Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, 2025 Otterbein University
Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes
Doctor of Nursing Practice Scholarly Projects
Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …
Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, 2024 Southern Illinois University Edwardsville
Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel
Doctor of Nursing Practice Projects
Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …
Addressing Stroke Care Disparities Through Patient Education, 2024 Northern Illinois University
Addressing Stroke Care Disparities Through Patient Education, Christina Annerino
Honors Capstones
It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …
Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, 2024 Southern Illinois University Edwardsville
Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga
Doctor of Nursing Practice Projects
Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …
Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, 2024 University of Nebraska Medical Center
Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper
Doctor of Nursing Practice Projects: College of Nursing
Rationale
Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …
Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, 2024 University of Nebraska Medical Center
Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross
Doctor of Nursing Practice Projects: College of Nursing
Background: Hospital-acquired pressure injuries (HAPIs) have been a longstanding problem in hospitals nationwide. HAPIs cause significant financial strain to a healthcare system and complications can be devastating to the patient.
Purpose: The purpose of this project was to implement the Standard Pressure Injury Prevention Protocol (SPIPP) 2.0 Checklist for patients in the Intensive Care Unit (ICU). The primary aim of this study was to determine if implementing the checklist would reduce the number of HAPIs.
Methods: This project took place over a four-week period at a Midwest hospital in the ICU. Data were collected via patient chart …
Improvement Of Patient Outcomes Through The Use Of Intensivist Nurse Practitioners, 2024 University of Arkansas, Fayetteville
Improvement Of Patient Outcomes Through The Use Of Intensivist Nurse Practitioners, Leigha Fish
The Eleanor Mann School of Nursing Student Works
This mixed retrospective and prospective cohort study aimed to compare mortality outcomes and associated factors between two cohorts of patients diagnosed with respiratory failure: on-call physicians and Interventional Nurse Practitioners (INPs). The analysis involved 143 patients, 82 in the on-call physician cohort and 61 in the INP cohort. Contrary to initial expectations, the two cohorts had no significant difference in mortality rates (p = 0.143). However, significant differences were observed in critical variables affecting mortality, including Time from Admit to Procedure Performance (p = 0.029), ICU Length of Stay (p = 0.013), and Ventilator Days (p = 0.048), with INP-managed …
Using The Confusion Assessment Method For The Intensive Care Unit (Cam-Icu) To Decrease Length Of Stay: A Scoping Review, 2024 University of Tennessee Health Science Center
Using The Confusion Assessment Method For The Intensive Care Unit (Cam-Icu) To Decrease Length Of Stay: A Scoping Review, Brooke D. Ward Bsn, Rn, Dnp Agacnp Student, Martina Little Bsn, Rn, Dnp Agacnp Student, Tracy Mcclinton Dnp, Agacnp-Bc, Aprn
Doctor of Nursing Practice Projects
Purpose/Background
Delirium is a prevalent challenge among ICU patients, impacting approximately 30% of admissions (Brennan et al., 2023). If left untreated, delirium can increase use of restraints, hospital length of stay, intensive care unit length of stay, and ultimately, morbidity and mortality. This scoping review assesses the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) to gauge its efficacy in reducing the length of stay in the ICU for adult patients with delirium.
Methods
A literature review from 2018 and 2023, using PubMed, CINAHL, and Medline were utilized for the search along with key words such as: length of …
A Benchmark Project On Early Mobility In The Intensive Care Unit, 2024 University of Texas at Tyler
A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo
MSN Capstone Projects
Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.
The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, 2024 University of Arkansas, Fayetteville
The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson
The Eleanor Mann School of Nursing Student Works
Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.
Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.
Results: In a comparison …
Cultural Education Interventions Impact On Cultural Competence, 2024 Ohio Northern University
Cultural Education Interventions Impact On Cultural Competence, Kaylie V. Griffin Ms
ONU Student Research Colloquium
Problem: In the United States, there is a substantial increase in diversity. This increase in diversity poses multiple challenges for healthcare workers and healthcare systems. Because nurses care for patients with various cultural backgrounds, health beliefs and practices, and languages, cultural competency plays a pivotal role in providing patient-centered care. There is a need to enhance cultural education for healthcare workers to ensure that healthcare workers have the skills and knowledge to effectively engage with all patient populations. Implementing cultural education interventions seeks to increase healthcare workers' competency, communication, and patient outcomes. Purpose: The purpose of this research question is …
Nurse Initiated Sepsis Protocol In The Emergency Department Setting, 2024 West Chester University of Pennsylvania
Nurse Initiated Sepsis Protocol In The Emergency Department Setting, Madilyn Siuta, Michelle Kaulback
Nursing Student Work
Sepsis affects hundreds of millions of patients across the world within various healthcare settings. Sepsis protocols vary between health systems and institutions which can lead to the lack of prompt client intervention. Each one hour delay in administration of antibiotics is associated with an 8% decrease in survival (Rhodes et al., 2017). The vision for this project is to explore the potential benefits of implementing a standardized national sepsis protocol. For this EBP project a PICO question was formulated. In adult patients presenting to the emergency room with suspected sepsis, how does a standardized international nurse lead sepsis screening protocol, …
Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, 2024 University of Tennessee, Knoxville
Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.
Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.
Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …
Emphasizing The Importance Of Clustering Care For Newborns In The Nicu Setting, 2024 Murray State University
Emphasizing The Importance Of Clustering Care For Newborns In The Nicu Setting, Callie Hines Sn, Alyssa Howell Sn, Elizabeth Crews Sn
Scholars Week
For our Evidence-Based Project, we have chosen to cover the topic concerning clustering care for premature infants in the neonatal intensive care unit. In many NICU's across the country preterm infants are taken care of on an as needed basis. Research and Swanson’s theory of caring supports that clustering care has a positive correlation with the improvement of vital signs, physical and intellectual development, and infection control.
Improving Anesthesia Handoff: Implementing Standardized Handoff Tool For Post-Open-Heart Surgery In Critical Care Settings, 2024 Murray State University
Improving Anesthesia Handoff: Implementing Standardized Handoff Tool For Post-Open-Heart Surgery In Critical Care Settings, Kelly Doyle
Scholars Week
The purpose of this project was to create a handoff tool implemented post-operatively by anesthesia providers during every transfer of care with patients undergoing open heart surgery and transitioning to the intensive care unit. Communication errors have been identified as a primary cause of anesthesia-related sentinel events, particularly during patient handoff, which can lead to negative patient outcomes due to incomplete relay of information. This Quality Improvement Project was conducted at a single facility where Certified Registered Nurse Anesthetists, (CRNAs) incorporated a handoff tool into their anesthesia handoff following coronary artery bypass graft surgery over a six-week period. Both pre- …
Education Of Ventilator-Associated Pneumonia Prevention In Adult Intensive Care Patients, 2024 Murray State University
Education Of Ventilator-Associated Pneumonia Prevention In Adult Intensive Care Patients, Carlin Morgan
Scholars Week
The purpose of this project was to improve knowledge related to evidence-based ventilator-associated pneumonia (VAP) preventative measures that decrease the prevalence of VAP in adult patients in the intensive care unit (ICU). An educational presentation was provided to twelve critical care nurses at a 349-bed hospital in western Kentucky. A pretest was obtained to measure the nurse’s knowledge prior to the presentation. A PowerPoint and pamphlet containing VAP prevention techniques were presented to the twelve critical care nurses during each meeting. A posttest was then administered after the presentation to measure the efficacy of the educational presentation. The mean of …
The Impact Of Telecritical Care On Length Of Stay In A Critical Care Setting, 2024 University of St. Augustine for Health Sciences
The Impact Of Telecritical Care On Length Of Stay In A Critical Care Setting, Mallory Oberts
Student Scholarly Projects
Practice Problem: At a major metropolitan VA hospital, there was a lack of adherence by the nursing staff to the TeleCritical Care program for adult patients in the critical care setting.
PICOT: The PICOT question guiding this project was: In adult patients admitted to critical care (P), does the implementation of TeleCritical Care (I) compared to standard critical care without telemedicine (C) decrease length of stay (O) within 8 weeks (T)?
Evidence: The literature review identified improved quality of care delivery, decreased length of stay, and reduced mortality rates as key benefits of implementing TeleCritical Care in …
Assessing Nursing Deployment Readiness-A Literature Review, 2024 University of San Francisco
Assessing Nursing Deployment Readiness-A Literature Review, George Mcenroe
DNP Qualifying Manuscripts
Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, military vehicles and aircraft, mass casualty care, and military-specific skills. Many Air Force nurses work in low acuity roles and do not maintain the clinical competency and skills necessary if called upon to deploy. A deployment notification may happen with little notification, limiting the opportunity for a quick “ramp-up” of critical skills. Maintaining deployment and clinical readiness is an ongoing …
Enhancing The Safety Of Medication Administration: The Synergistic Role Of Closed Loop Electronic Medication Management And Iv Medication Administration, 2024 Northern Kentucky University
Enhancing The Safety Of Medication Administration: The Synergistic Role Of Closed Loop Electronic Medication Management And Iv Medication Administration, Kelly Goetz, Angela Schoenung, Lauren Daugherty, Kaitlyn Hornsby
Posters-at-the-Capitol
The high acuity of patients in the ICU results in numerous medications being administered, increasing the risk of medication errors. The purpose of this project is to investigate the impact of integrating consistent closed loop electronic medication management (CLEMM) to decrease medication errors in the ICU for bedside nurses who use electronic health records (EHRs). The project type is a comprehensive literature review, with studies that included a single prospective cohort study, case report, single non-randomized trial, quasi experimental study, single cross-sectional studies, and systematic reviews. The importance of this project is to address the break in the loop of …
Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, 2024 University of Kentucky
Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, Laura K. Marcum
DNP Projects
Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction.
Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction.
Methods: New graduate nurse …