Critical Care Nursing Commons^™

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Student Research Posters

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Detection And Management Of Post Intensive Care Syndrome, Ann Tomy

Nursing | Student Research Posters

Post Intensive Care Syndrome (PICS) is a collection of symptoms that more than half of patients who survive a critical illness experience after discharge.Those symptoms include weakness, fatigue, sleep disturbances, cognitive dysfunction, post-traumatic stress disorder, mental health conditions, and a lack of effective coping strategies. PICS can significantly impact an individual's quality of life, complicating the recovery process and posing challenges for reintegration into daily activities and societal roles. The etiology of PICS is multifactorial, with the severity and duration of the illness, the nature of medical interventions in the ICU, and the pre-existing health condition of the patient all …

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 …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn Jansen

Nursing | Senior Theses

Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with …

Assessing Disparities In Culturally Competent Care In Ethnic Burn Patients, Min Kang

Nursing | Student Research Posters

One of the most debilitating injuries one can suffer is a burn. It is even worse when certain individuals can not access the high quality care such as immigrants. With immigration rates increasing over the last several decades, these populations often lack the proper medical care that they deserve. The overarching theme in this population is that they face challenges in attaining positive patient outcomes due to cultural differences.

• Lack of Culturally Competent Care in Burn Care
• Addressing Cultural Safety and Quality of Care in Burn Injury Management
• Analyzing Disparities in Access to Culturally Competent Burn care

Impact Of Nursing Education On Kangaroo Mother Care: Neurodevelopment Outcomes In Preterm Infants, Giana Usac

Nursing | Student Research Posters

Preterm birth poses a significant risk to the normal trajectory of brain development, particularly in the cortex, which is responsible for higher cognitive functions, motor control, and socio-emotional processing. However, Kangaroo Mother Care (KMC) has emerged as an important early intervention capable of improving neurodevelopmental outcomes in preterm newborns. This quantitative research proposal aims to assess the influence of nurse education on KMC practices, identifying pivotal periods in infancy when KMC has the most significant impact on neurodevelopment outcomes in preterm infants. The literature critique focuses on the efficacy of nursing education, the optimization of KMC regarding duration and frequency, …

The Impact Of Nursing Education On The Implementation Of Kangaroo Care: Neurodevelopment Outcomes In Preterm Infants, Giana Usac

Nursing | Senior Theses

Preterm birth poses a significant risk to the normal trajectory of brain development, particularly in the cortex, which is responsible for higher cognitive functions, motor control, and socio-emotional processing. However, Kangaroo Mother Care (KMC) has emerged as an important early intervention capable of improving neurodevelopmental outcomes in preterm newborns. This quantitative research proposal aims to assess the influence of nurse education on KMC practices, identifying pivotal periods in infancy when KMC has the most significant impact on neurodevelopment outcomes in preterm infants. The literature critique focuses on the efficacy of nursing education, the optimization of KMC regarding duration and frequency, …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Senior Theses

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Post-Traumatic Stress Disorder Among Healthcare Professionals Working In Emergency Transport And Critical Care Settings, Keenan Mai

Nursing | Student Research Posters

No abstract provided.

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Student Research Posters

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care based training, with …

Examining The Effects Of Music Therapy On Physical And Psychological Symptoms Among Cancer Patients Undergoing Chemotherapy, Guadalupe Saldana

Nursing | Senior Theses

Background: Patients undergoing chemotherapy experience undesirable physical and psychological effects in which medications are the preferred method of management. However, standard medications are often insufficient for patients. Failure to attend to the adverse effects can lead to worsening of the patient’s cancer diagnosis and quality of life. The importance of managing chemotherapy symptoms creates an urgent need to implement an approach that is noninvasive, non-pharmacological, and one that still meets the physical and psychological needs of patients receiving chemotherapy.

Objective: The purpose of this thesis is to examine the effects of music therapy (MT) on physical and psychological …

Understanding Language Barriers And Its Implications On Patient Outcomes In The Urgent Care Situation, Nicolo Co

Nursing | Senior Theses

Background

A common goal for healthcare is healthcare for all, through which can be achieved when communication between the client and healthcare team is established. There are millions of immigrants worldwide who are not granted the healthcare that they deserve simply because of a lack of understanding in a country’s dominant language.

Patients with a limited language proficiency in a new country can have difficulty in understanding the care that they receive, which leads them to toil with understanding their healthcare options, let alone establishing expectations. This issue also stretches onto the risks of patient safety, in which urgent needs …

Polypharmacy: Increasing Medication Adherence, James C. Kelly

Nursing | Student Research Posters

Polypharmacy is a common problem among older adults where they take multiple medications concurrently, leading to negative health outcomes such as adverse drug reactions, drug-drug interactions, and non-adherence to medications. To address this issue, a randomized controlled trial (RCT) is proposed that will involve elderly patients (aged 65 years or older) who are taking five or more medications. Participants will be randomly assigned to either the intervention or control group, with the intervention group receiving nurse-led medication therapy management (MTM) and patient education to improve medication adherence. The Health Belief Model can be used to educate and empower older adults …

Factors Impacting Organ Transplant Outcomes, Katelyn Grubich

Nursing | Senior Theses

Organ transplants are crucial to the survival of those on the receiving end. With medicine advancing, so has transplantation. Health care providers are becoming more aware of the strategies necessary to prolong the transplanted organ and how to obtain better outcomes. Heart, lungs, kidney, liver, pancreas, and some where more than one organ are involved, are the types of organ transplants performed.

Providing patients information will allow them to be a part of their treatment and can help to ease their anxiety knowing what is being performed and what can be expected. Health care providers must ensure that patients and …

The Impact Of Psychological Interventions Given To Icu Patients To Help With Pain Management, Kelly Liu

Nursing | Senior Theses

Pain management among the critically ill population is a significant issue in the intensive care setting. Whether the pain is acute or chronic, nurses tend to be the first-hand responders to help with pain management in the intensive care unit (ICU). With barriers ranging from patients’ inability to verbalize pain to nurses’ experience with obstacles to assessment such as sedation, confusion, or other concerns, pain management is a serious issue. Although pharmacological interventions such as opioids and analgesics help with pain control, in this thesis, we will focus on the impact of nonpharmacological and psychological nursing interventions and how it …

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased …

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

The Effects Of Sleep Disturbances On Patients In The Intensive Care Setting, Bronwyn Schmidt

Nursing | Senior Theses

The objective of this research proposal is to identify short-term and long-term health consequences due to sleep disturbances in patients admitted to intensive care units. When reviewing published literature regarding sleep loss in the intensive care unit (ICU), it was discovered that adult patients admitted to a variety of ICU settings both in the United States and abroad reported disruptions in sleep to be a common complaint and barrier to their recovery. This is due to noises made by bedside alarms such as IV pumps, lights in the unit, and interruptions made by medical staff members to provide time-sensitive care. …

The Effects Of Covid-19 On Healthcare Workers: An Exploration Of Burnout, Cherise Fernandez

Nursing | Senior Theses

The healthcare workplace has been challenged with the SARS-CoV-2 corona virus (COVID-19) for majority of the year 2020 and it has posed a number of challenges for healthcare workers (HCWs). Due to the increased workload and demanding work hours, the prevalence of physician burnout has increased amongst this population. The escalation of burnout may lead to negative effects on physical and mental health. This poses a health concern amongst patients because the increase of burnout affects patient care, safety, and quality of care. Various surveys have been sent out to HCWs in order to determine if burnout has increased within …

Pediatric Pain Management During Intravenous Line Placement: Nursing Perceptions And Interventions, Kate Shaffer

Honors Theses

Children are under assessed and under treated for pain associated with medical procedures, specifically during venipuncture. Recent studies show that procedural pain is preventable and that pain management interventions are underutilized. Failure to provide adequate pain relief can mentally and physically hurt children - in addition to inducing fear, suffering and lack of trust, exposures to pain can alter the central nervous system and increase a child’s sensitivity to pain. Pediatric nurses are responsible for assessing and managing pain before, during and after a procedure. Therefore, this review of literature and pilot study examines how registered nurses practicing in the …

Reported Interventions For Reducing Anxiety And Distress In Adult Oncology Patients Throughout Their Cancer Experience: A Review Of The Literature And An Analysis Of Adults In Remission, Katie Gomez

Honors Theses

Background: The purpose of this paper is to identify present methods at relieving anxiety and distress in adult oncology patients. According to the American Cancer Association (2016), 1.7 million American will be diagnosed with cancer in 2016, and therefore, it is important for nurses to be competent caregivers to this growing patient population.

Literature Review: A comprehensive review of current literature showed that consistent, competent caregivers, honest communication from the medical team, back massage, and music therapy were effective at cutting mean anxiety and distress scores by as much as 50 percent. Sixteen peer-reviewed articles from around the world …

Patient Characteristics Associated With False Arrhythmia Alarms In Intensive Care, Patricia R.E. Harris, Jessica K. Zègre-Hemsey, Daniel Schindler, Yong Bai, Michelle M. Pelter, Xiao Hu

Collected Faculty and Staff Scholarship

Introduction

A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms.

Objective

The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU.

Methods

This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 …

Hospice And Oncology Nurses’ Perspectives On Legalizing Physician-Assisted Suicide In California: A Pilot Study, Anna P. Rana

Scholarly and Creative Works Conference (2015 - 2021)

People are living with congenital anomalies, chronic diseases, and disabilities. It is universally agreed upon that every human being has a right to life, however, there is no unanimous decision regarding the right to death. Of the hospice nurses and social workers in Oregon, two-thirds of them reported having a patient ask them about the PAS option (Miller, Harvath, Ganzini, Goy, Delorit, & Jackson, 2004) California, Oregon, Vermont, and Washington have all legalized physician-assisted suicide through legislation. California’s law, the right to death passed on September 11th, 2015. The purpose of this research study is to examine hospice and oncology …

An Exploration Of Nurse Adherence To Ventilator-Associated Pneumonia Bundle Interventions: A Quantitative Study, Alexis Luna

Senior Theses

Ventilator-associated pneumonia (VAP) poses a significant health risk to patients on mechanical ventilation in hospital intensive care units (ICU). It is the responsibility of the nurse to implement VAP bundle interventions to decrease the prevalence of VAP in mechanically ventilated patients. The objective of the study was to measure nurse perception of adherence to VAP bundle interventions of oral hygiene, head-of-bed elevation, spontaneous breathing trials, daily sedation vacations, and peptic ulcer and deep vein thrombosis prophylaxis. A descriptive study involving a sample population of 28 ICU nurses at 3 hospitals in northern California was conducted. A 57-item questionnaire was developed …

Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

Collected Faculty and Staff Scholarship

Purpose: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing ‘‘alarm fatigue’’ which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms.

Results: A total of 2,558,760 unique alarms occurred in the …

Heart Rate Variability Measured Early In Patients With Evolving Acute Coronary Syndrome And 1-Year Outcomes Of Rehospitalization And Mortality, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty and Staff Scholarship

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS).

Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established.

Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency …

Heart Rate Variability Measurement And Clinical Depression In Acute Coronary Syndrome Patients: Narrative Review Of Recent Literature, Patricia R.E. Harris, Claire E. Sommargren, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty and Staff Scholarship

Aim: We aimed to explore links between heart rate variability (HRV) and clinical depression in patients with acute coronary syndrome (ACS), through a review of recent clinical research literature.

Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function.

Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search …

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty and Staff Scholarship

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina.

Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …