Medicine and Health Sciences Commons^™

Reducing Readmission (And Mortality) For Older Patients & Survivors Of Life-Threatening Conditions: A Study Using The Staarr Protocol, Akhenaten Amun

Symposium of Student Scholars

Readmission rates for patients admitted for heart failure, pneumonia, chronic obstructive pulmonary disorder, a myocardial infarction, a hip or knee arthroplasty, or coronary artery bypass surgery tend to have high readmission and mortality rates within 30 days of their discharge from a hospital. Starting in October 2012, the Healthcare Reimbursement Reduction Program enforced penalties on Medicare reimbursements for hospitals with readmission rates, for patients with the conditions above, were higher than averages based on facilities with similar characteristics and patient populations. Teach-back and verify (Klingbeil & Gibson, 2018), interdisciplinary teams that engage in patient care and support (Reiter-Palmon et al., …

Interventions To Decrease Readmission Rates In Lvad Patients, Karolina Jackson

Symposium of Student Scholars

Interventions to Decrease Readmission Rates in LVAD Patients

Karolina Jackson

WellStar School of Nursing, Kennesaw State University

NURS 4417: Advanced Clinical Practicum

Lynnda Campbell

October 21, 2022

Abstract

Background: Patients who have undergone implantation of a left ventricular assistive device are at a higher risk for readmission- whether that be due to driveline dressing infections, thrombosis, bleeding at the site of implantation, or electrolyte imbalances. These readmission rates in the LVAD population can be decreased through appropriate intervention methods. Literature Review: This study’s main purpose was to discover interventions healthcare facilities and core LVAD staff can implement in practice to …

Impact Of Alarm Management Classes In Reducing Alarm Fatigue, Elizabeth Laegen

Symposium of Student Scholars

Alarm fatigue is becoming a more and more common problem for nurses working in inpatient hospital units, especially critical care units. Monitoring systems, ventilators, vital signs monitors, and other electronic devices designed to detect critical or pending critical values and alterations in patients have become more of a nuisance than the lifesaving systems they were designed to be. With alarms sounding frequently for what are typically nonactionable alerts, nurses to have developed a decrease in sensitivity to all alarms, regardless of importance. Research of alarm fatigue has shown that while the significance of the problem is clear and studies have …

In Adult Icu Patients With Central Lines, Does Improved Staff Adherence To The Clabsi Prevention Clinical Practice Guidelines Reduce The Incidence Of Clabsis?, Job Waihiga

Symposium of Student Scholars

A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when bacteria or viruses enter the bloodstream through the central line. Background: This project is important because central line-associated bloodstream infections increase hospital mortality rates, lengths of stay, and 30-day readmission rates. They also impose heavy financial burdens on hospital systems. Furthermore, out of all the nosocomial infections, central line-associated bloodstream infections have the highest and most recent incidence rates in this adult ICU unit. Purpose: This project aims to identify an intervention to improve staff adherence to the CLABSI prevention bundle and decrease the rate of …

Reducing Noise Levels In Intensive Care Units Using Noise Monitoring Technology, Kayla Kloes

Symposium of Student Scholars

Intensive care units require many medical procedures, activities, machines, and staff that contribute to high levels of noise. These high noise levels have been found to cause adverse psychological and/or physiological health effects related to sleep disturbances, increased anxiety, and increased stress. These health effects may lead to decreased patient satisfaction. The purpose of this proposal is to explore the effectiveness of the SoundEar 3-300 device in decreasing levels of noise and as a result, increasing patient satisfaction. The current research indicates that the SoundEar 3-300 device is successful at reducing hospital noise levels. This device allows for the measurement …

Impact Of Alarm Fatigue In Critical Care Nurses On Patient Outcomes, Addie Mctyre

Symposium of Student Scholars

Background

Critical care units are equipped with extensive amounts of patient monitoring equipment that sound alarms to alert nursing staff to changes in the patient’s condition. The constant beeping of alarms can result in a phenomenon known as alarm fatigue, when nursing staff becomes accustomed to the continuous sound of alarms and either tune it out or ignore it completely. This can result in poor patient outcomes. The purpose of this project is to propose techniques to decrease false alarms to reduce the overall number of alarms during a shift. This will lead to a reduction in the occurrence of …

Does The Use Of Machine Learning Algorithms Help Reduce Mortality Rates In Patients With Sepsis, Jacqueline Easter

Symposium of Student Scholars

Abstract

Background: Sepsis is the result of the body’s dysregulated response to an infection. The response can cause an inflammatory chain reaction which can lead to multiple organ dysfunction septic shock, and death. Early recognition and treatment of risk of sepsis is essential to control the disease. Each hour of delay treatment is associated with 3%-9% increase in mortality rate (Kuo et al., 2021). The current methods for prediction of sepsis such as SOFA have prediction rates low as 61% (van Doorn et al., 2021). Research using Machine Learning Algorithm has demonstrated prediction rates of 95% within an hour (Singh …

Intensive Care Unit (Icu) Delirium, Mckenna Redmond

Symposium of Student Scholars

The purpose of this evidence-based practice project is to implement and evaluate an effective way to prevent intensive care unit (ICU) delirium. My research question is asking whether nonpharmacological or pharmacological therapies are effective for preventing intensive care unit delirium acquired during stay. Delirium is a mental state that occurs from a variety of reasons that creates changes in arousal, cognition, and in mental abilities. It results in confused thinking and a lack of awareness of someone's surroundings. Delirium during acute settings, such as the ICU, can cause an increased risk for mortality. Thorough evaluation of multiple studies exemplified that …

The Effects Of Hospital Policy And Procedure On Cauti Occurrence, Kevin Kaga, Michaela Morrison, Daniel John

Symposium of Student Scholars

Abstract

Background: Clients that require indwelling catheterization often get bacterial infection causing catheter-associated urinary tract infections. These infections lead to longer hospital admissions and poorer outcomes for clients.

Objectives: To assess the effectiveness of the use of suggested hygiene methods from hospital policy/guidelines in preventing catheter-associated urinary tract infections.

Methods: Using the Kennesaw State Library search system, 10 articles were found to support that the use of consistent evidence based practices can prevent urinary tract infection occurrence.

Results: Our articles identified appropriate and inappropriate indications for catheterization and effective hygiene techniques used by nurses in the prevention of CAUTIs. These …

Effects Of Oral Care And Positioning On The Incidence Of Ventilator-Associated Pneumonia, Nneka Uwaekwe

Symposium of Student Scholars

Abstract

Background: Ventilator-associated pneumonia (VAP) is a lung infection that is acquired after endotracheal intubation. It is associated with increased length of hospital stays, costs, and rate of mortality for mechanically ventilated patients in the intensive care unit. The role of oral care with chlorhexidine and patient positioning are being considered as interventions for VAP prevention, however, uncertainties remain regarding the benefits and harms of chlorhexidine and positioning for preventing VAP. Purpose: The purpose of this study is to determine the effect of positioning and the use of chlorhexidine for mechanically ventilated patients, on the incidence of ventilator-associated pneumonia …

Unmasking The Leading Injuries In Hospitals And A Promising Change, Taylor Karisny

Symposium of Student Scholars

Abstract

The problem that will be studied is the increased development of pressure ulcers among hospitalized intensive care unit patients. The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately and effectively is increasingly important for all professionals in wound care. The review of the literature shows, hospital-acquired pressure ulcers are expensive to treat with the U.S. median cost at $39,000 per patient stay and costing U.S. health care system $3.6 billion per year. Several interventions and preventive measures are current used …

Interventions To Combat Burnout In Intensive Care Unit Nurses, Emily C. Randall, Amber T. Mcclarty, Omotoyosi Ogedengbe

Symposium of Student Scholars

Background: This literature review summarizes the knowledge, causative factors, associations/relationships, and interventions of burnout, positive work environments, and sleep quality in intensive care unit (ICU) nurses.

Objectives: To answer the question, how effective is a positive work environment compared to psychological interventions, specifically improved sleep habits, in reducing burnout in ICU nurses?

Methods: A literature search was conducted using combined keywords in 4 databases of 10 peer reviewed publications from 2016 to 2022. Information related to burnout, positive work environments, and sleep quality in intensive care unit (ICU) nurses was compared and summarized.

Results: There is sufficient evidence that positive …

Interventions To Prevent Hospital Acquired Pressure Injuries, Astrid Geronimo

Symposium of Student Scholars

Background: Hospital acquired pressure injuries (HAPIs) are the most common preventable complication among critical care patients. This project is conducted to compare the effectiveness between the current implemented preventative measure versus the new measures that have data supporting their effectiveness. Brief Significance: Five articles were chosen that outlined the prevalence of hospital acquired pressure injuries in critical care patients and alternative interventions that have been effective in the prevention of HAPIs. These evidence-based interventions include: The application of multilayered foam dressing with hypo oxygenated fatty oils which would reduce sheer and provide support from the pressure of laying in the …

Cauti Prevention In The Icu, Kai Zheng, Christie Emerson, Nerma Redcross

Symposium of Student Scholars

Project Proposal Abstract

Background: ICU patients are often bedbound for extended periods. Routine insertion of a urinary catheter, lack of proper Foley care techniques, and reluctance to remove the urinary catheter increase the risk of CAUTI. Each day a catheter is left in place, the patient's risk for CAUTI increases by 5%.

Brief Literature review: The incorporation of the Plan-Do-Study-Act approach helped to reduce CAUTI by deliberately layering single interventions over an extended period of time, it allowed the nurses to fully adopt each intervention before moving on to the next.

Methods: Interventions included considering alternatives to indwelling urinary catheters, …

Prevention Of Pressure Ulcers Interventions, Halle Borgel

Symposium of Student Scholars

Pressure injuries continue to be a rising problem in hospitalized patients, specifically non-ambulatory patients. Without frequent turning and pressure relieving surfaces, patients may develop a pressure injury that costs them more and lengthens their hospital stay. By comparing frequent turning schedules and pressure relieving foam mattresses in the prevention of pressure injuries, thousands will be prevented. After a thorough search review on articles, five articles were selected in determining which prevention method happens to be the best. Although no articles researched the clinical prevention in foam mattresses and frequent turning, conducting a proposed project is effective. The proposed project consists …

Point-Of-Care Devices To Reduce Iatrogenic Anemia Among Preterm Infants, Jenna Craven

Symposium of Student Scholars

Abstract

In neonatal intensive care units (NICUs), the prevalence of anemia and required blood transfusions continues to rise. Blood testing is necessary in this population in order to accurately develop diagnoses and treatment options. However, blood loss in the NICU is the main cause of preterm neonatal anemia. Preterm infants tend to experience larger amounts of blood loss compared to other infants in the NICU. They are born with fewer red blood cells and are not able to rapidly reproduce these blood cells when needed, and multiple blood draws further deplete the infant’s hemoglobin and hematocrit levels. In current practice, …

Cauti Infection In Acute Care Setting, Kai Zheng, Katherine Waldron, Andrea Medina

Symposium of Student Scholars

CAUTI Infection in Acute Care Setting

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) is one of the most common and costly hospital-acquired infections (HAI) within the acute care setting that prolongs the length of stay and negatively affect patient health outcomes. Purpose: This evidence-based practice project addresses the question: Within the acute care setting, what nursing interventions are effective in preventing CAUTI? Methods: PRISMA was utilized, and various peer-reviewed literature have been appraised using the John Hopkins Evidence-Based Practice Tools to determine the most effective interventions to reduce the prevalence of CAUTI within the adult acute care setting. Results: Implementation of …

Noise Reduction In The Intensive Care Unit, Carolina Gomez

Symposium of Student Scholars

Abstract

The purpose of this study was to analyze the noise levels in an intensive care unit (ICU) in a metro atlanta medical facility and to establish interventions that could be used to reduce the noise. Determining the effects is significant because it can improve a patients’ outcome in the ICU. The challenge explored was evidenced by 15 out of 20 patients stating that they are suffering sleep deprivation due to excessive noise levels. After 3 days in the ICU, patients have developed confusion and delirium; they are not oriented to date and time without reminders. After 3 days in …

How Frequent Oral Care Can Decrease The Incidence Of Aspiration Pneumonia Within The Critical Care Setting, Patrick Subers

Symposium of Student Scholars

Within the critical care hospital setting, many patients are declared NPO, or nothing by mouth, for various reasons. Typically, these patients have had a stroke, are at risk for aspiration, or are pending an operation. In the case of stroke patients, they are often held NPO for an extended period while their ability to swallow improves to a safe level. One of the greatest risks for this patient population is the development of aspiration pneumonia, as they have a decreased ability to clear secretions from their throat and mouth. Pair that with the fact that this population is heavily care-dependent …

Uncovering The Benefits Of Naturalistic Blue-Depleted Lighting In Hospitals: A Qualitative Study, Sam P. Cotton

Symposium of Student Scholars

With exponential technological advances, hospitals are tasked with prioritizing which expensive innovations truly impact as many patients as possible to give them the greatest chance of recovering and discharge them earlier. It is no surprise that most of the attention is focussed on pharmaceutical drugs and a variety of different equipment and machinery, but hospital facilities should look into simpler additions that can aid every patient admitted. The use of naturalistic blue-wavelength lighting is something that can benefit each patient’s recovery immensely. Multiple studies have proven positive effects that blue-depleted lighting compared to standard indoor fluorescent lighting has lowered stress …

Shortening Wait-Times In The Emergency Department, Laura Clark

Symposium of Student Scholars

Many Americans visit the Emergency Department (ED) every day for a variety of reasons. Some are extreme emergencies while others could be handled by a primary care provider (PCP). However, the EDs throughout the United States and other countries throughout the world are consistently known for their extended wait-times. Evidence has shown the average ED wait-time is about 145 minutes, being significantly longer in other states. In a state of emergency, 145 minutes could mean life or death. Shortening wait-times in the ED is crucial to saving lives, efficiently utilizing staff members, and satisfying patient needs. In this project, various …

The Effects Of Nursing Overtime Work Hours On Medication Errors And Patient Safety, Camilla Byrd, Halle Borgel, Mykayla Stephens, Jena Killian, Mya Kinney

Symposium of Student Scholars

Abstract

Background: The recent global pandemic has uncovered health care inequities among nursing professionals. The nursing shortage has placed pressure on overworked nurses to perform higher level critical care under dire and unsafe conditions. The stress of overworked nurses is a culprit for medical errors that affect the quality and effectiveness of patient care. Methods: Kennesaw State Library, PubMed, 35 articles screened. After thorough screening of various articles addressing this topic, we examined the quantitative and qualitative studies performed in all areas of nursing. Results: Research suggests that nurses working overtime versus full-time hours experience physical, mental, and emotional exhaustion …

Post-Operative Delirium: Can Retraining On The Cam-Icu Tool Increase Nurses’ Confidence In Patient Assessment?, Alison Farraher

Symposium of Student Scholars

Background: Delirium is defined as an acute condition consisting of confusion, altered mental status, and disorganized thought processes. Patients who develop delirium have higher mortality rates, increased lengths of stay in the hospital, worse clinical outcomes, and place a higher burden on hospital staff. Affecting up to fifty percent of cardiac surgery patients, delirium is recognized as a major post-operative complication highlighting the importance of early detection. The Confusion Assessment Method for the ICU (CAM-ICU) is a widely accepted screening tool used to detect delirium in the ICU setting. Despite being clinically validated, many nurses lack adequate training on how …

Monthly Debriefing Sessions For Critical Care Nurses: Evaluating Nurse Burnout And Retention, Emilei Ison

Symposium of Student Scholars

Nurse burnout and retention is an ongoing issue in the trauma/surgery ICU, especially following COVID-19. Critical Care Societies Collaborative (CCSC) recently held a summit to address the issue of burnout among critical care professionals and call for action to implement change and promote research. Studies have shown that increased burnout amongst nurses is associated with increased healthcare associated infections, increased patient mortality, and decreased perceived quality of teamwork. With the cost of turnover being 1.2 to 1.3 times an RN’s salary, preventing burnout is a major issue for healthcare organizations. The purpose of this evidence-based practice project is to address …

A Project Proposal: The Effects Of Standard Protocols During Cpr On Hospital-Acquired Infections Of Post-Open-Heart Surgery Patients In The Cvicu, Jessica Monahan

Symposium of Student Scholars

Abstract

A Project Proposal: The Effects of Standard Protocols during CPR on Hospital-Acquired Infections of Post-Open-Heart Surgery Patients in the CVICU

Background: Hospital-acquired infections (HAIs) are one of the most common complications post-cardiac surgeries and are associated with longer hospitalizations, elevated use of healthcare resources, and increased morbidity and mortality. The effects of HAIs after cardio-pulmonary resuscitation (CPR) in recent post-open-heart surgery patients remains largely unexplored. Therefore, the purpose of this project was to determine, in the CVICU does implementing standard protocols during CPR on recent post-open-heart surgery patients reduce HAIs?

Literature Review: HAIs during CPR can be acquired through …

Reducing Catheter-Associated Infections Through A Two-Nurse Protocol, Jennifer Balagani

Symposium of Student Scholars

Catheter-associated infections related to Foley catheter insertion and maintenance is a current problem in my practicum unit and across the United States. Although we are only in the third month of 2022, my practicum unit has already documented three cases of catheter associated infections occurring this year. Unfortunately, these cases are not outside of the norm, in the United States, catheter-associated infections are the second most common hospital acquired infection (Zurmehly, 2018). The purpose of this project is to propose trial interventions at Kennestone Hospital that have been effective in other hospitals like the Shepherd Center to reduce the occurrence …

Preventative Interventions To Support Decreasing Compassion Fatigue Among Critical Care Nurses, Vanessa Otamendi

Symposium of Student Scholars

Title: Preventative Interventions to Support Decreasing Compassion Fatigue Among Critical Care Nurses

Background:

Nurses who are subjected to traumatic situations like difficult patient situations and a lack of support can experience compassion fatigue. Compassion fatigue is a problem throughout the healthcare field, especially in critical care where there are complex patients and high-pressure situations. Early forms of interventions such as workshops are important to offer in hopes of nurses becoming aware of and avoiding compassion fatigue.

Brief Literature Review:

This study aimed to synthesize existing interventions that focused on hospital nurses in a critical care capacity which focused on preventing …

Decreasing The Number Of Venipuncture Attempts In Infants On A Neonatal Intensive Care Unit, Laura Grace Holton

Symposium of Student Scholars

Decreasing the Number of Venipuncture Attempts in Infants on a Neonatal Intensive Care Unit

Laura Grace Holton

Obtaining intravenous access is a procedure performed on most preterm infants in neonatal intensive care units, for the purpose of obtaining blood samples, administering fluids and medications. Venipuncture is the process of puncturing the skin to insert a needle for IV access and often must be performed multiple times to be successful given the small veins of preterm infants. Research shows that multiple venipuncture attempts can be distressing to hospitalized infants, increases the risk of bloodstream infections, and causes lasting vein damage. Literature …

Ventilator Associated Pneumonia, Helena Walker

Symposium of Student Scholars

Ventilator Associated Pneumonia (VAP) is the instance in which a patient acquires pneumonia more than forty-eight hours after intubation with mechanical ventilation. VAP is a serious medical issue that occurs frequently in intensive care unit patients. Not only does this condition increase the morbidity and mortality of a patient, it also increases the cost of the patient’s health care as well. Commonly as recent literature suggests, in an effort to prevent this infection from occurring, hospital staff have taken several approaches including antibiotic cycling, surveillance cultures, and de-escalation therapies. These methods do not always prevent the cases though. Currently, research …

The Impact Of A 12-Hour Shift Compared To An 8-Hour Shift On Nurse Health And Safety, Matthew Kramer, Andrea Howell, Kayla Kloes, Emmy Lam, Brittney Levy

Symposium of Student Scholars

Abstract

Background: An international healthcare concern is extensive shift length among registered nurses and the negative factors associated with nurse burnout. Cognitive impairment, medical errors, sleep deprivation, job dissatisfaction, and overall declined health and safety of nurses have been associated to long shift work hours among registered nurses globally. However, there is limited published evidence about the difference between 8-hour and 12-hour shift work.

Objective: This systematic review summarized evidence on the impact that 12-hour shifts compared to 8-hour shifts has on the health and safety of registered nurses.

Methods: PubMed, SCOPUS, EBSCOHost, NCBI, Google Scholar, and …