Medicine and Health Sciences Commons^™

The Development And Implementation Of A Resource Nurse In The Float Pool: A Review Of The Literature And A Pilot Study Plan, Crystal M. Wiley

Interprofessional Research and Innovations Council

The Development and Implementation of a Resource Nurse in the Float Pool: A review of the Literature and a Pilot Study Plan.

Crystal M Wiley, BSN, RN, CMSRN

Background/Literature: It is pivotal that resources are available at the point of care allowing excellence in nursing care and exceptional outcomes. Currently, the staff have multiple resources to help with ethical dilemmas, patients who are unstable, and research. Discussion with leadership revealed a need for a support to busy units with a few newly hired staff and an interest in a resource nurse program to address these concerns and areas for improvement. …

Advanced Cardiovascular Life Support (Acls) And Obstetrical Critical Care (Ob Cc) Education For High Risk Labor And Delivery Nurses In Caring For Growing Population Of High Risk Patients, Tracey E. Mcmillan

Interprofessional Research and Innovations Council

Advanced Cardiovascular Life Support (ACLS) and Obstetrical Critical Care (OB CC) education for high risk Labor and Delivery nurses in caring for growing population of high risk patients

Tracey E. McMillan RNC, BSN

Clinical Nurse III

Labor and Delivery Unit Coordinator

BACKGROUND: Many studies show that an increasing number of pregnant women in the United States have chronic health conditions such as hypertension, diabetes, and chronic heart disease. The factors that place a pregnancy at risk can be divided into four categories: existing health conditions, age, lifestyle factors and conditions of pregnancy. The recent statistics from the Centers for Disease …

Improvement Of Chf Patients’ Fluid Restriction Education Through Self-Efficacy, Johanna Ruckey, William Fyler

Interprofessional Research and Innovations Council

Improvement of CHF patients’ fluid restriction education through self-efficacy

Johanna Ruckey RN and William Fyler BSN

Background: Dietary discretion through limited salt and fluid intake is an important aspect of heart failure (HF) management. Keeping accurate account of fluid intake has shown itself to be a difficult task, as both staff and patients often fail to do so on a fairly regular basis. Although staff are aware of a patient's fluid restrictions, there is a deficit in the patient's role in tracking their own intake. Patients often express confusion and frustration regarding their daily fluid intake, but also lack …

Did You Wash Your Hands?, Kelley Coyne

Interprofessional Research and Innovations Council

Did You Wash Your Hands?

Kelley Coyne, RN, OPD Maine Medical Center

Introduction: While there is great focus and education regarding the importance of hand hygiene among healthcare workers there appears to be less focus and education on the importance of patient’s hand hygiene. My observation, as a healthcare provider in pediatrics, is that patient’s compliance with hand hygiene is rare and it appears that there is a need to educate patients on the importance of hand hygiene. Hand Hygiene has the highest efficacy and is a cost effective measure for preventing infection. Researchers in London estimate that if everyone …

In Patients Having A Robotic Hysterectomy, How Does The Amount Of Iv Fluids Given Post-Operatively Affect The Patients' Length Of Stay?, Heidi Fox

Interprofessional Research and Innovations Council

In patients having a robotic hysterectomy, how does the amount of IV fluids given post-operatively affect the patients' length of stay?

Heidi Fox, RN III, CAPA, ASU, MMC

Background: Over the last few years, ASU (ambulatory surgery unit) nurses have noted difficulty with discharging patients undergoing robotic hysterectomy in a timely manner due to both nausea and the inability to void. The nurses have also discerned inconsistencies with regards to the post-operative care including pre-operative bowel prep, amount of IV fluid given post-operatively and anti-nausea meds given. This prompted a literature search and a critical appraisal of pertinent research articles …

Patient Throughput Time In The Emergency Department: Can Obtaining Blood Specimens In A Pre-Hospital Setting Increase Timeliness?, Arielle Rancourt

Interprofessional Research and Innovations Council

Patient Throughput Time in the Emergency Department:

Can Obtaining Blood Specimens in a Pre-hospital Setting Increase Timeliness?

Arielle Rancourt RN

Abstract

The Emergency Department (ED) at Mid Coast Hospital currently follows a practice in obtaining blood specimens in-hospital by emergency department staff; this is done despite the ability of pre-hospital personnel to obtain specimens at the time of intravenous catheter insertions. Our current practice may not be the most effective and timely method. Studies showed that there was no increase in hemolysis of blood specimens drawn by Emergency Medical Services (EMS), and that laboratory results were received quicker when blood …

Statistical Forecasting Models Used To Predict Daily Patient Volumes In The Emergency Department: A Proposal For A Systematic Review, Jon White

Interprofessional Research and Innovations Council

Statistical Forecasting Models Used to Predict Daily Patient Volumes in the Emergency Department: A Proposal for a Systematic Review

Jon White, MS, BSN, RN, CCRN

Background: The existing and projected worldwide shortage of nurses requires numerous distinct solutions to prevent a healthcare crisis. Proposed solutions typically address the situation from different angles, including identifying ways to add new nurses to the workforce, or finding new ways to work with limited resources. This review examines the efficacy of forecasting demand in one area of the hospital, understanding the potential of its uses for short-term resource balancing and projection of need.

This …

Patient Throughput Time In The Emergency Department: Can Obtaining Blood Specimens In A Pre-Hospital Setting Increase Timeliness?, Arielle Rancourt

Interprofessional Research and Innovations Council

The Emergency Department (ED) at Mid Coast Hospital currently follows a practice in obtaining blood specimens in-hospital by emergency department staff; this is done despite the ability of pre-hospital personnel to obtain specimens at the time of intravenous catheter insertions. Our current practice may not be the most effective and timely method. Studies showed that there was no increase in hemolysis of blood specimens drawn by Emergency Medical Services (EMS), and that laboratory results were received quicker when blood specimens were obtained in a pre-hospital setting. The purpose of this quality improvement project is to decrease time from patient arrival …

Do Premature Babies Who Are Fed Thickened Liquids, Versus Those Fed Standard Feeds, Transition More Quickly To Full Oral Feeds? A Review Of Current Research And Evidence Based Practice, Donna J. Bisbee

Interprofessional Research and Innovations Council

Do Premature Babies who are fed Thickened Liquids, versus those fed standard feeds, transition more quickly to full oral feeds?

A Review of Current Research and Evidence Based Practice

Donna J. Bisbee, MA CCC-SLP, Speech Language Pathologist, MMC,

Department of Rehabilitation Medicine October, 2017

Background/literature : Babies born prematurely (prior to 37 weeks gestational age) experience a greater percentage of medical complications than full term babies. Chronic lung disease and gastro-esophageal reflux are particularly prevalent in this population and can contribute to delays and difficulties in learning to orally feed. Inability to efficiently and safely feed orally frequently contributes to …

Statistical Forecasting Models Used To Predict Daily Patient Volumes In The Emergency Department: A Proposal For A Systematic Review, Jon White

Interprofessional Research and Innovations Council

Background: The existing and projected worldwide shortage of nurses requires numerous distinct solutions to prevent a healthcare crisis. Proposed solutions typically address the situation from different angles, including identifying ways to add new nurses to the workforce, or finding new ways to work with limited resources. This review examines the efficacy of forecasting demand in one area of the hospital, understanding the potential of its uses for short-term resource balancing and projection of need.

This systematic review will provide a current synopsis of the research published since the fall of 2007, expanding on Wargon and colleagues’ A systematic review of …

Development Of A Traumatic Brain Injury (Tbi) Order Set At Maine Medical Center, Sarah Bockian, Emily Esslinger, Martha Weatherhead

Interprofessional Research and Innovations Council

Background: Traumatic brain injury (TBI) occurs when an external force causes brain dysfunction. TBI management in the critical care setting focuses on treating the initial, or primary brain injury, as well as secondary injuries, caused by hypoxia, hypotension, and swelling. Due to the lack of consensus within the literature, in addition to numerous attending and resident physicians at Maine Medical Center (MMC), variability in care often occurs. Nursing staff within the neuro-intensive care unit at MMC noticed this variability, and approached leadership within the surgical-trauma service to create an order set focused on TBI management.

Purpose: In the TBI population, …

Development Of A Traumatic Brain Injury (Tbi) Order Set At Maine Medical Center, Sarah Bockian, Emily Esslinger, Martha Weatherhead

Interprofessional Research and Innovations Council

Development of a Traumatic Brain Injury (TBI) Order Set at Maine Medical Center

Sarah Bockian, RN, SCRN

Emily Esslinger, RN

Martha Weatherhead, RN

Background: Traumatic brain injury (TBI) occurs when an external force causes brain dysfunction. TBI management in the critical care setting focuses on treating the initial, or primary brain injury, as well as secondary injuries, caused by hypoxia, hypotension, and swelling. Due to the lack of consensus within the literature, in addition to numerous attending and resident physicians at Maine Medical Center (MMC), variability in care often occurs. Nursing staff within the neuro-intensive care unit at MMC noticed …

Is Trucking Along Enough? An Exploration Of Mid-Career Nurses’ Satisfaction, Heather Docherty

Interprofessional Research and Innovations Council

Is trucking along enough? An exploration of mid-career nurses’ satisfaction

Heather Docherty RN, BSN, BA, MA, CMRSN

Background: The topic of nursing retention and satisfaction has been the focus of much research; many studies have focused on the experience of novice nurses. This project focuses on exploring the factors that influence the job satisfaction of nurses who are “mid-career” in a sample of hospital’s medical surgical units. The approach to this work is informed by the theoretical work of Benner’s model of novice to expert as well Maslow’s work on hierarchy of needs.

Literature Review: A literature search was conducted …

Can Creating A Behavioral Task Force On The Medical And Surgical Floor Increase Staff Satisfaction Rates?, Amy Lee

Interprofessional Research and Innovations Council

Can creating a Behavioral Task Force on the medical and surgical floor increase staff satisfaction rates?

Amy Lee, RN

Abstract

Background. The medical and surgical units within Maine Medical Center have seen an influx of patients with behavioral disturbances. Staff voice concerns regarding lack of knowledge and lack of support while treating patients with a medical condition and dual diagnosis of a psychiatric disorder with behavioral disturbances.

Purpose (PICOT). In adult patients on R5 with behavioral disturbances, how does the implementation of a Behavioral Task Force compared to the current practice affect staff knowledge and satisfaction?

Method. This quality improvement …

What Are The Barriers And Facilitators To Nurses’ Utilization Of A Nurse Driven Protocol (Ndp) For Indwelling Urinary Catheter (Iuc) Removal?, Brenda Clark

Interprofessional Research and Innovations Council

What are the barriers and facilitators to Nurses’ utilization of a Nurse Driven Protocol (NDP) for Indwelling Urinary Catheter (IUC) removal?

By Brenda Clark, BSN, RN, CMSRN

Background: Urinary tract infections (UTIs) are recognized as a major cause of morbidity and mortality in hospitalized patients; 80% of UTIs are related to using indwelling urinary catheters.

Reducing these infections is recognized as a National Patient Safety Goal (NPSG) by the Joint Commission; the American Nurses Association (ANA) has classified catheter associated urinary tract infections (CAUTIs) as one of the nurse-sensitive indicators that reflect the quality of nursing care. Centers for Medicare …

Does Medication Safety And Diversion Education Improve Medication Securement Practices In Scu Compared To Current Practice?, Natasha Stankiewicz

Interprofessional Research and Innovations Council

This safety quality improvement project began as newly hired SCU2 team members saw an opportunity to improve our medication safety practices and culture. The convenience of having certain medications directly available at bedside was priority. There was a lack of awareness and interest in securing medications within the department. However, the risk to our patients, families, visitors and colleagues when medications are left out, available and unsecured was apparent to new staff and others. Prior to our education, the accepted practice of unsecured medications was rampant: medications were left drawn up or exposed, setting in various open areas at bedside …

Does Medication Safety And Diversion Education Improve Medication Securement Practices In Scu Compared To Current Practice?, Natasha R. Stankiewicz

Interprofessional Research and Innovations Council

Does medication safety and diversion education improve medication securement practices in SCU compared to current practice?

Abstract

Natasha R. Stankiewicz, MS, RN, NE-BC, CCRN-CMC

This safety quality improvement project began as newly hired SCU2 team members saw an opportunity to improve our medication safety practices and culture. The convenience of having certain medications directly available at bedside was priority. There was a lack of awareness and interest in securing medications within the department. However, the risk to our patients, families, visitors and colleagues when medications are left out, available and unsecured was apparent to new staff and others. Prior to …

Can Creating A Behavioral Task Force On The Medical And Surgical Floor Increase Staff Satisfaction Rates?, Amy Lee

Interprofessional Research and Innovations Council

Abstract

Background. The medical and surgical units within Maine Medical Center have seen an influx of patients with behavioral disturbances. Staff voice concerns regarding lack of knowledge and lack of support while treating patients with a medical condition and dual diagnosis of a psychiatric disorder with behavioral disturbances.

Purpose (PICOT). In adult patients on R5 with behavioral disturbances, how does the implementation of a Behavioral Task Force compared to the current practice affect staff knowledge and satisfaction?

Method. This quality improvement study began in May 2017 and is on-going. In May, a pre-implementation survey was given to all nurses and …

Evidence Based Nutritional Management Of Adult Patients With Severe Burns, Ashley Lazarz, Samantha Waller

Interprofessional Research and Innovations Council

Clinical Scholars Abstract 2017

Title: Evidence based nutritional management of adult patients with severe burns.

Presenters: Ashley Lazarz RD, LD and Samantha Waller MS, RD, LD

Background/Literature: It is estimated that more than 2 million people suffer burns in the United States annually, resulting in approximately 3400 deaths. Burns cause pathological alterations in nearly every system of the body and changes in both metabolism and immunity in the burned patient contribute to adverse outcomes. (1) Hyper-metabolism leads to severe catabolism and loss of lean body mass in the severely burned patient making nutrition intervention critical. (2) Literature indicates that enteral …

Or Rn Onboarding. A Quality Improvement Project, Victoria Burkhart, Eroica Hunter

Interprofessional Research and Innovations Council

OR RN Onboarding. A Quality Improvement Project.

Victoria Burkhart, BSN, RN

Eroica Hunter, BSN, RN, CNOR

Background: National Data¹ shows that about 18% (1 in 5) new RNs leave their 1^st job within 1 year; 1 in 3 leave within 2 years. National Data² also shows that OR nursing turnover was in 2014 17.2% and in 2015 this had increased to 19.2%. At MMC OR turnover compares to national data, but has been slightly lower over the past years (e.g. 2014 - 10.9%; 2015 - 10.8% and 2016 - 9.5%). However, today in MMC OR, 28 …

Deep Tissue Pressure Injury (Dtpi): Predictors And Risk Factors During Hospitalization. A Literature Review, Tricia Foley

Interprofessional Research and Innovations Council

Deep Tissue Pressure Injury (DTPI): Predictors and Risk Factors During Hospitalization. A Literature Review

Tricia Foley, RN, BSN, CWOCN, MMC

Background: Deep tissue pressure injuries (DTPI) at Maine Medical Center (MMC) have increased from 2014 to 2016. DTPI initially appear as purple or maroon discoloration and either resolve or evolve into a deeper wound. When a DTPI evolves into an eschar, this is called an unstageable pressure injury by the National Pressure Ulcer Advisory Panel. Patients with an unstageable, stage 3 or 4 pressure injury are reported to the State of Maine according to Maine Law. This is considered a …