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Title
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Intraoperative blood glucose management : a quality improvement project
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Creator
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Baker, Jake (Nurse)
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Date
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2022
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Collection
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Doctor of Nursing Practice Projects
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Description
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Perioperative hyperglycemia is associated with a myriad of post-surgical complications including an increased incidence of surgical site infections and prolonged hospital stays. The use of an evidence-based perioperative blood glucose management protocol reduces morbidity and mortality in adult patients undergoing surgical procedures. The project team describes a cost-effective quality improvement initiative aimed at improving protocol adherence by integrating an easy-to-use protocol...
Show morePerioperative hyperglycemia is associated with a myriad of post-surgical complications including an increased incidence of surgical site infections and prolonged hospital stays. The use of an evidence-based perioperative blood glucose management protocol reduces morbidity and mortality in adult patients undergoing surgical procedures. The project team describes a cost-effective quality improvement initiative aimed at improving protocol adherence by integrating an easy-to-use protocol algorithm, order sets, and practice reminders into an existing electronic health record system.
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Title
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Improving perioperative nausea and vomiting prophylaxis protocol compliance
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Creator
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Franz, Allison
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Date
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2022
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Collection
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Doctor of Nursing Practice Projects
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Description
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Postoperative nausea and vomiting (PONV) is a significant concern in anesthesia practice. Evidence-based guidelines have sought to provide recommendations on identifying patients at risk for PONV and mitigating its effect with multimodal antiemetic strategies. An anesthesia department within a large teaching hospital uses the Anesthesiology Performance Improvement and Report Exchange guidelines to identify and manage patients at risk for PONV. These guidelines are intended to integrate best...
Show morePostoperative nausea and vomiting (PONV) is a significant concern in anesthesia practice. Evidence-based guidelines have sought to provide recommendations on identifying patients at risk for PONV and mitigating its effect with multimodal antiemetic strategies. An anesthesia department within a large teaching hospital uses the Anesthesiology Performance Improvement and Report Exchange guidelines to identify and manage patients at risk for PONV. These guidelines are intended to integrate best practices into anesthetic care and improve overall surgical outcomes. The anesthesia department currently has a PONV protocol in place that aligns with the guidelines but has not achieved their compliance benchmark. This evidence-based quality improvement project describes interventions proposed to increase compliance with the PONV protocol. To address poor PONV compliance, an anonymous survey was developed to assess anesthesia provider's current familiarity with the new PONV guidelines and identify misconceptions. A visual feedback system was implemented using a preliminary confidential list that anonymizes staff. This allowed individual providers to identify their own performance in relation to their peers in a non-punitive way. The results of this quality improvement project demonstrate that the proposed interventions increased departmental compliance.
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Title
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Development and implementation of an enhanced recovery after surgery protocol for women undergoing a mastectomy
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Creator
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Braun, Michael
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Date
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2022
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Collection
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Doctor of Nursing Practice Projects
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Description
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This evidenced-based practice initiative includes the development and implementation of an evidence-based enhanced recovery after surgery (ERAS) guideline with a specific focus on the incidence of postoperative nausea and vomiting (PONV) and opioid administration in the postoperative setting. The clinical question was in adult women, age 18 years or greater, undergoing a mastectomy procedure, does the implementation of an ERAS guideline lower the incidence of PONV and reduce morphine...
Show moreThis evidenced-based practice initiative includes the development and implementation of an evidence-based enhanced recovery after surgery (ERAS) guideline with a specific focus on the incidence of postoperative nausea and vomiting (PONV) and opioid administration in the postoperative setting. The clinical question was in adult women, age 18 years or greater, undergoing a mastectomy procedure, does the implementation of an ERAS guideline lower the incidence of PONV and reduce morphine milligram equivalent (MME) requirements in a post-anesthesia care unit (PACU)? Patients undergoing breast cancer surgery have multiple risk factors and the reported incidence of PONV reaches up to 80%. Over half of post-surgical breast cancer patients develop neuropathic pain syndromes. A mastectomy ERAS guideline was developed then applied to the perioperative course of 22 patients. It was found that following an ERAS guideline reduced the incidence of PONV by 17% and reduced the average MME by 13.5 equivalents. Project implications include potential cost savings, reduced PACU length of stay, and improved patient outcomes.
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Title
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Increasing breast cancer self-awareness and screening in a vulnerable population through faith-based community outreach
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Creator
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Carpenter, Lauren J.
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Date
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2021
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Collection
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Doctor of Nursing Practice Projects
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Description
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Breast cancer is one of the leading cancer diagnoses for women in the United States. Certain vulnerable populations are at an increased risk for breast cancer mortality, including homeless and African American women. Providing healthcare navigation, cancer education, and connecting with faith-based communities has shown to increase cancer screening rates and knowledge in these vulnerable populations. The purpose of this QI project was to provide breast cancer screening education and access to...
Show moreBreast cancer is one of the leading cancer diagnoses for women in the United States. Certain vulnerable populations are at an increased risk for breast cancer mortality, including homeless and African American women. Providing healthcare navigation, cancer education, and connecting with faith-based communities has shown to increase cancer screening rates and knowledge in these vulnerable populations. The purpose of this QI project was to provide breast cancer screening education and access to care with the goal of increasing breast cancer screening rates and breast self-awareness among at-risk women in a midwestern Michigan community attending faith-based organizations. The project was implemented at three different faith-based communities, including a community soup kitchen serving homeless people and two predominantly African American churches. An educational presentation was created to deliver tailored breast cancer information. Participants were also provided the opportunity to be enrolled for a free mammogram. The intervention was delivered virtually via a PowerPoint presentation on a secure zoom session. Enrollment forms were provided for eligible participants to be screened with a mammogram. Participant's attitudes, knowledge, and confidence towards breast cancer screening were measured before and after the intervention with surveys. A statistically significant increase in participant's knowledge regarding breast cancer screening was found among the 15 total participants. This project demonstrates that education in conjunction with faith-based communities can increase breast cancer knowledge and screening in vulnerable populations to reduce breast cancer mortality.
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