Critical Care Nursing Commons^™

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

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 …

Assessing Culture Competence Among Nurses In An Acute Care Setting, Maleka Virani

Master's Projects

The aim of the study was to assess cultural competence among nurses in an acute care setting. A 25-item questionnaire developed by Campinha-Bacote (2003) titled Inventory to Assess Cultural Competence Among Health Care Providers (IAPCC-R) along with a demographic survey were utilized to assess cultural competence among 100 nurses in an acute care hospital. The results of the study indicated that 70% of nurses (n=63) were culturally aware and 30% (n=27) were culturally competent. There was no statistical significance between the level of cultural competence and years of experience, educational degree or self rating of 'being culturally competent'. The findings …

The Cost Of Negative Perceptions Of The Work Environment Among Intermediate Intensive Care Unit Nurses, Joselyn Peralta

Master's Projects

This descriptive study assessed the perceptions of the work environment and the retention plans among registered nurses (RNs) who worked in the Intermediate Intensive Care Unit at a tertiary university hospital. Results from the Moos Work Environment Scale found that nurses perceived high levels of work pressure and low levels of clarity, coworker cohesion, and supervisor support. Results indicated that the intent to leave the unit was dependent on the nurses having other options in nursing, desiring further education, an undesirable scheduling process and unsafe patient care. The direct and indirect costs to hospitals could be offset by developing strategies …

Does Culture Influence The Needs Of Critical Care Families?, Naomi Alston

Master's Projects

Purpose: This study explores ICU patient's family member needs, particularly Vietnamese and Latino families. Design: Convenience sampling at 24 bed ICU in acute care community hospital serving ethnically diverse population. Methods: Non-experimental survey with pretest-posttest design using Demographic sheet, Critical Family Needs Inventory (CCFNI), and Needs Met Inventory (NMI). Information pamphlets were distributed. Data analysis was by ethnic groups using measures of central tendency and descriptive statistics. Findings: CCFNI results indicate family members of all ethnicities experience the same priority of needs; support and information are top two needs. English, Spanish and Vietnamese pamphlets met information needs of the majority …

Nurses' Perception Of Family Presence During Resuscitation, Josephine Njoku

Master's Projects

Background Family witnessed resuscitation (FWR) is the concept of allowing family members at bedside during cardiopulmonary resuscitation. Studies have shown that the lack of standard policies by hospitals regarding FWR forces nurses to make different decisions regarding family presence at bedside during resuscitation. The framework for this study is Sandman's teleological model. Objectives To examine nurses' perceptions of having family members present during adult cardiac resuscitation. Methods A descriptive study of 57 registered nurses (n = 57) from northern California was conducted. Participants completed a mailed survey consisting of a 22-item Likert scale questionnaire titled "Family Presence Risk-Benefit Scale." Results …

Perceived Social Support Among Chinese American Hemodialysis Patients, Kaklam Wong

Master's Projects

Social support is linked to improved health outcomes both in Western and Asian societies and is a vital factor in a patient's adjustment to end-stage renal disease and its treatment regimen. This study explored perceived social support among 46 Chinese American hemodialysis patients in San Francisco's Chinatown using the Norbeck Social Support Questionnaire plus open-ended questions. Findings unexpectedly revealed low levels of perceived social support and lack of tangible support especially in elder patients. We can no longer assume that traditional family cultural values are providing adequate social support for this population.

Pain Management Through Music Therapy, Dereck H. Ko

Master's Projects

In 1999, approximately three quarters of patients admitted to emergency departments reported pain (Joint Commission on Accreditation of Healthcare Organizations, 2000). Managing pain pharmacologically alone may not be enough because pain perception is a complex phenomenon that consists of both physiological and psychological components (Trauger-Querry & Haghighi, 1999). Music therapy is one of the systematic applications in treatment of physiological and psychological aspects of an illness or disability (Cook, 1981).The objectives of this study were to measure the pain intensity index PPI (Melzack) level before after the intervention with music therapy to investigate if music therapy is effective for pain …

Barriers To Domestic Violence Screening In The Emergency Department, Lisa Yonaka

Master's Projects

Are you in a relationship in which you're being abused? That is not an easy question to answer or ask. Identification of those who are victims of domestic violence is important to prevent further abuse and injury. The purpose of this non-experimental study was to determine barriers of Emergency Department Registered Nurses screening patients for domestic violence. 33 ED RNs completed a short anonymous questionnaire that was developed by Dr. Mary Lou Moore, Wake Forrest University, Winston-Salem, North Carolina. The most significant barriers to screening identified, were the lack of education on how to ask questions about abuse, language barriers, …

Evaluation Of The Effectiveness Of An Anaphylaxis Training Program For Unlicensed Assistive Personnel, Jean A. Litarowsky

Master's Projects

This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's theory of sources of self-efficacy. Knowledge and perceived self-efficacy of participants were measured before and after the training program to determine if a theory-based anaphylaxis recognition and epinephrine auto-injector training program would increase participants' knowledge and self-efficacy in responding to an anaphylactic emergency. Paired t-tests revealed significant improvement …

The Differences Between Women And Men In The Length Of Time Between Onset Of Cardiac Symptoms And Undergoing A Cardiac Catheterization, Anita Gertsch

Master's Projects

Coronary artery disease is a leading cause of death among women. Even so, research suggests that women continue to receive less aggressive cardiac treatment than men. The purpose of the research was to determine if there was a time difference in initiation of cardiac catheterization in a selected population of men and women. A chart review was completed on adult women (n=20) and men (n=20), with varied adult ages, at a hospital based cardiac catheterization laboratory in Northern California. The charts were chosen randomly from the daily catheterization list. Data collection included age, gender, preferred spoken language, pay source, prior …