Award Date

5-1-2022

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing (ND)

Department

Nursing

First Committee Member

Necole Leland

Second Committee Member

Mary Bondmass

Third Committee Member

Jay Shen

Number of Pages

79

Abstract

Background: Sickle cell anemia, often referred to as sickle cell disease (SCD), is an inherited blood disorder that affects millions of people globally and affects more than 100,000 Americans, mostly of African or Hispanic descent. The SCD arises from a genetic defect that alters the structure of hemoglobin. The modified hemoglobin causes red blood cells (RBCs) to become stiff, sticky, and sickle shaped. These deformed RBCs block blood flow, cause severe pain, organ and joint damage and strokes. The sickled cells do not deliver oxygen to organs and tissues as healthy cells do, causing slow, inevitable damage over decades and intolerable pain. Problem: Sickle cell disease (SCD) patients face challenges when reporting to the emergency department (ED) during a vaso-occlusive crisis (VOC). Many are deprived of adequate care because their symptoms commonly cause them to be mistaken for opioid abusers, drug seekers or immense exaggerators. Purpose: The purpose of this DNP project is to measure attitudes towards adult patients with SCD and develop, implement, and evaluate an educational intervention for ED providers to increase their awareness, knowledge, and confidence in treating adults experiencing VOC. Measurement: Quasi-experimental pre-and post-intervention design was used to measure attitudes about SCD, knowledge, awareness, and confidence in treating patients. N = 25. Knowledge, awareness, and confidence about SCD and VOC were measured using a 10-item questionnaire and provider attitudes were measured using the General Perceptions about Sickle Cell Disease Patients Scale. The 17-item scale was administered pre-and post-intervention and consisted of four subscales which measured negative attitudes, positive attitudes, concern raising behavior, and red-flag behavior. Pre-and post-intervention mean scores were compared. Results: Negative attitudes trended toward significance (P = 0.06). Positive attitudes were significantly increased (P = 0.03), concern-raising behavior (P < 0.01), and red flag behaviors (P < 0.01) were significantly lowered. Confidence scores were significantly increased (P < 0.01). No significant difference noted in pre-and post knowledge assessments. Implications for Practice: This type of simple intervention can be used to provide additional training among clinicians and medical staff working in-patient and outpatient settings. Conclusion: Overall, participants felt the educational module met their learning objectives and evidence suggest the module was beneficial in raising positive attitudes and confidence levels. Although statistical significance was not obtained, there was a reduction in the number of negative attitudes. With a larger and more ethnically distributed sample, authors would likely see significance in the areas of knowledge and negative attitudes.

Keywords

pain crisis; sickle cell anemia; sickle cell crisis; sickle cell disease

Disciplines

Science and Mathematics Education

File Format

pdf

File Size

2100 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/


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