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Basics of flexible bronchoscopy and equipment
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Antoinette Wannes Daou, Carolyn Wallace, Joshua Shannon, Cherie A. Torres-Silva
The anesthesiologist/nurse anesthetist works with the bronchoscopist to deliver an adequate level of sedation that allows for a safe and comfortable diagnostic evaluation while the patient remains breathing spontaneously. Proper communication between anesthesia staff and the bronchoscopist is imperative for the safe management of the airway under conditions that resemble light sleep, which allows for an appropriate evaluation of the airway dynamics and anatomy, leading to the correct diagnosis.
Triangle Synergies in a National Quality and Safety Education Initiative in Nursing
Published in Paul Batalden, Tina Foster, Sustainably Improving Health Care, 2022
Linda R. Cronenwett, Pamela M. Ironside
In practice, the best-educated nurses are those who qualify for licensure as advanced practice registered nurses (APRNs) – namely, nurse anesthetists, nurse midwives, nurse practitioners, and clinical nurse specialists. As in the education of other health professionals, APRN education is focused primarily on the care of individual patients, with minimal attention to the development of the knowledge, skills, and attitudes required for improving health and health care.6In addition, APRNs are rarely exposed to role models who, within practices or through boundary-spanning efforts, work to simultaneously improve patient care, system performance, and professional development.
Burnout in Nurses across Practice Domains: Implications and Correlations to Physician Burnout
Published in George Mayzell, The Resilient Healthcare Organization, 2020
APRNs include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives, and all play a pivotal role in the future of health care. APRNs are often primary care providers and are at the forefront of providing preventive care services to the public.8 APRNs may diagnose illness, develop and manage treatment plans, prescribe medications, and may serve as a patient’s principal healthcare provider. Preparation includes a master’s degree and specific specialty clinical hours. The pathway to independent practice for APPs is happening across the United States.
Breast augmentation under local anesthesia with intercostal blocks and light sedation
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Martine Ditlev, Erik Loentoft, Lisbet R. Hölmich
As previously mentioned this specific anesthetic protocol corresponds to sedation level 2, where the patient is cooperative, oriented, and tranquil, as defined in the European guidelines [4]. It eliminates the need for an anesthesiologist or nurse anesthetist since the sedative and analgesic drugs can be administrated by the surgeon or even the circulating nurse after appropriate training. This way of administrating sedatives and analgesics has also been demonstrated as a safe procedure in a similar, but smaller US study [2]. Such reduction in personnel requirements compared with general anesthesia or deeper sedation procedures is associated with reduced costs. The specific costs were not analyzed in this study, but the cost containment associated with local anesthesia procedures has been demonstrated by other studies. The major concern about performing breast augmentation in local anesthesia is if pain control can be obtained. This study is of retrospective nature, and the medical charts contained no structured or formal information regarding patient pain(scores) neither intra- nor post-operatively. We can therefore not demonstrate, by data concerning the patients’ pain experience, that pain control can be obtained, however, the high completion percentage, the fact that patients accepted re-operations with the same kind of anesthesia, the low medication doses, and the surgeon’s experience substantiates that the procedure is indeed feasible.
The impact of aerosol box on tracheal intubation during the COVID‐19 pandemic: a systematic review
Published in Expert Review of Medical Devices, 2022
Trias Mahmudiono, Saurabh Singhal, Anas Amer Mohammad, Virgilio E Failoc-Rojas, Maria Jade Catalan Opulencia, Angel Santillán Haro, Yasir Salam Karim, Nizom Qurbonov, Walid Kamal Abdelbasset, Ahmed B. Mahdi, Yasser Fakri Mustafa
As listed in Table 1, most of the reviewed studies (18 out of 20, 90%) were designed as a mannequin-based simulation study. In general, 372 participants were enrolled in these studies. The effects of aerosol box on tracheal intubation were also evaluated in a variety of airway scenarios (from easy to difficult) [24–41]. Furthermore, there was a prospective randomized non-inferiority study that 78 patients were enrolled in the trial and were randomly assigned to either without the aerosol box group or with the aerosol box group. In this study, a total of 4 anesthesiologists and four nurse anesthetists were involved [42]. There was also a computational-based study which an airflow distribution in negative pressure isolation ward was simulated and then, the potential infection risks to healthcare workers were evaluated under two various respiratory conditions of a patient (i.e. patient with normal respiration and patient with endotracheal intubation) [43].
COVID-19 Pandemic Mental Health Challenges: Patients and Providers
Published in Issues in Mental Health Nursing, 2022
Carole R. Myers, Lauren Renee Muñoz, Tracey Stansberry, Mary Johnson, Mavis Schorn
A team of nurse researchers from the University of Tennessee, Vanderbilt University, and the University of Tennessee Health Science Center conducted a multiple methods, two-phased study relatively early in the pandemic (June to mid-October 2020). The study included a national, web-based survey with 7,467 respondents representing all 50 states (Kleinpell et al., 2021). Follow-up interviews were conducted with 15 Tennessee Advanced Practice Registered Nurses (APRNs include nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), and clinical nurse specialists (CNSs)). The aims of the study were to assess: (1) the impact of regulatory restrictions on APRN practice, (2) temporary changes in practice authority associated with the COVID-19 pandemic, and (3) pandemic-related changes in APRN practice. A number of states issued Executive Orders to waive or suspend APRN practice restrictions due to the pandemic. The purpose of this paper is to describe and discuss results from a secondary analysis of the Tennessee APRN interview transcripts. A manuscript with findings from the primary analysis is currently under review.