Frank Guido-Sanz
University of Central Florida, College of Nursing, Faculty Member
Research Interests:
Background Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. Objective To... more
Background Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. Objective To retrospectively evaluate outcomes associated with manual versus automatic prone positioning as part of a pronation quality improvement project implemented by a multidisciplinary team. Methods A retrospective, descriptive-comparative approach was used to analyze data from 24 months of a prone positioning protocol for ARDS. The study involved 37 patients, with 16 undergoing manual and 21 undergoing automatic prone positioning. Descriptive and nonparametric statistical analyses were used to evaluate outcomes associated with manual versus automatic prone positioning. Results Outcomes were similar between the 2 groups regarding time to initiation of prone positioning, discharge disposition, and length of stay. Manually pronated patients were less likely to ex...
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Background Patient safety and improved outcomes are core priorities in healthcare, and effective handoffs are essential to these priorities. Validating handoff tools using simulation is a novel approach. Methods The construct validity and... more
Background Patient safety and improved outcomes are core priorities in healthcare, and effective handoffs are essential to these priorities. Validating handoff tools using simulation is a novel approach. Methods The construct validity and instrument reliability of the I-BIDS© tool were tested. In Phase I, construct validity was substantiated with a convenience sample of 21 healthcare providers through an electronic survey. Content Validity Ratio (CVR) was tabulated using Lawshe’s CVR. Interrater reliability was tested in a simulated handoff scenario, in Phase II, with graduate nursing students and two raters, and simulation effectiveness was assessed by students. Results Construct validity was evaluated, and 17 of the 25 items were found significant at the critical level (0.42). Items scoring below were removed, and the tool was reduced by one category. Weighted kappa (Kw) with quadratic weights was run from the scenario data to determine if there was an agreement between raters of ...
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Patient handoffs are a common, yet frequently error prone occurrence, particularly in complex or challenging battlefield situations. Specific protocols exist to help simplify and reinforce conveying of necessary information during a... more
Patient handoffs are a common, yet frequently error prone occurrence, particularly in complex or challenging battlefield situations. Specific protocols exist to help simplify and reinforce conveying of necessary information during a combat-casualty handoff, and training can both reinforce correct behavior and protocol usage while providing relatively safe initial exposure to many of the complexities and variabilities of real handoff situations, before a patient’s life is at stake. Here we discuss a variety of mixed reality capabilities and training contexts that can manipulate many of these handoff complexities in a controlled manner. We finally discuss some future human-subject user study design considerations, including aspects of handoff training, evaluation or improvement of a specific handoff protocol, and how the same technology could be leveraged for operational use.
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Combat Life Savers, Combat Medics, Flight Medics, and Medical Corpsman are the first responders of the battlefield, and their training and skill maintenance is of preeminent importance to the military. While the instructors that train... more
Combat Life Savers, Combat Medics, Flight Medics, and Medical Corpsman are the first responders of the battlefield, and their training and skill maintenance is of preeminent importance to the military. While the instructors that train these groups are exceptional, the simulations of battlefield wounds are extremely simple and static, typically consisting of limited moulage with sprayed-on fake blood. These simple presentations often require the imagination of the trainee and the hard work of the instructor to convey a compelling scenario to the trainee. Augmented Reality (AR) tools offer a new and potentially valuable tool for portraying dynamic, high-fidelity visual representation of wounds to a trainee who is still able to see and operate in their real environment. To enhance medical training with more realistic hands-on experiences, we are working to develop the Combat Casualty Care Augmented Reality Intelligent Training System (C3ARESYS). C3ARESYS is our concept for an AR-based ...
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The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study's design involved content analysis of... more
The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study's design involved content analysis of interaction logs containing the process of APN care during two clinical trials: 1) APN care was added to physician care (n = 22); and, 2) half of physician care was substituted with APN care (n = 19). Women's' health problems and APN interventions were classified using the Omaha System's Problem Scheme and Intervention Scheme. The women, in the study, had a mean age of 30, and were predominantly Black, high school graduates, with a low income. The findings identified 61,004 health problems and 60,980 APN interventions from the interaction logs. APNs provided significantly more interventions antenatally to the women in the substitution group than to those in the additive group. However, the overall categories of problems were the same in both ...
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AIMS AND OBJECTIVES To explore current oral care practices in nonmechanically ventilated ICU patients. BACKGROUND Oral hygiene is an important aspect of nursing care in hospitalised populations. Oral care is a disease preventive and... more
AIMS AND OBJECTIVES To explore current oral care practices in nonmechanically ventilated ICU patients. BACKGROUND Oral hygiene is an important aspect of nursing care in hospitalised populations. Oral care is a disease preventive and cost-effective measure for patients, particularly in ICU patients. Numerous studies support the value of oral care practices in mechanically ventilated ICU patients. Due to evidence supporting the benefits of oral care in nonmechanically ventilated patients, it would be beneficial to examine the literature for oral care practices in this population. METHODOLOGY Literature searches of the following databases were performed: CINAHL Plus, MEDLINE, PsychInfo, Academic Search Premier, Cochrane Database of Systematic Reviews, and Web of Science. Three peer-reviewed articles were included in the review after inclusion criteria were applied. Findings were appraised, organised conceptually and synthesised using Torraco (2016b) as a guiding framework. Evidence was...
Research Interests:
BACKGROUND Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. OBJECTIVE To... more
BACKGROUND Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. OBJECTIVE To retrospectively evaluate outcomes associated with manual versus automatic prone positioning as part of a pronation quality improvement project implemented by a multidisciplinary team. METHODS A retrospective, descriptive-comparative approach was used to analyze data from 24 months of a prone positioning protocol for ARDS. The study involved 37 patients, with 16 undergoing manual and 21 undergoing automatic prone positioning. Descriptive and nonparametric statistical analyses were used to evaluate outcomes associated with manual versus automatic prone positioning. RESULTS Outcomes were similar between the 2 groups regarding time to initiation of prone positioning, discharge disposition, and length of stay. Manually pronated patients were less likely to ex...
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Interprofessional collaboration was essential for the conduct of research that demonstrated the effectiveness and significance of advanced practice registered nurses (APRNs) in providing care, in reducing health care costs, and in... more
Interprofessional collaboration was essential for the conduct of research that demonstrated the effectiveness and significance of advanced practice registered nurses (APRNs) in providing care, in reducing health care costs, and in developing innovative models of care for the nation's citizens. If the 2010 Affordable Care Act is to be implemented, APRNs, with their expertise and numbers, are essential to its implementation. Continued interdisciplinary collaboration is needed to expand the scope of APRN state practice regulations, to change reimbursement for APRN services, and to mute opposition to these changes by medical organizations.
Research Interests:
Research Interests:
The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study's design involved content analysis of... more
The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study's design involved content analysis of interaction logs containing the process of APN care during two clinical trials: 1) APN care was added to physician care (n = 22); and, 2) half of physician care was substituted with APN care (n = 19). Women's' health problems and APN interventions were classified using the Omaha System's Problem Scheme and Intervention Scheme. The women, in the study, had a mean age of 30, and were predominantly Black, high school graduates, with a low income. The findings identified 61,004 health problems and 60,980 APN interventions from the interaction logs. APNs provided significantly more interventions antenatally to the women in the substitution group than to those in the additive group. However, the overall categories of problems were the same in both ...