Specific Aims by Rae Walker, PhD RN FAAN (they/them)

Paragraph 1

2024-03-26 18:50:47 UTC

Sickle Cell Disease (SCD) is a group of inherited hemoglobinopathies affecting hemoglobin in red blood cells (RBC); the disease burden affects 100, 000 Black/African Americans in the United States. In its normal state, RBCs are round in structure and moves freely in small vessels. In persons with SCD, the hemoglobin is abnormal, the misshaped, becomes hardened and sticky. These abnormal RBCs get trapped in small vessels impeding blood flow, leading to vaso-occlusive crisis (VOC) marked by ischemic pain. VOC is most often the cause of patients with SCD presenting for care. Adults with SCD rely on a fragmented healthcare system to meet their specialized needs. Quality of care sickle cell patients receive is uneven in comparison to other known genetic disorders e.g., hemophilia and cystic fibrosis which more commonly afflict patients of European heritage. Influencing care disparity are race, most patients with sickle cell disease are of Black/African American race, education, socio-economic status, mental health challenges, providers not believing patients’ report of their symptoms, especially their reports of pain, thus leading to delays in treatment or under treatment. There is a gap in knowledge related to patient perception of obstacles in care disparity, care bargaining, and care acquisition and how these care experiences lend to additional mental health burdens of patients with SCD and inform future acquisition of care.

Paragraph 2

2024-03-26 18:51:56 UTC

The short-term goal is to identify specific mental health challenges and protective factors for persons with SCD. Long-term, this knowledge will be used to co-create with the SCD community, interventions for self-care and for healthcare providers to better inform comprehensive patient-centered care.

Understand the care experiences, challenges and consequential burdens thrust upon patients living with SCD navigating the healthcare space.

problem

2024-03-26 18:53:08 UTC

Despite a decade of study efforts and the application of numerous strategies and

technology, alarm fatigue persists among nurses, limiting their ability to respond

effectively to urgent patient alarms

knowledge gap

2024-03-26 18:54:46 UTC

There is a lack of comprehensive understanding regarding why alarm fatigue persists in

nursing practice, particularly from the perspectives of ICU nurses. Addressing this gap is

crucial for developing targeted interventions to mitigate alarm fatigue and enhance

patient safety in critical care settings.

PROBLEM: Nursing Simulation-based has proven to be an effective tool in nursing education, so my concern is How does the nursing simulation prepare nurses to be able to transfer the knowledge gain from the simulation sessions into clinical decision making in the real clinical setting?

hodeiopoku — 2024-03-26 18:55:15 UTC

PROBLEM:

2024-03-26 18:57:36 UTC

prevalence of cancer in Iran and lack of technology and real palliative care

Problem

2024-03-26 18:59:14 UTC

Equity, diversity and inclusion (EDI) is desired in higher education to meet accreditation standards, but there is limited guidance on how to consistently apply EDI in simulation from national and international organizations. (QI/measurement study versus implementation study?)

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2024-03-26 18:59:54 UTC

AIM1: Examine what are patient perceptions of disease specific care acquisition for patients living with SCD.

AIM2: Determine patient perceived mental health challenges linked to disease specific care acquisition.

AIM3: Understand how disease specific care acquisition and/or mental health challenges inform future care-seeking behaviors.

purpose

2024-03-26 18:59:58 UTC

To gain a deeper understanding of the persistence of alarm fatigue in nursing practice in order to inform the development

of more effective interventions.

Aim is to investigate the effectiveness of nursing simulation in facilitating the transfer of knowledge and skills to clinical decision-making in actual patient care settings to improve patient outcome.

hodeiopoku — 2024-03-26 19:00:20 UTC

Knowledge Gap

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While there is a Code of Ethics in simulation (SSIH) and Standards of Practice (INACSL), neither agency reflects how to apply EDI ethically to simulation. As a result, literature reviews have found that faculty who do not apply these resources, which are reinforced through professional certification programs by these agencies, this has resulted in harmful representations of patient communities, inconsistent application of standards and ethics of simulation design and application, and ineffective learning for students in simulation.

Purpose

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To improve ethical representation of the LGBTQIA+ population in clinical simulation to meet accreditation requirements and reinforce the need for inclusive nursing care models during a time when gender inclusive care is at risk the United States.

Para 1

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A recent meta-analysis showed that 43% of nurses report stress and sleep disturbances;
depression and anxiety were reported in over 30% of nurses (Al Maqbali et al, 2021) and more
than 30% of nurses are thinking about quitting (Ulupinal & Erden, 2024).

Long range goals

2024-03-26 19:01:52 UTC

Reflecting on the NLN Jeffries Simulation Theory and community-based partnerships, we aim to create a faculty guide EDI focused ethical principles to designing, administering, and studying the effectiveness of gender inclusive care scenarios. We also hope through this experience to help students understand personal biases can be harmful barriers to healthcare.

Knowledge Gap:

2024-03-26 19:02:04 UTC

Palliative care for elderly cancer patients in Tehran faces challenges in accessibility and quality, impacting both patients and caregivers.

Aims

2024-03-26 19:02:12 UTC

Aim 1: Gain perspective from UMass students on the importance of EDI taught in higher education medical programs (partnering with the Stonewall Center)

Aim 2: With collaboration from community partners (TransHealth), develop a simulation that reflects a representative simulation of a non-binary patient.

Aim 3: Study nursing students' feedback for insight on perceived confidence in clinical care following the simulation and awareness of bias as barriers to care.

Para 2

2024-03-26 19:02:15 UTC

Through early fieldwork, it is clear that nurses are making the connection between cost-saving
measures and the care we are able to provide in our work. Covid-support measures like
additional paid sick time, mask and vaccine mandates and free parking have all been eliminated
at the major medical center where I spoke with front-line nurses.

aims

2024-03-26 19:02:39 UTC

1. Examine nurses' perspectives on existing alarm management strategies

and their suggestions for improvement or alternative approaches

Describe impacts of alarm fatigue on nurses' work and patient care outcomes, from ICU nurses' perspectives."
any additional aims for me?? help!

Para 3

2024-03-26 19:02:53 UTC

My intention is to use a variety of qualitative methods to parse out the connections that nurses
are making between profit-driven healthcare and the quality of care they are able to provide,
and decipher if these connections have an impact on retention. It is also my intention to discover
what nurses think would improve their conditions and what they would need in order to continue
their nursing careers.

Purpose: To understand the effectiveness of nursing simulation in facilitating the transfer of knowledge and skills to clinical decision-making in actual patient care settings to improve patient outcome.

hodeiopoku — 2024-03-26 19:03:16 UTC

Research Qs

2024-03-26 19:03:28 UTC

Research Question 1: Do nurses make the connections between system austerity and the
quality of care they are able to provide?
Research Question 2: Do nurses experience symptoms of burnout and moral injury and are they
connecting these experiences to system austerity?
Research Question 3: What are solutions that could improve working conditions for nurses and
ultimately patients? Imagination is the only limitation!

Goals

2024-03-26 19:08:18 UTC

The long-range goal is to enhance the quality of palliative care services for elderly cancer patients and their caregivers in Tehran through the integration of technology. The short-term goal is to assess the feasibility and acceptability of technology-based interventions in this population.

The problem:

2024-03-26 19:09:57 UTC

In Saudi Arabia, the Ministry of Health is responsible for the
management of 284 hospitals, which make up 60% of the total number of hospitals in the country.

Out of these 105 hospitals, there are approximately 3,560 ICU beds available (Alkhamis & Miraj, 2020).

The knowledge gap regarding HAIs exists for the remaining 179 hospitals under the MOH's authority.

Additionally, do we have data on healthcare-associated infections (HAIs) for the 40% of hospitals not
under the Ministry of Health? If they adhere to similar healthcare strategies or meet the same hospital
accreditation standards, such as the Joint Commission International (JCI) or the Saudi Central Board for
Accreditation of Healthcare Institutions (CBAHI). What is the connection between hospital accreditation
and the occurrence of HAIs? Do disparities exist in healthcare access and the provision of equitable
health services between healthcare facilities under the authority of the Ministry of Health and those that
are not? What are the requirements for the nurses in terms of qualification? Do nurses' perceptions of nosocomial infections and the transmission of healthcare-associated infections (HAIs) differ between accredited hospitals and non-accredited hospitals? Are you referring to hospitals under the Ministry of Health (MOH) or other hospitals?

2024-03-26 19:11:04 UTC

Healthcare-associated infections (HAIs) are a major concern and represent a complex challenging issue in the healthcare system, particularly in the intensive care units. Between 4% and 12% of patients experience one or more infections following their admission to acute care hospitals (European Centre for Disease Prevention and Control, 2013). In Saudi Arabian intensive care units, ventilator-associated events (VAE) are the most common infections, occurring at a rate of 4.21 per 1000 ventilator days, while Central line-associated bloodstream infections (CLABSI) are the second most frequently occurring infections, with a rate of 2.57 per 1000 central line days (Alsheddi et al., 2023). The rate of catheter-associated urinary tract infections (CAUTI) is 1.08 per 1000 days of urinary catheter use (Alsheddi et al., 2023). Nevertheless, the information gathered pertains to the occurrence of healthcare-associated infections (HAIs) in central line-associated bloodstream infections (CLABSI), ventilator-associated events (VAE), and catheter-associated urinary tract infections (CAUTI) within intensive care units (ICUs) in 109 hospitals falling under the Ministry of Health systems in Saudi Arabia. However, surgical site infections are not included in the coverage.

Aims

2024-03-26 19:12:01 UTC

My research aims to investigate how nurses working in ICUs perceive infection prevention and control, as well as their knowledge and attitudes towards it, while exploring effective strategies for preventing infections.