Vallire Hooper - Academia.edu (original) (raw)

Papers by Vallire Hooper

Research paper thumbnail of Nursing Post Pandemic: The Path Forward

Journal of PeriAnesthesia Nursing

Research paper thumbnail of The Last Line of Defense: The Human/Technology Conundrum

Journal of PeriAnesthesia Nursing

Research paper thumbnail of A New Year…A New Hope??

Journal of PeriAnesthesia Nursing, 2021

Research paper thumbnail of The Shifting Paradigm of Healthcare

Journal of PeriAnesthesia Nursing, 2020

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Research paper thumbnail of Reliability Testing of Augmented Reality Glasses Technology

Journal of Wound, Ostomy & Continence Nursing, 2019

PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth t... more PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings. DESIGN: Intrarater reliability design focusing on treatment integrity. SAMPLE AND SETTING: Adult patients in a tertiary care hospital and a rural long-term care setting who were scheduled for routine wound care consults. METHODS: Intra- and interrater reliability were assessed using a documentation-based wound assessment tool comprising 6 discrete assessment points. The wound teleassessment was first conducted by the telehealth “hub” WOC nurse remotely in collaboration with a bedside nurse wearing the ARG. The same hub WOC nurse then conducted an assessment at the bedside. Initial assessment points and treatment plans were compared to establish assessment and treatment intrarater reliability. A different WOC nurse, blinded to the first assessment, also conducted a beds...

Research paper thumbnail of Risk Factors for Perioperative Hypothermia: A Literature Review

Journal of PeriAnesthesia Nursing, 2018

The purpose of this article was to review the literature to identify risk factors for the develop... more The purpose of this article was to review the literature to identify risk factors for the development of unplanned perioperative hypothermia and to evaluate the strength of the evidence for each risk factor. Design: Comprehensive literature review Methods: An evidence rating scale was used to evaluate the strength and quality of the research gathered. Findings: At this time, only anecdotal evidence is available to guide our efforts in the maintenance of perioperative normothermia. There is currently no strong evidence to implicate risk factors that do or do not cause a patient to develop unplanned perioperative hypothermia. Conclusions: It is crucial to prevention that health care providers are able to identify risk factors and implement interventions. However, vigilance in the perioperative period can only enhance patient safety when we know what to look for. More research is needed to identify risk factors of unplanned perioperative hypothermia and effectively maintain normothermia throughout the perioperative period.

Research paper thumbnail of The Relationship of Pain and Nausea in Postoperative Patients for 1 Week After Ambulatory Surgery

The Clinical Journal of Pain, 2015

The purpose of this study was to determine if pain level was associated with demographic or surge... more The purpose of this study was to determine if pain level was associated with demographic or surgery-specific characteristics among patients recovering from ambulatory surgery; and to assess the relationship between pain level and nausea over the 7-day postoperative period, controlling for demographic and surgery-related covariates. Materials and Methods: This longitudinal study assessed the pain and nausea of 248 eligible patients during the day of surgery (DOS) and the 7 days following ambulatory surgery. Postoperative data were assessed using standardized questions about severity of pain and nausea symptoms. Participants who had a cumulative pain score of Z24 over the 8-day period were categorized as having high pain. Repeated-measures analysis of variance was used to assess differences in nausea by pain group over time, controlling for demographic, surgical variables, and antiemetic and analgesic use. Results: There were significant differences between 2 pain groups in age, surgical procedure, cumulative morphine equivalent dose, and use of antiemetics postdischarge. The longitudinal analysis demonstrated that patients in the high-pain group reported a greater degree of nausea on DOS and on each of the first 5 days postsurgery, controlling for differences in age, sex, education, use of antiemetics presurgery and postsurgery, use of acetaminophen postsurgery, daily morphine equivalent dose, and surgical procedure. Discussion: Younger patients and those receiving orthopedic procedures may be at greatest risk for postoperative pain. Patients with high pain reported a significantly greater degree of nausea on DOS through the first 5 days postdischarge. As the majority of surgeries are now conducted in the ambulatory setting, it is imperative that we determine pain management regimens and patient education practices that will allow for a more comfortable recovery for our patients.

Research paper thumbnail of Postdischarge Nausea and Vomiting: Management Strategies and Outcomes Over 7 Days

Journal of PeriAnesthesia Nursing, 2014

The purpose of this study is to determine patient management strategies and outcomes for self-car... more The purpose of this study is to determine patient management strategies and outcomes for self-care of postdischarge nausea and vomiting (PDNV). Prospective, comparative, descriptive, and longitudinal study. The sample consisted of 248 patients aged 18 years or older undergoing a procedure requiring general anesthesia. Patients recorded incidence and severity of nausea and vomiting, the impact of symptoms, and actions taken to alleviate symptoms for 7 days postdischarge. The prevalence of PDNV was 56.9%. The methods used to relieve symptoms included antiemetic use by a minority and nonpharmacologic techniques of self-management by some. The effect of nausea on QOL, patient functioning, and patient satisfaction was significantly worse for those who experienced postdischarge nausea on all days. Patients with PDNV use minor self-care strategies to manage symptoms. The presence of PDNV affects overall quality of life, patient functioning, and patient satisfaction.

Research paper thumbnail of The Matter of an “A”

Journal of PeriAnesthesia Nursing, 2007

Research paper thumbnail of Through the eyes of a child

Journal of PeriAnesthesia Nursing, 2000

I LOVE THE HOLIDAY season! What a glorious time of year. The excitement at our house actually sta... more I LOVE THE HOLIDAY season! What a glorious time of year. The excitement at our house actually starts around the first of October as we decorate for Halloween. The frenzy and fun accelerates as fall blends into winter, with the onslaught of Thanksgiving, my little girl's December birthday, and f inal ly . . . Christmas. This season has always been special as I think that I have never truly grown up, but I must say that the past 7 years have been especially magical as I have experienced the wonders of Christmas through the eyes of my Lauren--what a truly wondrous blessing. I think that most of us would agree that we experience a new sense of wonderment when we have the privilege of experiencing this season through the eyes of a child. Children's lives are full of wonders. They put their complete trust in you, rarely questioning. Everything is new and magical, most everything brings joy, and they, subsequently, bring joy to us in return. How appropriate it is that this December issue is dedicated to the true believers among us, to our most precious gifts, to the children. One of the things that excited me the most when I transferred to PACU was the fact that I would finally get to take care of children. It was something that I had always meant to do but just had not been able to get around to. That first PACU

Research paper thumbnail of Perianesthesia Nurse Fatigue Advocating for our Staff Nurses and Safe Patient Care

Journal of PeriAnesthesia Nursing, 2008

The new federal mandates dictated the need for increasing awareness and education of all staff wi... more The new federal mandates dictated the need for increasing awareness and education of all staff with regards to skin integrity. A small work group was created to review mandates and implement an approach to inform the nursing staff. An in-depth educational program was created and distributed to Perianesthesia nurses. A specific plan of care and the development of a formal line of communication was established. Guidelines were developed to identify patients with current skin integrity problems and patients at risk for skin breakdown. A formal hospital wide Perioperative Skin Integrity Committee was founded using the blueprint developed by the small work team.

Research paper thumbnail of Where’s the Beef?

Journal of PeriAnesthesia Nursing, 2006

Research paper thumbnail of The ASPN’s EBP Conceptual Model: Framework for Perianesthesia Practice and Research

Journal of PeriAnesthesia Nursing, 2006

Nurses (ASPAN) highly regards evidence-based practice (EBP) as a guide to promoting "Best Practic... more Nurses (ASPAN) highly regards evidence-based practice (EBP) as a guide to promoting "Best Practices" and improving patient outcomes. EBP is now considered the "gold standard" in improving patient care through the use of the best available evidence. EBP models provide the health care provider with a rigorous systematic method of rating and appraising the evidence that includes, but is not limited to, randomized controlled trials, descriptive studies, qualitative studies, national guidelines, and expert opinion. ASPAN's EBP Team was charged with the development of an EBP Conceptual Model to provide the framework for future perianesthesia practice, education, and research. This article describes how ASPAN's EBP model may be used as a framework for practice and research.

Research paper thumbnail of Incidence and predictors of postdischarge nausea and vomiting in a 7-day population

Journal of Clinical Anesthesia, 2013

Study Objective: 1) To quantify the incidence and severity of postdischarge nausea and vomiting (... more Study Objective: 1) To quantify the incidence and severity of postdischarge nausea and vomiting (PDNV) for 7 days in adults undergoing outpatient surgeries with general anesthesia; 2) to evaluate whether a risk model previously developed for the first two postoperative days may be used to predict the patient's risk of PDNV for 7 days; and 3) to verify whether the same risk factors are applicable in the 3 to 7 day period. Design: Prospective study. Setting: Two university-affiliated centers. Patients: 248 adult (N 18 years) surgical outpatients undergoing ambulatory surgical procedures with general anesthesia between 2007 and 2008. Measurements: The incidence and severity of PDNV and a simplified risk score for PDNV was assessed prospectively from discharge up to 7 postoperative days. Main Results: The overall incidence of nausea was 56.9% and of emesis was 19.4%. The incidence of PDNV was highest on the day of surgery (DOS), with PDNV of 44.8% and decreasing over time to 6.0% on day 7. Using the simplified risk score for PDNV the area under the receiver operating characteristic (ROC) curve

Research paper thumbnail of Good-byes and hellos

Journal of PeriAnesthesia Nursing, 2001

If you need help with If you need help with If you need help with your burn permit(s), your burn ... more If you need help with If you need help with If you need help with your burn permit(s), your burn permit(s), your burn permit(s), Jeff Klundt has taken Jeff Klundt has taken Jeff Klundt has taken over for Frank and is over for Frank and is over for Frank and is available to help Monavailable to help Mon-available to help Monday through Thursday day through Thursday day through Thursday or by appointment.

Research paper thumbnail of Snow day

Journal of PeriAnesthesia Nursing, 2002

ABSTRACT

Research paper thumbnail of Taking outcomes to the next level

Nursing Management

A dvanced practice registered nurses (APRNs) directly impact acute and chronic conditions with a ... more A dvanced practice registered nurses (APRNs) directly impact acute and chronic conditions with a combination of clinical nursing experience, organizational expertise, and advanced education. They’re being used across the country to meet the ever-increasing demands on healthcare resources. The need for graduate nursing roles, both master’s and doctorally prepared, has increased exponentially over the past several years. In 2018, over 17% of RNs held a master’s degree and nearly 2% held a doctoral degree. However, this increase continues to fall short of the need for graduate level nurses practicing in advanced roles, specialty areas, research, and education.1 As the number of nurses practicing with graduate level degrees increases, a significant amount of role confusion has accompanied this transition. It’s imperative that nursing leaders understand the difference in roles and scope of practice variations between roles to optimize graduate prepared nurses as part of the leadership and care delivery teams. The clinical nurse specialist (CNS) role has been significantly impacted by this confusion and variation, leading to missed opportunities to harness the unique skill set and knowledge that a CNS can offer to an organization. This article describes the implementation of a nursing practice model incorporating the CNS role to lead multidisciplinary, evidence-based practice (EBP) change efforts across a large regional healthFA T C A M E R A /iS TO C K The clinical nurse specialist as a partner in changing practice

Research paper thumbnail of Enough Is Enough

Journal of PeriAnesthesia Nursing

Enough is enough! I really don't know what else to say. As I write this, it is Labor Day weekend.... more Enough is enough! I really don't know what else to say. As I write this, it is Labor Day weekend. I am mad. I am frustrated. I am aghast. I am in complete and utter disbelief! I do believe the world has tipped off of its axis. The majority of the human race-or at least a very large part of the United States-has COMPLETELY lost its mind. As a result, health care providers, with nurses being at the tip of the sphere, are suffering. The current pandemic of the unvaccinated may not only emaciate the population of disbelievers, but I believe it will also change the trajectory of the nursing profession. Regardless of the results of the next Gallup poll, it is obvious that nursing is no longer the most trusted profession. While the early days of the COVID pandemic saw nurses revered, cheered, encouraged, supported, and treated as superheroes, the current wave of the pandemic is seeing nurses abused by their patients and families, by the public, and also by the health care systems in which they work. Enough is enough. The time of the nurse as an angel, as a superhero, as a rescuer, as a sacrificial lamb, must end. The time of the nurse as a badass professional must ensue. Yes, I said it. I am contemplating a tattoo to mark the occasion. While I have always advocated for nursing professionalism, and for dedication to our patients, our community, our work in general, I am done. Meek, mild professionalism is getting us nowhere. We have professionally advocated for the safety of COVID vaccines, only to be ignored, ridiculed, and/or psychologically and physically attacked. We now find ourselves taking care of patients who COMPLETELY ignored the science, who ignored the professionals, who will take sheep dewormer, but won't take what is now a US Food and Drug Administration−approved vaccine. In many regions, the National Guard has been called in to provide extra staffing at hospitals. Elective surgeries are once again being canceled. Patients may soon be faced with the rationing of care, having to sign documents acknowledging that depending on age and chance of survival, one may not receive full treatment if resources, including ventilators and medications, are not available. The resulting burnout and moral distress of the nursing workforce is reaching critical levels. Nurses are resigning in droves, and they will likely never return. While current enrollments in nursing programs are yet unaffected, I would not be surprised to see enrollment numbers start to decline in the near future. I am now fully convinced the profession will never look the same after this pandemic. We have sacrificed too much; we have been placed in a wartime environment with no armor, no support, no backup , and no respite. I think it is time for the nurse to step up, take control, and call the shots. The days of asking, nicely requesting, are over. A bed in a hospital, without a nurse, is just a bed. Patients come to the hospital for nursing care. Without nursing, the wheelhousethe machine of what we know as traditional hospital care-grinds to a halt. Nurses must no longer be sacrificed for profit. Nurses must no longer be taken advantage of. Nurses must no longer be abused. Nurses must be warriors. Advocating is not an option. Forcefully demanding, a willingness to walk away, is in order if we are to survive and move out of the current crisis. We MUST take care of ourselves if we are to successfully and professionally provide care for others.

Research paper thumbnail of Reexamining Metoclopramide's Role in the Prevention of Postoperative Nausea and Vomiting: A Secondary Analysis

AANA journal, 2018

Postoperative nausea and vomiting (PONV) continue to be among the most undesirable and distressin... more Postoperative nausea and vomiting (PONV) continue to be among the most undesirable and distressing complications following general anesthesia, affecting 20% to 30% of all surgical patients and up to 70% of patients with multiple known risk factors. The purpose of this study was to reexamine the effectiveness of metoclopramide in the prevention of PONV when stratified by PONV risk scores. Secondary data from 2,116 adult ambulatory surgical patients were analyzed. Participants were, on average (SD), 49.7 (15.4) years of age, with a mean body mass index of 28.3 (6.9) kg/m², and were primarily female (65%). Risk scores for PONV ranged from 0 to 4, with a mean of 2.6 (1.0). Metoclopramide, 10 mg intravenously (IV) alone; metoclopramide, 10 mg IV, combined with ondansetron, 4 mg IV; and metoclopramide, 10 mg IV, combined with dexamethasone, 8 mg IV, and ondansetron, 4 mg IV, had a beneficial effect for adult ambulatory surgical patients with PONV risk scores of 1 to 4. Although this cohor...

Research paper thumbnail of A Plane Crashed Today … Do You Care?

Journal of PeriAnesthesia Nursing, 2020

A plane crashed today d actually five commercial jetliners crashed in the United States today d a... more A plane crashed today d actually five commercial jetliners crashed in the United States today d and the day before, and the day before that … and for at least the last 5 days. Twenty-five jetliners in 5 days, 5,000 souls lost. Do you care? If this were a true story, you would be outraged. How could this happen? Why have we not grounded all air travel in the United States? What is the federal government doing to remedy this atrocity? The reality, unfortunately, is that the atrocity is real, the numbers are true, but the cause of death is not a plane falling out of the sky; the cause of death is coronavirus disease 2019 (COVID-19). Let that sink in. As I write this editorial in the last week in July, the United States is averaging 1,000 COVID-related deaths per day. 1 To be exact, as of July 27, there have been, in the United States alone: 2 150,000 COVID deaths 4 million COVID cases 452 COVID deaths/million 120,000/100,000 hospitalized with COVID Contents lists available at ScienceDirect Journal of PeriAnesthesia Nursing j o u r n a l h o m e p a g e : w w w. j o p a n. o rg

Research paper thumbnail of Nursing Post Pandemic: The Path Forward

Journal of PeriAnesthesia Nursing

Research paper thumbnail of The Last Line of Defense: The Human/Technology Conundrum

Journal of PeriAnesthesia Nursing

Research paper thumbnail of A New Year…A New Hope??

Journal of PeriAnesthesia Nursing, 2021

Research paper thumbnail of The Shifting Paradigm of Healthcare

Journal of PeriAnesthesia Nursing, 2020

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Research paper thumbnail of Reliability Testing of Augmented Reality Glasses Technology

Journal of Wound, Ostomy & Continence Nursing, 2019

PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth t... more PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings. DESIGN: Intrarater reliability design focusing on treatment integrity. SAMPLE AND SETTING: Adult patients in a tertiary care hospital and a rural long-term care setting who were scheduled for routine wound care consults. METHODS: Intra- and interrater reliability were assessed using a documentation-based wound assessment tool comprising 6 discrete assessment points. The wound teleassessment was first conducted by the telehealth “hub” WOC nurse remotely in collaboration with a bedside nurse wearing the ARG. The same hub WOC nurse then conducted an assessment at the bedside. Initial assessment points and treatment plans were compared to establish assessment and treatment intrarater reliability. A different WOC nurse, blinded to the first assessment, also conducted a beds...

Research paper thumbnail of Risk Factors for Perioperative Hypothermia: A Literature Review

Journal of PeriAnesthesia Nursing, 2018

The purpose of this article was to review the literature to identify risk factors for the develop... more The purpose of this article was to review the literature to identify risk factors for the development of unplanned perioperative hypothermia and to evaluate the strength of the evidence for each risk factor. Design: Comprehensive literature review Methods: An evidence rating scale was used to evaluate the strength and quality of the research gathered. Findings: At this time, only anecdotal evidence is available to guide our efforts in the maintenance of perioperative normothermia. There is currently no strong evidence to implicate risk factors that do or do not cause a patient to develop unplanned perioperative hypothermia. Conclusions: It is crucial to prevention that health care providers are able to identify risk factors and implement interventions. However, vigilance in the perioperative period can only enhance patient safety when we know what to look for. More research is needed to identify risk factors of unplanned perioperative hypothermia and effectively maintain normothermia throughout the perioperative period.

Research paper thumbnail of The Relationship of Pain and Nausea in Postoperative Patients for 1 Week After Ambulatory Surgery

The Clinical Journal of Pain, 2015

The purpose of this study was to determine if pain level was associated with demographic or surge... more The purpose of this study was to determine if pain level was associated with demographic or surgery-specific characteristics among patients recovering from ambulatory surgery; and to assess the relationship between pain level and nausea over the 7-day postoperative period, controlling for demographic and surgery-related covariates. Materials and Methods: This longitudinal study assessed the pain and nausea of 248 eligible patients during the day of surgery (DOS) and the 7 days following ambulatory surgery. Postoperative data were assessed using standardized questions about severity of pain and nausea symptoms. Participants who had a cumulative pain score of Z24 over the 8-day period were categorized as having high pain. Repeated-measures analysis of variance was used to assess differences in nausea by pain group over time, controlling for demographic, surgical variables, and antiemetic and analgesic use. Results: There were significant differences between 2 pain groups in age, surgical procedure, cumulative morphine equivalent dose, and use of antiemetics postdischarge. The longitudinal analysis demonstrated that patients in the high-pain group reported a greater degree of nausea on DOS and on each of the first 5 days postsurgery, controlling for differences in age, sex, education, use of antiemetics presurgery and postsurgery, use of acetaminophen postsurgery, daily morphine equivalent dose, and surgical procedure. Discussion: Younger patients and those receiving orthopedic procedures may be at greatest risk for postoperative pain. Patients with high pain reported a significantly greater degree of nausea on DOS through the first 5 days postdischarge. As the majority of surgeries are now conducted in the ambulatory setting, it is imperative that we determine pain management regimens and patient education practices that will allow for a more comfortable recovery for our patients.

Research paper thumbnail of Postdischarge Nausea and Vomiting: Management Strategies and Outcomes Over 7 Days

Journal of PeriAnesthesia Nursing, 2014

The purpose of this study is to determine patient management strategies and outcomes for self-car... more The purpose of this study is to determine patient management strategies and outcomes for self-care of postdischarge nausea and vomiting (PDNV). Prospective, comparative, descriptive, and longitudinal study. The sample consisted of 248 patients aged 18 years or older undergoing a procedure requiring general anesthesia. Patients recorded incidence and severity of nausea and vomiting, the impact of symptoms, and actions taken to alleviate symptoms for 7 days postdischarge. The prevalence of PDNV was 56.9%. The methods used to relieve symptoms included antiemetic use by a minority and nonpharmacologic techniques of self-management by some. The effect of nausea on QOL, patient functioning, and patient satisfaction was significantly worse for those who experienced postdischarge nausea on all days. Patients with PDNV use minor self-care strategies to manage symptoms. The presence of PDNV affects overall quality of life, patient functioning, and patient satisfaction.

Research paper thumbnail of The Matter of an “A”

Journal of PeriAnesthesia Nursing, 2007

Research paper thumbnail of Through the eyes of a child

Journal of PeriAnesthesia Nursing, 2000

I LOVE THE HOLIDAY season! What a glorious time of year. The excitement at our house actually sta... more I LOVE THE HOLIDAY season! What a glorious time of year. The excitement at our house actually starts around the first of October as we decorate for Halloween. The frenzy and fun accelerates as fall blends into winter, with the onslaught of Thanksgiving, my little girl's December birthday, and f inal ly . . . Christmas. This season has always been special as I think that I have never truly grown up, but I must say that the past 7 years have been especially magical as I have experienced the wonders of Christmas through the eyes of my Lauren--what a truly wondrous blessing. I think that most of us would agree that we experience a new sense of wonderment when we have the privilege of experiencing this season through the eyes of a child. Children's lives are full of wonders. They put their complete trust in you, rarely questioning. Everything is new and magical, most everything brings joy, and they, subsequently, bring joy to us in return. How appropriate it is that this December issue is dedicated to the true believers among us, to our most precious gifts, to the children. One of the things that excited me the most when I transferred to PACU was the fact that I would finally get to take care of children. It was something that I had always meant to do but just had not been able to get around to. That first PACU

Research paper thumbnail of Perianesthesia Nurse Fatigue Advocating for our Staff Nurses and Safe Patient Care

Journal of PeriAnesthesia Nursing, 2008

The new federal mandates dictated the need for increasing awareness and education of all staff wi... more The new federal mandates dictated the need for increasing awareness and education of all staff with regards to skin integrity. A small work group was created to review mandates and implement an approach to inform the nursing staff. An in-depth educational program was created and distributed to Perianesthesia nurses. A specific plan of care and the development of a formal line of communication was established. Guidelines were developed to identify patients with current skin integrity problems and patients at risk for skin breakdown. A formal hospital wide Perioperative Skin Integrity Committee was founded using the blueprint developed by the small work team.

Research paper thumbnail of Where’s the Beef?

Journal of PeriAnesthesia Nursing, 2006

Research paper thumbnail of The ASPN’s EBP Conceptual Model: Framework for Perianesthesia Practice and Research

Journal of PeriAnesthesia Nursing, 2006

Nurses (ASPAN) highly regards evidence-based practice (EBP) as a guide to promoting "Best Practic... more Nurses (ASPAN) highly regards evidence-based practice (EBP) as a guide to promoting "Best Practices" and improving patient outcomes. EBP is now considered the "gold standard" in improving patient care through the use of the best available evidence. EBP models provide the health care provider with a rigorous systematic method of rating and appraising the evidence that includes, but is not limited to, randomized controlled trials, descriptive studies, qualitative studies, national guidelines, and expert opinion. ASPAN's EBP Team was charged with the development of an EBP Conceptual Model to provide the framework for future perianesthesia practice, education, and research. This article describes how ASPAN's EBP model may be used as a framework for practice and research.

Research paper thumbnail of Incidence and predictors of postdischarge nausea and vomiting in a 7-day population

Journal of Clinical Anesthesia, 2013

Study Objective: 1) To quantify the incidence and severity of postdischarge nausea and vomiting (... more Study Objective: 1) To quantify the incidence and severity of postdischarge nausea and vomiting (PDNV) for 7 days in adults undergoing outpatient surgeries with general anesthesia; 2) to evaluate whether a risk model previously developed for the first two postoperative days may be used to predict the patient's risk of PDNV for 7 days; and 3) to verify whether the same risk factors are applicable in the 3 to 7 day period. Design: Prospective study. Setting: Two university-affiliated centers. Patients: 248 adult (N 18 years) surgical outpatients undergoing ambulatory surgical procedures with general anesthesia between 2007 and 2008. Measurements: The incidence and severity of PDNV and a simplified risk score for PDNV was assessed prospectively from discharge up to 7 postoperative days. Main Results: The overall incidence of nausea was 56.9% and of emesis was 19.4%. The incidence of PDNV was highest on the day of surgery (DOS), with PDNV of 44.8% and decreasing over time to 6.0% on day 7. Using the simplified risk score for PDNV the area under the receiver operating characteristic (ROC) curve

Research paper thumbnail of Good-byes and hellos

Journal of PeriAnesthesia Nursing, 2001

If you need help with If you need help with If you need help with your burn permit(s), your burn ... more If you need help with If you need help with If you need help with your burn permit(s), your burn permit(s), your burn permit(s), Jeff Klundt has taken Jeff Klundt has taken Jeff Klundt has taken over for Frank and is over for Frank and is over for Frank and is available to help Monavailable to help Mon-available to help Monday through Thursday day through Thursday day through Thursday or by appointment.

Research paper thumbnail of Snow day

Journal of PeriAnesthesia Nursing, 2002

ABSTRACT

Research paper thumbnail of Taking outcomes to the next level

Nursing Management

A dvanced practice registered nurses (APRNs) directly impact acute and chronic conditions with a ... more A dvanced practice registered nurses (APRNs) directly impact acute and chronic conditions with a combination of clinical nursing experience, organizational expertise, and advanced education. They’re being used across the country to meet the ever-increasing demands on healthcare resources. The need for graduate nursing roles, both master’s and doctorally prepared, has increased exponentially over the past several years. In 2018, over 17% of RNs held a master’s degree and nearly 2% held a doctoral degree. However, this increase continues to fall short of the need for graduate level nurses practicing in advanced roles, specialty areas, research, and education.1 As the number of nurses practicing with graduate level degrees increases, a significant amount of role confusion has accompanied this transition. It’s imperative that nursing leaders understand the difference in roles and scope of practice variations between roles to optimize graduate prepared nurses as part of the leadership and care delivery teams. The clinical nurse specialist (CNS) role has been significantly impacted by this confusion and variation, leading to missed opportunities to harness the unique skill set and knowledge that a CNS can offer to an organization. This article describes the implementation of a nursing practice model incorporating the CNS role to lead multidisciplinary, evidence-based practice (EBP) change efforts across a large regional healthFA T C A M E R A /iS TO C K The clinical nurse specialist as a partner in changing practice

Research paper thumbnail of Enough Is Enough

Journal of PeriAnesthesia Nursing

Enough is enough! I really don't know what else to say. As I write this, it is Labor Day weekend.... more Enough is enough! I really don't know what else to say. As I write this, it is Labor Day weekend. I am mad. I am frustrated. I am aghast. I am in complete and utter disbelief! I do believe the world has tipped off of its axis. The majority of the human race-or at least a very large part of the United States-has COMPLETELY lost its mind. As a result, health care providers, with nurses being at the tip of the sphere, are suffering. The current pandemic of the unvaccinated may not only emaciate the population of disbelievers, but I believe it will also change the trajectory of the nursing profession. Regardless of the results of the next Gallup poll, it is obvious that nursing is no longer the most trusted profession. While the early days of the COVID pandemic saw nurses revered, cheered, encouraged, supported, and treated as superheroes, the current wave of the pandemic is seeing nurses abused by their patients and families, by the public, and also by the health care systems in which they work. Enough is enough. The time of the nurse as an angel, as a superhero, as a rescuer, as a sacrificial lamb, must end. The time of the nurse as a badass professional must ensue. Yes, I said it. I am contemplating a tattoo to mark the occasion. While I have always advocated for nursing professionalism, and for dedication to our patients, our community, our work in general, I am done. Meek, mild professionalism is getting us nowhere. We have professionally advocated for the safety of COVID vaccines, only to be ignored, ridiculed, and/or psychologically and physically attacked. We now find ourselves taking care of patients who COMPLETELY ignored the science, who ignored the professionals, who will take sheep dewormer, but won't take what is now a US Food and Drug Administration−approved vaccine. In many regions, the National Guard has been called in to provide extra staffing at hospitals. Elective surgeries are once again being canceled. Patients may soon be faced with the rationing of care, having to sign documents acknowledging that depending on age and chance of survival, one may not receive full treatment if resources, including ventilators and medications, are not available. The resulting burnout and moral distress of the nursing workforce is reaching critical levels. Nurses are resigning in droves, and they will likely never return. While current enrollments in nursing programs are yet unaffected, I would not be surprised to see enrollment numbers start to decline in the near future. I am now fully convinced the profession will never look the same after this pandemic. We have sacrificed too much; we have been placed in a wartime environment with no armor, no support, no backup , and no respite. I think it is time for the nurse to step up, take control, and call the shots. The days of asking, nicely requesting, are over. A bed in a hospital, without a nurse, is just a bed. Patients come to the hospital for nursing care. Without nursing, the wheelhousethe machine of what we know as traditional hospital care-grinds to a halt. Nurses must no longer be sacrificed for profit. Nurses must no longer be taken advantage of. Nurses must no longer be abused. Nurses must be warriors. Advocating is not an option. Forcefully demanding, a willingness to walk away, is in order if we are to survive and move out of the current crisis. We MUST take care of ourselves if we are to successfully and professionally provide care for others.

Research paper thumbnail of Reexamining Metoclopramide's Role in the Prevention of Postoperative Nausea and Vomiting: A Secondary Analysis

AANA journal, 2018

Postoperative nausea and vomiting (PONV) continue to be among the most undesirable and distressin... more Postoperative nausea and vomiting (PONV) continue to be among the most undesirable and distressing complications following general anesthesia, affecting 20% to 30% of all surgical patients and up to 70% of patients with multiple known risk factors. The purpose of this study was to reexamine the effectiveness of metoclopramide in the prevention of PONV when stratified by PONV risk scores. Secondary data from 2,116 adult ambulatory surgical patients were analyzed. Participants were, on average (SD), 49.7 (15.4) years of age, with a mean body mass index of 28.3 (6.9) kg/m², and were primarily female (65%). Risk scores for PONV ranged from 0 to 4, with a mean of 2.6 (1.0). Metoclopramide, 10 mg intravenously (IV) alone; metoclopramide, 10 mg IV, combined with ondansetron, 4 mg IV; and metoclopramide, 10 mg IV, combined with dexamethasone, 8 mg IV, and ondansetron, 4 mg IV, had a beneficial effect for adult ambulatory surgical patients with PONV risk scores of 1 to 4. Although this cohor...

Research paper thumbnail of A Plane Crashed Today … Do You Care?

Journal of PeriAnesthesia Nursing, 2020

A plane crashed today d actually five commercial jetliners crashed in the United States today d a... more A plane crashed today d actually five commercial jetliners crashed in the United States today d and the day before, and the day before that … and for at least the last 5 days. Twenty-five jetliners in 5 days, 5,000 souls lost. Do you care? If this were a true story, you would be outraged. How could this happen? Why have we not grounded all air travel in the United States? What is the federal government doing to remedy this atrocity? The reality, unfortunately, is that the atrocity is real, the numbers are true, but the cause of death is not a plane falling out of the sky; the cause of death is coronavirus disease 2019 (COVID-19). Let that sink in. As I write this editorial in the last week in July, the United States is averaging 1,000 COVID-related deaths per day. 1 To be exact, as of July 27, there have been, in the United States alone: 2 150,000 COVID deaths 4 million COVID cases 452 COVID deaths/million 120,000/100,000 hospitalized with COVID Contents lists available at ScienceDirect Journal of PeriAnesthesia Nursing j o u r n a l h o m e p a g e : w w w. j o p a n. o rg