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Articles 1 - 16 of 16
Full-Text Articles in Critical Care Nursing
Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez
Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez
Nursing | Student Research Posters
Abstract
Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand …
Sch Icu Expanding Pics Throughout Centracare, Jessica A. Tindal
Sch Icu Expanding Pics Throughout Centracare, Jessica A. Tindal
Nursing Posters
Purpose:
Sharing information about Post Intensive Care Syndrome (PICS) to all in CentraCare. PICS symptoms do not appear until weeks to months after a critical care illness so patients at home may not know what to do with their symptoms.
Future Plans:
- May 2023 - introducing CICU to the PICS process during their Nurse Practice meeting.
- May 2023 - updating the Hospital Medicine Section CNS
- Fall 2023 - meeting with the Ambulatory Work Cabinet group to see if our system of notification is working
- What opportunities do we have with teaching Progressive RNs about PICS and our Diaries?
- How can …
From Silos To Collaborative Working Relationships With Ems And Ed, Angela Moscho
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
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 …
Icu Cauti Incidence Reduction, Michelle Gamble
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
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
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
Recognition Of Nonconclusive Seizures In Patients After Cardiac Arrest Using, Teresa Jahn, Elizabeth Plante
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 …
Safe Intra-Hospital Transport Of Adult Patients On Non-Critical Care Units, Teresa Jahn, Janelle Maciej, Greta Titus
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
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 …
Promoting Patient Outcomes: Clabsi Prevention, Woon Paek
Promoting Patient Outcomes: Clabsi Prevention, Woon Paek
Nursing Posters
What is a CLABSI?
“A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line” (CDC, 2021)
Best practices for preventing CLABSIs:
- Perform hand hygiene
- Don proper PPE
- Sterile/aseptic technique during insertion
- Prioritize for cares related to central line first
- Daily assessment for need of central line
- Daily chlorhexidine gluconate bathing
- Remove catheters that are unnecessary
- "Scrub the hub" BEFORE EVERY access
- Change dressings every 7 days or as needed
- Assessment of site/dressing condition
- Change purple Ultrasite caps with dressings
- Tubing changes per CentraCare policy
- Discard …
Neurointerventional Post-Procedure Assessment And Documentation Compliance, Chandra Brower
Neurointerventional Post-Procedure Assessment And Documentation Compliance, Chandra Brower
Nursing Posters
Per stroke best practice guidelines, pulse and groin checks need to be completed post-neurointerventional procedure per orders. Our plan is to improve assessment and documentation of post-procedure pulse and groin checks by improving the flow of the Electronic Medical Record (EMR). By enhancing clinical documentation and improving the documentation process, nursing practice can be supported, and best patient care delivered.
Deep Tissue Injuries, Mary Pohlmann, Katie Meyer
Deep Tissue Injuries, Mary Pohlmann, Katie Meyer
Nursing Posters
Purpose Statement from Poster:
- Recognize and identify Deep Tissue Injuries
- Ability to describe and define Deep Tissue Injuries
- Increase awareness of Deep Tissue Injuries in order to promote early identification and treatment
Is The Evidence Worth It?, Christian Contessa
Is The Evidence Worth It?, Christian Contessa
Student Research Poster Presentations 2020
No abstract provided.
Implementation Of Proper Lead Selection Based On Ecg Practice Standards In Hospitalized Patients, Teresa Jahn, Nicole Hubbard, Samantha Pohlmann, Lauren Hoeschen, Shayna Lahr
Implementation Of Proper Lead Selection Based On Ecg Practice Standards In Hospitalized Patients, Teresa Jahn, Nicole Hubbard, Samantha Pohlmann, Lauren Hoeschen, Shayna Lahr
Nursing Posters
Ensure adult patients in a 36 bed Telemetry Unit and 14 bed Cardiac Intensive Care Unit (CICU) with the diagnosis of STEMI and NSTEMI are being monitored in the appropriate leads to detect acute or silent ischemia and arrhythmias.
Reduced Frequency Monitoring Post-Stoke Treatment, Melissa Freese
Reduced Frequency Monitoring Post-Stoke Treatment, Melissa Freese
Nursing Posters
In 2020, the nation was faced with a pandemic that quickly depleted health care resources. Standards of care were reviewed to identify opportunities to reduce the burden on healthcare resources. One of the standards of care that was reviewed nationally and locally at the St. Cloud Hospital (SCH), was the postalteplase/ thrombectomy patient placement and monitoring.
The standard of care for the placement and monitoring of post-alteplase patients was established during the 1996 NINDS trial and has not been studied since. Very minimal literature is available on the standard of care for patient placement and monitoring post-thrombectomy.