Critical Care Nursing Commons^™

Pediatric Specific Assessment Modalities In Pediatric Blunt Trauma Cases: A Literature Review, Haley Ranne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

With unintentional injury being the number one cause of death of children in the United States, it warrants the need for successful, cost effective ways to improve identification of severe injury and prevent mortality in children. The purpose of this review is to compile literature related to pediatric specific trauma assessments in the instance of blunt trauma. Twenty peer-reviewed articles that were published in notable journals were analyzed to include in this review. There are several assessments that are being utilized in pre-hospital and hospital emergency settings today, such as the Shock Index (Pediatric Age Adjusted), Pediatric BIG Score, and …

Tiny Tusks Internship: Barriers To Breastfeeding Surrounding Neonatal Intensive Care Units, Brianna Purser, Quinn Owen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

It is known that breastfeeding is beneficial to mothers and their children, and it is recommended that mothers exclusively breastfeed for the first six months of their infant's life. Despite this, in the United States only 1 in 4 infants is exclusively breastfed for the first six months. After being an intern for Tiny Tusks Breastfeeding and Infant Support, a program designed to facilitate and educate about breastfeeding, we have seen firsthand the barriers to breastfeeding. The goal of this literature review was to investigate barriers to breastfeeding specifically surrounding neonatal intensive care units (NICU) and how to address those …

Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño

Doctoral Projects

A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses' Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses' confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that …

Decreasing The Number Of Venipuncture Attempts In Infants On A Neonatal Intensive Care Unit, Laura Grace Holton

Symposium of Student Scholars

Decreasing the Number of Venipuncture Attempts in Infants on a Neonatal Intensive Care Unit

Laura Grace Holton

Obtaining intravenous access is a procedure performed on most preterm infants in neonatal intensive care units, for the purpose of obtaining blood samples, administering fluids and medications. Venipuncture is the process of puncturing the skin to insert a needle for IV access and often must be performed multiple times to be successful given the small veins of preterm infants. Research shows that multiple venipuncture attempts can be distressing to hospitalized infants, increases the risk of bloodstream infections, and causes lasting vein damage. Literature …

Too Loud: A Project For Sound Reduction In The Neonatal Intensive Care Unit, Peyton Cadwell, Amy Krazl

Scholars Week

Sound levels in any intensive care unit environment are significantly higher than the recommended volume. The neonatal intensive care unit (NICU) is included in this aggregate that frequently exceeds advised levels. There are consequences associated with increased sound, such as slower language development and behavior issues. Not only are babies subjected to physiological effects, but there is potential for psychological detriment as well, such as behavioral issues (Bremmer, 2003). Many solutions for this issue have been proposed, including lowering phone volumes, putting rubber shoes on furniture and switching audio alarms to visual alarms. One specific intervention that may reduce the …

How To Control Healthcare Associated Infection, Yeojin Son, Jungyoon Hur

Scholars Week

Healthcare-Associated Infections (HAI) are infections patients acquire while receiving care in hospital. The main reasons of occurring the infections are insufficient knowledge about infection control and decreased compliance with rules by hospital protocol. The purpose of this evidence-based presentation is to exemplify how to control HAI via motivating healthcare workers to comply with infection control policy.

Improving Antibiotic Administration Timing In Neonatal Early-Onset Sepsis, Donia B. Bass

Regis University Student Publications (comprehensive collection)

Abstract

Neonatal early onset sepsis (EOS) remains one of the most common causes of neonatal morbidity and mortality. Neonates requiring evaluation and treatment for suspected EOS inconsistently receive antibiotics within one hour of decision to treat as recommended in the 2012 neonatal sepsis guidelines by the National Institutes for Health and Care Excellence (NICE). A mixed method quality improvement initiative was employed in a level three NICU, applying a standardized admission process to mitigate systems flaws impacting delay of first dose antibiotic. A nursing sepsis education module was provided, and the novel SAM admission prioritization tool was developed to guide …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judy E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

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 …

2020 Nursing Annual Report, Children's Health System Of Texas

2020

No abstract provided.

The Changing Face In The Workplace: The Arrival Of The Millennial Generation, Sarah Clonch

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The entrance of the Millennial generation into the nursing workforce signifies a bright future for the nursing profession and the nursing workforce. This study began with a current review of available research that identified the Millennial generation and their views toward job satisfaction and work engagement, as compared with Baby Boomer and Generation X nurses.

PubMed, CINAHL Complete, and Google Scholar databases were employed to find 15 peer-reviewed articles for evaluation. The research findings suggest that Millennial nurses have lower rates of job satisfaction and work engagement, compared to nurses of older generations. Overall, the extracted data results were significant …

2021 Nursing Annual Report, System Of Texas Children's Health

2021

No abstract provided.

An Extensive Literature Review On Neonatal Pain Assessment & Management, Bailey Bishop

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Neonatal pain assessment and management is a field requiring much more research. This literature review outlines the current climate of neonatal pain assessment, compares a variety of neonatal pain scales on validity and clinical utility, and implications for how neonatal pain management can be improved. Neonates experience pain to the same degree, if not more, than everyone else. Unmanaged pain during the neonatal period leads to adverse health outcomes. In order to prevent these atrocities from this vulnerable population, NICU pain assessing needs to become the standard of care.

Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor

Undergraduate Honors Theses

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Family-Centered Care In The Neonatal Intensive Care Unit, Sarah Brown

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Family-centered care has not always been integrated with patient-care. In the mid-1900's, a movement began that altered the role of the family from observer to participant. With the help of family advocates, inclusive practices and partnerships between families, patients, and providers was initiated (Kuo et al, 2012). Now, family and patient-centered care is a widely practiced form of individualized care and relationship building between families, patients and their providers. Five principles shape the foundation for family-centered care. These include information sharing, respect and honoring differences, partnership and collaboration, negotiation, and care in the context of family and community (Kuo et …

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in …

Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings

Dissertations

Author: Lisa Cummings PhD RN

Fathers’ Experiences with Their Premature Infants or Unhealthy Neonates

Purpose and Background/Significance: Fifteen million babies worldwide are born prematurely each year, impacting a multitude of fathers. The importance of an early close father-infant relationship has been identified as central for the development of the child. Fathers influence on a child’s emotional and cognitive development and their physical well-being and health. Many times, the Neonatal Intensive Care Unit (NICU) is the initial contact environment between a father and his premature infant. Studies have shown that the NICU can be a stressful environment for parents, producing emotional …

Increasing Nursing Competence And Confidence During Obstetric Emergencies Through Simulation: A Quality Improvement Project, Tram Wallen

Dissertations

Problem: This quality improvement project aimed to improve the knowledge and confidence of the mother/baby nursing staff during postpartum hemorrhages through in situ simulation. PPH is a leading cause of maternal death. Hospitals across the U.S. lack a standard approach to managing obstetric emergencies; the complications of childbirth are often identified too late. Multidisciplinary simulation-based team training has been associated with improved outcomes in obstetrics.

Methods: A convenience sample of 26 registered nurses (RNs) that care for postpartum patients attended a one-hour instructor-led presentation followed by in situ simulations of postpartum hemorrhage. A knowledge assessment and confidence survey were administered …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Improving Analgesia Administration For Pediatric Patients In A Rural Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

When a child is in pain, parents often seek out treatment at an emergency department. After a detailed chart review it was determined that only 32.53% of the pediatric patients who present to a rural, northern California, ED in pain receive any documented form of analgesia during their time in the ED. A review of the literature revealed that triage nurse-initiated protocols can successfully manage to provide consistent and efficient analgesia to patients who present to an ED with pain. Therefore, a practice improvement project was undertaken to increase of the consistency and efficiency of analgesia administration for pediatric patients …

Nicu Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Renea L. Beckstrand, Rebecca F. Isaacson, Janelle L. B. Macintosh, Karlen E. Luthy, Lacey Eden

Faculty Publications

Background: Neonatal deaths (infants less than 28 days old) account for two thirds (66.7%) of all infant deaths with most occurring in an ICU setting. NICU nurses are frequently involved in end-of-life (EOL) care and face unique obstacles.

Objective: The objective of this study was to obtain NICU nurses’ suggestions for improving obstacles in EOL care in NICUs.

Methods: Suggestions were obtained through mailed survey research in qualitative study design. Returned surveys yielded 121 nurse respondents who gave a total of 138 suggestions.

Results: A total of 10 cohesive themes were identified: (1) environmental design issues, (2) improved communication between …

The Association Of Kangaroo Mother Care, Energy Conservation, And Bonding In Preterm Neonates, Dorothy Forde

Dissertations

Purpose:To examine the association of kangaroo mother care (KMC) on energy utilization and bonding as evidenced by reduced biochemical markers of adenosine triphosphate (ATP) degradation, hypoxanthine (Hx), xanthine (Xa), and uric acid (UA), and (allantoin), a measure of oxidative stress in preterm infants 24-36 weeks gestation. A secondary objective was to compare specific physiological parameters using bedside monitoring and perfusion and oxygenation of the gut using near-infrared spectroscopy (NIRS) during 1 hour of KMC compared to incubator care.

Study design: A randomized controlled trial (RCT) examining the effects of 1-hour of KMC or 1-hour incubator care on urinary markers …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Programs That Can Support Nurses To Reduce Compassion Fatigue And Secondary Traumatic Stress: An Integrative Literature Review, Molly Gruettner

Grace Peterson Nursing Research Colloquium

Compassion allows a nurse to empathize with their patient and their family, but it does not prepare the nurse to cope with stressful events. Repeatedly being exposed to traumatizing events, pain, distress, and suffering can lead to nurse burn-out and fatigue. Compassion fatigue is a unique form of burnout and secondary traumatic stress (STS) encompasses ideas of compassion fatigue and the two terms are often used interchangeably. Objective: The goal of this systematic integrated literature review is to discover interventions to reduce compassion fatigue and STS in trauma nurses Methods: A systematic integrated literature review study was conducted using Ebscohost …

An Examination Of The Moderating Effect Of Proactive Coping In Nicu Nurses, Britan M. Moore

Loma Linda University Electronic Theses, Dissertations & Projects

The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive …