Nursing Commons^™

Just Culture In Undergraduate Nursing Academia, Marcie Leonard

Doctor of Nursing Practice Projects

Understanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data …

Perioperative Corneal Abrasion: An Investigation Into Preventive Practices And Educational Interventions That Limit Corneal Abrasions In The Perioperative Setting, William Boyden

Doctor of Nursing Practice Projects

Corneal abrasions are the most common ophthalmic injuries that occur in the perioperative period. Corneal abrasions that occur while the patient is under anesthesia are the result of either physical trauma, exposure, or patient related factors. Anesthesiology departments rarely develop continuing education focusing on the reduction of corneal abrasion incidence. Evidenced-based guidelines for corneal abrasion prevention techniques were reviewed while developing an educational program focused on corneal abrasion prevention amongst a group of Certified Registered Nurse Anesthetists (CRNAs). An educational presentation was given to twenty-eight CRNAs. The goal of the presentation is to reduce corneal abrasions in the perioperative setting, …

Difficult Labor Epidural: Intrathecal Catheter Management, Andrew Screnchuk

Doctor of Nursing Practice Projects

Labor epidural analgesia is the most common method used to control pain associated with labor and vaginal delivery in the United States. However, the epidural catheter placement can cause accidental dural puncture in about 1 to 6% of laboring patients. Initiation of continuous intrathecal analgesia provides a good alternative to another attempt of epidural placement in certain types of the laboring population. While other countries have published referral guidelines of managing accidental dural puncture, the United States lacks such practice standards. The application of Accidental Dural Puncture Management with Intrathecal Catheter (ADPMIC) guidelines, used in other countries for difficult epidural …

Development And Implementation Of An Enhanced Recovery After Surgery Protocol For Thoracic Surgery Procedures, Nicholas Collier

Doctor of Nursing Practice Projects

A high prevalence of lung and esophageal cancers leads to significant healthcare dollars utilized for treatment and management. Surgical resection is regarded as a key component for multidisciplinary treatment and management of these cancers. By standardizing multidisciplinary patient care and utilizing evidence-based practice, Enhanced Recovery After Surgery (ERAS) protocols for thoracic surgery have offered better outcomes with fewer complications and reduced healthcare costs. The anesthesia providers at the host facility were deficient in basic knowledge related to ERAS protocols and best practice management of thoracic surgery patients. The purpose of this project was to educate anesthesia providers on ERAS principles …

Implementing Quality Into Practice: Nurse Driven Protocol To Reduce Unnecessary Telemetry Use, Richard Clapp

Doctor of Nursing Practice Projects

Abstract

Background: As part of the American Board of Internal Medicine's Choosing Wisely initiative, the Society of Hospital Medicine issued the recommendation to reduce unnecessary use of continuous telemetry monitoring in the inpatient setting. Outside of its primary purpose continuous telemetry monitoring rarely positively impacts clinical decision making and overuse can lead to unnecessary and costly diagnostic work-ups, cause alarm fatigue, lead to emergency department congestion, and increase institutional financial burden.

Objective: Pilot an evidenced based nurse driven protocol for discontinuation of continuous telemetry monitoring to reduce unnecessary telemetry use among adult patients hospitalized outside of the intensive …

The Development Of A Pain Medication Management Protocol, Kirstie Mcgrath, Jane M. Brown, Shannon D. Walle

Doctor of Nursing Practice Projects

Implementation of an organization-wide pain management policy incorporates a multifaceted team approach that could lead to improved patient outcomes. The absence of a standardized opioid prescribing policy within a healthcare organization has led to individual departments adopting their own guidelines. Management of an individual patient’s pain medication is often met with reluctance from providers when a patient is transferred from another department leaving the patient with inadequate care.

Transitioning With Grace: Improving Quality Of Life For Comfort Care Patients In The Intensive Care Unit, Melissa Ashley

Doctor of Nursing Practice Projects

The primary aim of this project was to develop and execute a standard protocol of interventions for comfort care patients on a medical intensive care unit. Staff at a 15 bed MICU at a Midwest urban teaching hospital from June 1 until August 11, 2018 were trained to execute a standardized protocol of interventions for comfort care patients. Seventeen MICU patients who transitioned to comfort care were offered a standardized set of evidence-based interventions, after staff attended educational in-services on providing high quality end of life (EOL) care. Checklists were used to determine intervention compliance. Pre-project and post-project surveys were …

Introduction Of Enhanced Recovery After Surgery For Colorectal Surgical Patients: A Quality Improvement Project, Amanda R. Mcvey

Doctor of Nursing Practice Projects

The purpose of this practice project was to develop and introduce an enhanced recovery after surgery (ERAS) protocol for colorectal surgical patients at a tertiary care center in southern Illinois. Project aims included reviewing available literature and study outcomes to develop an evidenced-based ERAS protocol for colorectal surgery and educating anesthesia providers about ERAS to introduce the evidenced-based ERAS protocol for colorectal surgery. An educational presentation and learning assessment tool were developed and subsequently presented to the anesthesia providers at the host facility. The first step toward implementing the protocol is education, as such, the results of the assessment questions …