Nursing Commons^™

Compassion Fatigue In Critical Care Nurses: An Educational Quality Improvement Project, Natasha Teixeira

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Compassion fatigue is estimated to affect 40% percent of the 2.9 million registered nurses in the United States. There exists a critical need to explore how nurses understand compassion fatigue, how they identify it in self and others, and what strategies they enact to lessen the eventual threats to health. With the current COVID pandemic, along with the high intensity nature of the intensive care unit (ICU), critical care nurses are vulnerable to the symptoms and side effects of compassion fatigue. This quality improvement project evaluated the impact of an educational session on compassion fatigue and self-care in relation to …

Diabetes Knowledge Of Critical Care Nurses: A Quality Improvement Project, Sarah Christine Huley

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Diabetes mellitus continues to become more prevalent in the United States, with approximately 1.5 million new cases diagnosed each year (ADA, 2018). Nurses play a key role in providing education to diabetic patients on the management of this disease. This encompasses a multitude of topics such as diabetic medications, treatments, and lifestyle choices that ultimately may aid in decreased morbidity and mortality otherwise associated with the disease and its co-morbidities. However, nurses’ own perceived diabetes knowledge has been found to be overestimated when compared to actual nursing knowledge (Alotaibi, Ghlizadeh, Al-Ganmi & Perry, 2017; Wakefield & Wilson, 2014). Research also …

Improving The Delivery Of Enteral Nutrition In The Neurocritical Care Unit Through The Implementation Of A Volume-Base Feeding Protocol, Joan M. Walsh

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Neurocritical care patients receiving rate-based enteral nutrition (RBEN) consistently received less than their full prescription of enteral nutrition (EN) volume due to interruptions in feeding. This study investigated the impact of the implementation of a volume-based feeding protocol (VBEN) on the percentage of prescribed volume of EN delivered over the course of patients’ neurocritical care unit (NCCU) length of stay. Aim: The aim of this study was to better meet the nutritional needs of adult neurocritical care patients receiving nutrition through the enteral route. Methods: A retrospective pre and postimplementation chart review was conducted on adult patients with age 18 …

Nurses' Perceptions Of Open Visiting Policy In The Adult Intensive Care Unit: An Integrative Review, Susan P. Mckenna

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The Intensive care unit (ICU) can undoubtedly be overwhelming and stressful at times. Open visitation has many demonstrated benefits for the patient and the family but can also have disadvantages. Nurses, who are a central element in the care of the critical patient, can be greatly affected by visitation. This integrative review explored nurses' perceptions of open visitation as well as visitation policies of ICUs across the nation. Beneficial effects of open visitation include enhanced teaching, improved communication, reduced anxiety, and physiologic benefits. Barriers of open visitation include hindrance in the delivery of care, physiological concerns, creating additional workload, and …

Does Prone Positioning Decrease Mortality Rate In Ards? A Systematic Review, Joseph Sarkis

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Acute Respiratory Distress Syndrome (ARDS) is a clinical condition in which the lungs suffer severe irreversible, large-scale damage causing a grievous form of hypoxemic respiratory failure. Acute respiratory distress syndrome is one of the most evasive diagnosis confronted in the Intensive care unit (ICU) as the name, definition and diagnostic standards have adapted over the past four decades. An ARDS diagnosis is established by physiological criteria and continues to be a diagnosis of exclusion, which makes it crucial that medical professionals expand their knowledge base to effectively diagnose ARDS. Patients admitted with ARDS have high mortality rates ranging from 40 …

Implementation Of The Critical Care Pain Observation Tool, Carla Angela Salvadore

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

In the United States, greater than half of the adult patients who are admitted to critical care experience pain and report poor pain control. Inadequate management of acute pain is associated with negative outcomes, including high blood sugar, insulin resistance, higher infection risk, increased discomfort, decreased satisfaction, and chronic pain. Patients in the intensive care unit (ICU) cannot always express that they are having pain. Recently modified guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult recommend a reliable and valid pain assessment instrument for patients who are unable to verbalize pain. For the adult …

Increasing The Knowledge Of Critical Care Nursing Staff Related To Sepsis: A Program Development Project, Matthew Willard

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Sepsis can lead the body into organ failure, tissue damage, amputations, and in severe cases, even death. Yale New Haven Health-Westerly Hospital has several new RN’s that are at a novice level of knowledge about how to treat and care for the septic patient. Knowledge of the signs and symptoms of sepsis can lead to a quicker diagnosis and improve patient outcomes. The purpose of this program development project was to improve the knowledge of sepsis identification and treatment by providing education to the critical care nursing staff at Yale Westerly Hospital.

A non-probability convenience sampling plan was utilized. Fifteen …

Nurses Perceptions' Of Bedside Reporting On An Intensive Care Unit Following Implementation, Christine Mcginn

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Shift handoffs were included in The Joint Commission's 2009 National Patient Safety Goals, which requires that shift hand-offs must include up-to-date information about the care, treatment, current condition, and recent or anticipated changes with the patient. Bedside reporting addresses The Joint Commission's Goal 13, a safety strategy that encourages the patient's active involvement in care. The demand for quality care while caring for the sick population with multisystem complex diagnoses calls healthcare provides to look at ways to provide more efficient care while improving patient safety and outcomes.

Bedside reporting is one nursing intervention which can be implemented to improve …

Does Early Mobility Lead To Decreased Ventilator Days?, Nicole Halton

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

It is well documented that bedrest has adverse outcomes for hospitalized patients. This is especially true for critically ill patients due to life support measures, invasive catheters, and mechanical ventilation. Consequences associated with bedrest in critical care patients include venous thromboembolism, ventilator associated pneumonia, pressure ulcer development, and muscle weakness. Respiratory muscle weakness is associated with prolonged ventilator support and delayed extubation. The Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle uses evidence based practice to prevent and treat ICU acquired delirium and weakness. The bundle aims to do this by standardizing care processes in …

Exploring The Presence Of Moral Distress In Critical Care Nurses, Justina Gonzalez

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

With healthcare moving toward greater outpatient and preventative approaches, hospitalizations are increasingly intended for those who are critically ill. Frequently this requires the need for highly specialized nursing as well as resource utilization. Technological advances have aided in providing this type of intensive care but they have also compelled practitioners to make treatment decisions that did not previously exist. The conflict of maintaining one’s life without ascertaining whether there will be quality of life is just one example of a difficult situation that can lead to moral distress. The purpose of this study was to explore the effects of moral …

Nurses Perceptions Of Family Presence During Resuscitation In The Emergency Department, Jennifer L. Jennings

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Family presence during resuscitation has been a controversial and much debated topic for many years. In the past decade, the movement toward family presence has steadily grown. The Emergency Nurses Association (ENA) and the American Heart Association (AHA) have endorsed family presence and incorporated guidelines for its implementation. Although becoming more accepted in practice, there are still many hospitals without family presence policies, and some nurses and other health care providers continue to identify concerns about its’ use. The purpose of this project was to survey nurses’ perceptions of family presence during resuscitation in the Emergency Department. A researcher developed …

A Student's Perspective Of Learning On A Dedicated Education Unit, Rachael L. Johnsen

Honors Projects

It is the intent of this honors project to give a student’s perspective of learning in the Dedicated Education Unit (DEU) on Bridge 7 at Rhode Island Hospital. Bridge 7 is a 38-bed unit specializing in general medical surgical patient care services. A student’s perspective is illustrated by journal entries written from each clinical experience over the course of one semester, during the course Adult Health II. In addition to a student’s perspective, it is the intention to compare the learning experience on the DEU, to the traditional model of clinical learning. This project will include current nursing research that …