Nursing Commons^™

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …

Optimizing Interprofessional Rounds To Reduce Extended Length Of Stay In Complex Patients, Christina May P. Santiago

Master's Projects and Capstones

Problem: Organizations have taken measures to reduce the length of stay by addressing logistical issues such as care coordination across the continuum. This becomes especially important for patients being discharged to skilled nursing facilities (SNF), where placement can be impeded due to complex care needs. In March 2021, the facility accounted for 20% of all extended length of stay (ELOS) patients across the organization. The average ELOS was 36 days, with 42% of these patients being discharged to a SNF.

Context: The Extended Length of Stay (ELOS) team functions at a mesosystem level within twenty-one medical centers across Northern …

Preventing Pressure Injuries On Patients Undergoing Treatment With Extracorporeal Membrane Oxygenation (Ecmo), Hediyeh Shakeri

Master's Projects and Capstones

One of the top National Patient Safety Goals by The Joint Commission is to prevent hospital-acquired pressure injuries, which is reiterated by Centers of Medicare and Medicaid as a valuable metric in determining the quality of patient care and safety as well as hospital performance. The Agency for Healthcare Research and Quality reports over 2.5 million patients affected by hospital-acquired pressure injuries per year, costing between $9.1-$11.6 billion per year with the cost of individual patient care ranging from $20,900 to 151,700 per pressure injury (Agency for Healthcare Research and Quality, 2014). Approximately 30% of these cases are related to …

Motivated2move: Icu Liberation And Early Progressive Mobility In Ventilated Patients, Leslie S. Bigler

Master's Projects and Capstones

The Motivated2Move: ICU Liberation and Early Progressive Mobility in Ventilated Patients project was implemented in a 24-bed intensive care unit (ICU) in a 241-bed general care, stroke certified not-for-profit community hospital in northern California. The primary purpose of this project was to educate the nurses on the structure and implementation of the Society of Critical Care Medicine’s evidence-based ICU Liberation (ABCDEF) Bundle (Society of Critical Care Medicine, n.d.). A secondary purpose of this project was to coordinate an early progressive exercise and mobility protocol for all ventilated patients. The primary goal of the project is 100% compliance with the ICU …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

Master of Science in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Practice Development Trajectories Of Experienced Nurses: Adaptive Experts, Routine Experts, And Non-Experts, Dee Mulcahy

Nursing ETDs

This qualitative study examined practice development among experienced, acute care nurses (n = 9) with at least 10 years of experience. Using an interpretive biographical approach, with participants’ written practice narratives and in-depth interviews, the study focused on how the work environment and life experiences influenced or impeded practice development. Participants were classified as routine- or adaptive experts (n = 3 of each type) with one intermediate case and two not readily classifiable. Antecedents to becoming a nurse included family influences, personal interests, altruistic values, and financial need. Experience was necessary but not sufficient for adaptive expertise. Compared …

Implementation Of Teach-Back For Discharge Teaching In A Critical Access Hospital: A Quality Improvement Project, Katie Beth Notch

Theses and Dissertations

A lack of comprehension of discharge instructions may cause high readmission and emergency room revisit rates for organizations. At the project site, there was no current evidence-based practice to ensure patient comprehension of discharge instructions. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the Institute for Healthcare Improvement (IHI) Always Use Teach-Back Toolkit would impact emergency room revisit rates among adult medical-surgical patients in a critical access hospital in rural Minnesota over four weeks. Afaf Meleis’ transitions theory and the Iowa model for evidence-based practice were the scientific underpinnings of the project. …

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judy E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Bedside Handoff In The Emergency Department, Sheila Pochron

MSN Capstone Projects

Background

A standardized approach to bedside handoff improves nurse and patient satisfaction as well as quality outcomes.

Objectives

To compare the preference for bedside handoff in the emergency department post implementation by analyzing nursing surveys and Press Ganey data.

Design

A mixed method pilot study.

Settings

A not-for-profit community-based safety net hospital which is Magnet designated. ED is a level 3 trauma center with 60,000 visits annually.

Participants

ED nurses (n=52) and adult patients (n=86)

Methods

A pre and post implementation survey that utilized the 5-point Likert scale was given to nursing staff in the emergency department. Questions were asked …

Deterring Delirium In The Intensive Care Unit, Kimberly Allen

MSN Capstone Projects

There is growing concern about the increase in cases of delirium associated with a critical care hospitalization encounter. Discovery of different types of research that can eliminate or at least minimize occurrences of delirium including early recognition, eye masks and earplug usage, and environmental changes have show promise in reducing the risk of ICU delirium.

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Burnout Among Intensive Care Nurses, Julia Brown

MSN Capstone Projects

At a time when the healthcare system is experiencing strain due to the current health crisis and nursing shortages, talking about, and addressing nursing mental health is of the utmost importance. Nurses who work in the pediatric intensive care unit (PICU) often face more stress due to the patient population they work with. These stresses can lead to burnout and moral distress if not addressed appropriately. Nurses should have a system in place at their workplace and tools readily available to support their mental health while on the job. Through a literature search, it is proposed that an initiation of …

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 …

The Effects Of Sleep Disturbances On Patients In The Intensive Care Setting, Bronwyn Schmidt

Nursing | Senior Theses

The objective of this research proposal is to identify short-term and long-term health consequences due to sleep disturbances in patients admitted to intensive care units. When reviewing published literature regarding sleep loss in the intensive care unit (ICU), it was discovered that adult patients admitted to a variety of ICU settings both in the United States and abroad reported disruptions in sleep to be a common complaint and barrier to their recovery. This is due to noises made by bedside alarms such as IV pumps, lights in the unit, and interruptions made by medical staff members to provide time-sensitive care. …

Adverse Childhood Experiences And Social Determinants Of Health In Relation To Pediatric Intensive Care Unit Admissions, Kasey Davis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review was conducted in order to examine the correlation between adverse childhood experiences (ACEs), social determinants of health and pediatric intensive care unit (PICU) admissions. Oftentimes, those admitted as patients in the PICU come from homes in which social determinants of health, such as poverty and lack of access to healthcare, and ACEs, such as abuse and neglect, are prevalent. Systematic studies of existing literature and experience in the hospital setting revealed the ways in which these conditions often cause children to reach such poor health conditions that they must be admitted to the PICU. In order to …

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

Nicu Nurse Burnout: The Influence Of Moral Distress, Compassion Fatigue, And Spirituality On Burnout In Neonatal Intensive Care Unit Nurses, Lucia D'Andrea

Undergraduate Theses

Nurses face a multitude of interpersonal and individual expectations, challenges, and hardships every day of their profession. These experiences accumulate and can lead to burnout. This is especially true for nurses in Neonatal Intensive Care Units (NICUs) who care for infants struggling with prematurity, congenital diseases, withdrawal, and more, all while working closely with grieving parents. This thesis specifically focuses on research discussing moral distress, compassion fatigue, and spirituality as variables associated with the experience of burnout. A critical review of current literature revealed patterns and inconsistencies in the relationships between these factors. Workplace Stressors and moral distress were found …

Implementing Mindfulness Meditation To Reduce Nurse Burnout, Jannelle V. Sanchez

Electronic Theses and Dissertations

Abstract

There will be an estimated shortage of 100,000 nurses by the year 2022, with 500,000 seasoned nurses retiring. The nursing profession has recently experienced a devastating pandemic that left no time to combat the detrimental effects of burnout, specifically for intensive care nurses, who are the frontline workers of a physically and psychologically draining working environment conducive to burnout. Nurses experience burnout for a mixture of reasons, but mainly it is due to the lack of interventions to help them combat the disease. Mindfulness meditation represents an interventional tool that has been shown to reduce the negative stressors associated …

Impact Of Central Line Bundle Care On Reduction Of Central Line Associated-Infections: A Scoping Review, Alisha James-Scott Msn, Fnp-C, Rachel Savoy Msn, Fnp-Bc, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Apn

Doctor of Nursing Practice Projects

Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use.

Methods A literature review was …

Reducing Burnout Through Guaranteed Breaks In Nurses In The Acute Care Setting: A Benchmark Study, Stefan D. Arias

MSN Capstone Projects

This benchmark study attempts to promulgate the issue of burnout and the importance of addressing at least one way to mitigate further damage to the profession of nursing.

Resuscitation Quality Improvement Mortality Rates, Jordan Priest

Dissertations

This paper explores and answers the question: What is the impact of Resuscitation Quality Improvement on survival at discharge rates after suffering an IHCA when compared to every two-year BLS/ACLS training? Articles are explored that identify positive patients’ outcomes when resuscitation training is repetitively learned. The design consists of a BLS/ACLS and RQI evaluation of quarterly survival to discharge rates prior to the initiation of the new RQI program and after the initiation of the new RQI program. The setting of the study is the east region of a midwestern faith-based health care system, that includes four hospitals in one …

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 …

Environmental Stressors Perceived By Patients In The Surgical Intensive Care Unit And Their Level Of Satisfaction With Nursing Care, Hacer Karaer, Esma Ozsaker

Journal of Perioperative Nursing

Purpose: The purpose of this study was to determine environmental stressors perceived by patients in the surgical intensive care unit and their level of satisfaction with nursing care.

Design: A descriptive cross-sectional study design was used in this study.

Methods: This study was conducted between January 2019 and June 2019 with 120 patients who were hospitalised in the surgical intensive care unit. Data collection was via a patient information form, the Intensive Care Unit Environmental Stressor Scale (ICUESS) and the Experiences of Nursing Care Scale (ENCS) component of the Newcastle Satisfaction with Nursing Scales (NSNS).

Findings: The mean ICUESS score …

Best Practices For Preventing Delirium In Critically-Ill Patients, Madi Williams, Hailey Trexler Price, Natalie Hosman

Scholars Week

Abstract:

Utilizing and integrating best evidence-based research to improve nursing care is a core responsibility of a nurse. Implementing best nursing practices leads to better patient outcomes and patient experiences. Through research, specific interventions that can reduce the incidence of delirium in critically ill patients were uncovered. Through utilization of theoretical framework, and multiple evidence-based research articles, a protocol was formed to initiate in the intensive care unit (ICU) at Murray-Calloway County Hospital in Murray, KY. This protocol consists of a multi-component intervention plan to hopefully decrease incidence of ICU delirium.

Preventing Ventilator Associated Pneumonia, Ally Samuel, Anna Grace Terry

Scholars Week

Ventilator Associated Pneumonia is a serious infection in the lungs that affects individuals who are being mechanically ventilated. These patients, who are already critically ill, have decreased defense mechanisms that allow pathogens such as bacteria to invade the sterile respiratory tract (Cooper, 2021). Many of the risk factors for the development of VAP may be preventable, and it is up to the ICU nurses, who care for these mechanically ventilated patients, to play a role in the implementation of certain guidelines and/or bundles that may help with the prevention of ventilator associated pneumonia ( Aysegul et al., 2020). Although ventilator …

Evaluation And Feasibility Of A Head Positioning Intervention In Patients With Intraparenchymal Hemorrhage, Wendy L. Dusenbury

Theses and Dissertations (ETD)

Stroke caused by intraparenchymal hemorrhage (IPH) is most commonly the result of hypertension-induced blood vessel rupture in the brain and is associated with devastating disability and high rates of death. To date, no intervention has improved outcomes in IPH stroke patients; however, head elevation may be one of the most important first steps to promote clinical stability in the hyperacute stage of IPH stroke because of the risk of increased intracranial pressure (ICP) in these patients. Nursing research completed in the late 1970s and early 1980s in patients with increased ICP due to traumatic brain injury showed that elevating the …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.