Nursing Commons^™

Icu Cauti Incidence Reduction, Michelle Gamble

Nursing Posters

Situation:

Catheter-Associated Urinary Tract Infection (CAUTI) rates in the adult Intensive Care Unit (ICU) increased from nine infections in FY21 to 18 in FY22.

Backgroud:

CAUTIs are the most reported healthcare acquired infection. It is important for healthcare providers to understand the complications and effects of CAUTIs. CAUTIs contribute to extended length of stay, increased healthcare costs, and patient morbidity and mortality.

Most CAUTIs are directly related to inadequate urinary catheter care. Evidence based practice demonstrates a decrease in CAUTIs related to the use of Theraworx^® Protect wipes twice daily (BID) and as needed (PRN) for patients with a …

Pupillometry, Elizabeth Plante, Casey Schmidt

Nursing Posters

Background:

• Measuring pupillary light reflex is a standard part of neurological assessment.
• Changes in pupil reactivity may indicate unfavorable outcomes, such as increased intracranial pressure and brain herniation.
• Physiologic and pharmacologic agents may affect pupil reactivity.
• In some instances, pupillary light reflex is the only piece of neurologic assessment readily testable.

What I Need: Self Care At The Unit Level, Jessica A. Tindal

Nursing Posters

Purpose:

Self-care is individualized and best done when awarded on a small scale.

Goals:

For all employees of the ICU to:

• Feel valued outside of work
• Be recognized for taking care of themselves
• Participate in positive discussions
• Be rewarded for work life balance
• Be reminded of self-care
• Not feel alone with their thoughts
• Pause and reflect
• Help others, spouses, kids, etc.

Future plans include:

• Seasonal questions of things to see, places to explore
• Recipe sharing
• Hobby experts
• Focusing on staffs' interests

Safe Intra-Hospital Transport Of Adult Patients On Non-Critical Care Units, Teresa Jahn, Janelle Maciej, Greta Titus

Nursing Posters

Plan:

Between 2021 and 2022, two non-critical adult patients returning from the imaging department after an invasive procedure developed increased oxygen needs, which ended in death for on patient and a transfer to critical care for the other.

No formal guidelines exist for the intra-hospital transport by unlicensed personnel may be absent. An intra-hospital transport checklist was developed for non-critical care patients leaving the unit for procedures in the imaging department.

Do:

• A "RN Pre-Invasive Procedure Transport Safety Checklist" was created by a telemetry RN (MSN student, Greta Titus) and CNS, Teresa Jahn
• The checklist was designed to answer questions …

Transitions To Normal Saline Only For Cvads, Megan Lehn, Ann Backes

Nursing Posters

Purpose Statement:

The purpose of this project is to implement a practice change throughout the system to remove heparin flushes for Central Venous Access Devices (CVADS) pending a successful pilot on Medical Oncology.

Synthesis of Evidence:

• Shama et al (2019) conducted a systematic review and meta-analysis including 886 participants that revealed no clear differences in CVC patency between heparin and NS.
• Klein et al (2018) conducted a pilot study on a 30-patient bone marrow transplant unit, each patient had a new CVC and were divided into two groups. Among 698 catheter-associated events overall incidence of central line issues were similar …

Implementing A Covid 19 Policy For Telehealth, Ashley M. Morello

Doctor of Nursing Practice Projects

The proposed DNP Project explored the implementation of a COVID-19 telehealth policy to clarify evidence-based practice, promote use of safe medications, and reduce hospitalizations. Providers were recruited from a telehealth organization, educated on current guidelines, and given a pocket card for reference and re-enforcement of training. Data was collected to examine guideline utilization, confidence in treating COVID-19, and efficacy of pocket card. COVID-19 patients also received follow up calls to determine if hospitalization was required post treatment. Chart audits were then completed to review compliance with guidelines. The results indicated both objective and clinical improvement in provider confidence treating COVID-19. …

Nutritional Medicine: Education For Advanced Practice Providers, Natalie Organ

DNP Research Projects

Abstract

OBJECTIVE: The project's primary goal was to educate the APP and develop positive attitudes and beliefs concerning plant-based nutrition regarding obesity, diabetes, cardiovascular disease, and cancer. The project addressed a crucial gap in healthcare education. APPs were not routinely given the chance to learn nutritional medicine, leading to decreased confidence in providing nutritional guidance in clinical practice.

METHODS: The DNP project participants were practicing advanced practice providers. The Knowledge, Attitude, Behavior (KAB) education theory and CREATION Life were used. This project used Qualtrics to send a pre-and post-intervention survey titled Student Survey for Nutritional Medicine. The intervention was a …

The Relationship Between Increased Wages And Nurse Satisfaction And Intent To Stay, Jean Andres

College of Health Sciences Posters

The recent COVID-19 pandemic contributed to a negative climate in healthcare and increased the workforce demands of nurses leading to decreased satisfaction and an unprecedented staffing crisis. Further compounding the problem, staffing agencies have offered fiscally lucrative contracts that enticed experienced nurses to leave permanent staff positions for external contract agency nursing.

Research Questions for this study are as follows:

• RQ1: What is the relationship between increased wages and nurse satisfaction?
• RQ2: What is the relationship between increased wages and intent to stay?
• RQ3: What is the relationship between demographic variables and nurse satisfaction?
• RQ4: What is the relationship demographic …

The Use Of Non-Icu Confusion Assessment Method (Cam) For Delirium Management, Stephanie Barendt, John Sharon Hudson

College of Health Sciences Posters

The purpose of this study was to determine the effect the use of the non-intensive care unit confusion assessment method (non-ICU CAM) as an early screening tool for delirium would have on the nursing practice of medical surgical nurses. This quasi-experimental study focused on early screening and prevention training of inpatient nurses caring for adult inpatients to proactively reduce episodes of delirium. The training included an educational video on how to perform the non-ICU CAM assessment, 4 scenarios to test knowledge on scoring patient, and techniques for reducing delirium if patient is positive. After one month of multimodal training for …

Prepaing Nursing Faculty For Next Generation Nclex: An Interactive Workshop, Rachel Loukota

DNP Research Projects

Abstract

Objective: The National Council of State Boards of Nursing (NCSBN) launched the next- generation NCLEX (NGN) in April 2023. Pre-licensure nursing faculty are unprepared for the change in teaching and evaluating nursing students' clinical judgment skills. Method: This was a quantitative workshop intervention with a pre-post survey. Intervention: Two-hour online and in-person workshops were held between August and October 2022 on how to create unfolding case studies following NCSBN’s clinical judgment measurement model. A template was created for use by participants, with samples to follow along. Results: There was a significant difference

in preparedness and confidence in those who …

Examining The Effects Of Music Therapy On Physical And Psychological Symptoms Among Cancer Patients Undergoing Chemotherapy, Guadalupe Saldana

Nursing | Senior Theses

Background: Patients undergoing chemotherapy experience undesirable physical and psychological effects in which medications are the preferred method of management. However, standard medications are often insufficient for patients. Failure to attend to the adverse effects can lead to worsening of the patient’s cancer diagnosis and quality of life. The importance of managing chemotherapy symptoms creates an urgent need to implement an approach that is noninvasive, non-pharmacological, and one that still meets the physical and psychological needs of patients receiving chemotherapy.

Objective: The purpose of this thesis is to examine the effects of music therapy (MT) on physical and psychological …

Dynamic Bronchoscopy For Excessive Dynamic Airway Collapse, Jennier Salaski, Krista Ophoven

Nursing Posters

Definition:

Excessive Dynamic Airway Collapse (EDAC) is a respiratory condition characterized by >50%luminal narrowing on expiration.

Recognition Of Nonconclusive Seizures In Patients After Cardiac Arrest Using, Teresa Jahn, Elizabeth Plante

Nursing Posters

Background:

Evidence - Prevalence of nonconvulsive status epilepticus or other epileptiform activity in patients who are comatose after a cardiac arrest is between 12-22%. Consistent with the literature, at this facility approximately 12% were found to have non convulsive seizures. Prolonged epileptiform discharges may cause secondary brain injury and increased mortality. In 2020, the American Heart Association recommended EEG monitoring should be promptly performed and interpreted for the diagnosis of seizures in all comatose patients following cardiac arrest.

Local Problem - Comatose patients admitted to critical care after cardiac arrest who require targeted temperature management (TTM) have continuous EEG monitoring …

From Silos To Collaborative Working Relationships With Ems And Ed, Angela Moscho

Nursing Posters

Opportunity:

To establish a strong, collaborative relationship between St. Cloud Hospital Stroke Center, St. Cloud Hospital Emergency Department and Emergency Medical Services.

Background:

Two separate health care systems with one goal in mind: best stroke care for a community member experiencing stroke-like symptoms.

Current Practice in 2017:

• Code stroke activation with LTKW (last time known well) up to 6 hours.
• Inconsistent pre-notifications and pre-activations by EMS and ED.
• St. Cloud Hospital and Mayo Clinic Ambulance with siloed/individualized protocols for their respective health systems.

Heated High Flow Oxygen Therapy Management Of Respiratory, Swallowing/Dysphagia And Nutrition Needs, Jenelle Overgaard

Nursing Posters

Problem

• Patients diagnosed with COVID-19 pose challenges for oxygenation. Often requiring heated high flow oxygen therapy (HHFOT) for days to weeks, with literflow commonly over 40 L/min with maximum of 60 L/min.
• There is minimal research on aspiration risk at higher literflow, therefore practice included decreasing liter flow to 20 L/min for oral intake was standard.
• During oral intake, with literflow decreased to 20 L/min, patients' oxygen saturations would quickly trend down.
• Alarms indicating low saturation would create anxiety, cause patients to eat faster potentially increasing risk for aspiration.

Solution

• For adult inpatients meeting criteria, increase maximum literflow allowed during …

Promotion Of National Certification In Telemetry, Janelle Maciej

Nursing Posters

Situation:

Goal to bring awareness to telemetry nurses, the specialty certifications they are eligible for, and criteria for eligibility. Currently, six telemetry nurses hold a nationally recognized certification.

Action Plan:

• March 19, 2023 was Certified Nurses Day and was the kickoff for the start of encouragement for telemetry nurses to be certified.
• Each telemetry nurse was delivered a card and lifesaver candy inviting them to consider a nationally recognized certification.
• A certification informational packet promoting CV-BC and PCCN certification was placed at each desk and referenced during huddle for one week.
• Certification preparation books are available upon request.

Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook

Doctor of Nursing Practice Projects

There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case …

Development And Implementation Of A Standardized Multimodal Nurse Training Program For The Placement Of Ultrasound-Guided Peripheral Intravenous (Usgpiv) Access, Timothy J. Belden

Regis University Student Publications (comprehensive collection)

Objective

The purpose of the quality improvement project was to develop and implement a standardized multimodal nurse training program following a fixed curriculum for the placement of USGPIV in patients with Difficult Venous Access (DVA) to increase nurse knowledge, self-efficacy, skill level, and increase the number of nurses proficient for independent placements.

Evaluation Methods

This project incorporated a quasi-experimental time series with a mixed methodology study design using purposeful and convenience sampling. Participant demographic and descriptive data were collected at the beginning of the training program. Additionally, quantitative data was collected by evaluating pre-test data, followed by post-test data collection …

The Impact Of Self-Care On Nursing Faculty Burnout And Worklife, Jennifer J. Harrington

Regis University Student Publications (comprehensive collection)

Nursing faculty are relied upon to prepare the nursing workforce of the future. The stress and pressure felt by nursing faculty impacts their ability to practice self-care, and this threatens their ability to perform optimally. Lack of self-care can lead to diminished quality of life, and ultimately burnout. Feelings of burnout and decreased quality of life, which are precursors to faculty turnover, further perpetuates the nursing shortage. A Quality Improvement (QI) Pilot Initiative, with an evidence-based design methodology was implemented within one university’s nursing department, located in a western state, to address this problem. Using a pre-post survey design and …

Anticoagulation Adherence In Atrial Fibrillation Patients With A Scheduled Cardioversion, Caitlin Naimo

West Chester University Doctoral Projects

Atrial fibrillation is a chronic disease managed through rate control, rhythm control, and anticoagulation. Anticoagulation compliance must be verified when a patient needs a cardioversion to convert to normal sinus rhythm. If a patient has missed a dose within the last four weeks, a Transesophageal Echocardiogram (TEE) is required to confirm that a clot has not formed in the heart. Medication noncompliance plagues the healthcare industry, costing millions of preventable healthcare dollars. The literature review shows that educational and behavioral interventions effectively increased medication compliance. Educational material was created, and a verified medication compliance survey was utilized to evaluate anticoagulation …

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

The Feminine Vs Masculine Nurse: The Effects Of Gender Stereotypes In Nursing, Makrisel Lapitan

Nursing | Senior Theses

Background

The field of nursing has been a predominantly female profession since the introduction of modern nursing by Florence Nightingale in 1860. While more men are beginning to enter the field, there are still many stereotypes surrounding the role of a nurse. For women, this may include qualities such as caring and being empathetic or motherly. Conversely, there are assumptions that men are unable to bestow those same qualities and are therefore unworthy of working within the occupation. Female nurses may experience difficulty progressing professionally or feel that their male counterparts are more favored. Male nurses may observe that the …

Effect Of Telemonitoring And As Needed Patient Support On Pap Adherence, Saoirse Owens

West Chester University Doctoral Projects

Obstructive sleep apnea (OSA) is an increasingly recognized condition affecting patient health and public welfare. While positive airway pressure (PAP) therapy has remained the preferred treatment for OSA since 1981, PAP therapy adherence rates have also remained stubbornly suboptimal. Measures for improving PAP therapy adherence have been under constant study, and current literature demonstrates telemonitoring interventions to be promising. Furthermore, the American Academy of Sleep Medicine (AASM) suggests that telemonitoring interventions be integrated into standard practice to support patients as they initiate and acclimate to PAP therapy. This quality improvement project examined the effect of interval PAP data telemonitoring and …

Reducing Catheter-Associated Urinary Tract Infection Rates By Educating Staff On Bundle Interventions, Tirath Kaur

Master's Projects

PURPOSE: Catheter associated urinary tract infection is an undesired burden to the patients and healthcare system. This systematic review explores the published literature and determines the impact of educating nursing staff on the indication of urinary catheter, insertion of foley catheters, maintenance of urinary catheters, and periodical communication between nurses and physicians for changing foley catheters can reduce the CAUTI rates in adult patients in the acute care hospital setting. METHOD: A systemic review was conducted using CINHAL, Science Direct, PubMed, and MEDLINE within the time period of ten years from 2012 to 2022. Eight published articles are reviewed and …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …

Prospective Generation Z Nurses: Expectation Of The Workforce In Connotation To The Great Resignation, Amelia Borders

Undergraduate Honors Theses

The Great Resignation has left an impact on the entirety of the American workforce. Coupled with the burnout rates caused by the COVID-19 pandemic, healthcare systems have been trying to find solutions to inhibit the nurse shortage. While solutions that focus on symptoms of the problem may work for a short period of time, hospitals will continue to encounter issues with staffing nurses and will need to find a new solution (Laskowskil-Jones & Castner, 2022). A possible solution would be for hospitals to recruit and retain prospective Gen Z nurses. In a quantitative study completed at a single university in …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Student Research Posters

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

A Comparison Of Outcomes For Lipid Emulsions In Total Parenteral Nutrition Among Home Infusion Patients, Gregory W. Wesley-Lynch

DNP Scholarly Projects

This quality improvement project aimed to compare the outcomes of lipid emulsions used in total parenteral nutrition among home infusion patients. The quality improvement project included 45 patients who received four weeks or more of either Intralipid or SMOFlipid. Paired t-tests were used to compare SMOFlipid and Intralipid regarding three liver function test (LFTs) values; (Alkaline Phosphate (ALP), Aspartate transaminase (AST,) and Alanine transaminase (ALT). Results demonstrated that SMOFlipid was superior to Intralipid, resulting in lower LFTs for ALP, AST, and ALT. This study provides evidence to support the use of SMOFlipid over Intralipid in total parenteral nutrition for home …

A Quality Improvement Initiative: Addressing Workplace Violence Toward Nurses To Promote A Culture Of Safety In An Inpatient Psychiatric Facility, Ernestina Danso

DNP Scholarly Projects

This quality improvement initiative aimed to address workplace violence against nurses in inpatient psychiatric facilities and promote a culture of safety. The QI project involved 27 participants, including inpatient psychiatric nurses and mental health counselors from Cahill 4 and 7 West units at the Cambridge Campus. The primary objective was to identify challenges that hindered the effective utilization of the Broset Violence Checklist (BVC) tool for referring patients to sensory modulation rooms.

Pre- and post-intervention surveys were conducted to assess participants' self-reported knowledge and barriers to BVC and sensory room utilization. Educational sessions covering workplace violence, debriefing techniques, and the …

Exploring & Mitigating Workplace Incivility At A Rural Community Hospital, Jacquelyn Ethier

DNP Scholarly Projects

Workplace Incivility (WI) is a well-known challenge in healthcare, with decades of mounting evidence showing the effects on workplace culture, healthcare worker retention and patient safety. The nursing workforce has become increasingly vulnerable to all stressful elements of the work environment. Organizational leadership must develop and deploy mitigation strategies to minimize the negative consequences of these behaviors for nurses, and the entire healthcare team. The purpose of this quality improvement project is to assess the current state of nurse perceptions of WI at a rural community hospital and deploy evidence-based education on strategies to address and mitigate WI. The method …