Nursing Commons^™

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 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 …

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 …

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. …

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 …

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 …

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 …

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 …

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.

Implementing The Richmond Agitation-Sedation Scale To Assess Delirium In A Pediatric Icu, Leigh Paridy

Dissertations

Purpose: The purpose of this quality improvement project was to establish early identification of delirium in the intensive care setting to reduce the impact of long-term patient outcomes. Description of project: A retrospective-prospective medical chart review was completed. The retrospective chart review looked at fifty-two patients admitted to the pediatric intensive care unit (PICU) between October 1, 2020 and December 1, 2020 for patient demographics and State Behavior Scale (SBS) and the Cornell Assessment for Pediatric Delirium (CAPD) charting compliance especially with children with developmental delay and those with a high susceptibility to delirium. The prospective chart review looked at …

University Of Louisville International Travel Clinic: Pivoting During The Covid-19 Pandemic, Dawn Balcom, Subathra Marimuthu, Leslie A Wolf, Luanne Didelot, Sarah Tan, Daniel Hall, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Association Of Lung Cancer With Pneumonia And Chlamydia Pneumoniae Infection, Johnny Zakhour Md, Daniel Muller, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: The degree of association and type of causal versus non-causal relationship between pneumonia and lung cancer (LC) are evolving discussions. We reviewed English publications on the degree of association between pneumonia and subsequent LC.

Methods: We searched the PubMed database using key words for pneumonia, LC, and chlamydia infection. We selected peer-reviewed studies of patients with pneumonia and LC. Case reports and other literature reviews were excluded from this review.

Results: Five studies examined the incidence and/or risk of LC for a total of 415,750 patients, and four studies examined cases with Chlamydia pneumoniae chronic infection at the time …

Spiritual Care Competency Of Critical Care Nurses: A Literature Review, Julia O. Rohm

Bachelors of Science in Nursing

While caring for their patients, nurses often encounter spiritual needs. In a study with 241 hospice, palliative care, and holistic nurses, “all respondents (100%) indicated they had encountered a patient with spiritual needs throughout their nursing clinical practice” (Lukovsky et al., 2021, p. 32). Despite the prevalence of spiritual needs, many nurses feel unable to confront spiritual issues among their patients. According to a survey conducted among 4054 nurses from the UK, “almost 93% of the nurses surveyed believed spiritual care should be addressed, yet only 5.3% felt always able to meet the spiritual need of patients on a regular …

Reducing Parental Stress In Neonatal And Pediatric Intensive Care Units, Nancy M. Abbene

Electronic Theses and Dissertations

Abstract

The neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) are highly operational and highly active environments. Health care workers must react quickly to care for patients and provide life-saving measures fundamental to favorable patient outcomes. Caregivers of this critical patient population are often overlooked as the healthcare team prioritizes patient’s needs. In addition, medical equipment, machines, and monitors have multiple safety alarms sounding frequently and contributing to high levels of parental stress upon their child’s admission to the NICU and PICU. Lack of giving adequate prominence to the value of caregiver support services in the hospital …

Pulmonary Inflammation And Injury Triggered By Spine Surgery In Recovered Covid-19 Patients Demand Consideration, Luciano Rodrigo Lopes, Silvana Kertzer Kasinski

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Coronavirus Disease 2019 (Covid-19): A Literature Review From A Nursing Perspective, Amir Emami Zeydi, Mohammad Javad Ghazanfari, Farzam Shaikhi Sanandaj, Reza Panahi, Hamed Mortazavi, Keyvan Karimifar, Samad Karkhah, Joseph Osuji

BioMedicine

Introduction: As the COVID-19 pandemic ravages the world, nursing resources, and capacities play an essential role in disease management. This literature review focuses on the central issues related to the nursing care of patients affected by COVID-19.

Material and Methods: This literature review was conducted with an extensive search of databases, including PubMed, Web of Science (WOS), and Scopus, using the keywords "COVID19", "2019-nCoV disease", "2019 novel coronavirus infection", "Nurse", "Nursing Care", and "Nursing management." The span of the literature search was between December 01, 2020, and January 12, 2021. A total of 28 original and English-language articles …

Why Should People Use Face Masks In The Time Of Covid? The Jri Position, Jose Bordon, Alex Glynn, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Maximizing Mobility In The Icu, Stephen Kupiec

Master's Projects and Capstones

Problem: In a large tertiary medical center in Northern California, the patients in the 20-bed ICU achieved averaged maximum mobility (AMM) scores well below the regional target. These patients had longer lengths of stay in the ICU and spent more days on ventilators, as compared to patients in other ICUs in the region. Barriers to mobilization included patient diagnosis, sedation practices, staff burnout, insufficient staffing, a knowledge deficit around the safety and benefits of mobility, lack of standard workflows, and lack of interdisciplinary collaboration.

Context: A microsystem assessment focused on metrics-that-matter to determine the focus of this quality improvement project. …

The Impact Of Nurse-Led Initiative Interventions On Cauti, Dalveer Kaur

Master's Projects and Capstones

Problem: National Healthcare Safety Network (NHSN) has reported U.S. hospitals having 0.2 to 4.8 per 1000 catheter-days for adult inpatient units. The insertion of a catheter and delay in removal have a significant impact on morbidity, mortality, length of stay, and reimbursement.

Context: Post-Acute Care Unit (PACU) is a microsystem that provides rehabilitation services for a patient with various post-surgical procedures. The staff of this unit was well aware of policies of catheterizations that led to prolonged use of urinary catheters and an increased rate of CAUTIs in the last quarter of this year. This project aims to increase staff …

Addressing Critical Care Nurse Burnout, Julie Suarez

Master's Projects and Capstones

Problem: Critical care nurses are at higher risk for developing burnout than nurses from other areas of clinical practice. If not addressed promptly, the problem of burnout can worsen, negatively affecting the healthcare provider, organization, and patient outcomes.

Context: Increased stress and burnout observed in the microsystem with the onset of the COVID-19 pandemic prompted consideration of ways to address the well-being of critical care nursing staff with targeted interventions that could be implemented quickly with readily available resources.

Interventions: The project aim was to reduce critical care nurse burnout scores through implementation of evidence-based strategies addressing participative management, camaraderie …

Delirium, Angela Lee

Nursing Student Class Projects (Formerly MSN)

Delirium is a severe neurocognitive syndrome characterized by acute changes in consciousness and cognition (American Psychiatric Association, 2013; Wilson et al., 2020). The syndrome is found to be prevalent within the adult intensive care population resulting from various triggers and stressors in the critical care setting (Wilson et al., 2020). On average, the prevalence of delirium is 23%, but the incidence significantly increases to 50-70% in mechanically ventilated patients (Wilson et al., 2020). As a result of the extension of cognitive deficits, if left untreated, delirium may lead to long-term impairments in cognitive disfunction (Wilson et al., 2020). Current studies …

Sars-Cov-2 (Covid-19), Matthew Baker

Nursing Student Class Projects (Formerly MSN)

SARS-CoV-2 (COVID-19) emerged in the fall of 2019 and impacted millions of people worldwide deeming it a global pandemic. The virus primarily impacts the respiratory system, but has shown to affect other organ systems such as the kidneys, heart, and brain. Respiratory failure leading to Adult Respiratory Distress Syndrome (ARDS) associated with COVID-19 requires ventilatory support and possibly prone therapy to increase lung volumes and prevention of atelectasis. There are several treatment modalities for mild and severe cases of COVID-19 that range from antivirals to vaccine development. COVID-19 is a complex virus that can vary from mild to severe cases …