Digital Commons Network^™

Reducing The Incidence Of Compassion Fatigue In Obstetrical Nurses, Naveen Samuel

Student Scholarly Projects

Practice Problem: Compassion fatigue is a growing problem that can affect 21% to 39% of nurses who work in hospital settings (Berger et al., 2015). Compassion fatigue has been further exacerbated due to the COVID-19 pandemic. Compassion fatigue negatively impacts the nurses in profound physical and emotional ways.

PICOT: The PICOT question that guided this project was: For obstetrical nurses working in a nonprofit organization, what is the effect of a compassion fatigue program, compared with no program, on nurses in reducing compassion fatigue after two months?

Evidence: Current evidence shows that mindfulness decreases compassion fatigue and increases compassion …

Wound Care Management And Documentation Non-Compliance In Prevention And Care Of Wounds, Tobechukwu Unaegbu

Student Scholarly Projects

The incidence of non-compliance and adherence to best practices wound care competence continues to be an issue among the clinical staff of the Veterans Affairs Medical Center (VA). At the VA, there is a practice problem of non-compliance and adherence to best practices wound care competency as evidenced in the electronic medical record (EMR) documentation among the clinical staff. A PICOT question was developed to explore if the establishment of a staff best practices wound care policy focusing on EMR documentation will improve proper wound care management among the clinical staff. The clinical site is a hospital consisting of 40 …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Improving Antibiotic Prescribing For Acute Respiratory Illnesses, Laurinia Hunter

Student Scholarly Projects

Practice Problem: Unwarranted antibiotic prescribing practices when treating acute respiratory illnesses contribute to the national health threat of antibiotic resistance.

PICOT: In a pediatric outpatient setting for patients ages 6-25 who have no documented uncontrolled comorbidities, presenting with an acute respiratory illness (P), does provider utilization of clinical guidelines, and patient and (caregivers) utilization of educational pamphlets, to collectively develop a plan of care (I), compared to providers and patients who do not utilize such strategies(C) result in a reduction in antibiotics prescribed for acute respiratory illnesses (O) in a 6-week timeframe (T)?

Evidence: The evidence reviewed reported the utilization …

Indwelling Urinary Catheter Removal Houdini Protocol, Fatima Villacruz

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) in spinal cord injury (SCI) patients have many negative health consequences, including increased cost, increased length of hospital stays, delay in bladder training, increased associated infections, and mortality.

PICOT: The PICOT question that guided this project was: In adult SCI patients (P), does the implementation of a nurse-driven indwelling urinary catheter removal protocol (I), compared to without a nurse-driven protocol (C), decrease the indwelling urinary catheter days and the occurrence of CAUTIs (O) within six weeks (T)? Evidence: Nurse-driven discontinuation protocols are an effective method of decreasing indwelling urinary catheter (IUC) days and …

Evidence-Based End-Of-Life Comfort Care Guidelines, Myla Maranan

Student Scholarly Projects

Practice Problem: In the absence of end-of-life (EOL) comfort care guidelines, the nurses in a medical-surgical unit are apprehensive about caring for patients in their active stage of dying, which leads to abandoning the values of holistic and patient-centered care.

PICOT: The PICOT question that guided this project was: "How do acute care bedside nurses (P) who utilize the evidence-based comfort care guidelines (I) compare to not using the evidence-based guidelines (C) perceive their confidence in their capability to provide holistic and patient-centered care (O) during the active onset of the patient's end-of-life stage (T)?"

Evidence: The literature indicated …

Protecting Sleep To Reduce Delirium In An Adult Intensive Care Unit, Heather Thomas

Student Scholarly Projects

Practice Problem: Delirium is a common, yet often preventable complication in hospitalized patients. It is often caused by fragmented sleep, medications, environmental stimuli, and treatment therapies.

PICOT: The PICOT question that guided this evidence-based practice change project was: For patients in an adult Intensive Care Unit (ICU), does using a nurse-initiated, non-pharmacological sleep-enhancement protocol, versus no sleep-enhancement protocol, reduce the incidence of ICU-delirium over a period of 2 months?

Evidence: The reviewed literature supported the evidence for effective use of a nurse-initiated protocol in reducing delirium in the ICU. Sixteen articles met the inclusion criteria for the review of literature …

A Safety Program In A Tertiary Care Center Emergency Department: An Evidence-Based Project To Increase Safety Event Reporting And Improve Frontline Staff Perceptions Of Hospital Management’S Response To Safety Events, Elizabeth Anne Mcmaster

Student Scholarly Projects

Practice Problem: The lack of a non-punitive safety culture with a healthcare organization is associated with decreased safety event reporting, reimbursement rates, and staff satisfaction.

PICOT: The PICOT question that guided this project was: In emergency department frontline staff, does hospital management involvement in a safety event program, contrasted with no safety event program, improve frontline staff’s reporting of safety events and perceptions of hospital management’s response to safety events management involvement over four weeks?

Evidence: Three overlapping themes that guided this project included: improving organizational culture, open communication, and leadership support in promoting patient safety.

Intervention: A safety event …

Reducing Patient Falls By Realigning Nursing Hours Per Patient Days, Hermes Vargas

Student Scholarly Projects

Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019).

The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared …

An Altitude Adjustment: Implementing A Clinical Practice Guideline In The Newborn Nursery At Moderate Altitude, Leeann Blaskowsky

Student Scholarly Projects

Practice Problem: All infants undergo many changes at birth, but for some, the transition from intrauterine to extrauterine life presents more of a challenge, especially at altitude. Despite continuing research, neonatal prescribing guidelines for oxygen therapy remain ambiguous.

PICOT: For term and late preterm infants requiring oxygen beyond transition, does a clinical practice guideline compared to practice without a guideline, provide consistent, evidence-based care, support the mother-infant dyad, and impact nursing perceptions over a six-week pilot period?

Evidence: Birth at moderate altitude presents the newly born with less oxygen than those delivered at sea level. Several studies …

Transition Of Care For Discharged Patients, Rolando Ramos

Student Scholarly Projects

Practice Problem: The 30-day readmission rate for patients discharged from the hospital and returned to their primary care in a clinical office setting (21%) was higher than the national average readmission rate (17%). The high readmission rate suggested patients were receiving transitional care that was fragmented and non-standardized. Therefore, the implementation of a collaborative transition of care practice was vital to reduce avoidable readmissions.

PICOT: The PICOT question that guided this project was, “In adult patients with chronic conditions, what is the effect of a transition of care practice, versus a non-standardized practice, on reducing 30-day readmissions, within a …

Reducing Suicide By Providing Cognitive Behavioral Therapy For Suicide Prevention, Wendy Larkin

Student Scholarly Projects

Veteran suicide is a serious and persistent national problem, which demands an effective treatment intervention. This Evidence-Based Practice project (EBP) addressed the question: Do patients with a psychiatric in-patient diagnosis of suicide ideation, who after discharge self-elect outpatient Cognitive Behavioral Therapy-Suicide Prevention (CBT-SP) treatment over a 6-week time frame, reduce the likelihood of hospital readmission for suicidal ideation vs. patients who decline CBT-SP treatment and elect Treatment as Usual (TAU)? The literature is prolific in validating that CBT-SP is successful in determining the effectiveness of CBT-SP vs. TAU in reducing suicidal behaviors in adults.

Hospital readmission data were collected on …

Nurse-Initiated Protocols For Chest Pain In The Emergency Department, Matthew Hodges

Student Scholarly Projects

Practice Problem: Emergency department crowding inhibits the ability to provide safe patient care to chest pain patients and negatively impact patient outcomes. A Veteran Affairs emergency department has identified a similar concern and implemented a nurse-initiated protocol to decrease the length of stay and improve patient outcomes.

PICOT: This evidence-based practice (EBP) project was guided by the following PICOT question: In the emergency department (ED), how does a nurse-initiated protocol (NIP) for chest pain (CP) patients compared to no protocol use influence length of stay (LOS) in the ED over 8 weeks?

Evidence: The reviewed literature supported the evidence of …

Bedside Shift Report: A Way To Improve Patient And Family Satisfaction With Nursing Care, Audriana Pevec

Student Scholarly Projects

Poor communication during the handoff process contributes to approximately 30% of malpractice claims costing up to $1.3 billion annually (Fenner, 2017), which demonstrates the importance of evaluating the quality of information exchange between nurses, patients, and families when associating quality of care to patient satisfaction (Kullberg et al.,2017).

The following question guided this Evidence-Based Project (EBP) project. In adult, progressive care unit patients (P), does the implementation of a nursing bedside handoff (I) compared to current handoff practices (C) improve patient/family satisfaction with nursing care (O) over eight weeks (T)?

The literature revealed evidence from 10 studies answering …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

Improving Patient Satisfaction In The Medical-Surgical Setting, Victoria A. Ogundeko

Student Scholarly Projects

Problem: Patients’ experiences at hospitals are multidimensional, and their satisfaction with the service is linked to the quality of patient care provided. In evaluating the quality of care of a hospital, the nursing handoff of patients, and the engagement efforts of healthcare staff is an important element of patient satisfaction.

PICOT: In adult medical-surgical patients, does the implementation of nursing bedside handoff reports, compared to the current method of nursing practice desk handoff reports, improve patient satisfaction scores by 10% within two months?

Evidence: After reviewing 103 articles, 12 were relevant to this project, and included observation …

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

Student Scholarly Projects

Practice Problem:There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

PICOT: This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Evidence: Thirteen pertinent studies recommended the use of …

Essential Oil Therapy For Alleviation Of Discomfort In Surgical Patients, Nenhuan Huang

Student Scholarly Projects

Practice Problem: Post-surgical pain (PSP) has not been sufficiently managed despite routine opioid use. The adverse effects of opioids led to the search for non-pharmaceutical intervention.

PICOT: The PICOT question that guided this project was, "In an acute hospital surgical setting, does essential oil therapy complement pain and discomfort relief comparing to conventional pain management alone after 6 weeks?”

Evidence: Seven clinical studies, five systematic or integrative reviews, and four conference proceedings were reviewed. The evidence supported lavender essential oil for the alleviation of PSP and discomfort.

Intervention: Patients breathe through a personal lavender essential oil inhaler hourly or …

Revisiting Cauti Prevention: A Multifaceted Approach Using Lean Six Sigma, Lisa Ann Behrend

Student Scholarly Projects

This project identified gaps in policy and processes to improve patient outcomes related to workflow in the catheter-associated urinary tract infection policy and process at a 400-bed hospital in southern California. Even with an evidence-based infection prevention bundle in place, the current process was not working, as demonstrated by high catheter-associated infection rates for the last two years.

This project answers the question: Does the use of a comprehensive evaluation of the current policy and process using the Lean Six Sigma quality improvement model influence a reduction in infection rates in patients who have an internal urinary catheter over 15 …

Implementing Protocols In The Emergency Department To Improve Care For Sexual Assault Patient, Kelly Ciccone

Student Scholarly Projects

This quality improvement project answered the following question: Does implementation of sexual assault forensic examination protocols with educational training increase the number of staff who are knowledgeable and available to complete sexual assault forensic examinations and reduce wait times for individuals who present to the emergency department and have indicated that they were sexually assaulted, over no use of protocols, within a 15-week time frame? Evidence-based state protocols for performing sexual assault forensic examinations were implemented through educational training that incorporated national training criteria and hands on simulation skills practice. Evaluation of outcome measures confirmed an increase to over 80% …