Medical Specialties Commons^™

Painting A Landscape Of Acute Care Nurse Scientist Work, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background: Hospitals are increasingly hiring nurse scientists, motivated in part by nursing excellence designations such as Magnet. Magnet designation requires at least three, nurse-led, Institutional Review Board-approved research studies to be conducted in the hospital every four years and for nurses to be actively implementing evidence-based practice (EBP) projects using research evidence. However, clinical nurses often lack the specialized knowledge and training necessary to engage in well-designed research or EBP. Nurse scientists are PhD-prepared individuals with expertise to mentor clinical nurses to navigate the rigor and complexity of creating, implementing, analyzing, and disseminating research and EBP projects. Yet, due …

Acute Care Staff Interactions With Chaplains To Discuss Team Or Personal, Non-Work-Related Stressors, Gary Weisbrich, Sarah Sumner, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background: Healthcare staff experience stress from the workplace when providing complex patient care and often may lean on specially trained spiritual support caregivers, or chaplains, for support navigating patient-related stressors. Yet, healthcare staff can also suffer from team-related or personal stressors that, if unresolved, could negatively impact care delivery. Little is known about whether, how often, and which staff may interact with chaplains for emotional support when experiencing non-patient-related stressors originating from work or personal lives.

Purpose: To describe the proportion of individuals who report discussing team-related or personal stressors with chaplains in the past 12 months, and to …

Alleviating Health Professionals' Moral Distress Through Hospital-Based Chaplain Care, Karen Colorafi, Sarah Sumner, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background: Healthcare workers frequently experience occupational stressors that negatively impact their emotional well-being. Recent evidence suggests that healthcare workers’ occupational stressors may translate to moral distress, defined as emotional turmoil occurring over an ethical dilemma secondary to a patient care or team-related issue. Following the COVID-19 pandemic, moral distress and a wide range of psychological and physical issues have been linked to high rates of healthcare worker burnout. Increased occupational stressors significantly augment turnover intentions and behaviors and negatively impact well-being. The resultant turnover rates have reached an all-time high among professional registered nurses. Some evidence suggests that the …

Perceived Moral Distress Among Patient-Facing Healthcare Professionals During The Covid-19 Pandemic, Sarah Sumner, Karen Colorafi, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background:

The most common framework for ethical decision-making in healthcare is principalism which is founded on three ethical traditions: utilitarianism, achieving the most good for the most people; deontology, upholding moral obligations to individuals; and virtue ethics, doing what is virtuous regardless of the consequences. Principalism is further guided by four principles: 1) respect for autonomy; 2) beneficence, the duty to do good; 3) nonmaleficence, the duty to do no harm; and 3) justice, the duty to treat similar cases similarly. Patient-facing healthcare professionals (HCPs) commonly expect all moral values will be considered when decisions are made that impact patients …

Dietary Intake And Continuous Blood Glucose Measurement In Nurses Working Either 12-Hour Day Shifts Or Night Shifts, Rachel Carlson, Teresa Rangel, Lindsey Miller, Sushana Sudhi

Providence Nursing Research Conference 2023 – Present

Background:

Night shift work is essential in the hospital yet shift work among nurses is linked to negative outcomes such as chronic fatigue and cardiometabolic illnesses. Furthermore, nurses working night shift are more likely to have aberrant glucose levels, defined as greater than 140 mg/dl. Currently, it is unclear whether nurses working night shift eat differently than those working day shift which may explain aberrant glucose levels.

Purpose:

To determine whether night shift nurses have altered glucose levels and dietary intake compared to day shift nurses.

Methods/Approach:

Nurses regularly working full time 12-hour night shifts (n=12) or full time …

Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation Rates, Stefanie Lai

Providence Nursing Research Conference 2023 – Present

Background: Electronic Medical Record (EMR) education and training for RNs should be multifaceted and targeted to the RN clinical workflow. Input from direct care RNs is essential to ensure EMR education is relevant and effective. Shared Governance at a community hospital identified quality and safety concerns among inpatient RNs. RNs reported that belongings inventories were not consistently documented in the EMR for Emergency Department (ED) admissions. Hospital policy requires belongings inventory EMR documentation for all admitted patients. An audit of charts for ED admissions over three months revealed only 5% compliance with this policy.

Purpose: The purpose of this project …

Preventing And Responding To Workplace Violence In The Emergency Department, Stefanie Lai, Alicia Rodriguez

Providence Nursing Research Conference 2023 – Present

Background: Workplace violence (WPV) is defined as physical violence or verbal threats of physical violence, regardless of whether an employee sustains an injury. Emergency department (ED) staff are at high risk of exposure to WPV, which can lead to burnout, job dissatisfaction, and secondary stress. Effective preparation for and response to WPV incidents can help mitigate these negative effects. Multicomponent interventions, including education, safety huddles, behavioral health rapid response teams, and environmental modifications, have been shown to reduce WPV incidents and increase staff perceptions of safety.

Purpose: The purpose of this evidence informed-quality improvement project was to increase knowledge of …

An Educational Intervention Differentiating Pressure Injuries From End-Of-Life Wounds, Alicia Perez Varela, Annette Callis

Providence Nursing Research Conference 2023 – Present

Background

End-of-life (EOL) wounds are identified in the literature as Kennedy Terminal Ulcers (KTU), Skin Failure (SF), Trombley-Brennan Terminal Tissue Injury (TB-TTI), and SCALE (Skin Changes at Life’s End). EOL wounds have a similar appearance to pressure injuries (PIs) with a fundamentally different etiology. The misclassification of EOL wounds as PIs results in increased Hospital Acquired Pressure Injuries (HAPI), hospital fines, and less-than-optimal EOL wound management.

Purpose

To examine the effectiveness of an educational intervention on EOL wounds in increasing nurse confidence in providing End-of-Life Care (EOLC) and differentiating PIs from EOL wounds.

Methods

This quasi-experimental study used the 28-item …

Management Of Sepsis With The Quick Sequential Organ Failure Assessment, Jeanna Adams

Providence Nursing Research Conference 2023 – Present

Abstract

Background:

Sepsis can be a source of morbidity and mortality particularly when there are delays in treatment. Early identification may improve time to antimicrobial administration. The quick Sequential Organ Failure Assessment (qSOFA) is an evidence-based practice screening tool that, when in used in conjunction with the Systemic Inflammatory Response Syndrome (SIRS) criteria can enhance recognition and treatment of sepsis. On a suburban Southern California hospital Neurological/Telemetry Unit the qSOFA is automatically calculated in the electronic medical record (EMR) but the bedside nurses were unaware of its availability and value. In addition, sepsis was not being identified in a timely …

An Evidence-Based Skin Management Improvement Project In The Intensive Care Unit, Chelsea Lannoo

Providence Nursing Research Conference 2023 – Present

Background:

Pressure injuries have detrimental effects on patients healing and outcomes and are costly to organizations due to payment programs. Pressure injuries are largely preventable if appropriate interventions are implemented early. In our ICU, post-pandemic monitoring showed increases in hospital-acquired pressure injuries (HAPIs) and consults for medical device HAPIs were increasing. Rounds with wound care department indicated lack of staff compliance with recommended preventive practices. Some issues reported were the use of diapers and excessive linens, failure to use scheduled turning for patients, lack of prevention related to medical devices

Purpose:

The goal of this skin-care management project is …

Using A Virtual, Case-Based Approach To Developing Clinical Competency In Hospice, Melissa Robinson, Sasha Holden, Tara Poulsen

Providence Nursing Research Conference 2023 – Present

Background:

There has been a shift in nursing education away from a teacher-centered approach that is focused on requiring learners to memorize large amounts of content to a concept-based approach that is learner-centered and focuses on the development of critical thinking, clinical judgment, and problem-solving skills (Giddens et al., 2020). Conceptual learning requires learners to connect facts and exemplars to concepts through active learning experiences such as completing case studies or problem-solving activities (Baron, 2017). This allows learners to ‘practice’ thinking and apply new knowledge to clinical practice.

The clinical education team is applying this knowledge to the current competency-based …

Effective Non-Pharmacological Pain Relief Interventions Among Neonates: An Integrative Research Review, Staci Shaw

Providence Nursing Research Conference 2023 – Present

Background:

Newborns encounter many painful events, including heel sticks, venous blood sampling, peripheral intravenous insertions, and more. Newborns cannot verbally express pain, and caregivers rely on changes in vital signs (increased heart rate, decreased oxygen saturations) behavior (long periods of inconsolable crying), and facial expressions to grade newborn pain. Pain management in neonates is critical to preserve neurodevelopment. Due to adverse effects of pharmacological pain management interventions in neonatal populations, non-pharmacological pain management interventions are often utilized in newborns, such as swaddling, non-nutritive sucking, kangaroo care, oral sucrose, holding, touching, music, and breastfeeding. However, the most effective pain management intervention, …

A Better Tool For Ed Fall Risk Assessments: The Monego-Barra Ed Fall Risk Assessment Tool (Moba), Roxanne Barra, Mary Waldo, Angela Graves, Jessica Monego

Providence Nursing Research Conference 2023 – Present

Background

The incidence of falls has been increasing in emergency departments (EDs), with some resulting in harm. In a large health care system in the Western United States, the Morse Fall Risk Assessment Tool (Morse) is used across care settings, despite not being validated in the ED. Other ED tools in the literature are the Memorial ED Fall Risk Assessment Tool (Memorial) and Kinder 1 Fall Risk Assessment Tool (Kinder). These three tools contain risk factors that may not be specific to EDs or are missing relevant factors. This led the researchers to create the Monego-Barra ED Fall Risk Assessment …

Comparison Of Data On Preterm Neonatal Growth Measures In The Neonatal Intensive Care Unit, Madison Baty, Emily Faerber, Cayenne Sirois

Providence Nursing Research Conference 2023 – Present

Background:

Extrauterine Growth Restriction (EUGR) has been defined as infant weight-for-age z-score (WAZ) of less than -1.28 standard deviations (SD), at discharge or 36–40 weeks (about 9 months) postmenstrual age. In 2018, the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition published indicators of neonatal malnutrition, including a decline in WAZ over time. Mild, moderate, and severe neonatal malnutrition is defined as a WAZ decline of 0.8-1.2 SD; >1.2-2 SD; >2 SD, respectively, and it is unclear how widely revised neonatal malnutrition indicators are being used.

Purpose/aim:

To investigate the sensitivity and specificity …

Adherence To Sb5195 Naloxone Distribution Requirements At Discharge From The Emergency Department, E Stewart, J Delfeld, J Mckay, J Corhei, Kailyn Elliot

Providence Nursing Research Conference 2023 – Present

Background: Washington State, mirroring a national crisis, experienced a surge in opioid-related deaths, with 17,502 fatalities from 2007 to 2021. This trend aligns with the U.S.'s broader opioid epidemic, marked by 70,000 drug overdose deaths in 2017, data show overdose deaths involving opioids increased from an estimated 70,029 in 2020 to 80,816 in 2021. Overdose deaths were from synthetic opioids, primarily fentanyl. In response, empowering registered nurses (RNs) in emergency departments (EDs) to issue Nurse-Initiated Orders (NIO) for patients to discharge from the hospital with physical naloxone pre-pack kits to be used in the community, an opioid antagonist, has …

March 2024: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program

Special Pathogens Newsletters

REGION 10 SPECIAL PATHOGENS NEWSLETTER

Improving Time To Defibrillation​, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

"ABSTRACT TITLE: Improving Time to Defibrillation

Background: Providence St. Vincent Medical Center (PSVMC) Medical Surgical units are not meeting the American Heart Association requirement of less than 3 minutes to defibrillation. Time to defibrillation in codes with shockable rhythms averages 4.2 minutes. In Mock Codes, only one met the time less than 3 minutes; four Mock Codes had times over 5 minutes. Resuscitation Quality Improvement CPR (RQI) training is required quarterly. Defibrillator practice with overall Code Blue competency is annual.

Purpose: Combine the hands-on practice of the defibrillator with the hands-on training for RQI.

Methods: The Medical Surgical unit 6 …

Research Action Brief: Healthcare Experiences And Perceptions As Drivers Of Gaps In Mammography, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Characterization Of Sarcoidosis At A Combined Rheumatology- Pulmonary Clinic, Megan Schermerhorn, Md, Julianna Desmarais, Md

Poster Presentations

No abstract provided.

A Diagnostic Challenge – Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md

Poster Presentations

No abstract provided.

Myth Of The Pentad: Approaching Thrombotic Thrombocytopenic Purpura, Nidhi Patel, Md, Meera Jain, Md, Natasha Edwin, Md

Poster Presentations

No abstract provided.

The Pernicious Right Shoulder Pain, Julie Hwang, Md, Weiya Wysham, Md, Qian Leng, Md, Mph

Poster Presentations

No abstract provided.

Case Study: A Severe Presentation Of Chronic Eosinophilic Pneumonia, Revati Kalluri, Md, Mari Kai, Md

Poster Presentations

No abstract provided.

From Dormant To Dangerous: Hepatitis B Reactivation Under Immunosuppression, Adam Knott, Md, Amy Dechet, Md

Poster Presentations

No abstract provided.

Endocarditis Prophylaxis In The Vulnerable Valve; Antibiotic Stewardship Or Suboptimal Care?, Zachary Taylor, Md, Andrea Roast, Md, Michael Layoun, Md

Poster Presentations

No abstract provided.

A Potentially Cat-Astrophic Missed Diagnosis: Systemic Autoimmune Disease, Or Something More Sinister?, Cameron Smith, Do, Mph, Amy Dechet, Md

Poster Presentations

No abstract provided.

Japanese: Understanding Your Sepsis Diagnosis, Providence

All Sepsis Education Materials

Graphic Novel: Understanding Your Sepsis Diagnosis (Japanese)

Vietnamese: Understanding Your Sepsis Diagnosis, Providence

Sepsis Education Graphic Novels

Graphic Novel: Understanding Your Sepsis Diagnosis (Vietnamese)

Spanish: Understanding Your Sepsis Diagnosis, Providence

All Sepsis Education Materials

Graphic Novel: Understanding Your Sepsis Diagnosis (Spanish)