
Nursing
Email
phuffman@fgcu.edu
Cheryl Swayne
Format
Institutional Scholar
Scholar's name
Cheryl Swayne
Department
Nursing
Email
chswayne@fgcu.edu
Susan Young
Format
Institutional Scholar
Scholar's name
Susan Young
Department
Nursing
Email
seyoung@fgcu.edu
Sharon Wright
Format
Institutional Scholar
Scholar's name
Sharon Wright
Department
Nursing
Email
swright@fgcu.edu
Judith Walters
Format
Institutional Scholar
Scholar's name
Judith Walters
Department
Nursing
Email
jwalters@fgcu.edu
Anne Harner
Format
Institutional Scholar
Scholar's name
Anne Harner
Department
Nursing
Email
aharner@fgcu.edu

Pages