Critical Care Nursing Commons^™

Poster: Clinical Practice Panel: Don't Skip A Beat, Follow The Sheet! Designing A Clinical Care Map For Open Heart Patients In The Icu, Danielle Fogel, Nico Vargas

2023 South Division Nursing Research Conference

No abstract provided.

Poster: Eliminating Hospital Acquired Pressure Injuries (Hapis) In The Intensive Care Unit, Luzbel Diaz

2023 South Division Nursing Research Conference

No abstract provided.

Poster: Moral Injury & Nurse Work Performance Following The Covid-19 Surges, Annette Callis, Trisha Saul, Ross Bindler

2023 South Division Nursing Research Conference

No abstract provided.

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

Nursing | Student Research Posters

No abstract provided.

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

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

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

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

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

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

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

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

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 …

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 Impact Of De-Escalation Training Among Emergency Department Nurses, Jonathan Recchi, Jeffrey N. Doucette, Janice E. Hawkins

College of Health Sciences Posters

Workplace violence is a growing concern for US nurses, especially in the context of COVID-19 and patient incivility. De-escalation training can help mitigate high-risk incidents, but its psychological benefits are not well understood. This study aimed to determine if de-escalation training for emergency department nurses provided psychological benefit. This pre-experimental pre-test, post-test study evaluated nurse confidence in coping with patient aggression, caregiver resiliency, professional quality of life, and intention to stay with the organization. Participants completed a pretest survey, attended a two-hour verbal de-escalation training via zoom, and then completed the posttest survey. The study showed that attending the two-hour …

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 …

How Efficient Is Telemedicine At Qi In The Critical Care Setting?, Christopher Sedeski

Student Research Poster Presentations 2022

No abstract provided.

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

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

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

Student Research Poster Presentations 2020

No abstract provided.

Crowded Er Waiting Rooms – Are Freestanding Ers The Way To Go?, Jesse Keats

Student Research Poster Presentations 2020

This poster discusses the differences in freestanding and hospital emergency departments. My position on this topic focuses on the idea that free standing ERs do not reduce overcrowding in an emergency room.

Are Healthcare Workers In The Hospital Ready For Disasters In The Community?, Nicholas Hromek

Student Research Poster Presentations 2020

This poster presents the idea that healthcare workers in hospitals are not equipped for disasters in the community. During such a vulnerable and relevant time such as the COVID-19 pandemic, this poster focuses on the pitfalls of the healthcare and hospital system.

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

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.

Alyssa Nicklas's Portfolio, Alyssa Nicklas

Honors College Portfolios

The portfolio I have put together is a collection of various pieces that I have composed throughout my four years at Duquesne. Each of these have great importance to me and all together the collection reflects my values and interests in the nursing field. These pieces act to show how throughout my time in the nursing program I was redefining my values and growing from my experiences. From the very beginning of nursing school my professors challenged me to compose my own personal philosophy of nursing. Over the course of the four years, I was interested in various fields of …

Clabsi Prevention Through Prevention Huddles And Clabsi Risk Assessment And Prevention Form In Electronic Medical Record, Tara Benton, Barb Haney, Lacey Bergerhofer, Yolanda Ballam, Kaitlyn Hoch

Posters

Our aim is to increase the awareness of high risks for central line associated bloodstream infection (CLABSI) and decrease the CLABSI rate with the implementation of CLABSI prevention huddles and an electronic medical record (EMR) "CLABSI Risk Assessment and Prevention" form.

Lighting The Way To Ensure Safe Transition Home, Barb Haney, Ashley Mirabile, Dianne Wilderson, Beckie Palmer, Ashley Lewis, Cris Mills, Eugenia K. Pallotto

Posters

All aspects of discharge (education, screenings, appointments, plans and home services" must be completed and appropriately communicated prior to discharge to ensure safe transition to home.

Goal: Standardize all aspects of discharge in a large, busy 84-bed Level IV NICU with >1000 admissions/year and >300 nurses, >60 NNPs, and >25 neonatologists.

• 95% of patients with lengths of stay >3 days have all discharge planning completed prior to discharge/Parent Care Unit overnight stay

Safe Sleep In The Nicu, Ashley Mirabile, Barb Haney, Dianne Wilderson, Beckie Palmer, Ashley Domsch, Eugenia K. Pallotto

Posters

Goal: To evaluate a staff education program on approach to improve in the rate of eligible NICU infants in safe sleep in a busy 84-bed level IV NICU.

Outcome Measures; Improve safe sleep compliance for eligible patients to 90% or greater by December 2019.

Process Measures: Audits from bedside RNs showing compliance with safe sleep.

Planned Intervention: In December of 2018 a multidisciplinary work group brainstormed and implemented best practice safe sleep education for staff and parents. September 2019 a Safe Sleep Educational Toolkit was made available for staff.

Results: Safe Sleep compliance has gone from 53% to 90% in …

Improving Care Of The Small Baby, Beckie Palmer, Abdebayo Oshodi, Brandy Huitt, Kaylee Hurt, Pamela Kliethermes, Trudy Koons, Patricia Lanzer, Ashley Mirabile, Allyson Owen, Christian Anthony Schneider, Betsi Anderson, Steven Olsen

Posters

Hierarchy of Aims:

• Global Aim: Create a Small Baby Unit for infants admitted to our NICU that arebirth, in which 90% of our patients are admitted to F pod on day of admission, by March 2019
• Interim Aim: Staff 80% of our micropremie patients with a Small Baby Team nurse from admission until >32 weeks by May 2019.
• Sub Aim: Increase rates of developmentally appropriate care (2 person cares, kangaroo care compliance) by 50% by August 2019.