The ScholarShip

The ScholarShip is a digital archive for the scholarly output of the ECU community. Its mission is to capture, preserve, and make available the intellectual output of East Carolina University's faculty, staff, and students.

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Now showing 1 - 8 of 8

Recent Submissions

Access status: Open Access ,
Prevention and Treatment of Local Anesthetic Systemic Toxicity: A DNP Project
(2025-11-18) Mary Elise Pierce
Local anesthetic systemic toxicity (LAST) is an adverse event after the administration of local anesthetics that can lead to seizures, cardiac arrest, and death. While rare, this potentially catastrophic event requires immediate diagnosis and treatment. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project is to assess CRNA perceptions of the adequacy of a LAST Quick Reference Guide designed to assist in identifying high-risk patients to quickly diagnose and appropriately treat LAST should it occur. A presentation and visual aids were given to the participating CRNAs, along with pre- and post-implementation surveys via anonymous Qualtrics links. The survey responses were collected and analyzed, showing mixed results. The results showed a net increase in the CRNA awareness of LAST (n=4). However, the overall confidence in maximum dosages of local anesthetics showed a decrease in confidence in the post-implementation responses. These results could be due to an immense amount of information on the QRG, a discrepancy between previous knowledge and what was learned from the QRG, or the possibility of having different participants in the pre- versus post- implementation surveys. The sample size from this project was small, so it is not possible to generalize the findings and further research is recommended. It is anticipated that knowledge gained from this project can be used in future quality improvement projects aimed at improving this rare but potentially catastrophic perioperative event at this facility.
Access status: Open Access ,
CRNA Perceptions of a Quick Reference Guide for Aspiration Pneumonitis in Clinical Practice: A DNP Project
(2025-11-19) Rachel Garrou
Aspiration pneumonitis is a rare but serious perioperative complication; timely recognition and effective management are essential for keeping patients safe during the administration of anesthesia. The purpose of this DNP project was to evaluate CRNAs’ perceptions of a Quick Reference Guide (QRG) designed to support the prevention, recognition, and treatment of aspiration pneumonitis in the perioperative setting. A pre-implementation survey, PowerPoint presentation, distribution of the QRG, and two-week implementation period were conducted at two rural hospitals, followed by a post-implementation survey. Three CRNAs from one of two facilities completed both surveys. Results appeared to increase confidence in managing perioperative aspiration, particularly regarding guideline adherence for aspiration risk factors and withholding GLP-1 medications. Limitations of the project included a small sample size of three participants, potential bias from self-reported surveys, and a short implementation period of two weeks. Despite these constraints, the project results suggest that the QRG may be a valuable reference tool to reinforce evidence-based practice and support real-time decision-making in the event of an emergency. Future projects should consider expanding implementation to larger and more diverse anesthesia groups, incorporate longer evaluation periods, and provide formal training opportunities, such as gastric ultrasound education, to strengthen provider preparedness and improve patient safety outcomes.
Access status: Open Access ,
Assessing CRNA Perceptions of a Cognitive Aid Regarding Local Anesthetic Systemic Toxicity: A DNP Quality Improvement Project
(2025-11-30) Cordelia G. Rios
Local anesthetic systemic toxicity (LAST) is a rare but potentially catastrophic complication of local anesthetic administration in the perioperative and operative setting. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project is to assess CRNA perceptions of the adequacy of a LAST Quality Reference Guide designed to assist in identifying high-risk patients to quickly diagnose and appropriately treat LAST should it occur. The setting of this QI project was an outpatient surgery center located in the southeastern United States. Five of seven CRNAs participated in this quality improvement project over a two-week implementation period. Key components of the project were the creation, implementation, and evaluation of CRNAs’ perceptions of the LAST Quality Reference Guide (QRG). The guide summarizes current evidence-based guidelines for LAST management and was introduced through a narrated PowerPoint Presentation to participants via email. A pre-implementation survey and a post-implementation survey were administered to participants. The results of this quality improvement project were positive. All participants who responded to the surveys agreed that the QRG and project implementation increased their awareness of LAST. No recommendations were made to improve the QRG. A major limitation of this project was the small sample size. Subsequent iterations of this quality improvement project should include a larger sample size for a longer implementation period to obtain data that may be generalizable in a larger hospital setting.
Access status: Open Access ,
Evaluating CRNA Perceptions of a Clinical Reference Guide for Aspiration Pneumonitis: A DNP Project
(2025-11-17) Davis, Caitlin
Aspiration pneumonitis is a serious perioperative complication associated with increased morbidity, extended hospital stays, and higher healthcare expenditures. Prompt recognition of risk factors, early prevention strategies, and appropriate treatment regimens are essential to mitigate adverse outcomes. However, variability in provider awareness and practice can contribute to the delay or inadequacy of interventions. This Doctor of Nursing Practice (DNP) project evaluated the perceived effectiveness of a quick reference guide (QRG) developed to streamline the identification of aspiration risk factors and reinforce evidence-based prevention and treatment techniques for perioperative aspiration pneumonitis. The QRG, along with a narrated PowerPoint, was distributed to Certified Registered Nurse Anesthetists (CRNAs) at a large academic hospital in Eastern North Carolina. Data from pre- and post-implementation surveys demonstrated that the QRG was perceived to be effective in improving knowledge and recognition of aspiration risk factors, increasing participant confidence in implementing prevention strategies, and enhancing consistency in clinical practice. The transition of aspiration prevention quality improvement projects, such as this QRG, into clinical practice can standardize care, reduce aspiration-related complications, and improve perioperative patient outcomes.
Access status: Open Access ,
Smart choices can help minimize holiday weight gain
(2025-11-19) Juarez, Dayana A.; Kolasa, Kathryn M.
This is a weekly Q and A newspaper column under the byline of Dr. Kathy Kolasa. Today's column is How to avoid weight gain on Thanksgiving.