Scholarship & Research
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Item Promoting opioid stewardship in an orthopedic ambulatory surgery center: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2022) Stromberg, Sara Elyse; Chairperson, Graduate Committee: Margaret HammerslaOverprescribing opioids poses a substantial risk to patients and communities as it may result in patients continuing to use or in-excess pills that can become diverted to others. Postoperative prescribing guidelines address the national epidemic at the local level by reducing the availability of opioids for nonmedical use. This project sought to align the postoperative discharge opioid prescribing practices of a small orthopedic ambulatory surgery center (ASC) in southwestern Montana with best practices. The evidence-based postoperative prescribing guidelines were pilot tested with a targeted surgical procedure over four weeks. Patients meeting inclusion criteria were prescribed an opioid pill quantity within the recommended amount was inconsistent, with the most adherence reaching 25%. Mechanisms within the electronic health record (EHR) system are recommended to improve adherence.Item An integrative process: acupressure to prevent and treat postoperative nausea and vomiting in patients undergoing abdominal surgery(Montana State University - Bozeman, College of Nursing, 2017) Seed Kinsler, Shoshannah; Chairperson, Graduate Committee: Alice RunningProblem Statement: Postoperative nausea and vomiting (PONV) continues to be problematic for surgical patients despite use of new-generation antiemetics. Purpose: This project was designed to bridge a knowledge gap for nursing staff by providing education on the implementation of acupressure at P6, assisting them in implementing this intervention, and analyzing the results. Methods: A survey of surgical nurses revealed an interest and lack of knowledge in acupressure implementation. Education for nurses was provided on the use of acupressure at P6 to prevent PONV. The implementation of acupressure by nursing staff was then assessed with a pilot study using a non-blinded, randomized controlled design. Jean Watson's Human Caring Theory and the Integrative Healthcare principles served as theoretical foundations for this project. Surgical patients undergoing abdominal surgery at risk for PONV were randomized to either the acupressure treatment group (acupressure and routine antiemetics) or control group (routine antiemetics only). Nausea and vomiting were rated using the PONV intensity scale and a Verbal-Rating scale. Nurse and patient attitudes toward holistic health and complementary and alternative healthcare were assessed, as well as patient perceptions of nurses' level of caring using the Caring Factor Scale. Analysis: Statistical analysis included Welch's two-sample t-test, Wilcoxson's Rank Sum Test, repeated measures ANOVA, and descriptive statistics. Results: Participants who received acupressure experienced less PONV, but this was not statistically significant. Those who received acupressure required more antiemetic medications, which marginally increased their healthcare cost. Participants who received acupressure had a significant improvement in CAM attitudes, but there were no differences in how patients perceived the level of care from nursing staff between groups. Significance: The results of this study provide evidence for the feasibility of nurse-implemented acupressure for PONV, and clinically significant data to promote use of acupressure at P6 to prevent and treat PONV. Future qualitative research regarding patient and nurse experiences with acupressure would add to the already extensive quantitative data available.Item Effects of preoperative instruction on selected surgical patients(Montana State University - Bozeman, College of Professional Schools, 1971) Fountain, Carol ElizabethItem A study of the development and use of a motion picture while teaching preoperative patients about their postoperative activities(Montana State University - Bozeman, College of Professional Schools, 1971) Burger, Dolores Lola AndersonItem Weight loss outcomes and health locus of control following gastric stapling surgery(Montana State University - Bozeman, College of Nursing, 1984) Hook, Colleen Beth