Project: Use of Manometry in the OR for Guiding Endotracheal Tube Cuff Inflation - A systematic literature review of the utility of manometry-guided endotracheal tube cuff inflation with dissemination to stakeholders and sustainment via policy.
Overall Impact: Evidence supports use of manometry in the operating room. Findings disseminated to Portsmouth NMC Anesthesia Department. Procedural and purchase information to implement and sustain manometry use made available to Department Chairperson.
- Explored usefulness of manometry-guided endotracheal tube (ET) cuff inflation.
- Manometry most effective way to assess and maintain ideal ET Cuff inflation pressure between 20-30 mmhg.
Title: Awareness and Utilization of Military Community Health Promotion Resources
Purpose: Conduct a gap analysis to assess provider and beneficiary awareness of resources available to support family centered weight loss.
Impact: Improve accessibility for families to learn healthy behavioral modification.
Title: Parturient Education for Neuraxial Analgesia: A Video Tool
Project: To develop and assess the impact of a video about labor analgesia on parturient knowledge and satisfaction.
Impact: Viewing the video was associated with improvements in subjective and objective knowledge about labor analgesia, and thus improved informed consent, but did not significantly impact maternal satisfaction at NMCP.
Title: Obesity Management: Standardizing the Process within Primary Care
Purpose: A standardized process using evidence-based practices and stakeholder input to ensure implementation of the VA/DoD CPG for Screening and Management of Overweight and Obesity within the primary care setting.
Impact: Using the VA/DoD Obesity Management CPG increases identification, surveillance and resources for obese patients.
Title: Behaviors and Barriers to Sexual Violence Screening by Healthcare Providers at Naval Medical Center Portsmouth
Purpose: Survey to complete a needs assessment of healthcare providers sexual violence screening behaviors and potential barriers.
Impact: Routine screening for sexual violence leads to early recognition and early intervention, providing better, safer care at a decreased cost while improving readiness.
Title: Barriers to Remifentanil Use for Labor Analgesia: A Process Improvement Initiative
Purpose: Purpose of this project was to remove barriers to the appropriate use of patient-controlled intravenous administration remifentanil in laboring patients at Naval Medical Center Portsmouth.
Impact: Patient Controlled Intravenous Administration of Remifentanil (PCIAR) is safe and effective for labor pain in women who are ineligible for neuraxial analgesia.
#1 Title: "Implementation of Video-Based Weight Loss Education in Primary Care"
Purpose: Develop and implement a video-based educational offering in Primary Care to increase awareness of weight loss programs that is sensitive to known time constraints and facilitates provider-patient dialogue.
Impact: Video-based education was well-received in the Primary Care setting and aligns with VA/DOD Clinical Practice Guideline recommendations for obesity management.
#2 Title: "An Evaluation of the Caregiver Occupational Stress Control Program at Naval Medical Center Portsmouth"
Purpose: The primary purpose of this DNP project was to determine the impact and effectiveness of the CgOSC program at Naval Medical Center Portsmouth.
Impact: Results from this project can strengthen local and regional leadership’s efforts in promoting systematic measurements for the impact and effectiveness of the CgOSC program.
#3 Title: "Residual Neuromuscular Blockade (RNMB) Educational Project for Post Anesthesia Care unit (PACU) Nurses"
Purpose: Increase the knowledge and confidence of PACU staff in their ability to recognize and manage RNMB.
Impact: Implementation of this training video to PACU staff across the MTFs can lead to decreased costs, enhanced patient outcomes, and improved customer satisfaction.
Documentation Workflow and Intake Processes Evaluation (NP)
Title: “A Needs Assessment of the Documentation Intake in Military Primary Care” (LCDR Hervey, LCDR Horne)
Purpose: Identifying evidence-based recommendations to decrease provider documentation burden.
Impact: Documentation burden (68 percent of providers surveyed report spending 2-4 hours after normal work hours) could be reduced by training support staff to complete preliminary documentation. Addressing challenges of extensive or incomplete documentation could decrease provider workload and increase the length of time for provider- patient interaction.
Title: Antidepressant Medication Adherence in Patients Diagnosed with Depression* (LT Moore, LCDR Nguyen)
Purpose: The primary purpose of this DNP project was to determine if adult patients with depression who receive additional education and support intervention during antidepressant initiation, sustain medication adherence at 6 weeks?
Impact: Initiating the use of an antidepressant educational pamphlet along with supportive follow-up phone calls is helpful in maintaining medication adherence and is linked to depression severity improvement by as much as 85%. Enhancing medication adherence improves service member functioning and thus contributes to enhancing military readiness.
Improving Obstetrical Patient Warming (RNA)
Title: "Implementation of a conductive fabric warming mattress to maintain normothermia in Cesarean Deliveries" (LCDR Bokan, LT Camp, LT Nagle)
Purpose: To implement a conductive fabric warming mattress during scheduled Cesarean deliveries to maintain perioperative normothermia.
Impact: Maintaining normothermia during cesarean deliveries supports the MHS Quadruple Aim of providing better care and becoming a high reliability organization.
Screening tool for postsurgical chronic pain (RNA)
Title: "Risk factors for persistent post-surgical pain: Implementation of a risk assessment questionnaire" (LT Beasley, LT Blais, LT Garcia, LT Tio)
Purpose: To improve the identification of preoperative patients at risk for persistent postsurgical pain.
Impact: Improved identification of patients at risk for persistent postsurgical pain which can lead to improved healthcare outcomes, increased patient satisfaction, and decreased costs which contribute to the Military Health System Quadruple Aim.