Critical Care Nursing Commons^™

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 …

The Impact Of Self-Care Education On Heart Failure Patients With A High Risk For Readmission, Neil Williams Ii

Nursing Theses and Capstone Projects

The purpose of this Capstone Project study was to answer the question: Does self-care education improve knowledge and decrease 30 day readmission rates in a class of heart failure patients that are at high risk for exacerbation? The study used a randomized control design with a pre-test/post-test. A convenience sample of 50 African Americans diagnosed with heart failure were entered; control group (n=25) and experimental group (n=25). Both groups received the Heart failure Pre/Post Test developed by the researcher during the initial interview and four weeks post discharge. The experimental group received a phone call weekly over the four weeks …

Implementation And Evaluation Of A Team Simulation Training Program, Yvonne Rice

Doctor of Nursing Practice Projects

Trauma care, characterized by complex, shifting priorities, presents many challenges to providers. Traditionally, immediate trauma care has been provided in emergency departments. It has recently been recognized that severely injured patients receive better care with improved outcomes when they bypass the emergency department and are admitted directly to the trauma surgical intensive care unit (TSICU). To assure that TSICU nurses and interprofessional staff are prepared to handle such patients, all new registered nurses in the TSICU of a Level I Trauma Center participate in a one-day Trauma Boot Camp. Originally, the focus of the Trauma Boot Camp was solely on …

Incorporating Simulation Into Advanced Cardiac Life Support, Lorraine Calwile

Nursing Theses and Capstone Projects

The knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Cardiac Life Support (ACLS) are among the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Every year there are millions of healthcare workers that dread coming to ACLS class for fear of failure of the written exam or the mega code. Many of these participants haven’t participated in a code situation since they left class the previous two years. Participants sit in class for two days listening to lectures and going through practice mega codes to prepare them for the final mega code. …

Stop Cautis: A Unit-Based Education And Leadership Bundled Approach, Jennifer Healy Msn, Rn, Ccrn, Jennifer O'Neil Bsn, Rn, Danielle Moody Rn, Leigh Jimmie Bsn, Rn, Anne M. Aquila

Posters

1. The CAUTI Prevention committee recognized a continued opportunity to reduce CAUTI occurrences in the MICU
2. A sub-group developed and implemented an evidence-based educational program which was completed in October 2014
3. The MICU Team has decreased their CAUTI rate from 12 occurrences (Sept. 2013- Aug. 2014) down to 3 occurrences (Sept 2014-Aug 2015)
4. The team continues to use an auditing process and the insertion checklist as ongoing quality improvement

Incontinence And Skin Integrity In Immobile Populations, Frederick Green, Alyssa Starr

Nursing Student Work

No abstract provided.

An Evaluation Of The Adherence To An Indwelling Urinary Catheter Maintenance Bundle, Jessica Lynn Johnston

DNP Projects

Background: There are more than 1 million Catheter Associated Urinary Tract Infection (CAUTI) occurrences per year in the United States, with an estimated cost to treat of $400 million dollars annually (Clarke et al., 2013). Urinary Tract Infections are the most common hospital acquired infection, comprising roughly 30 - 40% of all infections occurring in acute care hospitals (Gould et al., 2009). In February of 2013, the University of Kentucky (UK) Hospital made drastic changes to the current Catheter Associated Urinary Tract Infection (CAUTI) prevention standards by instituting a CAUTI Maintenance Bundle to prevent the incidence of CAUTIs.

Purpose …

Comparing Must And The Nri Tools In The Identification Of Malnutrition In Heart Failure Patients, Cassondra D. Degener

DNP Projects

The purpose of this project was to test the performance of albumin, NRI and MUST screening tools in comparison to the standardized measure of prealbumin among HF patients admitted to the University of Kentucky Chandler Medical Center. Inclusion criteria included all HF patients with the 428 diagnostic code, admitted from January 1, - December 31, 2013, ages 18 and older, with all laboratory values available specified in the data collection tool (Appendix A). A retrospective electronic medical record (EMR) review was performed for 100 patients who met the inclusion criteria. All data were collected through the University of Kentucky’s secure …

The Efficacy Of Stemi Networks And Systems Of Coordinated Stemi Care: An Evaluation Of The Implementation Of A Stemi Network, Julianne M. Evers

DNP Projects

Purpose: The purpose of this project was to evaluate the implementation of an ST-elevation myocardial infarction (STEMI) Network into a large metropolitan healthcare system in Kentucky. The objectives of this project were to (1) determine if (and to what extent) the implementation of the STEMI Network decreased walk-in, emergency medical services (EMS), and transfer door to balloon (D2B) times at a STEMI receiving center at a metropolitan Kentucky academic hospital, (2) determine if there is a difference in treatment times for those individuals who present during working hours compared to non-working hours of the day, and (3) examine the associations …

Verification Of Nasogastric Tube Placement In Inpatient Populations: A Review Of Current Literature, Sarah Hines, Jenna Magee

Nursing Student Work

No abstract provided.

Reducing The Incidence Of Hospital-Acquired Pressure Ulcers By Using Alternating Pressure Air Mattresses, Marie Morrison, Mary Wise

Nursing Student Work

No abstract provided.

Ng Tube Placement Methods: An Ebp Review, Amanda Salerno, Kim Robinson

Nursing Student Work

No abstract provided.

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

Addressing Moral Distress In Critical Care Nurses, Rose Allen, Eve Butler

All Publications

No abstract provided.

Review Of The Accuracy Of Two Pain Assessment Tools In Nonverbal Adult Patients, Mackenzie Mosley, Emily Hartman, Kristen Tankovich, James Galantis

Williams Honors College, Honors Research Projects

Intensive care units frequently have patients that are unable to verbally communicate their pain, thus negating conventional pain assessment techniques and making pain assessment difficult. Pain management is often a priority in all patients’ circumstances and therefore, assessment and reassessment are included in the plan of care. Different observational pain scales have been used in intensive care units, but often times these scales must be adapted to fit the patient’s circumstances. Pain scales that are used for nonverbal patients typically include behavioral indicators and some are adapted to incorporate physiologic indicators such as vital signs. The aim of this review …

Evaluation Of Chlorhexidine Bathing Practices In Trauma/ Surgical Intensive Care Units, Kara Willett

DNP Projects

Central venous catheters (CVC) are vital in present-day medical practice, particularly in the intensive care unit (ICU). However, their use puts patients at risk for developing central line-associated bloodstream infections (CLABSIs) which are a major concern in today’s health care system. CLABSIs are a significant source of patient mortality, increased length of stay, and healthcare spending. The heightened awareness of these infections along with their escalating cost has amplified implementation of preventative protocols.This practice inquiry project includes three manuscripts, each of which discusses relevant aspects of CLABSIs prevention utilizing daily whole body chlorhexidine gluconate bathing inlcuding a review of literautre …

Implementing A Hospital-Acquired Pressure Ulcer Prevention Program, Maryann L. Lancaster

DNP Projects

Objective: To implement a Hospital-Acquired Pressure Ulcers (HAPU) prevention program utilizing an assessment tool to identify patients at risk, and intervene with a sacral Mepilex® dressing. Our aims are to determine if a change in nursing knowledge and change in nursing behavior after implementing our program.

Background: HAPUs are a significant problem in patient care and healthcare organizations must implement prevention protocols to reduce HAPU prevalence. Guidelines for implementing HAPU prevention programs suggest use of a validate risk assessment tool and initiating preventive interventions. One intervention found in the literature is the adjunctive use of prophylactic Mepilex® dressings to sacral …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …