Nursing Commons^™

System-Wide Deployment Of Color Coded Pediatric Resuscitation Carts Supported By In Situ Simulation, Deborah Arnold Msn, Rn, Cmsrn, Jayne Febbraro Msn Rn Crnp, William Bond Md, Ms, Michele Dunstan, Margaret J. Chorazak, Melissa B. Walsh Bs, K Walker, T Dietz

Department of Education

No abstract provided.

Knowledge And Practice Gaps Among Pediatric Nurses At A Tertiary Care Hospital Karachi Pakistan, Rozina Roshan Essani, Tazeen S. Ali

School of Nursing & Midwifery

The advancement in medical science has created health care environments that require nursing professionals who posses specialized clinical knowledge and skills to provide care and deal with critically and acutely ill children. This study explored gaps between knowledge and practice as perceived by the registered nurses of pediatric units by further recommending the changes suggested by them. A descriptive exploratory Study Design under the quantitative research methodology was utilized using universal sampling of all pediatric nurses working at a tertiary care hospital in Karachi, Pakistan. The gaps between knowledge and practice, as perceived by the participants, were categorized into five …

Protocol Adherence During Inter-Facility Transfer Of Acute Ischemic Stroke Patients Treated With Iv Rtpa, Robin Reed Jones

Nursing Theses and Capstone Projects

Stroke is a common and serious health disorder, affecting approximately 795,000 people in the United States every year. Intravenous recombinant tissue plasminogen activator (IV rtPA) is the only FDA approved thrombolytic for treating acute ischemic stroke within 3 hours of symptom onset. Patients treated at rural health centers are often transported within hours to the closest primary stroke center. The purpose of this study was to evaluate the structure, process and outcomes related to the inter-facility transport of ischemic stroke patients treated with intravenous rtPA. The Quality-Caring Model© was the guiding framework.

A quantitative, retrospective, non-experimental analysis of inter-facility transport …

Diabetes Understanding Among Staff Nurses: Examining The Actual Versus Perceived Knowledge In The Acute Care Setting, Rebecca B. Ledbetter

Nursing Theses and Capstone Projects

Diabetes is the fourth leading cause of death world-wide claiming a staggering 3.8 million lives globally each year to related complications (World Health Organization, 2011). Diabetes complications account for 20% of all acute care admissions or 1 in every 5 patients have a diabetes-related condition (American Diabetes Association, 2011). Patient education in the areas of lifestyle modification, healthy eating habits, and proper medication administration is research-supported to clinically decrease the likelihood of acute complications. Bedside, acute care nurses are at the front line of patient education delivery and have the opportunity to determine behavioral stages related to a patient's readiness …

Monitoring Congestive Heart Failure Across The Healthcare Continuum, Katrina E. Walker

Nursing Theses and Capstone Projects

Congestive heart failure is a chronic condition where the heart no longer pumps adequate blood and oxygen to bodily organs. CHF is a chronic condition that affects millions of people on a yearly basis. Common diseases that cause CHF are coronary artery disease, high blood pressure, and diabetes. CHF patients face many compilations that affect their daily activities. Along with morbidity CHF has major financial implications because much of the cost associated with CHF healthcare is avoidable. The purpose of this study is to evaluate the effects of monitoring congestive heart failure across the healthcare continuum with application to the …

Effects Of Early Initiation Of Induced Therapeutic Hypothermia, Frank Castelblanco

Nursing Theses and Capstone Projects

Cardiac arrests are responsible for about 325,000 deaths annually in the United States (Heart Rhythm Foundation, 2010). The majority of these cardiac arrests occur outside the hospital setting, with a dismal national survival rate of 8% (American Heart Association, 2010). The Bernard (2002) and HACA (2002) studies demonstrated that by initiating therapeutic hypothermia as a treatment modality for cardiac arrests the survival rate could be as high as 49% and 55% respectively. Therapeutic hypothermia can be initiated in many different settings. The question remains, does the setting of the initiation of therapeutic hypothermia effect patient outcomes? The purpose of this …

Preparing The New Graduate Nurse Entering Critical Or Progressive Care Practice Areas: What Is The Effect Of Blended Orientation Approaches On Their Level Of Self-Confidence And Satisfaction With Current Orientation Methods?, Jennifer L. Forbes

Nursing Theses and Capstone Projects

The transition from student nurse to professional nurse is often difficult for the new graduate especially if transitioning into critical or progressive care areas of practice. It is imperative for new graduates to receive a clinical orientation that meets their educational and transitional needs. The orientation process should provide them with a strong foundation in critical or progressive care practices. Educators are challenged to provide educational opportunities while accommodating diverse learning needs and continuing to maintain competency that ensures the highest quality of patient care and improved patient care outcomes.

New graduate nurses hired into the critical or progressive care …

The Nurse's Knowledge Of Blood Conservation As A Part Of Blood Management, Lindsey Putnam Austin

Nursing Theses and Capstone Projects

Medicine has historically regarded blood transfusion as an integral component of major surgery or illness. However, clinical studies have shown that allogeneic blood transfusions are associated with increased morbidity and decreased survival. Knowledge of this research and the concepts of blood conservation so as to avoid unnecessary blood transfusions is needed in order to deliver holistic care and serve as patient advocate. This knowledge reaches every specialty of nursing care.

This study of the nurse's knowledge of blood conservation as a part of blood management utilizes The Conservation Model developed by Myra E. Levine in 1973. Levine's work is a …

The Effect Of Emergency Department Length Of Stay On Clinical Outcomes For Critically Ill Or Injured Patients, Sheila Radcliff

Nursing Theses and Capstone Projects

The purpose of the study was to identify the effects of the emergency department length of stay on clinical outcomes for critically ill or injured patients in the regional referral community hospital. Delays in transfer have been associated with increased mortality rates, prolonged length of stays, and poor outcomes. Emergency departments are designed to respond to immediate life or limb threatening emergencies.

A quantitative, descriptive, retrospective design was used in this study. Data was collected from APACHE II, trauma databases, and ED logs. The study was conducted in a 752 bed hospital in the western North Carolina. Data was analyzed …

Teamstepps Communication And In Situ Simulation Training To Improve Individual And Team Performance During Handoff Of The Immediate Post-Operative Cardiovascular Surgical Patient, Stacy Lynn Jepsen

All Graduate Theses, Dissertations, and Other Capstone Projects

The aim of this pilot study was to identify if establishing a reliable framework for consistent use of TeamSTEPPS communication would improve the team communication and performance during the critical handoff of the cardiac surgical patient from the OR team to the ICU team. Breakdown in handoff communication has been attributed as the cause of adverse health events, delays in treatment, inappropriate treatment, increased length of stay, and increased costs and inefficiencies from rework. Standardizing handoff communication is a Joint Commission National Patient Safety Goal, and immediate postoperative cardiac surgical patients are a high-risk population needing consistently high quality communication …

Empathy Of Nurses And Family Needs In The Intensive Care Unit, Jolene Marie Tietz

All Graduate Theses, Dissertations, and Other Capstone Projects

Introduction: Patients and patients' families are in crisis when the patient is in the Intensive Care Unit. There have been studies demonstrating the importance of recognizing patient and family needs, and meeting those needs. This study explored what needs families rank as important and if the nurse met their needs, and what effect nurse empathy had on meeting family needs. Methods: Families in the Intensive Care Unit were given questionnaires to complete that addressed which needs they felt were important, if their needs were met, and the level of empathy they gauged their nurse to have. The tools utilized in …

Critical Illness Myopathy, Salima Moez Meherali, Yasmin Parpio, Tazeen Ali

School of Nursing & Midwifery

Critical illness myopathy (CIM) is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit (ICU). This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive …

Subglottic Secretion Aspiration In The Prevention Of Ventilator-Associated Pneumonia: A Review Of The Literature., Rachel Scherzer

Jefferson Hospital Staff Papers and Presentations

Ventilator-associated pneumonia is a common nosocomial infection that results in both negative patient outcomes and increased health care costs. Recently, many efforts have been targeted at ventilator-associated pneumonia prevention, including the practice of subglottic secretion aspiration. Six randomized control studies examining the effectiveness of subglottic secretion aspiration in the prevention of ventilator-associated pneumonia were reviewed for this article. Results consistently show that subglottic secretion aspiration significantly reduces the incidence of ventilator-associated pneumonia in a variety of patient populations. Despite these findings, this practice is limited in clinical settings. This clinical practice should be implemented in individuals requiring mechanical ventilation to …

What Is The Experience Of Emergency Department Nurses With Lateral Verbal Aggression?, Wendi Harper-Lonabaugh

Nursing Theses and Capstone Projects

This descriptive study investigated the incidence of lateral verbal aggression among emergency department nurses. A sample of registered emergency department nurses currently working in western North Carolina with more than one year of full time work experience was surveyed (N=68). Roy's adaptation model was used as a theoretical framework for this qualitative study. A survey was utilized to collect the frequency, source, and incidences of reporting the lateral verbal aggression that occurred. Nurses also reported personal and professional ramifications to the lateral verbal aggression. Aggregate data was examined; no specific individual data was analyzed. The most common perpetrators of lateral …

Copd Care Coordination Program, Glenda Mccall

Nursing Theses and Capstone Projects

COPD is the fourth leading cause of death in the United States. Several studies confirm only 50% of COPD patients receive optimal care. The disease is greatly under-recognized and generally is not diagnosed until it is clinically apparent and moderately advanced. COPD is also a major resource consuming disease. Considering these facts, Mission Hospitals realized the opportunity to improve evidence based quality care for patients diagnosed with COPD as well as the development of a Care Coordinated Program to improve outcomes for the patient as well as the organization. The goal of the program is to provide correct, comprehensive, and …

Development Of An Educational Resource Tool To Improve Hospital Wide Knowledge Of Rehabilitation Care And Services, Vickey R. Allen

Nursing Theses and Capstone Projects

Health Care Organizations (HCO) are businesses. In an effort to be successful and to remain viable, HCOs must provide a myriad of services to meet their customer's needs. Included in these services is competent rehabilitation care that manages patients holistically. Utilizing Orem's theory of self care deficit, this project will demonstrate the growing need for rehabilitation services and the importance of all healthcare providers to understand the profession in general. In addition, this project will provide a resource tool to educate healthcare workers and others; students and non-licensed personnel, on the care and services patients receive during their stay in …

Practices And Perceptions Of Delirium Assessment By Critical Care Nurses, Jacqueline M. Meunier

Nursing Theses and Capstone Projects

Delirium has a tremendous impact on the patient, his family, and the health care system. In particular, the elderly patient in the Intensive Care Unit is the most susceptible to this condition. Delirium often results in longer hospital stays, more Intensive Care days, increased likelihood of being placed in a skilled nursing facility, and increases in mortality. For delirium to be treated properly it must first be identified. Critical care nurses are in the best position to identify these patients and initiate treatment. Past studies have shown that nurses do not identify patients that have delirium, and do not know …

Evaluation Of Purposeful Rounding On Patient Falls, Stephanie Spittle

Nursing Theses and Capstone Projects

The purpose of this study was to evaluate the effectiveness of routine purposeful rounding on the total number of falls on a medical unit in an acute care hospital. The project was prompted by high fall rates within the hospital and the implementation of the purposeful rounding initiative. Staff training was provided in a two hour educational class which covered the purpose for the initiative as well as the specific functions that must be performed with each round. To evaluate the effectiveness of purposeful rounding on patient falls, pre and post rounding fall rates were compared. These initial results were …

The Experienced Critical Care Rn's Perception Of New Graduate Rns Competence In Critical Care Using Benner's Novice To Expert, Denise H. Reid

Nursing Theses and Capstone Projects

The purpose of the study was to describe the experienced critical care RNs' perception of the new graduate RNs' competence in critical care areas. Using the Six-Dimension Scale of Nursing Performance (Six-D Scale) by Patricia Schwirian, experienced nurses from critical care areas with at least three years of experience were asked to rate new graduate RNs in their critical care area on specific nursing activities. Benner's theory of Novice to Expert is used as the theoretical framework. Findings revealed that experienced critical care RNs perception of new graduate RNs is greater than expected. All activities on the Six-D Scale were …

A.S.P.E.N. Ethics Position Paper, Albert Barrocas, Cynthia Geppert, Sharon M. Durfee, Julie O'Sullivan Maillet, Cheryl Monturo, Charles Mueller, Kathleen Stratton, Christina Valentine, A.S.P.E.N. Board Of Directors

Nursing Faculty Publications

No abstract provided.

Parent Involvement In End-Of-Life Care And Decision Making In The Newborn Intensive Care Unit: An Integrative Review, Lacey M. Eden, Lynn Clark Callister

Faculty Publications

Survival rates for very preterm and critically ill infants are increasing, raising complex ethical issues for health-care providers and parents who face the challenge of making end-of-life decisions for newborns. The purpose of this integrative literature review was to evaluate parental involvement in end-of-life care and decision making for their infant in the newborn intensive care unit. Findings revealed that establishing good relationships and clear communication between health-care providers and parents builds trust and eases stress placed on parents making decisions about the care of their infant. Palliative care programs provide support for parents and facilitate their decision making. Parents …

From Means To Ends: Artificial Nutrition And Hydration, Cheryl Monturo, Kevin Hook

Nursing Faculty Publications

No abstract provided.

Oncology Nurses' Perceptions Of Obstacles And Supportive Behaviors At The End Of Life, Renea L. Beckstrand, Josie Moore, Lynn Callister, A. Elaine Bond

Faculty Publications

Purpose/Objectives: To determine the magnitude of selected obstacles and supportive behaviors in providing end-of-life (EOL) care to patients with cancer as perceived by oncology nurses.

Design: Cross-sectional survey.

Setting: National survey sample.

Sample: A geographically dispersed national random sample of 1,000 Oncology Nursing Society members who had cared for inpatient patients with cancer, could read English, and had experience in EOL care.

Methods: Eligible respondents received a 68-item questionnaire in the mail adapted from previous studies and were asked to rate the size of obstacles and supportive behavior items in caring for patients with cancer at the EOL.

Main Research …

Resilience And Speed Of Recovery After Critical Illness, Tiffany Huffman, R.N., B.S.N.

Electronic Theses & Dissertations

Length of stay in the critical care setting is a topic of concern for both patients and the health care system. However, the subject of psychological influences on recovery time after critical illness is a one that little to no research has been conducted. This extensive literature review aims to look specifically at the relationship between resilience and speed of recovery after critical illness and research that has been done on this subject matter. Within this review lies an extensive review of literature, in-depth definitions of resilience, factors affecting length of stay in the intensive care units, a theoretical framework …

Assessing Culture Competence Among Nurses In An Acute Care Setting, Maleka Virani

Master's Projects

The aim of the study was to assess cultural competence among nurses in an acute care setting. A 25-item questionnaire developed by Campinha-Bacote (2003) titled Inventory to Assess Cultural Competence Among Health Care Providers (IAPCC-R) along with a demographic survey were utilized to assess cultural competence among 100 nurses in an acute care hospital. The results of the study indicated that 70% of nurses (n=63) were culturally aware and 30% (n=27) were culturally competent. There was no statistical significance between the level of cultural competence and years of experience, educational degree or self rating of 'being culturally competent'. The findings …

The Artificial Nutrition Debate: Still An Issue…After All These Years, Cheryl Monturo

Nursing Faculty Publications

No abstract provided.

The Effect Of A Nurse-Respiratory Therapist Weaning Protocol On The Duration Of Mechanical Ventilation And The Incidence Of Ventilator-Associated Pneumonia, Andrea Lucas

Theses, Dissertations and Capstones

The purpose of this research study was to show the effectiveness of implementing a standardized nurse-respiratory driven weaning protocol in decreasing the time spent on mechanical ventilation and the incidence of ventilator-associated pneumonia in mechanically ventilated patients compared to using individual physician methods. Chart reviews were performed to compare the incidence of ventilator-associated pneumonia (VAP) prior to the initiation of the nurse-respiratory driven weaning protocol. Sister Callista Roy’s Adaptation theory was used as a framework for this study to show that nurses could promote adaption by using a standardized ventilator weaning protocol. The study did not show statistical significance that …

The Effect Of Nurse Initiated Paracetamol On Emergency Department Patients With Pain From Low Acuity Injury, Joanne G. Wilson

Theses: Doctorates and Masters

Early identification and management of pain was identified at the commencement of this study as a key area requiring research in emergency departments. Prolonged waiting times for analgesia especially, was highlighted in the National Institute of Clinical Studies emergency department collaborative in 2003. Many barriers exist for a patient to receive analgesia. In Western Australia this is compounded by the legislation which restricts prescribing rights for nurses. Three considerations guided the development of the research project. Firstly, the patient has initial contact with the emergency department from the nurse at triage. Secondly, paracetamol was recognised as a potentially effective analgesic …

Symptom Clusters In Acute Myocardial Infarction: A Secondary Data Analysis, Catherine J. Ryan, Holli A. Devon, Rob Horne, Kathleen B. King, Kerry A. Milner, Debra K. Moser, Jill R. Quinn, Anne Rosenfeld, Seon Young Hwang, Julie J. Zerwic

Nursing Faculty Publications

Background: Early recognition of acute myocardial infarction (AMI) symptoms and reduced time to treatment may reduce morbidity and mortality. People having AMI experience a constellation of symptoms, but the common constellations or clusters of symptoms have yet to be identified.
Objectives: To identify clusters of symptoms that represent AMI.
Methods: This was a secondary data analysis of nine descriptive, cross-sectional studies that included data from 1,073 people having AMI in the United States and England. Data were analyzed using latent class cluster analysis, an atheoretical method that uses only information contained in the data.
Results: Five distinct clusters of symptoms …

Advance Directives At End-Of-Life: Nursing Home Resident Preferences For Artificial Nutrition, Cheryl Monturo, Neville E. Strumpf

Nursing Faculty Publications

No abstract provided.