Critical Care Nursing Commons^™

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects and Capstones

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes so …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

The Efficacy Of Non-Pharmacological Pain Management Methods Amongst Premature Neonates In The Neonatal Intensive Care Unit (Nicu), Hannah R. Martinez

Honors Undergraduate Theses

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

University Scholar Projects

Abstract

Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical.

Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge.

Method:

This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA) …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Implementation Of Interprofessional Education And Physician Order Set Improves Compliance With Early Recognition And Treatment Of Maternal Sepsis, Lori Susan Olvera

Doctoral Projects

Septic shock is rare in pregnancy; however, sepsis remains an important contributor to maternal mortality. The perinatal patient can appear deceptively well before rapidly deteriorating to septic shock. There is a need for protocols regarding early recognition and management of maternal sepsis. The Surviving Sepsis Campaign developed guidelines to provide guidance for the clinician caring for patients with severe sepsis or septic shock. The purpose of this doctoral project was to evaluate compliance with early goal directed therapy before, during, and following the implementation of a standardized physician order set and interprofessional education for nurses and physicians in the perinatal …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

Hearing The Child's Voice: Their Lived Experience In The Pediatric Intensive Care Unit, Andrea Prentiss

All Publications

Background: More than 200,000 children are admitted annually to Pediatric Intensive Care Units (PICUs) in the US. Research has shown young children can provide insight into their hospitalization experiences; child reports rather than parental reports are critical to understanding the child’s experience. Information relating to children’s perceptions while still in the PICU is scarce.

Aims: The purpose of this qualitative study was to investigate school age children’s and adolescents’ perceptions of PICU while in the PICU; changes in perceptions after transfer to the General Care Unit (GCU); differences in perceptions of school age children/adolescents and those with more invasive procedures. …

Nurses’ Perspectives On Neonatal Massage Therapy In The Neonatal Intensive Care Unit, Kayla R. Hanson

Senior Honors Theses

Research in neonatal massage therapy has shown many possible benefits to the baby and family. Though there has been a growing trend towards family-centered care, along with a substantial and growing body of research, the practice of neonatal massage therapy is not routine in most NICUs. This study was conducted to evaluate neonatal intensive care nurses’ perspectives and attitudes towards neonatal massage therapy before and after evidence-based education. Willingness to discuss benefits of neonatal massage therapy significantly increased after education on neonatal massage therapy. The findings suggest that with proper training on the techniques and safety monitoring of massage therapy, …

Parent Involvement In End-Of-Life Care And Decision Making In The Newborn Intensive Care Unit: An Integrative Review, Lacey M. Eden, Lynn Clark Callister

Faculty Publications

Survival rates for very preterm and critically ill infants are increasing, raising complex ethical issues for health-care providers and parents who face the challenge of making end-of-life decisions for newborns. The purpose of this integrative literature review was to evaluate parental involvement in end-of-life care and decision making for their infant in the newborn intensive care unit. Findings revealed that establishing good relationships and clear communication between health-care providers and parents builds trust and eases stress placed on parents making decisions about the care of their infant. Palliative care programs provide support for parents and facilitate their decision making. Parents …

A Survey Of Neonatal Suction Techniques Performed By Registered Nurses, Craig H. Register

Theses, Dissertations and Capstones

Purpose. The purpose of this study was to determine the suction practices of the registered nurse in the neonatal intensive care unit.

Design. A descriptive research design was used to describe the suctioning practices of the registered nurse providing care to the neonatal patient.

Method. Data were collected through the use of demographic and knowledge questionnaires. Frequency and percentages of responses were determined. The independent samples t test was used to determine what, if any, differences in practice existed based upon nursing education, nursing experience, or NICU experience.

Findings. The results of this study demonstrated that the current practices were …

An Explanatory Study Of Maternal Stress And Coping With A Cystic Fibrosis Child, Leslie G. Potter

Ellmer School of Nursing Theses & Dissertations

The purpose of this study was to explore the concept of coping with a cystic fibrosis (CF) child and to define coping strategies from the perspective of the mother. The research design was based upon a phenomenological approach with analysis of transcribed, semi-structured interviews with mothers of CF children. A purposive sample of eight mothers with CF children were interviewed to explore the maternal CF experience. Each interview was tape recorded and followed up with a phone call to allow the mothers to add additional information, if so desired. Data analysis consisted of reviewing each typed, verbatim transcript to categorize …

Parental Perceptions Of Neonatal Intensive Care Unit Discharge Teaching, Virginia A. Passero

Dissertations

The purpose of the study was to determine parental perceptions of Neonatal Intensive Care Unit (NICU) discharge teaching. Orem's (1985) self-care deficit theory was the conceptual framework. Fifty mothers and 15 fathers were interviewed in their homes following the infant's discharge to determine their perceptions of involvement, recall, need, satisfaction and importance of NICU discharge teaching.

The 50 infants in the sample were hospitalized an average of 41 days with a variety of neonatal diagnoses. The average age of the mothers was 27 years, and the sample of 50 included 82% married women, 42% primiparas, and 52% cesarean deliveries. Forty-two …