Critical Care Nursing Commons^™

Nursing Compliance With Vap Bundle, Taylor Meadows

Scholars Week

It has been proposed that by initiating the highest percentages of nursing compliance, overall patient outcomes will improve along with a decrease in the number of ventilator-associated events (VAEs). The aim of the study is to appraise the association between nursing compliance with a ventilator bundle and a successful decline in the number of events of ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). The study also provides evidence-based direction on the best nursing practices essential to reducing the rates of VAP. Objectives include expanding the awareness of critical care staff on prevention and compliance and to improve teamwork ...

Transitioning Experienced General Care Float Pool Nurses To A Critical Care Float Pool, Troy T. Betts, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: A nationwide nursing shortage has resulted in a significant reduction in the number of qualified nurse applicants for critical care positions. Additional recruitment solutions for critical care staffing needed to be explored.

Purpose: The purpose of this project was to evaluate the effectiveness of an orientation program designed to transition experienced general care trained float pool nurses to a critical care float pool.

Methods: This descriptive study measured participants’ pre and post critical care orientation knowledge, and completion of core computerized competencies. Critical thinking questions, unit-based competencies, and measurement of participants’ individual perception of competence were also completed. Pre ...

A Correlation Between Parental Visitation Neglect And Pediatric Intensive Care Unit Psychosis: An Integrative Literature Review, Alia Mohammad

Grace Peterson Nursing Research Colloquium

Abstract

Background: Pediatric intensive care unit psychosis is a serious disorder where patients experience anxiety, hallucinations, delirium, and other symptoms, setting them back in their recovery process during their hospital stay.

Purpose: This study is an integrative literature review aimed at the use of evidence based practices to establish the most effective solution in preventing ICU psychosis in pediatric patients, and discovering if parental presence is a factor to successful recovery.

Methods: WorldCat.org, MEDLINE, ABI/INFORM Complete, Academic Search Complete, OAlster, PsycARTICLES, ERIC, Business Source Complete, and Computers & Applied Sciences Complete were searched using the keywords pediatric, intensive care unit, and psychosis.

Results: This topic has not been studied well however; the literature review examined various factors that impact the mental, physical ...

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

Evaluation Of A Critical-Care Pain Observation Tool Quality Initiative, Caissy Goe

DNP Projects

Background: Patients unable to self-report pain are at increased risk for inadequate pain management and less than optimal outcomes. The implementation of behavioral pain scales, such as the Critical-Care Pain Observation Tool (CPOT), have demonstrated an improvement in pain management and patient outcomes.

Local Problem: A lack of the routine use of behavioral pain scales for mechanically ventilated patients unable to self-report pain was identified as a significant barrier to optimal pain and agitation management.

Methods: A retrospective pre and post design was used to evaluate the effectiveness and impact of a CPOT quality initiative on the management of pain ...

Pediatric Delirium: Development Of A Standard Of Practice In A Cvicu And Picu Setting, Frances Gililand

DNP Projects

Pediatric delirium remains a significant cause of morbidity in pediatric critical care resulting in longer lengths of stay and increased healthcare costs that may extend beyond critical illness. Prevalence rates of pediatric delirium in pediatric intensive care settings are 20%. Not all children’s hospitals regularly assess for pediatric delirium. At the time of this project, the assessment of pediatric delirium was not a standard of practice at John Hopkins All Children’s Hospital (JHACH). Examining provider’s experience, knowledge and self-efficacy of pediatric delirium was the primary aim of this project. The secondary aim was to use information obtained ...

Fall Prevention In The Ed, Ninojoseph Lacap

Master's Projects and Capstones

This project focuses on the prevention of patient falls in the emergency department (ED). Kaiser Santa Clara Hospital is an academic medical facility in the heart of Silicon Valley. The facility has a 46 bed ED with an average daily census of 220, specializing in stroke, pediatrics, heart, and left-ventricular assist device (LVAD) patients. For the calendar year of 2016 there were thirty-reported patient falls in the ED. The global aim is to reduce the patient fall rate by 35% for the 2017 calendar year. The project’s objective is to continue the road to patient safety and to have ...

Improving Early Sepsis Identification On Inpatient Units, Yee Yang

Master's Projects and Capstones

Sepsis is a serious complication caused by an overwhelming immune response to infection that affect millions of people worldwide each year. Sepsis is a time sensitive illness that requires early identification and quick interventions to improve patient outcomes. This quality improvement project includes a team of clinical nurse leader (CNL) students and gathering information on the nursing compliance of the sepsis protocol at a large metropolitan hospital. The observations on different inpatient units and chart review conducted at the large metropolitan hospital led to increased awareness of gaps that prolong the identification of sepsis among patients; also to the creation ...

To Asq Or Not To Asq: A Suicide Risk Screening Improvement Project, Gina Mumper

Master's Projects and Capstones

Abstract

Suicide is the second leading cause of death in children between the ages of 10-19 years. Most people who die by suicide have visited a healthcare provider within the prior year. Inpatient healthcare providers, particularly clinical nurse leaders (CNLs), are in a strategic position to assess adolescents for suicide risk regardless of their admitting diagnosis. “To ASQ or Not to ASQ” is an evidence-based project aimed at improving compliance with the Ask Suicide Screening Questions (ASQ) in an eight-bed medical-surgical adult and pediatric overflow intensive care unit (MSICU) in a large tertiary 629-bed academic medical center. Methods included convenience ...

Increasing Student Registered Nurse Anesthetists Clinical Self-Efficacy Using Peer Mentoring, Megan Christine Bass

Doctoral Nursing Capstone Projects

The purpose of this project is to determine if clinical self-efficacy is increased in SRNAs at The University of Southern Mississippi after participation in the peer mentoring program. The project was a one-group pre and posttest design in a sample of SRNAs who received peer mentoring. To evaluate the students’ perceived clinical self-efficacy before and after the peer mentoring educational intervention, the Rowbotham and Schmitz Student Self-Efficacy scale (SSE) (2013) was adapted and administered to second-year SRNAs (N=17). Clinical performance, skill and knowledge development, social interaction with clinical faculty, and coping with clinical stress are the four areas evaluated ...

Improving Trauma Activation Guideline Adherence In A Level Iii Emergency Department, Jesus Valdez

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase appropriate use of trauma activation guidelines by nurses in a level III emergency department. Care provided by a multidisciplinary trauma team is paramount for the severely injured patient, as this may facilitate rapid diagnosis and treatment. Trauma related mortality can be significantly decreased through the care provided. Trauma patients require specialized care at a precise time often called the “golden hour” to help prevent death or disability. Almost 30 Texans die every day from trauma related injuries, which averages to 10,000 people each year. Trauma is the leading cause ...

Nurses Can Do Better At Recognizing And Treating Sepsis, Stefan Lindsay

Grace Peterson Nursing Research Colloquium

No abstract provided.

Sensitivity Of Pain Assessment For Critically Ill, Nonverbal Adults, Ruta Jarmontaviciute

Grace Peterson Nursing Research Colloquium

Abstract

Background: Patient’s self-report is a “gold standard” in assessing pain, yet it is not always possible in critically ill, nonverbal adults. In such cases, the use of reliable behavioral pain assessment tools is paramount to patient outcomes. However, the literature presented conflicting information regarding behavioral pain assessment tools and their sensitivity in assessing pain in critically ill, nonverbal adults.

Objective: This integrative research aimed to explore the effectiveness and barriers in the clinical guidelines of the Critical-Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS) assessment tools for the detection of pain in critically ill, nonverbal ...

Stem Cell Therapy As An Effective Treatment Method For Traumatic Burn Injuries, Axita Patel

Grace Peterson Nursing Research Colloquium

Effectiveness of Stem Cell Treatment for

Burn Patients: An Integrative Literature Review

Axita Patel

Faculty Sponsor: Elizabeth Moxley

Abstract

Background: Current literature suggests that packing burn wounds with antimicrobial solutions and skin barrier creams are no longer considered to be effective in the patient’s recovery process. Stem cell therapy has been introduced as an alternative treatment strategy that aims to yield reliable and improved patient outcomes.

Objectives: To explore what research has been conducted regarding stem cell therapy as a treatment option for burn patients and to explore the benefits of using the suggested newly proposed method as opposed ...

Patient Experiences In Intensive Care Units: A Systematic Review, Serpil Topçu, Şule Ecevit Alpar, Bilgi Gülseven, Ayda Kebapçı

Patient Experience Journal

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: “remembering the intensive care period” and “recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive care ...

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

Carrie-Ellen Briere

Abstract Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical. Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge. Method: This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA ...

Comparison Of The Behavioral Pain Scale And The Critical-Care Pain Observation Tool In Assessing Pain In Ventilated Critical Care Patients, John Weldon

MSN in Leadership in Nursing Final Projects

Purpose: The study aimed to compare the Behavioral Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT) in their effectiveness to identify the presence of pain in nonverbal mechanically ventilated critically ill patients. Nurses’ evaluation with the feasibility, clinical relevance, and satisfaction of the tools were also gathered and compared.

Design: This study followed a non-experimental, correlational, comparative design.

Methods: Nurses were recruited from the surgical intensive care unit in a midsized community hospital in the Southeastern United States. After training, nurse participants obtained pain assessments on ventilated critically ill patients at rest, following a normal blood pressure ...

Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann

Graduate Student Projects and Scholarship

Nurses are at the forefront in the care of patient pain management; however, many nurses do not possess the knowledge, skills, and attitudes required for best pain management outcomes. Adequate pain management education is often infrequent in academic settings and in post-graduate health care environments. That shortcoming suggests a need to improve pain management education as advocated by The Joint Commission and U.S. Department of Health and Human Services. The purpose of this study is to measure 20 nurses’ knowledge and attitudes regarding pain and pain management while working in an orthopedic setting. It was an evidence-based practice project ...

Perceived Knowledge And Perceptions Of Palliative Care Among Advanced Practice Cardiac Providers, Jordan Vance

Doctoral Dissertations and Projects

Providers of healthcare have continued to focus on addressing patients’ chronic health outcomes. When understanding how to manage chronic disease, there remains many opportunities in facilitation of better management. With such a wide range of individuals who suffer with a chronic condition, better management to address this population is essential. Palliative care aids in accomplishing this task. It was seen that there was a lack of education in relation to palliative care, with perceptions that continued to be a barrier to the utilization of the service. Due to the lack in education, the strongest barrier to palliative care service utilization ...

Reducing Delirium, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Maine Medical Center

No abstract provided.