Medicine and Health Sciences Commons^™

Medical Device-Related Pressure Injury (Mdrpi) Prevention In The Intensive Care Unit (Icu): An Evidence Based Practice Quality Improvement Project, Sana Shah

DNP Projects

Introduction: All intensive care unit (ICU) patients utilize various medical devices for care and treatment, placing them at high-risk for medical device-related pressure injuries (MDRPIs), which can lead to life-threatening infections, wounds/scars, and consumption of additional time and products to rectify these issues. Lack of appropriate decompression measures and improper bedside handoff report was recognized in the ICU at a hospital in Connecticut (CT).

Method: A literature search using CINAHL, MEDLINE, and the Cochrane Database of Systematic Reviews was conducted, restricting the search to the period between 2018-2022. The keywords searched were: “pressure injuries,” “adult patients,” “intensive care …

A Multifaceted Approach To Improving Sedation Practices In The Cardiovascular Intensive Care Unit, Casey Mingua

DNP Projects

Purpose: Sedation protocols have been positively correlated with improved patient outcomes in the intensive care unit (ICU). Therefore, healthcare leaders should direct efforts to improving protocol compliance through evidence-based strategies. The purpose of this study was to evaluate the impact of a multifaceted intervention, consisting of educational outreach, point of care (POC) reminders, and audit and feedback (A&F), on nurse compliance with an ICU sedation protocol. A secondary data analysis was performed to evaluate the impact of the intervention on patient outcomes.

Methods: This was a before/after comparative analysis. A Research Electronic Data Capture (REDCap) pre-survey (n=58) was distributed to …

Nurses' Knowledge Of Delirium In The Icu, Sara Hancock

DNP Projects

Abstract

Background: Delirium costs the healthcare system $38 to $152 billion dollars annually. Nurses have a unique opportunity as healthcare providers to assess for and identify delirium, but often fail to recognize delirium.

Purpose: The purpose of this DNP project was to determine the effect of implementing an educational intervention regarding delirium risk factors, symptoms, prevention strategies, and treatments, on the knowledge of nurses working in an intensive care unit.

Methods: This DNP project used a quasi-experimental pre-test post-test design. Participants completed a pre-test (Appendix A), an educational intervention (Appendix C & D), and a post-test (Appendix B). Pre-test …

Family Rounds In The Medical Intensive Care Unit: An Intervention To Enhance Communication, Travis R. Klein

DNP Projects

Background: In the Intensive Care Unit (ICU) family member satisfaction is an important element of quality patient care. Families of ICU patients value communication with care providers and involvement in their relative’s care.

Objectives:

1. To determine if scheduled family rounds each day can improve the satisfaction and feelings of support with decision-making for family members of ICU patients?

2. Evaluate any associations between patient characteristics (hospital length of stay, ICU length of stay, and ventilator days) and family satisfaction?

Methods: This pilot project was conducted in a 12-bed medical ICU led by advanced practice nurses (APRN-MICU). Using the family …

Evaluating Utilization Of An Early Mobility Protocol In An Adult Icu In The Veterans Administration System, Julie Duffy

DNP Projects

Purpose: To evaluate ICU staff’s adherence to a new progressive mobility protocol as part of a quality improvement project in an adult medical-surgical intensive care unit (ICU).

Background: Bedrest can lead to complications for hospitalized patients and current literature supports that mobility within the ICU is safe and feasible for critically ill patients. Current evidence based literature identifies barriers to patient mobilization which can be addressed through implementation of a mobility protocol. Utilization of mobility protocols is one way to improve quality of care and prevent common bedrest complications in the critically ill patient population.

Methods: Retrospective medical record reviews …

Evaluation Of Move Early Mobility Screening Protocol In Non-Surgical Mechanically Ventilated Patients In The Intensive Care Unit, Lauren Johnson

DNP Projects

Objective: To evaluate the effectiveness of a previously implemented, nurse driven early mobility screening protocol, called “MOVE”, during its first 6 months of use.

Methods: A retrospective electronic medical record review was conducted (n=100) at Norton Audubon Hospital in Louisville, KY. Eligible electronic medical records were randomly selected and audited for the following variables: age, sex, ethnicity, admission diagnosis, comorbidities, ventilator days, invasive catheters, utilization of vasoactive or inotropic medications, restraint use, continuous sedation medications, Richmond Agitation Sedation Score (RASS), Confusion Assessment Method for the ICU (CAM-ICU), nurse adherence to charting of MOVE enrollment eligibility, physical …

The Impact Of Nursing Staff Adherence With Chlorhexidine Gluconate Bathing On Intensive Care Unit Patient Outcomes, Tara M. Jones

DNP Projects

Purpose: The purpose of this study is to evaluate nursing staff adherence to a chlorhexidine gluconate (CHG) bathing protocol in the intensive care unit at Norton Brownsboro Hospital.

Methods: This study utilized a single-site, quasi-experimental, retrospective electronic medical record review format. The sample consisted of 200 patient records post CHG bathing protocol initiation from the Norton Brownsboro Hospital Intensive Care Unit during the period of March, 2015 to May, 2017.

Results: The sample was divided into adherent and non-adherent groups. No significant differences in age, sex, race, ICU length of stay (LOS), BMI, or mortality scores, presence of indwelling medical …

Monitoring For Delirium In The Intensive Care Unit Following The Introduction Of The Confusion Assessment Method For The Intensive Care Unit, Charity A. Batman

DNP Projects

PURPOSE: The goals of this study were to: improve delirium recognition by implementing the Confusion Assessment Method for the ICU (CAM-ICU), evaluate adherence to routine delirium monitoring, measure the incidence of CAM-positive patients, and measure the use of analgesic and sedative medications in ICU patients.

METHODS: This study was a single-center post-implementation retrospective medical record review examining the adherence and incidence of delirium after the introduction of the CAM-ICU assessment on the surgical ICU. Prior to the beginning of the study the surgical ICU nurses were educated on how to assess for delirium using the CAM-ICU instrument. During the six …

Review Of Current Mobility Practice In Non-Surgical Mechanically Ventilated Intensive Care Unit Patients, Catharine Morgan

DNP Projects

Purpose: The purpose was to: (i) conduct a retrospective electronic medical record review to evaluate current practice related to mobility, (ii) determine the association between current mobility practice patterns and characteristics specific to the patient population, and (iii) make recommendations for the implementation of an evidence-based progressive early mobility protocol for non-surgical mechanically ventilated patients.

Population: Non-surgical, ventilated patients in the Intensive Care Unit (ICU)

Inclusion Criteria: Ventilated patients at least 18 years old who have been ventilated for at least 48 hours and did not have major surgery lasting more than one hour at any point during their hospital …