Nursing Commons^™

Heart Rate Variability Measured Early In Patients With Evolving Acute Coronary Syndrome And 1-Year Outcomes Of Rehospitalization And Mortality, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty Scholarship

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS).

Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established.

Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency …

Family Presence During Resuscitation Of Adults: The Impact Of An Online Learning Module On Critical Care Nurses' Perception And Self-Confidence, Kelly Powers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family presence during resuscitation (FPDR) involves offering family members the option to remain with their loved one who is undergoing life-saving measures. FPDR has been shown to enhance comfort and facilitate grieving, and 90% to 100% of patients and family members support it as an option. However, critical care nurses are not fully supportive of FPDR and approximately only one-third implement it in their care of patients. The perceived risks of FPDR are cited as a primary reason for lack of support and implementation. Yet, the perceived risks have not been proven, while the benefits have been established in research. …

Heart Rate Variability Measurement And Clinical Depression In Acute Coronary Syndrome Patients: Narrative Review Of Recent Literature, Patricia R.E. Harris, Claire E. Sommargren, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty Scholarship

Aim: We aimed to explore links between heart rate variability (HRV) and clinical depression in patients with acute coronary syndrome (ACS), through a review of recent clinical research literature.

Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function.

Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search …

Lessons Learned In Caring For Patients Treated With Therapeutic Hypothermia, Catherine H. Swedberg Rn, Kelly A. Wolfenden Rn, Bsn, Cci, Jeffrey Martin Rn, Carolyn Ordway Msn, Rn, Crnp

Patient Care Services / Nursing

No abstract provided.

Humor As A Buffer For Stress In Nurse Anesthesia Students, Kayla C. Forbis

Honors Theses

This simple, quantitative study was carried out on 18, first-year, CRNA students to determine if humor could act as a buffer for some of his or her perceived stress. Before an impending final exam, when stress levels would most likely be at their highest, the students were broken into three groups: a control group, a non-humorous group, and a humorous group. The students in the control group ranked their level of stress on a 0-10 scale without any other intervention. The other two groups watched a video clip, either humorous or non-humorous, while ranking their perceived stress on a scale …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

The Effect Of Breathable Under Pads To Decrease Hospital Acquired Pressure Ulcers: A Nurse Resident Project, Sara Meshino, Bsn, Rn, Bridget Trefz, Bsn, Rn

Department of Nursing papers and presentations

PURPOSE

To reduce the rate of hospital acquired pressure ulcers (HAPU), in June 2013, a large urban academic medical center switched from non-breathable to breathable under pads for incontinent patients lying on either a standard bed (low risk patients) or low-air-loss mattress (high risk patients). Standard pressure ulcer prevention measures were maintained. Staff on two oncology units sought to determine the effectiveness of breathable vs. non-breathable under pads in reducing the rate of HAPU and UAPU.

Mobilizing Mechanically Ventilated Neuroscience Patients - A Clinical Practice Guideline To ‘Get Up And Go’, Bonnie Wasilowsky Bspa-Hca, Rn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Ready-Set-Go! A Clinical Practice Guideline That Promotes Safe Care Of The Sedated Patient Before, During And After Transport, Kimberly A. Martin Rn, Cnrn, Jennifer Houp Rn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Staff Perception Related To Family Presence During Resuscitation, Stephanie L. Herron

Nursing Theses and Capstone Projects

The purpose of this study was to examine the perception of health care professionals (staff nurses) regarding family presence during resuscitation. The sample consisted of 59 nurses of different ages and working in different departments. The Staff Perceptions of Family-Witnessed Resuscitation questionnaire was used to collect data. The relationships between participants' demographic data and perceived attitudes and beliefs were also analyzed. Many of the healthcare professionals felt that it was acceptable to have family members present during resuscitation if the patient makes clear decisions prior to the incident or if the physician makes the decision for the patient. Almost half …

Discharge Education In The Emergency Department: Are We Effectively Teaching Chest Pain Patients?, Emily Edwards Nishiyama

Nursing Theses and Capstone Projects

Millions of individuals visit the emergency department (ED) each year with complaints of chest pain. Many chest pain patients do not have an underlying condition of Acute Coronary Syndrome (ACS) but the health and well-being of these patients is indispensable. Research has indicated soaring costs, an increased demand in medical resources, and an increasingly poor quality of life for these patients after discharge. Although research encourages quality education at discharge, very few studies have been conducted on ED discharge education for non-ACS chest pain patients. Using a cross-sectional descriptive research design, this quantitative study discovered the frequency of education provided …

Nursing Retention In Critical Care, Jeannine A. Eckman

Nursing Theses and Capstone Projects

The purpose of the study was to examine anticipated turnover in critical care nurses and if having previous nursing experience prior to working in critical care affects that turnover. Using the Anticipated Turnover Scale (ATS) by Hinson and Atwood, nurses that had been employed in the critical care areas five years or less were asked to participate. They were asked to complete the ATS and answer the question relating to previous nursing experience. Findings of the study indicated that the nurses with previous nursing experience before working in critical care had a higher ATS score than the nurses with no …

Patient Education In The Emergency Department, Bryan K. Devinney

Nursing Theses and Capstone Projects

Patient education is a core component to the practice of nursing in many countries, including the United States. Emergency department nurses are often overwhelmed with the number of patients they must care for in short amounts of time. The patients are often in varying stages of evaluation and treatment, and the nurse may be involved in one-on-one interventions with these patients. This can leave little time for patient education, especially if the nurse does not feel like the patient education is meaningful or useful. Various factors can influence the ability and desire of the emergency department nurse to provide proper …

Nurse Manager Role Perception In An Acute Care Facility, H. Gale Waters

Nursing Theses and Capstone Projects

The Nurse Manager role is a crucial part of the healthcare delivery system in an acute care facility, particularly in the current wave of healthcare reform. These are unprecedented times for nursing leadership as they develop and move in a new direction. The role of Nurse Manager is complex with numerous studies including: past roles, characteristics, innovation, outcome, education, and advancement. This study observed the role through the point of view of the Nurse Manager. The Nurse Managers participated in a survey in which they ranked themselves on a one to five scale, with one being a novice in the …

The Effects Of Oral Pain Medication Being Administered In Phase I As Compared To Oral Pain Medications Administered In Phase Ii, Dana Jones

Nursing Theses and Capstone Projects

Healthcare and the provision of care are ever-changing as governing bodies over-see and regulate the way institutions provide care for patients. Pain assessment, reassessment, and pain management are a focus nationally and healthcare providers are held accountable for how pain is managed for patients. One piece to this broad topic is the use of oral pain medications, more specifically in the ambulatory surgical patient. The purpose of this project was to compare the length of stay, reported pain scores, and total amount of IV medications administered between patients who receive the first dose of oral pain medications in Phase I …

Simulating Real Life Enhances Palliative Care For Patients In The Micu, Jennifer O'Neil Bsn, Rn, Leigh Jimmie Bsn, Rn

Posters

The objective of this project was to determine whether or not a palliative care education program would increase RN knowledge and comfort in caring for palliative care appropriate patients in the Medical Intensive Care Unit.

Improving Efficacy In And Across The Intermediate Care Area (Ica) Team, Jennifer O'Neil Bsn, Rn, Emma Branca Bsn, Rn

Posters

PURPOSE •Improve staff efficacy through improved communication, management of daily workflow and allocation of work assignments •Better meet patient needs •Promote patient safety •Improve patient and staff satisfaction

Assessment Of Mild Traumatic Brain Injury By Advanced Practice Registered Nurses, Mary Lou Garey

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to evaluate the knowledge about assessing mild traumatic brain injured patient by the advanced practice registered nurse (APRN) as reflected in the Centers for Disease Control (CDC) Acute Concussion Evaluation (ACE) Tool Kit. A descriptive cross-sectional survey research design was used to assess knowledge about the evidenced based assessment of APRNs practicing in an urgent care setting as established by the CDC for the evaluation of acute concussion. Specifically the history and physical assessment practices of the APRNs for the mild traumatic brain injured patient (MTBI) were evaluated in relationship to the CDC / …

Trauma Resource Nurse: A Leadership Role In A Pediatric Level 1 Trauma Center, Claudia Hines

Theses and Graduate Projects

Nurses in a pediatric emergency department are accustomed to caring for critically ill and injured children. Pediatric trauma requires nurses to have a high level of expertise. However, along with this expertise, nurses need to demonstrate strong leadership skills to be an effective partner in the trauma team. Attaining a pediatric level I trauma designation by the American College of Surgeons generated uncertainty in emergency nurses' perceptions of their ability to care for trauma patients. Emergency departments within trauma centers have recognized the need for specialized nursing programs or nursing roles in the care of trauma. Nursing leadership competencies, interprofessional …

Augmentative And Alternative Communication In The Intensive Care Unit, Jonathan Todd Sizemore

Online Theses and Dissertations

Current research is lacking on the frequency of augmentative and alternative communication (AAC) system use in intensive care units (ICU) and clinical decision making patterns. AAC is use of any alternative method of communication when oral communication cannot be achieved (ASHA, 2013). Patients in the ICU may become nonverbal for many reasons including tracheostomy, mechanical ventilation (McKinley, Pooke, & White, 2010) and intubation (Radtke, Bauman, Garrett, & Happ, 2011). Being nonverbal in the ICU may lead to poorer health outcomes (Patak, Wilson-Stronks, & Costello, 2009). AAC systems may improve outcomes by allowing patients to communicate more clearly with family, friends, …

Evidence-Based Blood Conservation Education For Icu Nurses: A Pre And Post-Test Evaluation Of Nursing Knowledge, Stefanie M. Bull

DNP Projects

Purpose: The purpose of this evidence-based education project was (i) to evaluate baseline nursing knowledge of anemia, blood conservation and transfusion medicine, (ii) to identify current blood conservation practice and the nurse’s prior exposure to blood conservation education (iii) to determine the potential impact of evidence-based education on nursing knowledge, and (iv) to determine the impact of education on the nurse’s attitudes towards future implementation of blood conservation practices based on the nurse’s self report.

Setting: The project was implemented in the Cardiovascular and Thoracic ICU (CVICU) at an 875-bed level-1 Trauma and Multi-Organ Transplant Center located in central Kentucky. …

Novel Oral Anticoagulants: Bedrest And Bleeding In Patients Undergoing Atrial Fibrillation Catheter Ablation, Lynn Mcwhirter

UNF Graduate Theses and Dissertations

Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and …

Hearing The Child's Voice: Their Lived Experience In The Pediatric Intensive Care Unit, Andrea Prentiss

All Publications

Background: More than 200,000 children are admitted annually to Pediatric Intensive Care Units (PICUs) in the US. Research has shown young children can provide insight into their hospitalization experiences; child reports rather than parental reports are critical to understanding the child’s experience. Information relating to children’s perceptions while still in the PICU is scarce.

Aims: The purpose of this qualitative study was to investigate school age children’s and adolescents’ perceptions of PICU while in the PICU; changes in perceptions after transfer to the General Care Unit (GCU); differences in perceptions of school age children/adolescents and those with more invasive procedures. …

Stahl, Sandra Fulkerson, B. 1950 (Sc 1124), Manuscripts & Folklife Archives

Manuscript Collection Finding Aids

Finding aid only for Manuscripts Small Collection 1124. Student paper written by Sandra Fulkerson Stahl titled, “Critical Care: The Birth of a Nursing Specialty,” which discusses the history of critical care nursing and the development of a coronary care unit at Bowling Green’s City-County Hospital.

Using Nursing Knowledge To Improve Health Literacy, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

Health Literacy: an ability to obtain and understand written, oral, and numerical health information, which allows people to make appropriate healthcare decisions for themselves and their family members.

The Problem:

*Low Health Literacy affects up to twenty percent of the adult population in the US and is not correlated with highest education achieved.

*Hospitals and healthcare professionals are increasingly being held accountable to create systems of care that address this issue with every patient encounter.

*AHRQ talks about implementing Universal Literacy Precautions.

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty Scholarship

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina.

Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …

Making Meaning In The Legacy Of Tissue Donation For Donor Families, Nancy S. Hogan, Lee A. Schmidt, Maggie Coolican

Nursing: School of Nursing Faculty Publications and Other Works

Context-Individuals needing lifesaving (heart valves, skin grafts for repair of critical burn injuries) and life-enhancing (corneas, bone and tendon grafts, skin, and veins) tissue donations outnumber the tissues available for transplant. Objective-To describe the grief family members experienced 6 months after donation and to learn how family decision makers gained meaning from the decision to donate a loved one's tissues. This is phase 1 of a longitudinal study in which family decision makers will be surveyed again at 13 and 25 months after donation. Design-Qualitative descriptive. Participants-One hundred seven family decision makers whose family member died a traumatic sudden death …

Performance Differences Between Novice And Experienced Critical Care Nurses: A Replication Study, Josefina Inoturan Alejandro

Doctoral Projects

No abstract provided.

Nurses’ Perspectives On Neonatal Massage Therapy In The Neonatal Intensive Care Unit, Kayla R. Hanson

Senior Honors Theses

Research in neonatal massage therapy has shown many possible benefits to the baby and family. Though there has been a growing trend towards family-centered care, along with a substantial and growing body of research, the practice of neonatal massage therapy is not routine in most NICUs. This study was conducted to evaluate neonatal intensive care nurses’ perspectives and attitudes towards neonatal massage therapy before and after evidence-based education. Willingness to discuss benefits of neonatal massage therapy significantly increased after education on neonatal massage therapy. The findings suggest that with proper training on the techniques and safety monitoring of massage therapy, …

The Ties That Bind: The Relationships Between And Among Registered Nurses' Clinical Experience, Clinical Decision-Making Processes, And Nursing Practice Issues Related To Physical Restraint Use With Attitudes Toward The Use Of Physical Restraints In The Critical Care Environment, Kristi Stinson

Seton Hall University Dissertations and Theses (ETDs)

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