Critical Care Nursing Commons^™

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

Topical Normal Saline, Alcohol, And Petrolatum For Marsi: A Randomized Controlled Trial, Michael Hartanto Angriawan, Shannaz Nadia Yusharyahya, Rahadi Rihatmadja

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Medical adhesive-related skin injury (MARSI) is a common complication associated with acrylic-based adhesive removal. Topical agents such as 0.9% NaCl (normal saline), white petrolatum, and 70% alcohol are commonly used to assist adhesive removal; however, their effectiveness in reducing MARSI remains unclear.

Methods: This single-blind randomized controlled trial with a within-subject design included 56 healthy adults. Acrylic-based adhesives were applied to four sites on the upper arms. Adhesive removal was performed on days 3 and 6 using three interventions (normal saline, petrolatum, alcohol) and one control (no topical agent). Outcomes included MARSI incidence, clinical erythema score, erythema index, transepidermal …

Best Practices For Interprofessional, Community-Based Interventions In Preventing Type 2 Diabetes Among Adults Aged 50 And Older, Julie Joseph Mrs

Journal of Interprofessional Practice and Collaboration

The prevalence of Type 2 Diabetes Mellitus (T2DM) is rapidly increasing among adults aged 50 years and older in the United States, posing a significant public health challenge. In 2021, an estimated 38.4 million Americans had diabetes, with adults aged 50years and above constituting a disproportionately large segment of this population. Evidence suggests that community-based lifestyle and educational interventions are effective in reducing the risk of T2DM among older adults. These interventions particularly promote dietary modification, increased physical activity, and diabetes education. Integrating the expertise of nurses, dietitians, pharmacists, physicians, and other professionals through interprofessional collaboration strengthens diabetes prevention and …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Early Sepsis-Recognition Simulation Training: An Evidence-Based Initiative, Blanca A. Zavala

SACAD: Scholarly Activities

Sepsis is a life-threatening condition that requires rapid recognition and intervention to prevent poor patient outcomes. Delays in identification remain a significant concern for patient safety, particularly among nurses and nursing students who may lack confidence and clinical judgment in early sepsis recognition (Marsack et al., 2022). This evidence-based practice project aimed to examine the existing evidence on sepsis education and evaluate the effectiveness of simulation-based learning in improving clinical judgment and sepsis recognition, with the goal of informing a potential sepsis training initiative for nursing students.

A literature review of six peer-reviewed studies (2022–2026) was conducted using the PubMed …

Efficacy And Safety Of Stem Cell-Based Interventions For Burn Wound Healing: A Systematic Review And Meta-Analysis Of Pre-Clinical And Early Clinical Evidence, Prayuth Poowaruttanawiwit, Patsanan Kulla, Naveeya Pakpoomkamonlert

The Thai Journal of Pharmaceutical Sciences

Background: Burn injuries remain a major therapeutic challenge, with conventional treatments often failing to achieve complete functional skin regeneration. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and exosome derivatives, have demonstrated regenerative and immunomodulatory potential, yet their translation to clinical practice remains limited.
Objectives: To systematically evaluate the efficacy and safety of stem cell-based therapies for burn wound healing across pre-clinical and clinical studies.
Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, four databases (PubMed, Embase, Scopus, and Cochrane) were searched through April 2025. Eligible studies included randomized controlled trials and controlled pre-clinical …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Living With Disability After Spinal Cord Injury: A Grounded Theory Methodology, Diaa K. Abd Ali

Al-Ameed Journal for Medical Research and Health Sciences

Study Design: A Grounded Theory Methodology is employed to investigate the study phenomenon. the entire study started from Jan. 15^th. 2021 to March, 1^st. 2022.

Aim: The study is conducted to explore the concepts that shape the experience of living with disability among patients with spinal cord injury, and to formulating a grounded theory regarding nursing care for patients with spinal cord injuries.

Setting: The study is conducted in Ibn Alkuf Hospital for Spinal Cord Injuries, Baghdad, Iraq.

Methods: A non-probability purposive sampling technique was used to select (12) patients with chronic (more than 5 years) …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Continuous Renal Replacement Therapy Training In The Icu: An Evidence-Based Practice Proposal, Joseph C. Brabec

SACAD: Scholarly Activities

Continuous renal replacement therapy (CRRT) is a complex, high-risk intervention used in intensive care units (ICUs) for critically ill patients with acute kidney injury and hemodynamic instability. ICU nurses are responsible for initiating, monitoring, troubleshooting, and discontinuing CRRT while providing continuous bedside care (Richardson & Whatmore, 2015). However, variability in training frequency and competency validation remains a significant gap, potentially contributing to errors and adverse patient outcomes. Guided by the Iowa Model of Evidence-Based Practice, a literature review was conducted to identify best practices for CRRT training. A proposed evidence-based practice (EBP) project was developed to implement a standardized CRRT …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Effectively Addressing Hospital-Acquired Pressure Injuries With A Multidisciplinary Approach, Nicki Roderman, Shandlie Wilcox, Andrew Beal

HCA Healthcare Journal of Medicine

Background

Hospital-acquired pressure injuries (HAPIs) result in patient harm, discomfort, and even death, with an estimated 2.5 million HAPIs occurring annually in the United States. These pressure injuries from prolonged pressure on the skin and deeper tissues cause reduced blood flow and the breakdown of skin and tissues, resulting in wounds. Additionally, these injuries contribute to longer hospital stays and increased health care costs. Hospitals have programs aimed at reducing HAPIs as well as ongoing surveillance to identify new trends early on. This ongoing monitoring revealed a trend early at our institution that HAPIs were 66% higher than the national …

Central Line-Associated Bloodstream Infection Reduction In Hemodialysis Patients Across 9 Hospitals And 3 States, Nicki Roderman, Kasadi Moore, Shandlie Wilcox, Jennifer Jellerson, Zoey Bridges

HCA Healthcare Journal of Medicine

Background

This quality improvement project was initiated to reduce hospital-acquired catheter-associated bloodstream infections (CLABSI) in hospitalized patients receiving dialysis. A team dedicated to reducing hospital-acquired infections led the implementation of evidence-based interventions across all the included hospitals. This innovative approach demonstrated substantial enhancements in outcomes for patients on hemodialysis.

Methods

To enhance patient safety in patients receiving hemodialysis, new strategies were implemented, including (1) transitioning from a vendor model to an internal model, enabling dialysis program standardization, (2) empowering intensive care nurses with increased autonomy and ownership, (3) transitioning to a standardized dialysis machine, and (4) introducing chlorhexidine gluconate (CHG) …

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

Inpatient Falls: Epidemiology, Risk Assessment, And Prevention Measures. A Narrative Review, Taylor Locklear, Jeannie Kontos, Callaham A. Brock, Alexander B. Holland, Rachel Hemsath, Anna Deal, Shannon Leonard, Carsten Steinmetz, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such …

Companion Dogs And Depression, Anxiety, And Posttraumatic Stress Disorder In Adult Icu Survivors: A Scoping Review, Lindsey Nelson, Sue Lasiter, Amanda Emerson

People and Animals: The International Journal of Research and Practice

Intensive care unit (ICU) survivors are at risk for developing persistent psychological sequelae that have been linked to decreased quality of life and increased mortality after hospital discharge. Standardized evidence-based treatments are lacking, mainly focus on physical rather than psychological recovery, and often occur in formal settings. Benefits of human– companion dog relationships have not been explored in the ICU survivor population before. Thus, the purposes of our review were to summarize the literature focused on the influence of companion dogs on depression, anxiety, and posttraumatic stress disorder (PTSD); identify what is known about the potential role companion dogs play …

Post Anesthesia Care Unit Comprehension Safety Program Quality Improvement Project On De-Escalation Of Patients, Mary M. Gaukler Giannavola, Basil George Verghese, Deborah Maier

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Violence within the healthcare setting has risen significantly, and has crossed into areas where staff are less prepared to manage and deescalate challenging patient encounters. This lack of preparedness and confidence has led to increased staff stress, burn out, and can potentiate poor patient outcomes.

Methods:

A pre/post-simulation quality improvement project was performed within a tertiary hospital Post-Anesthesia Care Unit in Upstate New York to evaluate the effect of simulation on feelings of confidence and preparedness in patient de-escalation with PACU nurses and patient care technicians. The project evaluation included the Thackrey’s Clinician Confidence in Coping with Patient Aggression …

Neuroprognostication In Patients With A Subarachnoid Hemorrhage: A Quasi-Review Of Anti-Inflammatory Agent Administration Versus Blood Pressure Management, Julia Gabalski, Marcie Mcmahon

Soaring: A Journal of Undergraduate Research

A subarachnoid hemorrhage (SAH) is a type of stoke where a blood vessel bursts and causes the subarachnoid space to become filled with blood. Traditional nursing management of SAH includes close monitoring of blood pressure goals in order to prevent complications such as vasospasm. Vasospasm causes delayed cerebral ischemia and neurological deficits secondary to the initial injury. Recent research has expanded understanding of the underlying mechanisms behind the neuroinflammatory cascade that occurs after a SAH. In this study, a methodical search was conducted through the CINAHL and PubMed databases to form a quasi-review of current research. The comparison of traditional …

Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske

Graduate Medical Education Research Journal

Background: Code status orders are important features of patient-centered clinical decisions, patient autonomy, and end-of-life care. Despite proper documentation of “do not resuscitate” (DNR) code status, hospitalized patients may be subjected to cardiopulmonary resuscitation (CPR) efforts that go against their wishes.

Purpose: The objective of this study was to identify and describe the population of hospitalized patients receiving discordant resuscitation efforts at a Midwest academic medical center utilizing electronic health records (EHR).

Method: The study included EHR records between 01/01/2011 and 01/01/2021 for hospitalized patients 19 years and older who experienced cardiac arrest (ICD-10 I46) and were documented as DNR. …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Coronary Care Unit Nurses’ Experiences Of Care Management Self-Efficacy: A Qualitative Content Analysis, Fatemeh Mansouri, Parand Pourghane, Maryam Rajab Pour Nikfam, James C. Oleson

The Qualitative Report

Recognizing various aspects of the self-efficacy concept in specialized medical units such as intensive care units (ICUs) and coronary care units (CCUs) has the potential to help nurses improve their quality of care. Therefore, we conducted a qualitative content analysis study in 2018 in hospitals of the Guilan Province, northern Iran, to help explain nurses’ perceptions of self-efficacy in care management within CCU wards. Thirty-four semi-structured interviews were conducted with nurses from CCUs. Using Graneheim and Lundman’s (2004) analytical techniques, we extracted three main themes and nine sub-themes from the data: decline in self-efficacy (e.g., time constraint, high work pressure, …

Parental Contextual Factors And Decision-Making Related To Periviable Birth: An Integrative Review, Amy L. Wright, Elizabeth Mens, Gausiha Rathitharan

The Qualitative Report

Parents facing a periviable birth, or birth before 25 weeks of gestation, commonly engage in antenatal consultation with healthcare providers to determine a plan of care. Parents’ pre-existing contextual factors, beliefs, and values influence their decisions regarding birth and the care of their infant. This study aims to understand the role of parental contextual factors and best-practices to their integration during antenatal consultation The Whittemore and Knafl (2005) approach to conducting an integrative review along with thematic analysis was employed to determine and present the findings. Results describe three themes related to how contextual factors influence parental decision-making: personal values …