An Innovative Ultrasound-Guided Approach: Stimulating Student Query in Advanced Nursing Health Assessment.

An ultrasound curriculum was developed to enhance advanced health-assessment delivery of didactic and laboratory content to advanced practice nursing students. Ultrasound (US) focused on cardiac, pulmonary, and abdomen image acquisition and interpretation. A convenience sample of 80 advanced practice nursing students from the nurse anesthesia program and the family nurse practitioner program were enrolled in the study. Time frame coincided with their Advanced Health Assessment and Diagnostic Reasoning course program curriculum. Utilizing a survey, self-reported data were obtained for measures assessing the curriculum and confidence levels pre and post implementation. Survey data indicated students felt the US curriculum improved their understanding of anatomy (n = 76; 98.75%) and more effectively helped them learn physical exam skills (n = 75; 97.4%). When comparing confidence levels (M = 5.62, SD = 1.71) from before the health-assessment course to confidence levels (M = 2.82, SD = 1.19) following the US curriculum, a significance difference was discovered, t(77) = 14.99, P < .001. The physical examination is a key component of the patient-anesthesia provider interaction. With the use of US technology, students can learn in a positive environment, while improving their physical health-assessment skills.

Cost-effective Hybrid Airway Model to Improve Airway Cricothyroidotomy Outcomes.

To the editor: Cricothyrotomy has been the technique used when ventilation/intubation has failed, and emergent oxygenation must be delivered.

Use of Computer-Assisted Instrument Guidance Technology by Student Registered Nurse Anesthetists for Simulated Invasive Procedures.

This study was conducted to determine if computer-assisted instrument guidance (CAIG, Clear Guide Medical), with an optical tracking mechanism, enhances simulated transversus abdominis plane (TAP) block performance in a porcine model by novice student registered nurse anesthetists (SRNAs) compared with standalone ultrasonography (US). In a crossover design, 26 students were randomly assigned into 2 groups: US only and CAIG. Performance was assessed using a task-specific checklist survey tool and a global rating scale to assess performance. Time to hydrodissection and number of insertion attempts were recorded. A pre-procedure and postprocedure survey obtained participants' demographics and measured overall experience. Results revealed higher mean scores for all items in the global rating scale and overall performance (P = .010). The checklist survey results indicated no significant between-group differences. The CAIG group was observed to have significantly lower simulated block performance times (P = .037) and number of attempts (P = .002). The postprocedure survey results showed most participants (88%) reported an enhanced experience using the CAIG. Use of the CAIG showed favorable results in novice SRNAs performing the simulated block. Procedure performance, number of attempts, and time to complete were significantly lower, with a strong preference for the CAIG system.

Evaluation of a Low-Cost, High-Fidelity Animal Model to Train Graduate Advanced Practice Nursing Students in the Performance of Ultrasound-Guided Central Line Catheter Insertion.

INTRODUCTION: Ultrasound-guided central venous catheter insertion (UGCVC) is a commonly performed procedure taught through simulation. The aims of the study were to examine the utilization of an animal model and compare it with two currently used Blue Phantom central line models to determine whether an animal model provides good or better simulated conditions for the performance of UGCVC insertion. METHODS: Using a randomized cross-over study, 46 advanced practice nursing students were assessed using a task-specific performance tool in their performance of UGCVC insertion on both the animal model and the Blue Phantom models. The number of insertion attempts and time to performance was recorded. A preprocedure survey was used to ascertain their presimulation workshop experience, followed by a postprocedure survey. A cost comparison was completed as a secondary outcome. RESULTS: A comparison was conducted on the performance scores and the postsurvey results between the animal model and the Blue Phantom models. The number of venous access attempts was not significantly different when comparing the three models. A cost comparison showed the total cost of each animal model was US $15.66 as compared with the approximate cost for the Blue Phantom IJ model of US $1500.00 and the Gen I model of US $2700.00. CONCLUSIONS: Current Blue Phantom models lack the ability to fully perform all the necessary steps critical to the performance of UGCVC insertion. At a total cost of US $15.66 per model, this study showed that training with an alternative economical model was comparable with more expensive mannequin simulators. The results of this study may serve to guide clinicians and educators who are seeking alternative simulation models to provide skill acquisition.

HIV Risk Perception, HIV Knowledge, and Sexual Risk Behaviors among Transgender Women in South Florida.

OBJECTIVES: Transgender women experience a variety of factors that may contribute to HIV risk. The purpose of this study was to explore links among HIV risk perception, knowledge, and sexual risk behaviors of transgender women. DESIGN AND SAMPLE: A descriptive, correlational study design was used. Fifty transgender women from the South Florida area were enrolled in the study. MEASURES: Transgender women completed a demographic questionnaire and standardized instruments measuring HIV risk perception, knowledge, and sexual risk behaviors. RESULTS: Transgender women reported low levels of HIV risk perception, and had knowledge deficits regarding HIV risk/transmission. Some participants engaged in high-risk sexual behaviors. Predictors of sexual risk behaviors among transgender women were identified. CONCLUSIONS: More research is needed with a larger sample size to continue studying factors that contribute to sexual risk behaviors in the understudied population of transgender women. Evidence-based guidelines are available to assist public health nurses in providing care for transgender women. Nurses must assess HIV perception risk and HIV knowledge and provide relevant education to transgender women on ways to minimize sexual risk.