Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · December 2025
PurposeThis quality improvement project used operating room black box (ORBB) technology to evaluate adherence to liposomal bupivacaine (LB) administration protocols, specifically to identify obstacles to compliance with these protocols to mitigate ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · October 2025
PurposeThis quality improvement project aimed to improve postoperative handoff communication between anesthesia providers and neuroscience intensive care unit nurses by developing and implementing a standardized postoperative handoff checklist for ...
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Journal ArticleTransfusion · August 2025
BACKGROUND: Previous studies have called for the implementation of provider reeducation efforts to improve massive transfusion protocol adherence. OBJECTIVE: This quality improvement project implemented an educational module designed to increase anesthesia ...
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Journal ArticleClinical Simulation in Nursing · April 1, 2025
Background: Simulation learning involves multiple interconnected phases, such as prebriefing, which includes preparation and briefing activities, laying the foundation for a successful learning experience. To date, relatively little knowledge exists on the ...
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Journal ArticleClinical Simulation in Nursing · March 1, 2025
Background: High spinal is a rare, yet potentially life-threatening, complication of obstetric (OB) anesthesia that is defined as a blockade of spinal nerves above T4. Providers often feel inadequate to respond to emergencies they rarely or never experienc ...
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Journal ArticleClinical Simulation in Nursing · February 1, 2025
Background: Airway fire (AF) is a rare, sentinel event that certified registered nurse anesthetists (CRNA) may not be fully prepared to manage due to lack of mandatory intermittent training and clinical experience. Methods: This quality improvement (QI) pr ...
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Journal ArticleAORN journal · February 2025
Repositioning a patient from the prone to supine position can delay the initiation of cardiopulmonary resuscitation (CPR). Investigators used high-fidelity simulation to assess the time to initiate chest compressions and the time during which compressions ...
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Journal ArticleClinical Simulation in Nursing · January 1, 2025
Background: Medication errors in anaesthesia occur at alarming rates and can increase perioperative morbidity and mortality. Standardized nurse anaesthesiology curricula for medication preparation and administration do not exist; rather, most nurse anaesth ...
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Journal ArticleJournal of Perianesthesia Nursing · January 1, 2025
Purpose: Food insecurity (FI) is a social determinant of health and health disparity that leads to increased risk of chronic health conditions. Despite the widespread implementation of FI screening in other settings, the role of the anesthesia team in FI s ...
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Journal ArticleAmerican journal of infection control · January 2025
BackgroundHand hygiene and double-gloving practices during induction of general anesthesia can decrease transmission of bacteria to patients and subsequent health care-associated infections; however, compliance to these practices is low.Method ...
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Journal ArticleClinical Simulation in Nursing · December 1, 2024
Background: Non-technical skills (NTS) include situational awareness, teamwork, decision making, and leadership. Intraoperative errors and adverse patient outcomes are associated with providers lacking NTS. Screen-based simulation (SBS) can be used to teac ...
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Journal ArticleClinical Simulation in Nursing · November 1, 2024
Background: Amniotic fluid embolism (AFE) is a rare, yet deadly obstetric (OB) crisis. Simulation-based training (SBT) can promote provider self-confidence and protocol adherence for multidisciplinary OB care teams during AFE. Methods: Two multidisciplinar ...
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Journal ArticleAANA journal · October 2024
This project sought to educate providers on the benefits of lung protective ventilation (LPV), implement a LPV protocol in robotic surgery, and evaluate adherence to the protocol in the adult (≥ 18 years) robotic-assisted surgery population. This project u ...
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Journal ArticleAANA journal · August 2024
The transversus abdominis plane (TAP) block is a regional anesthesia technique used as part of a multimodal pain management plan in patients undergoing abdominal surgery. There are numerous approaches and techniques described in the literature, resulting i ...
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Journal ArticleTrends in Anaesthesia and Critical Care · August 1, 2024
Background: The distal pharyngeal airway (DPA) is a novel airway management tool that relieves airway obstruction. Elongated tubing extends to distal pharyngeal tissues which traditional oral and nasal airways fail to reach. This Quality Improvement initia ...
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Journal ArticleClinical Simulation in Nursing · July 1, 2024
Background: "Cannot ventilate, cannot intubate" is a challenging airway emergency that can lead to negative patient outcomes. Screen-based simulation (SBS) as a learning adjunct could help anesthesia providers improve decision-making skills in difficult ai ...
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Journal ArticleAANA journal · April 2024
This project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded ...
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Journal ArticleClinical Simulation in Nursing · April 1, 2024
Background: Factors outside of formal didactic sessions during healthcare education can influence students’ learning and achievement of desired learning outcomes. The Healthcare Simulation Standards of Best PracticeTM emphasize the importance of ...
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Journal ArticleClinical Simulation in Nursing · February 1, 2024
Background: Certified registered nurse anesthesiologists (CRNAs) undergoing high stakes assessment must demonstrate competency. Written competency is the current method of high-stakes assessment, and this paper uses Miller's Pyramid of competency to explor ...
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Journal ArticleQuality management in health care · January 2024
Background and objectivesOperating rooms (ORs) disproportionally contribute 20% to 33% of hospital waste nationwide and therefore have a major impact on hospital waste management. Seventy percent of general OR waste is incorrectly eliminated as cl ...
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Journal ArticleJournal of Nursing Regulation · January 1, 2024
Background: The healthcare industry is experiencing a rise in substance use disorder (SUD) as healthcare professionals who have access to controlled substances are at increased risk of developing SUD. However, individuals with SUD do not typically self-rep ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · December 2023
PurposeThe purpose of this quality improvement (QI) project was to reintroduce and assess the feasibility of a standardized, electronic health record (EHR) handoff tool and to evaluate the sustainability of a structured, team-based approach in a p ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · December 2023
PurposeThe use of lung protective ventilation (LPV) during general anesthesia is an effective strategy among certified registered nurse anesthetists (CRNAs) to reduce and prevent the incidence of postoperative pulmonary complications. The purpose ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · August 2023
PurposeAppropriate preoperative screening techniques are needed to safely provide anesthesia to increasing numbers of cannabis using surgical patients.DesignThis was a quasi-experimental quality improvement project.MethodsPreoper ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · June 2023
PurposeThis quality improvement project implemented job-related education for registered nurses (RNs) completing preoperative anesthesia interviews (PAIs) to increase their knowledge and confidence, improve completeness of documented preoperative ...
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Journal ArticleAANA journal · February 2023
Difficult and failed airway management remains a significant cause of anesthesia-related morbidity and mortality. Failed airway management guidelines include performing a cricothyrotomy as a final step. Correct identification of the cricothyroid membrane ( ...
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Journal ArticleClinical Simulation in Nursing · February 1, 2023
Background: Certified registered nurse anesthetists (CRNAs) recertify through the Continued Professional Certification (CPC) Program. Screen-based simulation (SBS) is broadly accessible and should be considered as a recertification option. Methods: Using t ...
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Journal ArticleAANA journal · February 2023
Cricothyrotomy proficiency is imperative for anesthesia providers; however, opportunities to perform this skill are infrequent making skill maintenance essential. Increased accessibility of three-dimensional (3D) printing allows for production of low-cost ...
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Journal ArticleAANA journal · February 2023
In 2016, the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) launched a Continued Professional Certification (CPC) Program to promote lifelong learning and to facilitate ongoing professional competency checks for practic ...
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Journal ArticleAANA journal · February 2023
Simulation manikins provide anesthetists a training modality to practice ultrasound-guided central venous catheter (CVC) insertion safely without the risk of patient harm. The goals of this quality improvement (QI) project were to increase technical skills ...
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Journal ArticleJournal of Interprofessional Education and Practice · December 1, 2022
Background: Preoperative anesthesia interviews lacking necessary health history information may lead to cancelled or delayed elective cases on the day of surgery (DOS) in outpatient settings. This project introduced interprofessional preoperative anesthesi ...
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Journal ArticleTransfusion · November 2022
BackgroundFailure to comply with institutional and national standards for blood product administration poses patient safety risks. Monitoring adherence to blood product administration policy is important for maintaining patient safety and ensuring ...
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Journal ArticleJournal of perioperative practice · July 2022
Patients with risk factors for gastroparesis are at increased risk for aspiration into the tracheobronchial tree. Current American Society of Anesthesiologists fasting guidelines use subjective measures to determine aspiration risk. A gastric ultrasound pr ...
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Journal ArticleJournal of nursing care quality · July 2022
BackgroundMalignant hyperthermia (MH) is a potentially lethal pharmacogenetic disorder triggered by certain anesthetic agents. There is currently no standardized preoperative screening tool utilized to identify MH-susceptible individuals.Local ...
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Journal ArticleJ Perianesth Nurs · June 2022
PURPOSE: Over 3 million people have a cardiac implantable electronic device (CIED) in the United States. Without an organization-wide, standardized approach to the perioperative management of patients with CIEDs, communication errors and subsequent periods ...
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Journal ArticleJournal of Radiology Nursing · June 1, 2022
The first scheduled surgical or diagnostic procedure of the day sets the tone for the entire daily operating room (OR) schedule. Delayed first procedures of the day result in subsequent delays, affecting productivity, staffing, and most importantly, patien ...
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Journal ArticleAANA J · June 2022
Cricothyrotomy is an invasive airway used in "cannot intubate, cannot ventilate" events and can be taught using simulation. A mobile cricothyrotomy simulation for 66 anesthesia providers included an initial cricothyrotomy attempt (pretest), education, prac ...
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Journal ArticleJournal for nurses in professional development · May 2022
In-hospital cardiac arrests have high mortality rates, increased by delayed resuscitation. Using a single group pre-post interventional design to implement virtual cardiac arrest simulations for medical-surgical units, the purpose of this project was to de ...
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Journal ArticleClinical Simulation in Nursing · May 1, 2022
Background: Transgender individuals face significant health disparities which can be largely attributed to lack of provider education on healthcare issues faced by this population. Methods: A quality improvement project using a pre-posttest design was used ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · December 2021
PurposeThe purpose of this quality improvement project was to determine if implementing a Phase II postanesthesia care unit (PACU II) to fast-track patients following surgery in an academic hospital would decrease OR hold times and increase patien ...
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Journal ArticleAANA journal · October 2021
The clinical application of intraoperative mechanical ventilation is highly variable and often determined by providers' attitudes and preferences, rather than evidence. Ventilation strategies using high tidal volumes (VT) with little to no posit ...
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Journal ArticleJournal of Interprofessional Education and Practice · September 1, 2021
Background: Emergent undocking of the surgical robot is a high-acuity low-frequency event that requires knowledge and proficiency to optimize patient safety. Simulation was used to codify sequential processes, roles, and responsibilities. Purpose: This qua ...
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Journal ArticleJ Perianesth Nurs · August 2021
PURPOSE: Approximately 2% of surgical patients have an existing cardiac implantable electronic device (CIED). Perioperative device reprogramming requires postoperative care to ensure that device settings are restored. Electronic health record (EHR) alerts ...
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Journal ArticleInternational journal of nursing education scholarship · June 2021
ObjectivesThis manuscript describes the application of deep learning to physiology education of Student Registered Nurse Anesthetists (SRNA) and the benefits thereof. A strong foundation in physiology and the ability to apply this knowledge to cha ...
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Journal ArticleJournal of dental anesthesia and pain medicine · June 2021
BackgroundEmergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to ...
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Journal ArticleWaste management (New York, N.Y.) · March 2021
Approximately 90% of medical waste generated in the operating room (OR) is considered to be non-infectious and non-regulated (Wyssusek, Keys & van Zundert, 2019). Frequently, this waste is inappropriately disposed of into infectious regulated medical waste ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · February 2021
PurposeThis quality improvement project implemented an evidence-based multimodal analgesia protocol among patients undergoing outpatient spine surgery in an attempt to decrease postoperative opioid requirements, postoperative pain scores, and faci ...
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Journal ArticleClinical Simulation in Nursing · December 1, 2020
Background: In-hospital cardiac arrests (IHCA) in the United States have a 21% survival-to-hospital discharge rate. This quality improvement project aimed to improve Basic Life Support–trained nursing staff responses to IHCAs at a large academic teaching h ...
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Journal ArticleJournal of Interprofessional Education and Practice · December 1, 2020
Background: Robotic-assisted surgery is an increasingly prevalent technique that offers benefits to surgeon and patient. Inherent safety concerns exist with surgical robots yet can be mitigated by developing an emergency robotic undocking protocol (ERUP) a ...
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Journal ArticleComputers, informatics, nursing : CIN · October 2020
The handoff or handover is the exchange of pertinent medical information from one provider to another. Inadequate handoff communication between healthcare providers can negatively impact patient outcomes. In an effort to improve handoff communication, many ...
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Journal ArticleJournal of Nursing Regulation · October 1, 2020
The National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA) uses high-fidelity simulation for high-stakes competency assessment as a part of the Reentry Program. Purpose: This quality improvement project aimed to develop and vali ...
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Journal ArticleJournal of pediatric nursing · September 2020
PurposeThe purpose of this quality improvement project was to implement an educational intervention involving High-Fidelity Simulation (HFS) with deliberate practice for low-frequency, high-impact events in a Pediatric Intensive Care Unit (PICU), ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · August 2020
PurposeThis quality improvement project integrated the STOP-Bang (Snoring, Tiredness, Observed apnea, Blood Pressure, Body Mass Index, Age, Neck circumference, male Gender) questionnaire into the preanesthetic assessment to identify patients at ri ...
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Journal ArticleAANA journal · August 2020
Anesthetic modalities to mitigate the development of phantom limb pain have not been standardized into an evidence-based, multimodal anesthesia protocol to promote improved patient outcomes. This quality improvement project involved the implementation of a ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · October 2019
PurposeThe primary purpose of this project was to preoperatively identify frail and vulnerable geriatric patients aged 65 or older using the Vulnerable Elders Survey (VES-13) tool, and to use those scores to assist with perioperative decision-maki ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · October 2019
PurposeThorough and accurate preoperative anesthesia interviews may help improve perioperative efficiency by reducing unnecessary preoperative testing and preventable surgical cancellations, both of which create financial burdens. Standardized ane ...
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Journal ArticleClinical Simulation in Nursing · October 1, 2019
Background: The nature and process of suspending disbelief is complex, subjective, and has not been well researched in clinical simulation. Methods: A descriptive phenomenological approach with semistructured interviews explored student experiences of susp ...
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Journal ArticleAANA journal · October 2019
This project aimed to develop and implement a nasal ventilation mask (NVM) guideline to reduce the incidence of airway obstruction in outpatients undergoing endoscopy procedures. An observational design was used to evaluate implementation of an NVM guideli ...
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Journal ArticleJ Perianesth Nurs · August 2019
PURPOSE: The primary aim of this project was to decrease the incidence of postoperative delirium after spine surgery. DESIGN: A prospective preimplementation and postimplementation design was used. METHODS: A reduced dose ketamine protocol was implemented ...
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Journal ArticleCritical care nursing quarterly · July 2019
Pulmonary artery catheters (PACs) are invasive devices placed in critically ill patients to monitor hemodynamic data. They are a high-risk, and in some settings a low-volume, medical device due to the complex insertion procedure and potentially lethal comp ...
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Journal ArticleJournal of Nursing Regulation · July 1, 2019
Background: Certified Registered Nurse Anesthetists (CRNAs) who fail to comply with the Continued Professional Certification Program, or those out of practice for an extended time, must recertify with the National Board of Certification and Recertification ...
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Journal ArticleJ Perianesth Nurs · June 2019
PURPOSE: This quality improvement project examined whether the use of a validated physiological scoring protocol to determine discharge readiness for surgical procedures proximal to the airway would decrease the time at which discharge criteria were met an ...
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Journal ArticleGastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates · May 2019
Twenty percent of all ambulatory surgery cases utilizing monitored anesthesia care and sedation report at least one perioperative respiratory complication such as bronchospasm, hypoxia, laryngospasm, or aspiration (). However, the national Standards of Pra ...
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Journal ArticleNursing for women's health · April 2019
ObjectiveTo decrease hospital expenses by administering oral acetaminophen rather than intravenous (IV) acetaminophen to women who undergo laparoscopic hysterectomy.DesignA quality improvement project using a between-groups, pre-/postimpl ...
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Journal ArticleOrthopedic nursing · March 2019
Effective pain management for orthopaedic major joint replacement is key to achieving earlier recovery, better functioning, and high rates of patient satisfaction. In an effort to decrease opioid dependency, practitioners are turning to multimodal pain man ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · February 2019
PurposeThis quality improvement project aimed to change the practice of administration route of acetaminophen from intravenous (IV) to oral to patients having a hysterectomy at a community hospital, reduce costs, and maintain postanesthesia care u ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · February 2019
PurposeThis article describes the implementation of a postoperative nausea and vomiting (PONV) risk prediction and prophylaxis protocol.DesignThis is a retrospective pre/post implementation quality improvement project.MethodsThis ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · February 2019
Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease in which antibodies against the post-nicotinic acetylcholine receptor at the neuromuscular junction develop. Although the exact cause of MG remains unknown, the thymus is a common factor ...
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Journal ArticleClinical simulation in nursing · January 2019
BackgroundTransgender people often experience inequities, discrimination, and violence within health care environments by ill-informed health care professionals. Simulation has been beneficial in increasing students' knowledge about transgender he ...
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Journal ArticleClinical Simulation in Nursing · January 1, 2019
Background: Malignant hyperthermia (MH) is a low-frequency, high-impact event that many certified registered nurse anesthetists may be unprepared to manage due to limited clinical experience. Method: A pretest, posttest, repeated-measures design was used t ...
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Journal ArticleClinical Simulation in Nursing · November 1, 2018
Background: In-hospital strokes are life-threatening emergencies that require prompt and skillful treatment to prevent poor patient outcomes. Currently, however, a national gap in care exists for patients who experience an in-hospital stroke. Methods: Mult ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · June 2018
Perioperative management of pediatric patients demands knowledge of the relevant ways in which pediatric physiology and physiological regulation differs from the adult. This article will outline some of these most pertinent differences, and also present cu ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · April 2018
PurposeThe primary aim of this quality improvement project was to improve mobilization for patients after total knee arthroscopy by developing and implementing a standardized, evidence-based, multimodal analgesia regimen and patient-educational vi ...
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Journal ArticleClinical Simulation in Nursing · January 1, 2018
Background To cultivate clinical expertise, many critical care transport (CCT) programs have engaged simulation as a means of providing ongoing clinical education for crewmembers. Method A pretest, posttest, repeated-measures design was used to evaluate wh ...
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Journal ArticleJournal of Nursing Regulation · January 1, 2018
Introduction The National Board of Certification and Recertification for Nurse Anesthetists addressed a barrier to return to practice of uncertified practitioners by replacing required direct patient care experiences with high-fidelity simulation. Objectiv ...
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Journal ArticlePlastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses · October 2017
Many patients undergoing plastic surgery experience significant pain postoperatively. The use of preemptive, multimodal analgesia techniques to reduce postoperative pain has been widely described in the literature. This quality improvement project evaluate ...
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Journal ArticleAANA journal · August 2017
Simulation is an accepted teaching tool that focuses on active learning and is used to solidify cognitive, motor, critical thinking, and communication skills. This method of experiential learning was introduced and integrated into the distance-based degree ...
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Journal ArticleAORN journal · April 2017
Surgery cancellations are costly and can be frustrating for patients, their families, and the surgical team. Because of the inherent nature of an ambulatory surgery center, which only performs scheduled elective procedures, surgical cancellations typically ...
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Journal ArticleAANA journal · February 2017
Most anesthesia providers will experience at least one perioperative critical incident during their career, potentially causing critical incident stress symptoms that may affect their ability to provide patient care. The purpose of this descriptive pilot i ...
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Journal ArticleClinical Simulation in Nursing · January 1, 2017
Rooted in aviation and used consistently in the training and preparation of health care professionals for decades, simulation is an innovative teaching strategy that facilitates experiential learning in a safe learning environment. Effective simulation hin ...
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Journal ArticleJournal of continuing education in nursing · June 2016
The development of psychomotor and procedural skills requires opportunities for repetitive practice combined with specific, informational feedback from the teacher, another expert, or simulator to correct performance errors. Practice enables learners to re ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · April 2015
PurposeThe purpose of this process improvement project was to introduce and evaluate the efficacy of fast-tracking ambulatory surgical patients in a community hospital.DesignAn observational pre-post design was used, in which patient data ...
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Journal ArticleJournal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses / American Society of PeriAnesthesia Nurses · December 2012
In an effort to reduce costs, many hospitals may use registered nurses (RNs) with little to no formal education or training in anesthetic or surgical risk to perform anesthesia preoperative interviews (APIs). This lack of education and training can result ...
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