Medicine and Health Sciences Commons^™

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

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

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

Mindfulness Based Interventions To Reduce Burnout And Ptsd Symptoms In Critical Care Nursing, Kelly A. Pellegrino, Libby M. Colley, Carly R. Fazendin, Emma R. Parrotta, Mollie Johnson

Non-Thesis Student Work

Within the medical field, nursing is a career that can be very taxing on both one’s physical and mental wellbeing, especially in regards to critical care. The life-threatening situations and strenuous work that critical care nurses are met with everyday make them especially susceptible to struggling with burnout, compassion fatigue, and PTSD-like symptoms. This not only puts their own safety at risk, but the safety of their patients as well. This raises the question: In critical care nursing, does the utilization of mindfulness based interventions, compared to no intervention, aid in the reduction of nursing burnout and PTSD symptoms? In …

Eye Care For Corneal Transplant Donors In The Icu: What We Didn’T See Coming, Ashton Lackey, Joey Royea, Alexandra Hartman, Aaron Worthley

South Atlantic Division Research Day 2024

No abstract provided.

Implementation And Utilisation Of Australian Critical Care Practice Standards: What Do We Know?, Yolanda Cox, Justin L. C. Bilszta, Debbie Massey

Research outputs 2022 to 2026

Background: The Australian College of Critical Care Nurses published the third edition of practice standards (PSs) for specialist critical care nurses in 2015. Higher-education providers currently use these standards to inform critical care curricula; however, how critical care nurses perceive and use PSs in clinical practice is unknown. Objectives: The objective of this study was to explore critical care nurses' perceptions about the Australian College of Critical Care Nurses PS for specialty critical care nursing, to understand how the PSs are used in clinical practice, and what opportunities exist to support their implementation. Methods: An exploratory qualitative descriptive design was …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Student Research Posters

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care based training, with …

Readiness For Transfer: A Mixed-Methods Study On Icu Transfers Of Care, Soo-Hoon Lee, Clarice Wee, Phillip Phan, Yanika Kowitlawakul, Chee-Kiat Tan, Amartya Mukhopadhyay

Management Faculty Publications

Objective Past studies on intensive care unit (ICU) patient transfers compare the efficacy of using standardised checklists against unstructured communications. Less studied are the experiences of clinicians in enacting bidirectional (send/receive) transfers. This study reports on the differences in protocols and data elements between receiving and sending transfers in the ICU, and the elements constituting readiness for transfer.

Methods Mixed-methods study of a 574-bed general hospital in Singapore with a 74-bed ICU for surgical and medical patients. Six focus group discussions (FGDs) with 34 clinicians comprising 15 residents and 19 nurses, followed by a structured questionnaire survey of 140 clinicians …

Improving Use Of A Standardized Medical Icu Order Set, Ernesto Munoz-Pena, Sesha Sai Kanakamedala, Ramzy Daoud, Suhail Saad-Omer, Aarushi Varshney, Tristan Tanner, Alexander Kong, Joshua Shultz, Ashwini Komarla

North Florida Division Research Day 2023

No abstract provided.

Implementation Of A Bowel Management Care Bundle On The Spinal Cord Injury Patient Population During Acute Recovery, Jessica Rene Baldwin

Doctor of Nursing Practice Scholarly Projects

Over 17,000 Americans suffer from spinal cord injuries (SCI) annually. Although the loss of motor function is a blatantly obvious sequela, the loss of autonomic nervous system control, and its direct effects on various body systems, is scarcely understood. The most frequently reported impairment associated with SCI-related bowel dysmotility is Neurogenic Bowel Dysfunction (NBD), affecting approximately 20-60% of the SCI population. NBD is defined as slow colonic time and is hallmarked by constipation and often impaction, leading to life-threatening complications, such as bowel obstruction, fecal impaction, autonomic dysreflexia, and even death. Identifying dysmotility within the SCI patient population and early …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Clinical Skills And A Quick Reference Guide For Critical Care, Kayla Mccarty

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Assessment Of A Comparative Bayesian-Enhanced Population-Based Decision Model For Covid-19 Critical Care Prediction In The Dominican Republic Social Security Affiliates, Amado A. Baez, Oscar J. Lopez, Maria Martinez, Colyn White, Pedro Ramirez-Slaibe, Leticia Martinez, Pedro L. Castellanos

School of Medicine Publications and Presentations

Introduction: The novel coronavirus disease 2019 (COVID-19) has been a major health concern worldwide. This study aims to develop a Bayesian model to predict critical outcomes in patients with COVID-19.

Methods: Sensitivity and specificity were obtained from previous meta-analysis studies. The complex vulnerability index (IVC-COV2 index for its abbreviation in Spanish) was used to set the pretest probability. Likelihood ratios were integrated into a Fagan nomogram for posttest probabilities, and IVC-COV2 + National Early Warning Score (NEWS) values and CURB-65 scores were generated. Absolute and relative diagnostic gains (RDGs) were calculated based on pretest and posttest differences.

Results: The IVC-COV2 …

The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner

The Eleanor Mann School of Nursing Student Works

Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …

Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans

Walden Dissertations and Doctoral Studies

AbstractPatients in the trauma care setting are often dependent on their families and physicians to decide medical treatments when they cannot participate in the process.But in up to one-third of cases, the surrogate decision-maker (SDM)selected by the patient is not the emergency contact listed in the electronic medical record (EMR).SDM identification and documentation will ensure that the patient is best represented by someone who knows their values and goals if they become incapacitated.Nurses can facilitate identifying a patient’s SDM and document this choice in the EMR.The purpose of this study was a staff education program to improve intensive care unit …

Systematic Literature Review Of Residency Program For Transition To Intensive Care, Sonja Marguerite Thornton

Walden Dissertations and Doctoral Studies

The purpose of the systematic literature review project is to present the benefits of a nurse residency program (NRP) to assist new graduate nurses (NGNs) in transition to intensive care nursing. A theory-to-practice gap in knowledge and experience results in the need to support these nurses during their transition to professional practice. This project focused on compiling a systematic review of existing literature to provide evidence and insights into the optimal structure and process of transitioning new graduate nurses to intensive care nursing practice. The American Associations of Critical Care Nurses synergy conceptual model and Patricia Benner's novice to expert …

Delirium In Hospitalised Adults With Acute Burns – A Systematic Review, Guy H.M Stanley, Angus R.J Barber, Aoife M. O'Brien, Cheryl Hamill, Glenn Boardman, Cody C. Frear, Dale W. Edgar, Hannah Seymour, Fiona M. Wood

IHR Papers and Journal Articles

Introduction: Delirium is a potentially modifiable, acutely altered mental state, commonly characterised as a hospital-acquired complication. Studies of adult inpatients with acute burns with and without delirium identify causative risks related to the injury or treatment and outcomes related to the patient and healthcare system. We compare patients with and without delirium, providing a high-level quantitative synthesis of delirium risks and outcomes to inform guidelines and future research.

Methods: A systematic review, meta-analysis and GRADE evaluation of risks and outcomes associated with delirium in adults with acute burns was conducted using PRISMA guidelines and PROSPERO protocol CRD42021283055. The Newcastle-Ottawa Scale …

The Effect Of Frailty On The Development Of Acute Kidney Injury In Critically-Ill Geriatric Patients With Covid-19, Murat Küçük, Bi̇şar Ergün, Mehmet Nuri̇ Yakar, Özer Ural Çakici, Erdem Yaka, Bi̇lgi̇n Cömert, Ali̇ Necati̇ Gökmen, Begüm Ergan

Turkish Journal of Medical Sciences

Background/aim: Acute kidney injury is strongly associated with mortality in critically ill patients with coronavirus disease 2019 (COVID-19); however, age-related risk factors for acute kidney injury are not clear yet. In this study, it was aimed to evaluate the effects of clinical factors on acute kidney injury development in an elderly COVID-19 patients. Materials and methods: Critically ill patients (?65years) with COVID-19 admitted to the intensive care unit were included in the study. Primary outcome of the study was the rate of acute kidney injury, and secondary outcome was to define the effect of frailty and other risk factors on …

High Risk Newly Diagnosed Multiple Myeloma, Phebe Abraham, Cassie Robertson, Aswin Srinivasan, Murtaza N. Bhuriwala, Shan Guo

Gulf Coast Division Research Day 2022

No abstract provided.

Supporting Premature Infants’ Oral Feeding In The Nicu—A Qualitative Study Of Nurses’ Perspectives, Evalotte Mörelius, Charlotte Sahlén Helmer, Maria Hellgren, Siw Alehagen

Research outputs 2022 to 2026

One major task in the neonatal intensive care unit (NICU) involves ensuring adequate nutrition and supporting the provision of human milk. The aim of this study was to explore nurses’ experiences of the oral feeding process in the NICU when the infant is born extremely or very preterm. We used a qualitative inductive approach. Nine nurses from three family-centered NICUs were interviewed face-to-face. The interviews were transcribed verbatim and analyzed using content analysis. Five sub-categories and two generic categories formed the main category: ‘A complex and long-lasting collaboration.’ The nurses wished to contribute to the parents’ understanding of the feeding …

Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison

Doctor of Nursing Practice Projects

Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …

Strategies To Prevent Hospital Acquired Pressure Injuries In The Intensive Care Unit, Theresa Ann Pomerleau

Doctor of Nursing Practice

Background. Despite prevention strategies, hospital acquired pressure injuries continue to occur, especially in intensive care units. This led to an impetus for nurses to have a robust knowledge of pressure injuries to promulgate prevention strategies in their practice. Significance of the Problem. The hospital acquired pressure injury rate in the medical surgical intensive care unit for the year 2019 at Hospital X was greater than the national benchmark. Purpose. The global aim statement was to improve the quality of patient care by developing an evidence based educational suite in collaboration with interdisciplinary team members for prevention of hospital acquired pressure …

Education To Prevent Psychological Distress In Icu Patients, Casey Robinson

Master of Science in Nursing Scholarly Project

Admission to an intensive care unit can become a traumatic event for some patients and can cause them to experience psychological distress. Psychological distress is when patients experience anxiety, depression or post-traumatic stress disorder related to ICU admission. With the introduction of the COVID-19 pandemic, this psychological distress has become more of a problem with patients and current nursing practices are falling short in providing quality psychological care. Surgery ICU nurses at the University of Cincinnati Medical Center were given a pre-test on preventing psychological distress in ICU patients to facilitate practice change. A short educational offering was provided to …

Association Between Vitamin D Deficiency And Sepsis In Pediatric Icu, Ahmed A. Khattab, Aliaa A. Abdel-Aziz, Fady M. El-Gendy, Rehab G. Naser

Menoufia Medical Journal

Objective To evaluate association between 25-hydroxyvitamin D [25(OH)D] and sepsis in pediatric ICU (PICU). Background Vitamin D is a fat-soluble steroid hormone that helps maintain proper calcium homeostasis and has a role in the function of the immune system. Data on the prevalence of vitamin D deficiency (VDD) in PICU in children with sepsis and its association with poor outcome were obtained. Patients and methods This study was carried out on 45 patients with sepsis admitted to the PICU, Pediatric Department, Menoufia University Hospital, and 45 controls, who attended the patient clinic and were found to be healthy. Demographic data, …

Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken

Walden Dissertations and Doctoral Studies

This study was conducted to test how social exclusion, experienced through a culture of healthcare hierarchy, influenced the feelings/attitudes of respiratory therapists (RTs) who are excluded from discussions of end-of-life (EOL) care. Data analysis was conducted using a multivariate analysis of variance to address the research questions. A quantitative nonexperimental survey research design incorporating four evidence-based surveys was used. There was no significance found between professional exclusion from EOL care discussions and the abilities of RTs to collaborate with intensive care unit (ICU) team members within the shared decision-making model as it relates to providing care in the ICU. There …

Extracorporeal Carbon Dioxide Removal (Ecco2r) In Copd And Ards Patients Withsevere Hypercapnic Respiratory Failure. A Retrospective Case-Control Study, Volkan İnal, Serdar Efe

Turkish Journal of Medical Sciences

Background/aim: Treatment of severe hypercapnic respiratory failure (HRF) has some challenges in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS), especially when lung protective ventilation (LPV) strategies are required. Extracorporeal CO2 removal (ECCO2R) therapy is an emerging option to manage hypercapnia while allowing LPV in these cases. However, further data on ECCO2R use is still needed to make clear recommendations. Materials and methods: This study was conducted on patients admitted to intensive care unit (ICU) between January 1st, 2016 to December 31st, 2019. The medical records were retrospectively scanned in institutional software database. Patients who …

Can Omentin-1 Be A Prognostic Marker In Surgical Intensive Care Patients?, Yücel Gülteki̇n, İsmai̇l Bi̇ri̇, Afi̇g Gojayev, Selen Yilmaz Işikhan, Oytun Portakal Akçi̇n, Yusuf Alper Kiliç

Turkish Journal of Medical Sciences

Background/aim: A member of the adipokine family, omentin-1 is selectively secreted from visceral fat tissue and the omentum. It has been shown that omentin-1 is involved in the pathogenesis of certain diseases and can be used as a prognostic marker. This study first investigated the prognostic significance of omentin-1 in surgical intensive care patients. In addition, the relationship between omentin-1 and laboratory and clinical parameters commonly used in intensive care units (ICUs) was evaluated. Materials and methods: One hundred and fifty-four patients hospitalized in the surgical ICU were included in the study. Blood samples for omentin-1 were collected from the …

The Relationship Of Extent Of Initial Radiological Involvement With The Need Of Intensivecare, Mortality Rates, And Laboratory Parameters In Covid-19, Yusuf Aydemi̇r, Yasemi̇n Gündüz, Mehmet Köroğlu, Oğuz Karabay, Hamad Dhei̇r, Aysun Şengül, Selçuk Yaylaci, Havva Kocayi̇ği̇t, Ali̇ Fuat Erdem, Özlem Aydemi̇r, Ertuğrul Güçlü, Yusuf Yürümez

Turkish Journal of Medical Sciences

Background/aim: It is very important for the efficient use of limited capacity and the success of treatment to predict patients who may need ICU with high mortality rate in the Covid-19 outbreak. In our study, it was aimed to investigate the value of the radiological involvement on initial CT in demonstrating the ICU transfer and mortality rate of patients. Materials and methods: All PCR-positive patients were included in the study, whose CT, PCR, and laboratory values were obtained simultaneously at the time of first admission. Patients were divided into 4 groups in terms of the extent of radiological lesions. These …

Revealing Meaning From Story: The Application Of Narrative Inquiry To Explore The Factors That Influence Decision Making In Relation To The Withdrawal Of Life-Sustaining Treatment In The Intensive Care Unit, Fiona Foxall, Deborah Sundin, Amanda Towell-Barnard Phd, Mnursing, Beverly Ewens, Vivien Kemp, Davina Porock

Research outputs 2014 to 2021

This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story …

Quantification Of The Negative Impact Of Sedation And Inotropic Support On Achieving Early Mobility In Burn Patients In Icu: A Single Center Observational Study, Lauren Bright, Lisa Van Der Lee, Dana Hince, Fiona M. Wood, Dale W. Edgar

IHR Papers and Journal Articles

Introduction: Early rehabilitation for burns survivors in the intensive care unit (ICU) is arguably more challenging than the general population. Early achievement of functional verticality milestones (FVMs) has the potential to ameliorate the detrimental effects of bed rest and immobility observed in ICU patients and reduce healthcare costs. However, the time to achieving FVMs after burn injury is influenced by factors such as sedation practices, cardiovascular stability, mechanical ventilation, acute skin reconstruction and length of stay (LOS) during the acute intensive care period.

Objectives/Aims: The aims of this study were to identify the association between early achievement of FVMs and …

Fathers’ Experiences Of Feeding Their Extremely Preterm Infants In Family-Centred Neonatal Intensive Care: A Qualitative Study, Evalotte Mörelius, Sofia Brogren, Sandra Andersson, Siw Alehagen

Research outputs 2014 to 2021

Background:

Extremely preterm infants need advanced intensive care for survival and are usually not discharged before they reach the time of expected birth. In a family-centred neonatal intensive care unit both parents are involved at all levels of care including the feeding process. However, studies focusing on fathers in this situation are scarce. The purpose of this study was to explore the experiences of feeding extremely preterm infants in a neonatal intensive care unit from fathers’ perspectives.

Methods:

The study adopts a qualitative inductive method, reported according to the COREQ checklist. Seven fathers of extremely preterm infants (gestational age 24–27 …