Critical Care Nursing Commons^™

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

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 …

Promoting A Healthy Work Environment In The Icu Through Prayer And Bible Study, Jo Ann Aberilla

All Publications

No abstract provided.

Septic Shock, Lacey Lauer

Nursing Student Class Projects (Formerly MSN)

Sepsis is a frequently seen diagnosis in hospital settings, which when left untreated can progress to severe sepsis and septic shock. Septic shock occurs in more than 230,000 patients in the United States annually and is the cause of more than 40,000 deaths (Seymour & Rosengart, 2015). It is very important for hospital staff members to quickly and accurately identify signs of sepsis, severe sepsis, and septic shock so that patients can undergo treatment as quickly as possible. Studies have shown that the early treatment of sepsis may lead to decreased sepsis-related mortality (Benedict, 2015).

Investigating Disparities In Behavior And Care Between Alaska Native And Non-Hispanic White Victims Of Sexual Violence: The Importance Of Culturally Competent Nursing Care, Danielle Koster

Inquiry: The University of Arkansas Undergraduate Research Journal

The purpose of this research was to determine the existence of health care disparities experienced by Alaska Native women victims of sexual violence and to address the need for sexual assault nurse examiners (SANEs) to provide culturally competent care. This was a secondary data analysis of research collected from over 1,600 Alaska SANE surveys between 1996-2006. Variables investigated included: behaviors during examination, condition during assault, time from assault to report, hospital admittance, injuries sustained, and victim-suspect relationships. Alaska Native women were described as having less controlled behavior, being less cooperative, and less likely to be sober; they also often suffered …

An Exploratory Inquiry And Creation Of Emergency Room Discharge Education Materials, Ivory Catalano

Honors Undergraduate Theses

Background

Each Emergency Room (ER) across the USA provides every patient with paperwork upon discharge, which commonly includes information about the patient’s diagnosis. This information will briefly describe the condition, provide information on treatment outside the ER, and possibly more, depending on the document and source. These documents are not made by hospital staff, but are generally purchased from outside providers who mass market such documents as resources for hospitals to use to educate patients. One issue with these documents lies in their mass usage, which is not necessarily designed to target the general population’s reading and educational levels.

Purpose …

Music Therapy As An Intervention To Reduce Anxiety In Mechanically-Ventilated Patients, Stephanie L. Levine

Honors Undergraduate Theses

Patients receiving mechanical ventilation endure high levels of stress and anxiety due to the invasiveness of the procedure. These critically ill patients are often uncomfortable as a result of their serious conditions and the high-intensity environments in which they are placed. Health care workers heavily sedate these patients to minimize pain and induce a state of relaxation. However, sedatives are known for their wide-ranging, and often deleterious, side effects. Music therapy is an intervention that has been studied in a variety of hospital settings to determine any potential beneficial effects on patients. Many studies have demonstrated a relationship between music …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Exploring The Art Of Nursing And Its Influence On Patient Satisfaction In Acute Care Settings, Enid Tirado

Honors Undergraduate Theses

‎Nursing is a trusted profession aimed at delivering quality, patient-centered care perceived by patients as caring and satisfactory. While empiric care components are measurable as associated with clinical outcomes, patients’ perceptions of care are increasingly important in determining satisfaction with the patient care experience. Not clearly defined, nor empirically measurable, the “art” of nursing is taking on increasing importance as a component of satisfaction with the patient experience. The purpose of this integrative literature review was to review the literature in order to find common themes influencing determination of the art of nursing on patient satisfaction in acute care settings. …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

Identification Of Early Markers Of Occult Tissue Hypoperfusion In Patients With Multiple Trauma Injuries, Kathryn M. Moore

Theses and Dissertations--Nursing

Injury is a global health problem and in the United States is the leading cause of death for persons aged 1 – 44 years. The primary causes of trauma related death are head injury and hemorrhage; hemorrhagic shock is difficult to recognize in the first hours after trauma. Identification of specific and optimal criteria upon which to base effective triage decisions for trauma patients has been an elusive goal for decades.

The purpose of this dissertation was to identify measures available in the prehospital phase of care and in the Emergency Department that should be included for a more comprehensive …

Hearts In The Balance: The Impact Of Desired Versus Received Social Support Needs On Persons With Heart Failure, Melanie P. Schrader

Theses and Dissertations--Nursing

Social support is the collection of tangible and intangible experiences that surround people as they cope with daily stressors. High quality social support is important among patients with cardiovascular disease (CVD) because it has positive effects on social, psychological and physical well-being, and those with good social support cope better with the travails of CVD. Although there are many studies of social support in CVD, little work has been done on the topic of discrepancies between desired and received social support in the context of gender.

The purpose of this dissertation was to determine if there are gender differences in …

Psychological Distress And Cardiac Disease, Tracey Vitori

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications …

Evaluation Of Central Line Insertion Bundle Practices In A Trauma/Surgical Intensive Care Unit, Margaret A. Moore

DNP Projects

Central venous catheters, also known as central lines, serve an essential role in critical care settings across the globe. However, these lines put patients at an increased risk for hospital-acquired infections in the form of central line-associated bloodstream infections (CLABSI). In an effort to prevent these infections, evidence-based nursing interventions in the form of insertion and maintenance bundle are undertaken. It is the focus of this practice inquiry project to evaluate nurse adherence to central line insertion bundles before and after implementation of routine reporting of adherence rates within an ICU. The evaluation will provide insight to the degree of …

Improving The Identification, Delivery Of Care, And Outcomes Of Hospital-Acquired Sepsis, Nicholas James Welker

DNP Projects

Sepsis syndromes that develop among a hospital inpatient population can be difficult to differentiate from other disease processes that share systemic inflammatory response syndromes. A bedside nurse-driven screening process was developed at Baptist Health Lexington to aid with early sepsis identification and foster prompt goal-directed therapy. This retrospective study of 26 patients identified over a 6 month period measures intensive care length of stay, mortality, and sepsis severity. Exclusion criteria were pregnancy and Do Not Resuscitate orders.

Screening compliance was poor at 23.1 percent (n=6). Complete compliance with goal directed therapy was 7.7 percent, though some components of therapy such …

Effect Of Enteral Feeding Timing In Septic Shock Patients, Shane D. Slone

DNP Projects

The goal of this research project was to identify the effect of the timing of enteral nutrition (EN) initiation timing on in-hospital mortality, ICU LOS and hospital LOS among patients with septic shock requiring norepinephrine. The study design was a cross-sectional analysis of retrospective electronic health record data. Patients who had received norepinephrine for septic shock were divided into early EN initiation (within 48 hours of ICU admission) and late EN initiation (Greater than or equal to 48 hours after ICU admission) groups. 680 subjects were included; 469 in the early group and 211 in the late group. Demographics, comorbidities, …

Use Of High-Fidelity Simulation Training For New Cardiothoracic Intensive Care Unit Nurses, Bryan Boling

DNP Projects

Critical care nursing is one of the most challenging, high-stress fields in healthcare. This is especially true for nurses in the highly specialized environment of the cardiothoracic intensive care unit (CTICU). The experience level of nurses in critical care is positively linked with patient outcomes; however, with older nurses retiring or moving away from the bedside and younger nurses increasingly moving into advanced practice or management and leadership roles it is becoming more difficult to maintain a high degree of nursing experience in the ICU. Simulation training has been used to provide safe, effective training, and it is even possible …

Do Call-Backs Help Patients Post Stroke, Taylor E. Clark

DNP Projects

Aim and Objective: To determine if the implementation of a post-discharge call-back intervention for patients discharged home from the hospital after stroke was associated with a decrease in 30-day readmissions and improved patient satisfaction.

Background: Stroke is a leading cause of death and disability in the United States (American Stroke Association, 2015). Several studies have examined various post-discharge interventions, including a call to the patient and/or family after their return home, to determine the benefit to patients, if any (Zolfaghari, Mousavifar, Pedram & Haghani (2012). Understanding and anticipating patient needs and removing barriers post-stroke may decrease readmission rates …

Family Presence During Resuscitation: An Evaluation Of Attitudes And Beliefs, Alysia Adams

DNP Projects

Background: Family presence during cardiopulmonary resuscitation has been provided for more than 20 years (Hanson & Strawser, 1992). The American Association of Critical Care Nurses, The Emergency Nurses Association, The American College of Emergency Physicians, The American Heart Association, and The American Academy of Pediatrics have all endorsed family presence during resuscitation (AACN, 2004; AHA, 2000; Dingeman, Mitchell, Meyer, & Curley, 2007; ENA, 1994; Lowry, 2012). Despite validation by distinguished professional organizations, the option of family presence remains inconsistent. Objectives: 1.) To explore the attitudes and barriers to family presence during resuscitation. 2.) To examine the relationship between pre, midpoint …

Need Assessment For Early Identification Of Delirium In Post-Operative Patients In Intensive Care Unit, Raji Rajan

DNP Projects

Background: Delirium is an acute dysfunction of cognition, memory, and attention resulting in changes in perception, mood, and activity. Delirium is associated with increased length of hospital stay, prolonged mechanical ventilator days, increased mortality rate, and a higher number of discharge disposals to rehabilitation centers. The purpose of the study is to assess the current practice in delirium assessment and management strategies among postoperative patients in Intensive Care Units.

Methods: A retrospective medical record review was conducted in postoperative patients admitted to Norton Women’s and Kosair Children Hospital between January 2015 and December 2015. Postoperative delirium was diagnosed in compliance …

Impact Of The Advanced Practice Registered Nurse On The Stroke Patient Population, Jessica Moldenhauer

DNP Projects

PURPOSE: The purpose of this study is evaluate the APRN care model utilized for stroke patients by examining the pre and post impact on outcomes of the stroke clinical practice guidelines (CPGs), patterns of service use, stroke patient outcomes, and patient satisfaction.

METHODS: This study was a single-center, pre-post implementation retrospective study of the impact for the stroke APRN care model on the stroke patient population at Norton Brownsboro Hospital. The sample consisted of 145 patients for the pre-implementation period, March 2012 to August 2012, and 202 patients for the post-implementation period, March 2014 to August 2014.

RESULTS: No differences …

Monitoring For Delirium In The Intensive Care Unit Following The Introduction Of The Confusion Assessment Method For The Intensive Care Unit, Charity A. Batman

DNP Projects

PURPOSE: The goals of this study were to: improve delirium recognition by implementing the Confusion Assessment Method for the ICU (CAM-ICU), evaluate adherence to routine delirium monitoring, measure the incidence of CAM-positive patients, and measure the use of analgesic and sedative medications in ICU patients.

METHODS: This study was a single-center post-implementation retrospective medical record review examining the adherence and incidence of delirium after the introduction of the CAM-ICU assessment on the surgical ICU. Prior to the beginning of the study the surgical ICU nurses were educated on how to assess for delirium using the CAM-ICU instrument. During the six …

Evaluation Of Early Mobilization Strategies In The Mechanically Ventilated Patient Population, Katherine B. Stewart

DNP Projects

Purpose

This practice inquiry project was designed to evaluate current mobility practice and identify associations between mobility practice and specific patient characteristics in a cardiovascular intensive care unit.

Population and Setting

The sample consisted of electronic medical records of adult patients that required mechanical ventilation in a 16-bed cardiovascular intensive care unit in a private, urban hospital in Southern U.S. Of the selected participants, 48 were male and 52 were female with an average age of 64.49 (SD = 14.58).

Inclusion Criteria

Inclusion criteria for this study were patients who 1) were aged 18 and older; 2) were mechanically ventilated …

Review Of Current Mobility Practice In Non-Surgical Mechanically Ventilated Intensive Care Unit Patients, Catharine Morgan

DNP Projects

Purpose: The purpose was to: (i) conduct a retrospective electronic medical record review to evaluate current practice related to mobility, (ii) determine the association between current mobility practice patterns and characteristics specific to the patient population, and (iii) make recommendations for the implementation of an evidence-based progressive early mobility protocol for non-surgical mechanically ventilated patients.

Population: Non-surgical, ventilated patients in the Intensive Care Unit (ICU)

Inclusion Criteria: Ventilated patients at least 18 years old who have been ventilated for at least 48 hours and did not have major surgery lasting more than one hour at any point during their hospital …

Preventing Delirium Through The Implementation Of The Abcde Bundle And Pad Guideline Into Everyday Care In A Community Hospital Intensive Care Unit: Opportunities For Practice Improvement, Mary Zody

DNP Projects

This DNP project focuses on the reduction of delirium through improvement of nursing knowledge of delirium and implementation of evidence based bundle ( Awake, Breathing, Coordination, Early Mobility, and Pain, Agitation, Delirium) into a twelve bed intensive care unit located in a 150 bed community hospital. Specifically, this project will review the literature supporting the evidence based bundle and report on a comprehensive gap analysis which was done to determine areas for practice improvement to reduce delirium and improve patient outcomes. The gap analysis included a comparison of current practice to the evidence, a review of administrative policies/ statements of …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

The Efficacy Of Non-Pharmacological Pain Management Methods Amongst Premature Neonates In The Neonatal Intensive Care Unit (Nicu), Hannah R. Martinez

Honors Undergraduate Theses

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted …

The Emotional Intelligence Of Registered Nurses Commencing Critical Care Nursing, Yvette Nagel, Amanda Towell, Elzabe Nel, Fiona Foxall

Research outputs 2014 to 2021

Background: Critical care is described as complex, detailed healthcare in a unique, technologically rich environment. Critical care nursing requires a strong knowledge base and exceptional clinical and technological skills to cope in this demanding environment. Many registered nurses (RNs) commencing work in these areas may lack resilience, and because of the stress of the critical care environment, coping mechanisms need to be developed. To prevent burnout and to enable critical care nurses to function holistically, emotional intelligence (EI) is essential in the development of such coping mechanisms.

Objective: The aim of this study was to describe the EI …