Critical Care Nursing Commons^™

Rescue Dosing As A Standardized Treatment Protocol For Neonatal Abstinence Syndrome (Nas) To Decrease Length Of Hospital Stay, Mallory Lanier

Chancellor’s Honors Program Projects

No abstract provided.

Early Extubation After Cardiac Surgery: An Evidenced-Based, Nurse-Driven Protocol, Emily Brooks

DNP Final Reports

Prolonged mechanical ventilation in cardiac surgery patients has been associated with increased hospital stay, increased intensive care unit (ICU) length of stay, higher health care costs, and higher morbidity from atelectasis, intrapulmonary shunting and pneumonia. Early extubation of post-operative cardiac surgery patients has been associated with shorter ICU and overall hospital stays, reduced mortality, decreased resource use, and is safe and effective in elderly patients with no increased risk of reintubation. As such, the question arises in intubated post-operative cardiac surgery patients, how does a nurse-driven extubation protocol compared to no standardized protocol affect extubation rates within six hours post-operative? …

The Efficacy Of Mechanical Compression Devices In Cardiopulmonary Resuscitation, Emma A. French

Scholars Week

This project examines the ability of mechanical compression devices, such as the popular LUCAS device, to produce the desired outcomes of cardiopulmonary resuscitation (CPR) when compared to manual chest compression performed by a CPR certified individual. For the purpose of this project, desired outcomes include correct compression rate and depth according to American Heart Association (AHA) guidelines, return of spontaneous circulation (ROSC) in the patient, long term survival of patients who achieve ROSC, and prevention of serious physical damage related to chest compressions. Data from multiple research studies comparing outcomes of mechanical compression devices and manual chest compression was reviewed …

Does Preoperative Ostomy Education Decrease Anxiety In The New Ostomy Patient?, Michelle Suzann Harris

Doctoral Projects

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. …

Addressing Disparities In Nurses’ Understanding Of Congestive Heart Failure, David Tomas Palecek

Doctoral Projects

Congestive heart failure (CHF) continues to affect millions of people a year and remains one of the leading causes of re-hospitalization in the US. Within the Central San Joaquin Valley (CSJV) the incidence of CHF remains significantly higher than the rest of California. In order to ensure appropriate patient care and outcomes registered nurses (RNs) must have a thorough and full understanding of the disease process and its associated symptomatology. This study aimed to find if the implementation of an interactive multimedia educational program focusing on all aspects of CHF could improve RNs education and understanding of CHF. It is …

Developing An Evidence-Based Supportive Services Program For Cancer Survivors In A Private Oncology Practice, Joseph Ellul

Doctoral Projects

Improvements in cancer treatment have led to a rapidly increasing survivor population. In response, multiple side effects of cancer and cancer treatment as well as the various wellness needs of survivors have been recognized. Survivorship programs have been developed to care for survivors with residual effects of cancer and the side effects of treatment; however, additional support is needed. The purpose of the project was to highlight the need for a comprehensive supportive services program for the cancer survivor population and describe the steps that were required to successfully develop the program. The clinical question addressed by the project was: …

Critical Care Nurses At Higher Risk Of Burnout, Jayden Rusher, Barbara Mcclaskey

Posters

In practice today, units with high intensity, stress, and patient needs are being burnt-out quickly due to patients’ intense needs, uncertain outcomes, and the ongoing witnessing of suffering and death. The purpose of this paper is to determine if there is a significant relationship between critical care units, and a high risk of nurses who work on those units exhibiting more characteristics of burnout. The study was done to gauge burnout, strength, and prevalence of moral distress, differentiated moral distress from day-to-day stressors, and determine fortitude and other aspects indicative of resilience. There was a cross-sectional survey model to test …

Implementation Strategies To Increase Uptake Of Hester Davis Tool Tailoring Of Fall Prevention Interventions, Beena Philip

Doctoral Projects

Introduction. Falls are the most common cause of injury to patients in acute care hospitals globally and higher incidences of falls with injury are reported in the hospitalized elderly. Falls can result in physical and emotional injury, long-term pain, functional impairment, disability, loss of income, increased hospital stay and mortality. Research demonstrates individualized, multifactorial fall prevention interventions are most beneficial in preventing falls and related injuries. This paper reports whether accurate fall risk assessment using the Hester Davis, proactive use of 5T’s (toileting, tolerating pain, tidy, turn, technology), appropriate gait belt use, individualized interventions and intentional toileting for patients with …

Extracorporeal Cardiopulmonary Resuscitation, Emily Carr

Senior Honors Theses

Extracorporeal cardiopulmonary resuscitation (ECPR) is a method of resuscitation in which venoarterial (VA) extracorporeal membrane oxygenation(ECMO) is initiated during refractory cardiac arrest. ECPR promises to enhance outcomes after cardiac arrest by minimizing neurological deficits, stabilizing the patient for early reperfusion and hypothermia, and serving as a bridge to treatment or transplant. ECPR must be initiated according to structured guidelines and protocols, which are based on the patient’s age, comorbidities, code status, neurological baseline, no flow time, and low flow time.

If a patient achieves return of spontaneous circulation on ECMO, the patient will receive post cardiac arrest care which includes …

Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, Mckenna Scharlau, Jacob Schneider

Nurse Presentations

Describes a project to improve use of the Sepsis Tool in the Emergency Department and to improve documentation of blood pressure measurements in high risk sepsis patients under three years of age.

Minimizing Unplanned Extubations In The Intensive Care Nursery, Lindsay Barrosse, Blaire Collins, Cassidy Horton, Jodie Seitzer, Brittney Hunter, Jenny Mckee

Nurse Presentations

Describes a project to ensure compliance with a standardized process for endotracheal tube management in the intensive care nursery in order to reduce the number of unplanned extubations and their consequent adverse effects.

Timely Interventions In Patients Developing Sepsis Within The Picu, Lindsey Bloom, Ashley Bramel, Kelsey Cumpton, Christopher Damrat, Emily Lingo, Grace Sexton, Breton Struble

Nurse Presentations

Describes a project to increase the number of sepsis interventions completed within one hour in the pediatric intensive care unit, and to improve the documentation (COW Cards) of rapid interventions.

Engaging Student Nurses In A Professional Association, Nicholas Craig

Student Engagement Posters

Nicholas Craig discusses student engagement at Linfield College with regard to his involement with the Critical Care Nurses' Club.

Sepsis: Triage Triggers, Outcomes Quicker, Rylee Ainge, Mackenzie Flaws, Natalie Heim, Emily Herndon, Hayley Norris, Amy L. Scott

Posters

No abstract provided.

Temperature Management: All Shook Up! Managing Shivering In Normothermia, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Identify key factors related to maintaining normothermia
• Describe the use of the Bedside Shivering Assessment Scale
• Provide interventions to manage shivering in the Neuro patient population

Practice With Purpose & Passion, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Integrate the components of clinical practice in an ICU environment including elements of team membership/performance, teamwork, shared decision making, communication and collaboration
• Demonstrate passion in delivering care in the ICU environment by reflecting on the meaning of nursing care and generating fuel to inspire the clinical team in the work environment

Technology: Inside The Black Box -- Managing Neuro Patients, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Identify the pathophysiology and cellular processes related to brain injury responses
• Describe the indications, functions, data analysis, and suggested interventions with various monitors of the brain
• Apply this technology to the care of the critically injured neuro patient using evidenced based protocols

Managing Severe Tbi In The Icu Setting Using A Three Tier Approach, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Assess the effects of injury to the brain in the neurologic injured patient and implement a tiered approach to manage severe TBI
• Evaluate TBI patients using multimodality monitoring
• Apply interventions to manage brain injury & integrate the complex multi-system issues and manage these patients using an actual case study.

Improving Inpatient Pediatric End Of Life Care Education For Bedside Nurses, Grace Wolcott

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose:45,000 infants, children and adolescents die in the US annually. Bedside nurses in inpatient pediatric units receive minimal education on the topic of pediatric end of life care. The purpose of this project was to assess the needs of pediatric inpatient nurses and trial an online educational module for effectiveness in teaching nurses about pediatric end of life care

Methods. This was a quality improvement project aimed at inpatient nurses on 4 different units. Electronic 7 question pre-surveys were sent via email, followed by an educational module accompanied by a 3 question post-survey.

Results. Of 78 participants, 51% reported …

Association Of Skeletal Muscle And Psychological Responses To Immobility After Major Injury, Jacob T. Higgins

Theses and Dissertations--Nursing

The purpose of this dissertation was to explore the physical and psychological responses to the combination of major trauma (Injury Severity Score [ISS] > 15) and variable periods of immobility. Specific aims were to: 1) develop a conceptual model that illustrates physiological and psychological alterations that occur after injury and subsequent immobility, and their association with skeletal muscle responses and recovery; 2) evaluate daily measures of skeletal muscle strength (bicep and quadricep) using dynamometry and skeletal muscle (rectus femoris and biceps brachii) muscle thickness measured with ultrasound in patients after major trauma; and 3) assess the predictive ability of anxiety and …