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The Effectiveness Of Increasing Frequency Of Central-Line Dressing Changes And Monitoring On Clabsi Rates: A Scoping Review, Jacob Schmidt, Bsn, Rn, Ccrn, Georgia Brown, Bsn, Rn, Laura Dickey, Agpcnp-C, Lauren Faulkner, Bsn, Rn, Margaret Harvey, Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Abstract

Purpose/Background

Central lines provide many benefits to critically ill patients; however, there are additional risks with them, including central line-associated bloodstream infections (CLABSIs). CLABSIs place patients at increased risk for morbidity and mortality, longer length of stay, and higher medical costs. Studies evaluating various methods of reducing CLABSIs have been performed. This scoping review was completed to determine the effectiveness of frequent central-line dressing changes and increased monitoring on the incidence of central-line associated blood stream infections in adults with central-lines.

Methods

An extensive database search through the University of Tennessee Health Science Center (UTHSC) Online Library was performed …

Implementation Of A Rounding Tool To Promote Compliance With Central Line Dressing Changes In An Adult Intensive Care Unit, Fabiola Demuth

DNP Projects

Abstract

Evidence supports implementing central line (CL) maintenance bundles and nurse-led rounding interventions to prevent central line-associated bloodstream infections (CLABSIs). In a Tennessee intensive care unit (ICU), increased CLABSI rates were associated with inconsistent CL dressing maintenance and documentation. This Doctor of Nursing Practice scholarly project was implemented to improve ICU CLABSI rates and reinforce nursing standard practices for CL dressing care. This quality improvement project used the Institute for Healthcare Improvement (IHI) model for improvement, which used the plan, do, study, act (PDSA) cycles as part of the framework to implement a daily nurse-led rounding tool in the ICU, …

Champion Training For Two Clinicians Indwelling Urinary Catheter Insertion Technique, Punitha Stevenson

Liberty University Research Week

Graduate

Basic

Dnp Final Report: An Evidence-Based Initiative To Reduce Risk Of Ventilator-Associated Events, Bailey Dee Burge

DNP Final Reports

Ventilator-associated events have been considered an outcome metric for quality patient care. Ventilator-associated events are associated with unnecessary medical expenses. These events are multifactorial, yet bedside nurses can help decrease this nosocomial infection through proper oral care. A PICOT question was constructed to search the evidence systematically. The systematic literature search evidence was appraised to provide recommendations for the bundle of care process regarding ventilator-associated event prevention, specifically oral care. The body of evidence was comprised of five articles reporting statically significant outcomes. The evidence-based oral care protocol was implemented for a quarter of a year in patients with mechanical …

Importance In Decreasing Blood Culture Contaminations, Jannery Valdelamar

MSN Capstone Projects

Blood culture collection was a skill introduced while in nursing school. We are all human and make mistakes, and sometimes errors are made. Blood culture contamination happens. It happens even more in hectic departments like Emergency Department and Intense Care Unit. The American Society for Microbiology and Clinical Laboratory Standard have recommended that the %3 should be the overall rate for blood contamination rate (Center for Disease Control, 2023). In the current facility that I am in, blood culture contamination is an enormous issue. The facility rate is 9.3%, the Emergency Department was 11.3%, and the Phlebotomy was 5.2%. Multiple …

Standards Of Care In Surgical Site Prevention Benchmark Study, Jasmine Taylor

MSN Capstone Projects

In depth synthesis of studies supporting efficacy of alcohol-based rubs in prevention of surgical site infections.

Challenges To Coordination Of Care In The Diabetic Homeless Population, Melissa K. Smith

Doctoral Dissertations & Projects

Abstract

Diabetes mellitus (DM) significantly impacts the lives of Americans and the healthcare industry. Clinicians and patients utilize significant time, effort, and resources to combat the challenges faced. Homeless patients have additional burdens not experienced by those of housed individuals. A Midwest homeless shelter recognized the ongoing unmet needs for primary care and behavioral health services for their clinic patients. It was postulated that implementing a streamlined referral process to primary care services, enabling patients to be seen same day or next day, would increase utilization of services by this population. To increase the probability of patients presenting for their …

Outpatient Intravenous Antibiotics, Audrey Crews

MSN Capstone Projects

This paper discusses the use of outpatient intravenous antibiotics in comparison to inpatient intravenous antibiotics. Hospital admission rates, cost of care for patients and facilities, length of stay, patient experience, and patient outcomes are compared and evaluated with treatment to determine the efficacy of use.

Effects Of An Evidence-Based Practice Bundle Project On Nurse Empowerment, Kevin Jay Inman

Graduate Theses, Dissertations, and Capstones

The project determined the effect of an Evidence-Based Practice bundle program on nurses’ perception of empowerment. The EBP bundle included 7 interventions implemented simultaneously throughout a small community hospital. There was a significant increase in nurses’ perception of empowerment (p<.001), EBP beliefs (p<.001), and use of EBP (p<.001) after the implementation of an EBP bundle.

Creating A Culturally Adaptable Comprehensive Sexuality Education Teacher's Manual, Stephanie Carteciano

Student Works

Purpose: The purpose of this project was to create a culturally adaptable comprehensive sexual education teacher’s manual by (a) standardizing content using The United Nations Educational, Scientific and Cultural Organization’s (UNESCO) 2018 International Technical Guidance on Sexuality Education (CSE), (b) providing evidence-based CSE pedagogy in the form of classroom activities, and (c) including adaptable teaching methods to fit diverse cultural contexts.

Development: The manual lessons were derived from UNESCO’s 2018 International Technical Guidance on Sexuality Education, and the pedagogy followed Anderson and Krathwohl’s revision of Bloom’s Taxonomy. Health information was obtained from various medical and university resources. We surveyed eight …

Clabsi Prevention Methods, Noah Heine, Talon Cockrel

Scholars Week

Infection and the risk thereof is one of the major concerns regarding patient outcomes in the health care facility. One of the interventions with the highest causes of infection is the use of central lines. These lines provide necessary venous access for medication administration but can cause infections called CLABSI or Central Line Acquired Bacterial Infection. The purpose of our article was to research CLABSI prevention methods and provide a new policy using these safe effective methods. These new methods include the use of stat locks for central line securement, using antimicrobial lines, and flushing/locking the central line with a …

Strategies To Prevent Clostridioides Difficile Infections In Acute-Care Hospitals: 2022 Update, Larry K Kociolek, Dale N Gerding, Ruth Carrico, Philip Carling, Curtis J Donskey, Ghinwa Dumyati, David T Kuhar, Vivian G Loo, Lisa L Maragakis, Monika Pogorzelska-Maziarz, Thomas J Sandora, David J Weber, Deborah Yokoe, Erik R Dubberke

College of Nursing Faculty Papers & Presentations

No abstract provided.

Preoperative Skin Preparation Protocol For Patients Undergoing Abdominal And Spinal Surgery, Lia Moyer

The Eleanor Mann School of Nursing DNP Capstone Projects

Surgical site infections are an avoidable complication in surgical patients and one of the most common hospital-acquired infections. Adverse effects of surgical site infections include increased hospital length of stay, increased costs to patient and healthcare system, disability, morbidity, and mortality. The purpose of this quality improvement project was to design a protocol with the objective of decreasing surgical site infections in abdominal and spinal surgery patients. The protocol developed used targeted depilation and antisepsis with a chlorhexidine wipe to mitigate infection risk. Results of the project showed a static hospital length of stay, no increase in preoperative time, and …

Implementation Of A Daily Central Line Maintenance Audit Form In An Outpatient Infusion Center: A Quality Improvement Project, Sarah E. Christiana

DNP Projects

Significance and Background: Best evidence supports central venous access device (CVAD) dressing changes occur every 7 days or sooner, if indicated. At a community hospital in New England, patients receive outpatient antimicrobial therapy via CVADs. It is vital that nurses adequately maintain CVAD dressings according to evidence-based protocols to reduce the risk of central line-associated bloodstream infection (CLABSI). CLABSIs, associated with increased morbidity, mortality, and health care costs, are largely preventable through proper CVAD maintenance. At the project site, a review identified that dressing changes were frequently changed beyond the 7-day parameter. Documentation and surveillance processes were identified as opportunities …

Impact Of An Evidence-Based Order Set On Pneumonia Length Of Stay, Troy Wayne Spires

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Among adult patients admitted with pneumonia, what is the effect of Computerized Provider Order Entry (CPOE) sets for pneumonia, as compared to usual practice, on the length of stay over three months.

Purpose: The project aimed to determine if inpatient LOS related to pneumonia could be impacted by utilizing appropriately completed computerized physician order entry (CPOE). The current pneumonia order set was evaluated and updated to reflect the latest evidence-based standards of care. Pneumonia order sets with evidence-based practice treatment algorithms was the intervention focus as they have been shown to impact the length of stays …

2023 Research Day Program, Lincoln Memorial University

Research Day

This program contains abstracts and presentation summaries from LMU's 2023 Annual Research Day conference.

Mandates, Mistrust, And Misconceptions: An Overview Of Vaccine Hesitancy, Evelyn Ryan

Senior Honors Theses

Vaccines are one of the most successful ways to prevent diseases and are considered one of the most influential achievements in the history of public health. While vaccines have many benefits, the number of parents that refuse vaccinations for their children is increasing. People are concerned about potential risks and health problems that are thought to result from vaccination. There are risks and contraindications involved with vaccines, but many reasons for vaccine hesitancy that are cited by the public are not founded on evidence-based data. When making vaccine decisions, it is essential that the public has accurate information and that …

Nurses' Preparedness For Disaster Response In Rural And Urban Primary Healthcare Settings In Tanzania, Kahabi Isangula, Mary Lyimo, Yudas Ndungile, Elisha Robert

School of Nursing & Midwifery, East Africa

Introduction: Nurses are often on the frontline of disaster management, providing care to patients with emerging physical, mental, and emotional turbulence, and acting as educators for health promotion and disaster prevention in both rural and urban contexts. However, the literature suggests that nurses are inadequately prepared for disaster response. This study examined preparedness for disaster response among nurses in rural and urban primary healthcare settings in Tanzania.

Methods: This qualitative descriptive study involved purposefully selected qualified nurses and nurse administrators working in rural (n=20) and urban (n=11) primary healthcare facilities in Tanzania. Telephone-based interviews were conducted to gather …

Strategies For Supporting Healthcare Workers’ Resilience And Mental Health During A Pandemic: A Scoping Review, Eka Oktavianto, I Made Moh. Yanuar Saifudin, Gani Apriningtyas Budiyati

Jurnal Keperawatan Indonesia

As a group, health workers are at risk of experiencing stress and mental health problems at work, which may negatively affect their resilience. This study assessed the effectiveness of mental health support strategies for health workers during the COVID-19 pandemic. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines in searching through three journal databases, such as: EBSCO, Scopus, and PubMed. The quality of the studies was assessed with the Crowe Critical Appraisal Tool, and the results of the review emerged from a process of synthesis that identified common themes. The search yielded five main …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Implementation Of Evidence-Based Multiple Focus Integrated Intensified Tb Screening To End Tb (Exit-Tb) Package In East Africa: A Qualitative Study, Kahabi Isangula, Doreen Philbert, Florence Ngari, Tigest Ajeme, Godfather Kimaro, Getnet Yimer, Nicholaus P. Mnyambwa, Winters Muttamba, Irene Najjingo, Aman Wilfred

School of Nursing & Midwifery, East Africa

Introduction Tuberculosis (TB) remains a major cause of morbidity and mortality, especially in sub-Saharan Africa. We qualitatively evaluated the implementation of an Evidence-Based Multiple Focus Integrated Intensified TB Screening package (EXIT-TB) in the East African region, aimed at increasing TB case detection and number of patients receiving care.

Objective We present the accounts of participants from Tanzania, Kenya, Uganda, and Ethiopia regarding the implementation of EXIT-TB, and suggestions for scaling up.

Methods A qualitative descriptive design was used to gather insights from purposefully selected healthcare workers, community health workers, and other stakeholders. A total of 27, 13, 14, and 19 …

Botulinum Neurotoxin A4 Has A 1000-Fold Reduced Potency Due To Three Single Amino Acid Alterations In The Protein Receptor Binding Domain, William H. Tepp, Marite Bradshaw, Alexander P. Gardner, Rebecca L. Kaufman, Joseph T. Barbieri, Sabine Pellett

College of Nursing Faculty Research and Publications

Botulinum neurotoxin subtype A4 (BoNT/A4) is ~1000-fold less potent than BoNT/A1. This study addresses the basis for low BoNT/A4 potency. Utilizing BoNT/A1-A4 and BoNT/A4-A1 Light Chain-Heavy Chain (LC-HC) chimeras, HC-A4 was responsible for low BoNT/A4 potency. Earlier studies showed BoNT/A1-receptor binding domain (Hcc) bound a β-strand peptide (556–564) and glycan-N⁵⁵⁹ within Luminal Domain 4 (LD4) of SV2C, the BoNT/A protein receptor. Relative to BoNT/A1, the Hcc of BoNT/A4 possesses two amino acid variants (D¹¹⁴¹ and N¹¹⁴²) within the β-peptide binding interface and one amino acid variant (R¹²⁹²) located near the SV2C glycan-N⁵⁵⁹. …

Best Practices For Improving Blended Learning In Nigeria: Critical Reflections On The Breast Cancer Clinical Pathway Development Course, Peace I. Egharevba, Kelechi Eguzo, Enyichukwu M. Anya, Nuhu Tumba, Kingsley Nnah, Chukwuemeka Oluoha, Precious Mbaraonye

Journal of Graduate Education Research

Although cancer clinical pathways (CPs) are standardized care plans for the treatment of specific cancers, they are not commonly used in Nigerian hospitals. Many Nigerian clinicians do not have the requisite skill for developing and implementing the use of CPs. Critical reflections provide an important perspective in the philosophy, design, implementation, and outcome of interventions. This paper critically reflects on the design and implementation of a multidisciplinary, blended learning (i.e. online and in-person) course which sought to improve the competence of local doctors, nurses, and allied students in developing clinical pathways. Reflective feedback was obtained from a mix of project …

Development Of A Rn Clinical Coach Program To Improve Retention Of Icu Residents And Fellows, Megan Jones, Sarah Sumner, Kristen Mayberry

Providence Nursing Research Conference 2023 – Present

Development of a RN Clinical Coach program to improve retention of ICU residents and fellows

Background:
The COVID-19 pandemic caused contributed to significant increases in ICU nurse turnover. To restore the ICU nursing workforce and rebuild a healthy work environment, evidence-based strategies are needed to provide social support and ongoing clinical skills development for large cohorts of ICU residents and fellows.

Purpose:
The purpose of the Clinical Coach program was to increase retention of ICU residents and fellows and foster a healthy work environment at a ministry in Southern California.

Methods:
In September 2021 the ICU manager at Providence Saint …

Empiric Antibiotic Management Pathway (Eamp), Michelle Brunelle

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Scoping Review: Positive And Negative Impact Of Technology On Clinicians, Susan Mcbride, Gregory L. Alexander, Marianne Baernholdt, Margaret Vugrin, Beth Epstein

Nursing Faculty Publications and Presentations

Background: Unnecessary electronic health record (EHRs) documentation burden and usability issues have negatively impacted clinician well-being (e.g., burnout and moral distress). Purpose: This scoping review was conducted by members from three expert panels of the American Academy of Nurses to generate consensus on the evidence of both positive and negative impact of EHRs on clinicians. Methods: The scoping review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews guidelines. Results: The scoping review captured 1,886 publications screened against title and abstract 1,431 excluded, examined 448 in a full-text review, excluded 347 with …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Connecting Contemporary Trauma Care To Florence Nightingale's Visionary Work, Lynn Stover Nichols, Michael T. Hyde, Michael Mosley, Melanie Gibbons Hallman

Nursing Faculty Publications and Presentations

The impact of Florence Nightingale's visionary work continues to influence the delivery of nursing care in the contemporary emergency department (ED). Her foundational work in the Crimean War resulted in data-based recommendations for using the environment to promote healing and wellness among sick and wounded British soldiers. She advocated for attention to environmental details, including ventilation, air, warmth, drainage, cleanliness, natural light, and low noise levels. These important environmental concepts play a significant role in the nursing management of trauma patients in today's ED. This article features an application of Nightingale's environmental concepts to a trauma patient case exemplar and …

Substrate Electronics Dominate The Rate Of Reductive Dehalogenation Promoted By The Flavin-Dependent Iodotyrosine Deiodinase, Jeffrey M Carlson, Ayzsa Tannis, Kate R Woodworth, Megan R Reynolds, Neha Shinde, Breanne Anderson, Keivon Hobeheidar, Aisha Praag, Kristen Campbell, Cynthia Carpentieri, Teri Willabus, Elizabeth Burkhardt, Elizabeth Torrone, Kevin P O'Callaghan, Kathryn Miele, Dana Meaney-Delman, Suzanne M Gilboa, Emily O'Malley Olsen, Van T Tong

Faculty, Staff and Student Publications

Despite universal prenatal syphilis screening recommendations and availability of effective antibiotic treatment, syphilis prevalence during pregnancy and the incidence of congenital syphilis have continued to increase in the United States (1,2). Concurrent increases in methamphetamine, injection drug, and heroin use have been described in women with syphilis (3). CDC used data on births that occurred during January 1, 2018-December 31, 2021, from two states (Arizona and Georgia) that participate in the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) to describe the prevalence of substance use among pregnant persons with syphilis by congenital syphilis pregnancy outcome (defined …