Medicine and Health Sciences Commons^™

Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …

Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Current recommendations to reduce pain associated with mechanical ventilation is the administration of opiate and benzodiazepine infusions for Pediatric Intensive Care Unit (PICU) patients. If these infusions are weaned too quickly, iatrogenic withdrawal syndrome (IWS) often occurs. IWS symptoms include tachycardia, hypertension, diaphoresis, fever, irritability, tremors, clonus, hyperactive reflexes, vomiting, and diarrhea. Untreated IWS can lead to life-threatening complications.
LOCAL PROBLEM: The PICU at the project site contains fourteen beds and treats critically-ill pediatric patients. There was no standardized withdrawal assessment tool in practice. The purpose of this project was to implement the Withdrawal Assessment Tool-Version 1 …

Ultrasound-Guided Intravenous Access As A First-Line Approach By Nurses: A Quality Improvement Project, James Austin Burkhart, Pamela Hardesty, Melissa Mcdonald

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Up to 9% of patients admitted to EDs (Emergency Departments) have difficult intravenous insertion access issues (DIVA). This creates delays in patient care that includes interruptions for physicians providing medical emergency care. Often the utilization of RNs to perform US (ultrasound) IV insertions is limited related to lack of training and supportive policies.

Local Problem: The site for this project was an ED Level 1 Trauma Center associated with a large teaching hospital located in the southeastern U.S. Prior to the implementation of the process improvement project, there was no formal education of RNs in the use of US …

Implementing A Pressure Ulcer Bundle, Amy D. Johnson, Pamela Hardesty, Janice Zimmer, Patricia Moore

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: A quality improvement DNP project in a rural southern hospital was implemented to improve hospital-acquired pressure ulcers by implementing an evidence-based pressure ulcer prevention policy and education. Framework: The Evidence-Based Practice framework utilized in the project's development, implementation, and evaluation was the John Hopkins Evidence-based Practice Model. Local Problem: The hospital had no pressure ulcer bundle in place. Design: Quality improvement project utilizing the plan-do-study-act cycle. Methods: An educational presentation on pressure ulcers and the steps to implement a bundle. A pre-and post-test using Pieper's Pressure Ulcer Knowledge Test, modified from Agency for Healthcare Research and Quality (AHRQ) website. …