Digital Commons Network^™

Putting The Kibosh On Bugs: Nurses Lead Reduction In Blood Culture Contamination Rates, Echo Ashley

Nursing Research & Professional Development Conference

Background

Blood culture contamination results in unnecessary waste of supplies and resources, increased medical costs related to inappropriate of antibiotics, and threatens successful antibiotic stewardship. A spike in blood culture contamination rates in emergency department settings has been examined in relation to elevated patient acuity levels. Other studies have examined the financial impact of contaminated blood cultures and found that, on average, there is a $4538 cost savings associated with prevention of blood culture contamination. Blood culture contamination rates within a local emergency department increased to 5% which was above the national benchmark of 2.3%. Evaluation of pre-intervention data revealed …

Tele-Critical Care Nurse Initiative Drives Central Line Stewardship To Improve Quality Of Care, Noelle M. Hartley, Lynn Thompson

Nursing Research & Professional Development Conference

Background

Central line-associated bloodstream infections (CLABSIs) lead to increased hospital length of stay, cost, morbidity, and mortality, and negatively impact patient experience with an average inpatient cost of $48,108 (AHRQ, n.d.). Critically ill patients are at increased risk for CLABSI.

Local Problem

Atrium Health’s Virtual Critical Care (VCC) standardizes and delivers care at 14 ICUs across the Advocate Health Southeast region utilizing evidence-based practice, Intensivist-managed care, and multidisciplinary teamwork. VCC nurses also collaborate to support the units’ clinical quality goals. Atrium Health Union’s Critical Care Unit (CCU) experienced 8 CLABSIs in the first 3 quarters of 2022, and CL utilization …

The Family Support Person Role During Resuscitation: A Qualitative Exploration, Kelly Powers, Jaclyn Duncan, K Renee Twibell

Nursing Research & Professional Development Conference

Background:

Nurses can serve as family support persons when family members witness a loved one’s resuscitation. However, few studies have examined the role of family support person, and no clinical guidelines exist to provide nurses with sufficient knowledge to enact the role.

Objectives: To provide guidance to nurses by examining how critical care nurses perceive and perform the family support person role during patient resuscitation.

Methods: An exploratory-descriptive qualitative design was used. Sixteen critical care nurses who had served as a family support person completed with individual, semi-structured interviews. The data were analyzed by thematic analysis.

Results: Six themes were …

Ready, Set, Go! Implementing An Electronic Handoff Tool To Decrease Emergency Department Length Of Stay, Jennifer Peterburs

Nursing Research & Professional Development Conference

Background:

According to the CDC’s (2019) review of health care data in 2019, over 150 million patients were seen in Emergency Departments across the United States. Of these patients, more than 20 million were admitted to the hospital. Longer Emergency Department wait times equate to worse patient outcomes, including higher in-hospital mortality rates and increased occurrence of in-hospital cardiac arrest.

Handoff is considered a high-risk activity (Freel & Flaherty, 2021). Studies have shown most effective handoff tools include the use of mnemonics or tools to aid in the organization of critical information (Kear, 2016).

Aim or purpose of the initiative: …

Decreasing Ventilator Days In Medical Intensive Care Unit By Implementing Abcdef Bundle, Audrone De La Vega

Nursing Research & Professional Development Conference

Background:

The ventilator length of stay index (VLOS) is defined as the ratio of actual/predicted ventilator days. Amid the COVID-19 pandemic, the Medical Intensive Care Unit rate increased to 1.62 and remained above the 0.99 goal.

Problem:

Despite the use of multiple assessment tools and evidence-based practices to help identify patients’ readiness for extubation, the performance levels in the medical intensive care unit remain above target goal. The aim of this project was to implement the evidence based ABCDEF bundle to improve the assessment and management of patient’s pain, agitation, delirium, early mobility, and family engagement while on mechanical ventilation …

Can Preventative Dressings Be As Effective As Specialty Beds For Hapi Prevention On Your Unit?, Katie Sparks, Mary Pilon, Amber Wylie, Chrystal Clark

Nursing Research & Professional Development Conference

Background:

Hospital-acquired pressure injuries (HAPIs) often lead to increased costs, longer hospital lengths of stay, increased recovery time, comorbidities, and death. Despite interventions, HAPIs often manage to develop (Hahnel et al., 2020).

Local Problem:

In 2022, our medical-surgical unit identified 14 HAPIs (Stage I/II). They began placing patients identified at higher risk for HAPI development (BRADEN score of 17 or less) on treatment surface beds. While the utilization of treatment surface beds reduced HAPIs, it also resulted in higher costs and increased nursing workload. Literature supports the use of preventative foam dressings in a hospitalized at-risk population for HAPI reduction, …

Can You Escape An Infection?, Teresa Flowers, Jennifer Mcconnell

Nursing Research & Professional Development Conference

Background: Healthcare acquired infections are a major safety concern for both health care providers and patients; and increases morbidity, mortality, length of stay and costs.

Local Problem: In 2021, there was an increase in infections at Atrium Health Stanly (10 infections up from four in 2020). For years, staff were educated through learning modules. Teammtes were bored with this method and did not retain the information. The team decided to incorporate an Escape Room as a creative educational opportunity to increase knowledge of infection prevention evidence-based best practices.

Method: The escape rooms were focused on quality improvement topics and ways …

Screening Colonoscopy: Your Gut Will Thank You For It, Ashley Lemmon, Tanisha Davis, Maria Patricia Morales

Nursing Research & Professional Development Conference

Background

With the increased rates of colorectal cancer in the population less than 50 years old, the American Cancer Society lowered the recommended age to 45 years old for screening colonoscopies. Colorectal cancer rates have increased 51% since 1994 for people under 50 years old, while overall colorectal cancer rates have decreased.

Local problem

Early detection becomes difficult to achieve for people that are required to see a Gastrointestinal physician prior to being scheduled for their colonoscopy. Providers are scheduled out for several months and most of the population meet criteria colonoscopy without an office visit.

Method

South Suburban Hospital …

Stay Home: Nurses Spur Decline In Emergency Visit Returns, Deanna Strebig, Amber Koplitz, Heather Ludy

Nursing Research & Professional Development Conference

Background

Approximately 21 million older adults visit the emergency department. Thus, development of patient-centered approaches to care delivery of older adults in this setting are critically important in preventing recidivism. Embedding evidence-based practice into nursing workflow allows nurses to screen, assess, intervene, and refer patients to social services and physical therapy prior to leaving the emergency department. Nurse communication provides actionable information to create the plan of care.

Purpose

A small community hospital utilizes the Identification of Seniors at Risk screening tool to collaboratively initiate a patient-centered approach to care delivery that prevents repeat emergency department visits for older adults …

We Are ... Marshall, November 15, 2023, Office Of Marshall University Communications

We Are ... Marshall: the Newsletter for Marshall University 1999-2023

No abstract provided.

Risk Factors For Cmv And Bk Infections In An Elderly Veteran Population Following Kidney Transplantation: Implications For Immunosuppression Induction And Management, Anne Thorndyke, Cara Joyce, Manpreet Samra, Laura Cotiguala, Christine Trotter, Oswaldo Aguirre, W. James Chon, Rupinder Sodhi, Reynold I. Lopez-Soler

Biostatistics Collaborative Core: Faculty Publications and Other Works

Cytomegalovirus (CMV) and BK Polyomavirus (BKPyV) are the most common opportunistic pathogens following kidney transplantation. We evaluated 102 patients with a median age of 63 at Edward Hines VA Hospital from November 2020 to December 2022. Our primary interest was the incidence of CMV and BKPyV infections, as well as CMV and BKPyV coinfection. Secondary interests included time to infection, rejection, and graft and patient survival. There were no statistically significant differences in patient age, donor age, race, transplant type, incidence of delayed graft function, or induction in both cohorts (any infection (N = 46) vs. those without (N = …

Nurses’ Compliance With Handover Practices In Adult Medical Surgical Units At A Tertiary Care Hospital In Karachi, Pakistan, Amber Qasim Ali

MSCN 2023

Background: The exchange of the shift changeover report of patient, from nurse to nurse at the patient's bedside is known as "bedside handover." Although this method is becoming more and more popular in the nursing sector, not many people genuinely practice it.
Purpose: To determine the different factors impacting nurses' compliance and to evaluate the compliance rate of nurses to comply with bedside handover guidelines. Methods: A cross-sectional observational study was conducted in the medical surgical ward at the Aga Khan University Hospital, Karachi. During the study, the structured bedside handover technique known as "kardex," which adheres to SBAR (Situation, …

What The Butt? Pressure Injury Reduction In Intensive Care, Noor Bontz, Michelle Emick, Matthew Lemke, Laura Reindl, Kristan Jesel

Nursing Research & Professional Development Conference

Background:

Healthcare-acquired pressure injuries cause significant harm to over two-million patients annually in the United States, increase length of stay, and pose a significant financial burden to hospitals. The cost of treating a single injury can be more than $70,000.

Local Problem: After unit expansion during the Covid-19 pandemic, and with associated acuity increase and staff turnover, healthcare-acquired pressure injuries increased 285% from 21 injuries in 2019 to 60 injuries in 2021 in Aurora Sinai Medical Center’s intensive care unit.

Methods: This intensive care unit used an active multi-modal intervention approach to pinpoint contributing factors. The intervention started with “What …

Increasing Mobility To Increase Discharges, Karen Uribe, Gina Castillo, Vanessa Narag Lichner

Nursing Research & Professional Development Conference

Background:

Patient mobility reduces complications and reduces length of stay, which improves patient outcomes and throughput.

Local Problem:

A 44-bed medical unit specializing in patients with neurological diagnoses at a large, urban, Level 1 trauma center experienced decreased patient mobility, resulting in longer length of stay and reduced throughput. The goal for the unit was to increase the number of steps measured in feet ambulated by patients and increase daily discharges.

Method:

An interdisciplinary team designed and implemented a workflow improvement process. The process initiated consistent use of the Comprehensive Mobility Evaluation Tool (CMET) when patients were admitted to the …

Nurse Driven Intervention To Improve Acute Kidney Injury (Aki), Theresa Briggs

Nursing Research & Professional Development Conference

Background and/or rationale

Acute kidney injury (AKI) following the use of contrast agents is a known complication of coronary angiography. The National Cardiovascular Data Registry (NCDR) defines AKI as an acute increase of > 0.3mg/dl or a 50% or greater increase in the serum level of creatinine from baseline and cardiac patients are at high risk for AKI. At a Midwest quaternary medical center, the risk adjusted AKI rate was 8.63% (Q3, 2021) which is above the national average of 3.46% (NCDR).

Aim or purpose of the initiative

The purpose of this project was twofold: 1) Increase nurse’s knowledge about oral …

Patient Experience Best Practices: An Exemplar Of Advanced Practice Registered Nurse Ebp Mentor Team Led Inquiry, Jodie Pufundt, Kelly Perez, Megan Morgan

Nursing Research & Professional Development Conference

Background/Rationale

Patient experience is one of the five tenets of the Quintuple Aim- population health, cost of care, clinician wellbeing, and health equity. The Aim is a model for achieving high quality, safe, and cost-effective care. Engagement is an important strategy for reaching an optimal state of the patient and family care experience. At our organization, the patient experience scores have been static and under target for a while, despite implementation of many interventions. A team of APRN evidence-based practice (EBP) Mentors (Clinical Nurse Specialists and a Nurse Practitioner) engaged in the EBP process identified practices that impact the patient …

A Nursing Led Initiative In Collaboration With The Performance Of Excellence Center To Change Psychiatric Emergency Department Triage Procedures To Improve Patient Care, Kristen Edmunds, Nicholas Archer, Michell Olshan-Perlmutter, Marquita Boggess

Nursing Research & Professional Development Conference

Background

Psychiatric emergency room visits are often associated with long wait times, leading to agitation and dissatisfaction among patients, delay in care, some patients leaving without receiving care, staff frustration and increased cost. Research indicates that triage guidelines correlate with wait times and patient satisfaction.

Local Problem

Atrium Health Charlotte is a dedicated psychiatric emergency room that has consistently seen an increase in yearly patient visits. Overcrowding and long wait times are commonplace. Last year almost 10,000 patients were seen, and 839 left without being seen. The average time for patients’ length of stay from door to discharge was 245 …

Improving The Patient Experience Through Bedside Shift Report - A Quality Improvement Project, Jocelyn Azanon, Carolyn Brumm

Nursing Research & Professional Development Conference

Background/Relevance:

Without the standardization of bedside shift reports, patient and family involvement in care planning and decision-making is lacking, affecting patient satisfaction. Patient satisfaction scores and safe handoff become impacted when not occurring at the bedside, leading to miscommunication and errors. Increasing compliance may promote patient engagement and safety as the nurses discuss the care plan for a safe handoff.

Local Problem:

The quality improvement project aimed to improve the completion of bedside shift report in patient rooms on a medical-surgical unit. A total of 50 pre-data observations completed by the hospital site Certified Nurse Specialists and Nursing Professional Development …

Come On Down! Utilizing Gamification Learning Techniques To Improve Knowledge Of Nurse Sensitive Indicators, Jamie Gordon, Kari Remer

Nursing Research & Professional Development Conference

Background: Research has shown the “gamification” method of learning appeals to the modern-day learner. Combing technology and tactile experiences have proven to increase knowledge retention and begin building muscle memory. Evidence has also displayed a positive impact in decreasing unfavorable events such as hospital acquired conditions.

Purpose: At a Midwest quaternary medical center, new nursing team members represent the majority in inpatient units. Due to limited preceptors and growing staffing challenges, there is added pressure for new inpatient nurses to complete the orientation process as competently and quickly as possible to provide safe patient care and improve staffing ratios. …

Implementation Of An Emergency Department Communication Tool To Assist In The Prevention Of Acute Care Readmissions, Matthew Shall, Christopher Griggs, Ronella Eaddy, Denise Comeaux, Wes Hofferbert, Sushma Racharla, George Ross, Zachary Lutwick, Kimberly Price

Nursing Research & Professional Development Conference

Background:

This presentation highlights how nurses from a post-acute care rehabilitation hospital led the way in reducing acute care readmissions though the development and implementation of a standard communication tool. Hospital readmissions have negative impacts to patient care which include higher financial costs, program interruption, and decreased overall functional recovery. We noticed 14 percent of our patients were being readmitted to the hospital after being evaluated by an ED physician. When we investigated the issue, we identified there was a communication gap between the ED and rehab physicians.

Method:

We determined our improvement plan by using the Plan, Do, Study, …

Nurses' Compliance With Central Line Maintenance (Handling) Guidelines At A Tertiary Care Setting In Karachi, Pakistan- A Descriptive Cross-Sectional Study, Alina Amir Ali

MSCN 2023

Background: Central venous catheters (CVCs) are integral to modern healthcare, facilitating critical treatments. However, the risk of complications, particularly infections, necessitates strict adherence to central line maintenance protocols. This study explores the compliance of nurses in executing these protocols.
Purpose: In a tertiary care facility in Karachi, Pakistan, this study sought to evaluate nurses' adherence to each item on the central line management checklist as well as the checklist's total adherence in the Special Care Units.
Method: A total of 119 registered nurses were assessed, using a quantitative structured observational design for central line handling in adult medical surgical special …

Parents’ Emotional And Psychological Perspective Of Caring Children With Oncological Disorders: A Descriptive Qualitative Study, Ambreen Navroz Ali Salyani

MSCN 2023

Background: Childhood cancer has a profound effect on the emotional and psychological well-being of parents, yet often their own psychological health is overlooked as the primary focus while treating the child. These parents silently suffer from psychological distress while caring for their children. They use their own coping strategies to overcome the situation. However, limited studies have been carried out in low- and middle-income countries (LMIC) regarding parents’ emotional and psychological perspectives of caring their children with oncological disorder.
Purpose: The objective of this study was to explore the psychological perspectives that parents of children with cancer diagnosis, treatment, social …

Malignant Hyperthermia Simulation And Competency, Nicholas Nowak, Anna Auger

Nursing Research & Professional Development Conference

Background

Malignant hyperthermia (MH) is a potentially fatal reaction to a volatile anesthetic or succinylcholine producing a hypermetabolic state. Prompt recognition and treatment of MH are essential for survival.

Local Problem

Rapid Response Team (RRT) leaders identified a nursing knowledge gap about the process for treating MH for patients outside high-risk areas at a level 1 trauma center.

Method

A new process, workflow, and medication box were created for obtaining the necessary supplies to treat MH patients. RRT nursing leaders developed a simulation education program with the goals to improve overall MH knowledge and to develop RRT nurses’ response skills …

Implementation Of A Pediatric Intensive Care Unit Diary, Linda Esposito

Nursing Research & Professional Development Conference

Background: Critical illness and the PICU environment may contribute to the development of Post Intensive Care Syndrome (PICS) in children, their parents, or their siblings. PICS has a negative impact on quality of life, including development of PTSD, reduced school performance, or delay in meeting developmental milestones. Diaries have been used to create context and memory after discharge, extending cognitive and emotional support beyond the PICU stay. Entries are staff-written in letter format, including details about the patient’s day, events, or feelings. The diaries become a supportive tool for the patient and family on their journey post critical illness.

Purpose …

Reduction Of Hospital-Acquired Pressure Injuries On A Progressive Care Unit, Kathryn Beres

Nursing Research & Professional Development Conference

Background: In a systematic review, hospitalized patients face a significant burden of pressure injuries, (pooled prevalence=12.8%; hospital-acquired rate=8.4%) with superficial pressure injuries, (stages I and II), predominantly affecting sacrum, heels, and hips.

Local Problem: In a 36-bed progressive care unit in a non-profit hospital in the Midwest, a significant increase in Hospital-Acquired Pressure Injuries (HAPIs) was observed, predominantly heel-acquired injuries in bedridden patients.

Method: The purpose of this quality improvement project was to decrease the number of HAPIs. To achieve this, a weekly audit was established, monitoring immobile patients for over 24 hours. A unit-developed protocol, the "Bedrest Checklist", …

Use Of Rapid Medical Evaluation In The Emergency Department Setting, Cassie Kohl, Meaghan Gallagher, Tricia Urbanik, Ashley Vilona

Nursing Research & Professional Development Conference

Background: Advocate Condell Medical Center in 2022 had an average left without being seen (LWBS) rate of 7.5% with some months exceeding >20% of the patient they serve. Many patients were leaving the emergency department prior to a provider evaluation, which increases the risk of safety events.

Local Problem: The national average for an Emergency Department LWBS rate is

Method: Rapid Medical Evaluation (RME) is an emergency department process developed by the Vituity Medical Group to decrease patients leaving prior to medical care and to increase overall team collaboration and engagement. RME is a forward facing provider that screens in …

Move It Or Lose It: Competing To Improve Hospitalized Patient Mobility, Julie Bialas, Mary Mcmanus

Nursing Research & Professional Development Conference

Background: Patient immobility contributes to hospital-acquired complications and poor hospital outcomes. Despite its importance, patient ambulation is often missed with barriers that limit mobility and keep patients in bed.

Local Problem: Medical staff who work at a large suburban Level 1 Trauma Center voiced concerns that limited patient ambulation was contributing to longer length of stay and discharge to skilled care. Nursing units identified several perceived barriers to ambulation: lack of time and lack of staff.

Method: A nurse-led improvement team utilized a gaming strategy to engage and motivate clinical units to compete to improve outcomes. The …

November 15, 2023 Greenmail, University Of Alabama At Birmingham

GreenMail (student newsletter through 2024)

No abstract provided.

Reflections From A Maternity Leave: The Complex History Of Beaver Dam Flats And Refinery Park, Emily Ursuliak

The Goose

A personal essay reflecting on my relationship with Refinery Park and Beaver Dam Flats in light of its complex history.

Natsukashii – Time And Place, Yvonne Blomer

The Goose

A woman walks her dog along Fort Street in Victoria, BC and ponders the senses, the past and present while her son is in music therapy class.