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Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee 2016 The University of San Francisco

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL ...


Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale 2016 University of San Francisco

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys ...


Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters 2016 University of San Francisco

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier ...


Debriefing In The Emergency Department, Alyssa Johnson 2016 University of San Francisco

Debriefing In The Emergency Department, Alyssa Johnson

Master's Projects

Emergency Department (ED) staff are repeatedly exposed to high stress situations and as a result suffer from compassion fatigue, secondary traumatic stress, symptoms of post-traumatic stress disorder, burnout and high turnover rates. Staff turnover is costly to the health system in the form of training new staff and potential poor patient outcomes due to under staffing or inexperience of staff. Based on a survey about debriefing, Level 1 Adult and Pediatric Emergency Department staff reported 81% felt there was inadequate support for critically stressful events that occur. Debriefing was identified by 75% of the staff as an option for support ...


Regional Anesthesia Introduced Into An Emergency/Trauma, Jennifer Bryant Covalt 2016 University of Southern Mississippi

Regional Anesthesia Introduced Into An Emergency/Trauma, Jennifer Bryant Covalt

Doctoral Nursing Capstone Projects

Emergency rooms across the United States have an incredibly large number of shoulder dislocations that need to be manipulated and reset on a daily basis. A cost-benefit analysis in this Doctor of Nursing Practice Project will demonstrate a new form of care for shoulder dislocations in the emergency room with certified registered nurse anesthetists (CRNA) providing regional anesthesia with local lidocaine injections into the shoulder joint. A level II trauma center in Mississippi with many shoulder dislocations was the location that was used to evaluate conscious sedation, length of procedure, and pain scores. A retrospective chart review was performed at ...


In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel 2016 University of Southern Mississippi

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Nursing Capstone Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus ...


The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar 2016 University of Southern Mississippi

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Nursing Capstone Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in ...


Liver Transplant Education And Training For Medical Surgical Icu Nurses, Matthew Redila 2016 University of San Francisco

Liver Transplant Education And Training For Medical Surgical Icu Nurses, Matthew Redila

Master's Projects

This project focuses on the CNL curriculum element of Nursing Leadership and explores the need for appropriate education and training for liver transplant as a new patient population for Medical Surgical ICU nurses. The transplant experience for these nurses currently include critically ill Bone Marrow Transplant, as well as stable heart and lunch transplant. The methods used to implement the project were to develop an education curriculum, a clinical orientation program, and a process to ensure proper communication occurs between all parties prior to clinical orientation. The competency-based orientation document, which is still being drafted, is used to determine clinical ...


Standardized Blood Transfusion Documentation, Kelly A. Hill 2016 University of San Francisco

Standardized Blood Transfusion Documentation, Kelly A. Hill

Master's Projects

The aim of this project was to improve nurse satisfaction through the use of a standardized blood administration documentation template. The goal was to reduce the time that nurses spend charting by offering a structured documentation template and to ensure that the procedure is correctly recorded in the patient’s electronic record. The leadership theme that supported this project is Information Manager, as the clinical nurse leader (CNL) uses information systems and technology at the point of care to improve health care outcomes. The selected microsystem is a medical/surgical/telemetry unit, which has 38 beds with 38 registered nurses ...


Hypoxic Pulmonary Vasoconstriction, Miranda Shull 2016 Otterbein University

Hypoxic Pulmonary Vasoconstriction, Miranda Shull

Master of Science in Nursing (MSN) Student Scholarship

A poster project about Hypoxic Pulmonary Vasoconstriction.


The Artificial Nutrition Debate: Still An Issue…After All These Years, Cheryl Monturo 2016 West Chester University of Pennsylvania

The Artificial Nutrition Debate: Still An Issue…After All These Years, Cheryl Monturo

Cheryl Monturo

No abstract provided.


A.S.P.E.N. Ethics Position Paper, Albert Barrocas, Cynthia Geppert, Sharon M. Durfee, Julie O'Sullivan Maillet, Cheryl Monturo, Charles Mueller, Kathleen Stratton, Christina Valentine, A.S.P.E.N. Board of Directors 2016 West Chester University of PA

A.S.P.E.N. Ethics Position Paper, Albert Barrocas, Cynthia Geppert, Sharon M. Durfee, Julie O'Sullivan Maillet, Cheryl Monturo, Charles Mueller, Kathleen Stratton, Christina Valentine, A.S.P.E.N. Board Of Directors

Cheryl Monturo

No abstract provided.


Advance Directives At End-Of-Life: Nursing Home Resident Preferences For Artificial Nutrition, Cheryl Monturo, Neville E. Strumpf 2016 West Chester University of Pennsylvania

Advance Directives At End-Of-Life: Nursing Home Resident Preferences For Artificial Nutrition, Cheryl Monturo, Neville E. Strumpf

Cheryl Monturo

No abstract provided.


Malignant Hyperthermia, Aaron Roth 2016 Otterbein University

Malignant Hyperthermia, Aaron Roth

Master of Science in Nursing (MSN) Student Scholarship

Malignant hyperthermia is a rare disease trait and can take place in a variety of settings. If not treated in a timely manner, the consequences will be dire. It is recommended that nurses and other healthcare personnel be properly educated on MH crises. By detecting the signs and symptoms associated with the disease, providers can efficiently remedy the crisis and save patient lives (Seifert, 2014). Since the discovery of dantrolene in 1975 and the advancement of genetics regarding MH, death rates dropped from about 80% to about 5% (Schneiderbanger et al., 2014). Today there is a MH group called the ...


Guillain-Barre Syndrome, Tyler B. Skelton 2016 Otterbein University

Guillain-Barre Syndrome, Tyler B. Skelton

Master of Science in Nursing (MSN) Student Scholarship

Guillain-Barre Syndrome consists of a group of neuropathic conditions characterized by progressive weakness and diminished or absent myotatic reflexes. The estimated annual incidence in the United States is 1.65 to1.79 per 100,000 persons (Walling & Dickson, 2013). Understanding how this condition progresses and the affects it has on a patient will assistant in providing optimal patient care as a future nurse anesthetist. As stated by Turakhia, P., Barrick, B., and Berman, J. (2013) “the anesthetic implications for the various comorbidities are varied and can be profound” (p.1). An individual who suffers from Guillain-Barre is a patient who ...


Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller 2016 The University of San Francisco

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes ...


National Institute Of Health Stroke Scale (Nihss) Inter-Rater Reliability And Confidence Among Nihss Certified Nurses: Implementation Of A Standardized Patient Simulation, Kelly J. Trieglaff 2016 Valparaiso University

National Institute Of Health Stroke Scale (Nihss) Inter-Rater Reliability And Confidence Among Nihss Certified Nurses: Implementation Of A Standardized Patient Simulation, Kelly J. Trieglaff

Evidence-Based Practice Project Reports

The National Institute of Health Stroke Scale (NIHSS) is the most common stroke assessment used by nurses. Nurses certified on the NIHSS do not consistently demonstrate inter-rater reliability nor are they confident when assessing stroke patients using the tool (Josephson, Hills, Johnston, 2006). This EBP project evaluated a standardized patient simulation for maintaining inter-rater reliability and confidence in NIHSS certified nurses. A literature review showed that a decrease in inter-rater reliability occurs within four weeks to three months of NIHSS certification. A single cohort of intensive care nurses and emergency department nurses used the NIHSS tool in a standardized patient ...


Nursing Input During Interprofessional Rounds In The Intensive Care Unit, Kathrine A. Winnie 2016 California State University, Northern California Consortium Doctor of Nursing Practice

Nursing Input During Interprofessional Rounds In The Intensive Care Unit, Kathrine A. Winnie

Doctoral Projects

Interprofessional rounding has become a standard in intensive care units. Healthcare organizations such as The Joint Commission (2013) and the Institute of Medicine (2010) promote interprofessional teamwork with the goal of improving patient safety and outcomes. The 2010 IOM report, The Future of Nursing – Leading Change, Advancing Health discusses the need for all nurses to work as part of an interprofessional team to improve healthcare. Interprofessional rounding offers a venue for nurses to demonstrate their role as an equal member of the healthcare team. At the hospital of focus, there has been no previous formal attempt to measure the actual ...


Teaching And Evaluation Of Suicidal Assessment, Five-Step Evaluation And Triage (Safe-T) In The Emergency Department, Evangeline Rico 2016 California State University, Northern California Consortium Doctor of Nursing Practice

Teaching And Evaluation Of Suicidal Assessment, Five-Step Evaluation And Triage (Safe-T) In The Emergency Department, Evangeline Rico

Doctoral Projects

Suicide remains to be a global and a national problem, and it continues to be one of the leading causes of death in the United States (U.S.) The Emergency Department (ED), being the gateway to the hospital can provide a great opportunity to assess each patient for suicidal ideation, and evaluate if patients present with risk factors for suicide. The competency of the ED staff plays a critical role in early recognition of patients who are at risk, and in implementing a plan of care for those with positive screens. However, researchers showed that knowledge deficit and lack of ...


Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens 2016 California State University, Northern California Consortium Doctor of Nursing Practice

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention ...


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