Nursing Commons^™

Interventions To Prevent Hospital Acquired Pressure Injuries, Astrid Geronimo

Symposium of Student Scholars

Background: Hospital acquired pressure injuries (HAPIs) are the most common preventable complication among critical care patients. This project is conducted to compare the effectiveness between the current implemented preventative measure versus the new measures that have data supporting their effectiveness. Brief Significance: Five articles were chosen that outlined the prevalence of hospital acquired pressure injuries in critical care patients and alternative interventions that have been effective in the prevention of HAPIs. These evidence-based interventions include: The application of multilayered foam dressing with hypo oxygenated fatty oils which would reduce sheer and provide support from the pressure of laying in the …

Nurse Role In Preventing Substance Abuse, Catherine Williams

Symposium of Student Scholars

Background: Pain is the number one reason why people seek medical attention, meaning pain management is an important intervention in caring for patients. However, over prescribing opioids has caused a major problem in healthcare. The United States is facing a crisis related to opioid abuse and opioid overdose deaths. A major contribution to this crisis is from an over prescription of opioids, which has caused a four-time increase in prescription opioid overdose death since 1999. It is the nurse’s responsibility to screen, assess, monitor, and educate patients about substance abuse. All patients while being triaged should be screened for abuse; …

Effectiveness Of Distraction Techniques In Reducing Pain And Anxiety During Pediatric Venipuncture, Gina Hernandez

Symposium of Student Scholars

Abstract

Venipuncture is consistently identified as one of the most painful and feared experiences of hospitalized children, often resulting in traumatic memories and resistance to future procedures. Currently, standard practice for pediatric venipuncture involves physical restraint, either by another person or by utilizing a restrictive tool. This proposal will explore the efficacy of various distraction techniques in mitigating pain and anxiety experienced by pediatric patients undergoing venipuncture. Current research shows that procedural pain and anxiety can be significantly reduced by implementing distraction techniques such as bubble-blowing, deep breathing, audiovisual distraction, and immersive virtual reality. Effectiveness of each technique varies based …

Nurse-Initiated Protocols Leading To Improved Patient Flow, Shanyne Douglas

Symposium of Student Scholars

As we grow and age as a population, more people are frequenting the emergency department (ED). Leading to an increase in ED capacity and longer wait times. These long wait times have been shown to lead to increased length of stay, decreased patient satisfaction, and increased mortality. There are many studies on ways to improve these ED challenges. The most common consensus is to improve patient flow. Patient flow is the patient's movement from admission to discharge. The best way to improve patient flow in the ED is to have a competent triage system. The Emergency Severity Index is what …

Educating Parents On Infant Safe Sleep To Reduce Sleep-Related Deaths, Marleni Cervantes

Symposium of Student Scholars

During my pediatric clinical rotation, I saw parents practicing unsafe sleeping practices with their infants. Infants would sleep with their pillows, blankets and in non-supine positions. There are around 3000 sleep related infant deaths annually in the United States (Patrick et al., 2021). To combat this issue a safe sleep education program should be implemented in labor and delivery and NICU units to ensure parents are getting the proper training before discharge. Parents will attend an education program before discharging from the hospital. The program will be completed in 2 days to ensure the parents are able to ask questions …

Reduction Of Analgesia Delivery Time Based On Pca Data, Jonathan Lynch

Symposium of Student Scholars

Evidence based practice changes motivated by reduced time between patient's reported pain onset and analgesia administration as shown by PCA research.

Preventing Clabsi In Bedside Nursing, Ashlyn Winegarner

Symposium of Student Scholars

Abstract

Central line associated blood stream infections, better known as CLASBIs, are a prominent problem in the hospital setting. Due to the direct connection between the blood stream and the outside world, these catheters are at great risk for growing infections that can spread to the bloodstream within hours. Research has been done on how compliant registered nurses are in regards to keeping these catheters sterile. A survey was conducted on one hundred and seventy-one nurses that concluded only seventy percent of the nurses were compliant in following the proper central line protocol. Another study was performed that introduced five …

Best Practice For Confirmation Of Nasogastric Tube Placement In Pediatric Patients, Joey Gondhalekar, Hannah Baines, Jacob Barcenas, Kaci Giles, Katie Crocker

Symposium of Student Scholars

Abstract

Background: Nasogastric (NG) tubes are used to provide nutrition or charcoal to patients who cannot swallow or are intubated. For pediatric patients, auscultation confirmation is often used to confirm placement despite the evidence that x-ray confirmation is a more accurate way to confirm placement. Incorrect placement leads to incidents of higher rates of healthcare acquired infections, financial strain on the hospital, and longer lengths of stay for patients.

Objectives: The objective of this evidence-based review is to review relevant published studies in determining the best practice for confirmation of NG tubes in pediatric patients.

Methods: A database search was …

Prenatal Care: Access For All?, Jasmin Stewart

Symposium of Student Scholars

Prenatal care is an essential part of a woman’s pregnancy journey. It ensures that both mother and child are doing well, and helps to locate and diagnose any issues before they become complications. Without regular check ups, mothers will not be aware of life-threatening complications such as preeclampsia or placenta previa. Women in low socioeconomic brackets often do not have good access to prenatal care. Research studies have interviewed women and have stated many times there are no providers in the area where they live and they have to make long trips to see a doctor, which they cannot afford. …

Does Triage Education Reduce Classification Errors In The Ed?, Rachel Abukhdeir

Symposium of Student Scholars

IN A METRO ATLANTA LEVEL TWO EMERGENCY DEPARTMENT, DOES THE APPLICATION OF TRIAGE EDUCATION REDUCE TRIAGE CLASSIFICATION ERRORS?

Abstract

Incorrect triage of patients leads to excessive wait times, an increase in length of stay, and escalating medical conditions. One of the most common triage systems in the United States is the Emergency Severity Index (ESI), a five-level triage system that focuses on prioritizing patient care based on the urgency of the patient’s illness. An assessment is performed by nurses to determine patients’ level of acuity. This method is subjective to the nurse performing triage. Currently, nurses have no or minimal …

Making Strides To Improve Quality Nursing Care, Arielle Holland

Symposium of Student Scholars

Background: Over the last few decades America’s non-English (predominantly Spanish) speaking population has significantly increased and is predicted to continue rising in the coming years. With an increase in Spanish speaking patients and low numbers of nurses who are fluent, miscommunications between nurses and non-English speaking patients are inevitable. These language barriers lead to increased sentinel events, mistrust, and dissatisfaction with nursing care for patients and their families. The purpose of this research study is to call for reevaluation of current practices and implementation of more reliable techniques for communication between nurses and their non-English speaking patients. Methods: Two acute …

Cauti Prevention In The Icu, Kai Zheng, Christie Emerson, Nerma Redcross

Symposium of Student Scholars

Project Proposal Abstract

Background: ICU patients are often bedbound for extended periods. Routine insertion of a urinary catheter, lack of proper Foley care techniques, and reluctance to remove the urinary catheter increase the risk of CAUTI. Each day a catheter is left in place, the patient's risk for CAUTI increases by 5%.

Brief Literature review: The incorporation of the Plan-Do-Study-Act approach helped to reduce CAUTI by deliberately layering single interventions over an extended period of time, it allowed the nurses to fully adopt each intervention before moving on to the next.

Methods: Interventions included considering alternatives to indwelling urinary catheters, …

Prevention Of Pressure Ulcers Interventions, Halle Borgel

Symposium of Student Scholars

Pressure injuries continue to be a rising problem in hospitalized patients, specifically non-ambulatory patients. Without frequent turning and pressure relieving surfaces, patients may develop a pressure injury that costs them more and lengthens their hospital stay. By comparing frequent turning schedules and pressure relieving foam mattresses in the prevention of pressure injuries, thousands will be prevented. After a thorough search review on articles, five articles were selected in determining which prevention method happens to be the best. Although no articles researched the clinical prevention in foam mattresses and frequent turning, conducting a proposed project is effective. The proposed project consists …

Copd Rehabilitation Benefits, Jena Killian

Symposium of Student Scholars

Abstract

Chronic obstructive pulmonary disease is a progressive illness restricting airflow that is long term burden due to its uncurable nature and incapacitating symptoms such as dyspnea and a chronic cough. Pulmonary rehabilitation is shown to increase quality of life and exercise capacity. This project is aimed at emphasizing the benefits of PR and different approaches to increasing self-induced participation in rehab facilities and at home. From different articles gathered, there was a variety of tests completed including 6-min walk (6mWT), mMRC dyspnea scale, COPD assessment, pulmonary function test using incentive spirometer, etc. showing increased lung function and decrease symptom …

Point-Of-Care Devices To Reduce Iatrogenic Anemia Among Preterm Infants, Jenna Craven

Symposium of Student Scholars

Abstract

In neonatal intensive care units (NICUs), the prevalence of anemia and required blood transfusions continues to rise. Blood testing is necessary in this population in order to accurately develop diagnoses and treatment options. However, blood loss in the NICU is the main cause of preterm neonatal anemia. Preterm infants tend to experience larger amounts of blood loss compared to other infants in the NICU. They are born with fewer red blood cells and are not able to rapidly reproduce these blood cells when needed, and multiple blood draws further deplete the infant’s hemoglobin and hematocrit levels. In current practice, …

Cauti Infection In Acute Care Setting, Kai Zheng, Katherine Waldron, Andrea Medina

Symposium of Student Scholars

CAUTI Infection in Acute Care Setting

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) is one of the most common and costly hospital-acquired infections (HAI) within the acute care setting that prolongs the length of stay and negatively affect patient health outcomes. Purpose: This evidence-based practice project addresses the question: Within the acute care setting, what nursing interventions are effective in preventing CAUTI? Methods: PRISMA was utilized, and various peer-reviewed literature have been appraised using the John Hopkins Evidence-Based Practice Tools to determine the most effective interventions to reduce the prevalence of CAUTI within the adult acute care setting. Results: Implementation of …

Noise Reduction In The Intensive Care Unit, Carolina Gomez

Symposium of Student Scholars

Abstract

The purpose of this study was to analyze the noise levels in an intensive care unit (ICU) in a metro atlanta medical facility and to establish interventions that could be used to reduce the noise. Determining the effects is significant because it can improve a patients’ outcome in the ICU. The challenge explored was evidenced by 15 out of 20 patients stating that they are suffering sleep deprivation due to excessive noise levels. After 3 days in the ICU, patients have developed confusion and delirium; they are not oriented to date and time without reminders. After 3 days in …

How Frequent Oral Care Can Decrease The Incidence Of Aspiration Pneumonia Within The Critical Care Setting, Patrick Subers

Symposium of Student Scholars

Within the critical care hospital setting, many patients are declared NPO, or nothing by mouth, for various reasons. Typically, these patients have had a stroke, are at risk for aspiration, or are pending an operation. In the case of stroke patients, they are often held NPO for an extended period while their ability to swallow improves to a safe level. One of the greatest risks for this patient population is the development of aspiration pneumonia, as they have a decreased ability to clear secretions from their throat and mouth. Pair that with the fact that this population is heavily care-dependent …

Mentoring Infection Preventionists: An Infection Prevention Practice Fellowship Program, Sejal Naik

DNP Qualifying Manuscripts

Background: The COVID-19 pandemic created enormous demands on infection preventionists (IPs). It seriously taxed IPs and required hiring new IPs to support these demands. It is highly competitive to hire experienced IPs, and it can take up to two years for new IPs to demonstrate proficiency before pursuing their certification. A gap analysis revealed that current infection prevention (IP) programs did not provide formal training or mentoring.

Methods: The fellowship program will use the Association for Professionals in Infection Control and Epidemiology (APIC) competency model to train and build IP competency. The APIC accelerated training program will provide training to …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

Constant Observation The Benchmark Study, Kalana Sanders

MSN Capstone Projects

Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 …

Nursing Considerations For Elderly Adults With Urinary Tract Infections In Nursing Homes, Mary Marlett

D.U.Quark

No abstract provided.

Ed To Telemetry Bed: Optimizing Nurse Communication & Decreasing Team Frustration, Harmandeep (Harm) S. Madra

Master's Projects and Capstones

PROBLEM: According to the Institute of Medicine, boarding inpatients in the emergency department (ED) can result in an increased risk for medical errors, delay in treatments, and decreased quality of care. The goal is to move the patient to the hospital bed within 60 minutes from when an order is written for admission. The current average monthly compliance for ED throughput and admission to the inpatient bed is at 45% compared to the target of 70%. Lack of standardization during handoff can lead to delays, miscommunication and causes team frustration.

CONTEXT: In 2022, this community hospital’s ED microsystem had limited …

Implementation Of Provider Education Regarding Exercise As Adjunctive Treatment For Common Mental Health Diagnoses, Lauren Grace Martin

Doctoral Dissertations and Projects

Mental and physical health are inextricably linked. The advent of the Covid-19 pandemic reduced physical activity levels while worsening mental health symptoms. Pharmacological treatments are frequently used to treat mental health conditions; however, side effects can worsen metabolic issues. There is significant evidence that exercise can improve mental health conditions. The purpose of this project was to utilize provider education as an intervention to increase the use of exercise as an adjunctive treatment in the psychiatric treatment plan. This project was implemented at Nevada Mental Health, an outpatient behavioral health clinic in Las Vegas, Nevada. The investigator conducted a chart …

An Education Intervention Project In Community Clinics To Improve The Identification Of Patients With Pulmonary Alveolar Proteinosis And To Correctly Identify The Type Utilizing The Differential Diagnostic Algorithm, Catherine J. Poisson

Doctoral Dissertations and Projects

With over 7000 types, rare diseases affect 25-30 million Americans and contribute to over one trillion dollars in healthcare-related costs. Prescribers lack the knowledge to improve awareness, identification, and treatment of rare diseases. Pulmonary alveolar proteinosis is a rare disease in which patients present with symptoms such as dyspnea, fatigue, and respiratory infections. Diagnosis can take four to 92 months. A differential diagnostic algorithm published in the literature can guide clinicians in identifying the type of pulmonary alveolar proteinosis the patient has. In addition, if the clinicians perform a laboratory test called the granulocyte-macrophage autoantibody test, this test provides 100% …

Focused Group Meetings To Promote Job Satisfaction For Emergency Department Advanced Providers, Kendra Osei-Wusu

Doctoral Dissertations and Projects

Objective: Over the last few years, the pattern of increased burnout, operating under adverse environments, and being under- appreciated as led to a decrease in job satisfaction among emergency room providers(physicians, advanced practicing nurses, and physician assistants). Therefore, this scholarly project examined if small focused group discussions among emergency room providers will help combat poor job satisfaction scores and increase the well-being of the practitioners that keep the emergency room functioning. Methods: Using a quasi-experimental design, 10 providers that work in the emergency department at Lifebridge Health were randomly selected. Baseline well-being and job satisfaction rates were measured prior to …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

Congestive Heart Failure Educational Approach Benchmark Study, Sheridan B. Westmoreland

MSN Capstone Projects

Heart failure continues to burden the American healthcare system. Disease management programs and transitional care services are used by hospitals to help patients living with congestive heart failure (CHF) transition from the hospital to home life. Twelve articles were chosen to evaluate the effectiveness of a multidisciplinary approach in reducing hospital readmission rates, cost, and death. One article was chosen to see how a nurse-led 1:1 patient educational approach was effective, and one article evaluated patients’ perception on living with CHF. This paper aims to evaluate the best educational approach on reducing hospital readmission rates, death, and cost in CHF …

Adjustable Velcro Compression Devices, Spring Reed

MSN Capstone Projects

Venous Ulcers and edema are expensive to treat and chronic conditions that are a strain on home health care companies and decrease patient quality of life. The standard treatment is expensive multilayer compression wraps that time consuming requiring three weekly visits, a strain on home health care agencies and are often not successful in resolving edema and venous ulcers. Adjustable Velcro compression devices are proven to be successful compression therapy due to low one-time cost, patient's increased comfort and the patient or patients' family self-sufficient in their application.