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An Exploratory Study Of The Utlization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron 2017 University of Southern Mississippi

An Exploratory Study Of The Utlization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron

Dissertations

The purpose of this study was to explore the relationship of adherence to evidence-based guidelines for pharmacologic management by select Mississippi hospitals and their hospital readmission rates. This was an exploratory study with a retrospective design. This design offered insight into the relationship between readmissions of heart failure patients and adherence to the national guidelines for the pharmacologic treatment of heart failure. The study took place in a hospital in the southeastern section of the United States. Data were collected from a database of patients with heart failure seen between January 2011 and June 2014.

The unit of analysis for ...


Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver 2017 Mount Royal University

Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver

The Qualitative Report

The issue of the literature review remains a conundrum and a controversy within the discourse on grounded theory methodology. Grounded theory researchers are expected to minimize preconceptions to ensure the concept of interest is grounded in data, yet at the same time are required to evaluate existing literature to support institutional ethics and scientific review of the research proposal. In addressing this dilemma, we espouse that literature review in grounded theory should comprise a multistage nonlinear approach to the literature and introduce a framework for novice grounded theory researchers. This framework offers a reflexive, dynamic and integrative process for conducting ...


From The Top Down: Assisting Critical Care Nurses In Coping With Job Stresses, Cynthia R. Bryant 2017 Liberty University

From The Top Down: Assisting Critical Care Nurses In Coping With Job Stresses, Cynthia R. Bryant

Senior Honors Theses

Critical Care nurses are faced with traumatic scenarios on a daily basis at work and are expected to remain professional in the face of chaos. In the midst of caring for their patients and catering to each family’s emotional needs, their own mental health tends to get pushed aside. Nurses are expected to remain supportive to sick patients and their families while enduring psychologically disturbing images and sounds, witnessing phases of the dying process, and hearing end-of-life care decisions being made. Because these nurses are only human, their energy reserves are rapidly depleted and they are left emotionally exhausted ...


Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle 2017 Liberty University

Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle

Senior Honors Theses

Cerebrovascular accidents (CVA), known as strokes, are a leading cause of death worldwide. The delivery and timing of treatment for CVAs is a critical factor in restoring health to the patient. One of the variables in recovery is the method of transport used in bringing the patient to a health care facility. Aeromedical transport remains a valuable resource to achieve full recovery in stroke patients. An ongoing debate of risk versus benefit of helicopter emergency services will be included as well as examination of variables including location, time, physiology of the flight, and the patient’s condition to be scrutinized ...


Improving Tissue Integrity In Intensive Care Unit Patients, Stacie L. Hearell 2017 Murray State University

Improving Tissue Integrity In Intensive Care Unit Patients, Stacie L. Hearell

Scholars Week

Throughout clinical experiences in western Kentucky intensive care units, it has been observed that critically ill patients are not receiving fully implemented skin care practice according to hospital and company policy. Patients are not turned completely to one side or the other due to size, mechanical intubation, and other medical devices that may be intimidating to staff. Alderen et al., (2011) states that “in mechanically ventilated, critically ill patients, pressure ulcer risk is high and may result in negative patient outcomes and increased healthcare costs.” Gallant, Morin, St-Germain, and Dallaire (2010) state that “In practice, pressure ulcers are indicators of ...


Preventing Sepsis Mortality, Karli Tabers 2017 Murray State University

Preventing Sepsis Mortality, Karli Tabers

Scholars Week

This research project explores recent evidence based research on preventing sepsis mortality in inpatient units. Sepsis mortality is an increasing problem in the state of Kentucky and demands immediate intervention. At Baptist Health Paducah, 44 deaths were related to sepsis in a 5-month period. Most deaths related to sepsis can be prevented. This research looks at how these deaths can be prevented and how nurses must change their practice to avoid further mortality from sepsis. This paper includes a literature review of recent research proving that sepsis mortality can be prevented by focusing on discharge teaching to all patients, implementing ...


Post Evaluation Of A Nurse Driven Early Mobility Program, Paula R. Halcomb 2017 University of Kentucky

Post Evaluation Of A Nurse Driven Early Mobility Program, Paula R. Halcomb

DNP Practice Inquiry Projects

Abstract

The goal of this study was to evaluate the effectiveness of a recently implemented nurse driven early mobility program on patients in two Trauma Surgical Intensive Care Units at the University of Kentucky HealthCare (UKHC). The purpose of this study was to evaluate the effectiveness of a recently implemented nurse driven early mobility program (NDEMP) on patients in two Trauma Surgical Intensive Care Units at the University of Kentucky HealthCare (UKHC). Nursing staff are responsible for mobilizing patients to their maximum ability twice daily in addition to any therapy provided by Physical and Occupational Therapists. The study was an ...


Evaluating Utilization Of An Early Mobility Protocol In An Adult Icu In The Veterans Administration System, Julie Duffy 2017 University of Kentucky

Evaluating Utilization Of An Early Mobility Protocol In An Adult Icu In The Veterans Administration System, Julie Duffy

DNP Practice Inquiry Projects

Purpose: To evaluate ICU staff’s adherence to a new progressive mobility protocol as part of a quality improvement project in an adult medical-surgical intensive care unit (ICU).

Background: Bedrest can lead to complications for hospitalized patients and current literature supports that mobility within the ICU is safe and feasible for critically ill patients. Current evidence based literature identifies barriers to patient mobilization which can be addressed through implementation of a mobility protocol. Utilization of mobility protocols is one way to improve quality of care and prevent common bedrest complications in the critically ill patient population.

Methods: Retrospective medical record ...


Oral Hygiene Practices In Non-Ventilated Intensive Care Unit Patients, Kimberly P. Emery 2017 University of Central Florida

Oral Hygiene Practices In Non-Ventilated Intensive Care Unit Patients, Kimberly P. Emery

Honors in the Major Theses

Introduction: Oral hygiene is a significant aspect of nursing care. Endocarditis, stroke, lung cancer, and hypertension have been associated with poor oral hygiene. Research exploring oral care practices for mechanically ventilated patients is well documented. In contrast, oral hygiene for the non-mechanically ventilated acute care population remains underestimated. The purpose of this study was to establish a baseline of the type, frequency, and consistency of oral hygiene being performed on non-mechanically ventilated ICU patients and explore how the oral care provided was documented.

Methodology: A literature search was conducted and reported as a literature review. The databases CINAHL Plus with ...


Stroke Outreach In The Lao Community, Noor A. Dythavon 2016 University of San Francisco

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern ...


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 and Capstones

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 and Capstones

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 and Capstones

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 ...


An Apn-Led Copd Discharge Education Program To Decrease 30-Day Readmission Rates, Moira Elizabeth Kendra 2016 Seton Hall University

An Apn-Led Copd Discharge Education Program To Decrease 30-Day Readmission Rates, Moira Elizabeth Kendra

Seton Hall University DNP Final Projects

The purpose of this project was to implement an APN-led COPD discharge education program to decrease 30-day readmission rates. This Doctorate of Nursing (DNP) project combined strategies obtained in the literature search and blended these into a cutting-edge and state-of-the-art discharge education program at a major medical center. The significance of chronic obstructive pulmonary disease (COPD) readmission rates include financial implications, a large number of Medicare patients who return to the hospital within 30 days, poor quality of patient care, and poorly coordinated discharge processes. An APN-led transitional care COPD education discharge plan was implemented on the pulmonary floor at ...


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

Debriefing In The Emergency Department, Alyssa Johnson

Master's Projects and Capstones

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 ...


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 ...


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 ...


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 and Capstones

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 and Capstones

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 ...


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