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Articles 1 - 30 of 131
Full-Text Articles in Critical Care Nursing
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Oscar J. Castillo
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Oscar J. Castillo
Master's Projects and Capstones
Problem: The Quality Improvement (QI) Project focused on improving early sepsis management and sepsis bundle adherence among Emergency Department (ED) nurses to decrease sepsis mortality rates and avoidable length of hospital stays (LOS).
Context: A group of Clinical Nurse Leaders (CNL) students evaluated sepsis protocol compliance at Hospital A's ED, which provides critical care for patients with various medical conditions. The CNL students concentrated on patients identified with sepsis for the QI Project.
Interventions: Limitations and time did not allow for the implementation of interventions. Recommendations offered to management included increasing sepsis training biannually and intravenous placement skills, offering sepsis …
Improving Early Sepsis Recognition: Resocializing Intensive Care Unit Nurses In A Large Hospital On The Inpatient Sepsis Bundle Checklist, Elizabeth Rose Maykel
Improving Early Sepsis Recognition: Resocializing Intensive Care Unit Nurses In A Large Hospital On The Inpatient Sepsis Bundle Checklist, Elizabeth Rose Maykel
Master's Projects and Capstones
Problem: In order to lower sepsis morbidity and mortality rates through early recognition and treatment, this quality improvement project sought to raise sepsis awareness and bundle compliance within the Intensive Care Unit.
Context: Clinical Nurse Leader (CNL) students completed a microsystem assessment of the Intensive Care Unit at Hospital X in Northern California. This unit cares for patients with sepsis, organ failure, respiratory failure, different types of shock, acute kidney injury, and traumatic brain injury.
Interventions: The implemented intervention included a refresher huddle on sepsis bundle awareness. Though the intervention was ineffective, the students did offer recommendations …
Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji
Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji
Master's Projects and Capstones
Mentoring Nurses After Specialty Training or Orientation in Labor and Delivery
Abstract
Background: The setting for this project was a northern California hospital-based healthcare system referred to as “Hospital KV.” Hospital KV is a non-profit, integrated hospital that operates to improve the community’s health. Hospital KV’s maternal child health (MCH) department comprises a labor and delivery(L&D) unit, a mother and baby unit (MBU), also referred to as a postpartum unit, and an intermediate nursery (IMN).
Problem: The hospital KV MCH department faced the challenge of a nursing shortage. The nursing shortage was associated with substantial challenges to Hospital KV, its …
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Efrain Perez Trujillo
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Efrain Perez Trujillo
Master's Projects and Capstones
Problem: This quality improvement (QI) project aims to optimize early sepsis management and sepsis bundle compliance among Emergency Department (ED) registered nurses in order to reduce the risk of sepsis-related deaths and associated hospital length of stay.
Context: Clinical Nurse Leader (CNL) students conducted a microsystem assessment on the ED at Hospital A, located within the greater San Francisco Bay Area. This microsystem, equipped with 115 nurses and 44 rooms, consists of an acuity of care for urgent to life-threatening medical conditions, including sepsis.
Intervention: Following time constraints, and limitations, implementation of an intervention was not feasible; however, CNL students …
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Camila Sanchez
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Camila Sanchez
Master's Projects and Capstones
Problem: The purpose of this quality improvement (QI) project revolves around increasing overall staff nurse compliance, enhancing their sepsis education resources, and usage of their provided education and bundle. This goal was created to produce more positive patient outcomes at Hospital X, along with its improved management of sepsis. Hospital X is an acute care facility located in the San Francisco Bay Area.
Context: The unit that was studied during this QI project was the emergency department of Hospital X. This unit provides level I trauma services in addition to other types of emergency care and contains 44 beds. Not …
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Monica P. Rabago Moreno
Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Monica P. Rabago Moreno
Master's Projects and Capstones
Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths as well as hospital length of stays.
Context: A microsystem assessment, in the emergency department (ED) unit, was performed in Hospital A located in the Greater San Francisco Bay area by Clinical Nurse Leader (CNL) students. This ED unit cares for a variety of critical care patients ranging from urgent to life-threatening conditions.
Intervention: An intervention was not implemented in the ED unit due to time constraints and limitations; however, CNL students provided recommendations …
Improving Triage Accuracy In The Emergency Department, Joselyn Silverman
Improving Triage Accuracy In The Emergency Department, Joselyn Silverman
Master's Projects and Capstones
Problem: High rates of patients being mis-triaged was occurring at Hospital X leading to poor patient outcomes and incorrect staffing levels.
Context: This quality improvement project took place at Hospital X’s emergency department. A stakeholder analysis and a microsystem assessment along with a staff survey was created in order to determine areas of improvement and staff responsiveness.
Interventions: Eight educational seminars were conducted along with Hospital X leadership and students created supplemental materials for the staff to use on a daily basis.
Measures: Two data pulls were conducted over the course of the quality improvement project; one prior to the …
Improving Early Sepsis Recognition: Resocializing Intensive Care Unit Nurses In A Large Hospital On The Inpatient Sepsis Bundle Checklist, Nancy Zhu
Master's Projects and Capstones
Problem: Sepsis is a life threatening disease that has caused over a million deaths annually in the nation. Early recognition of sepsis is highly crucial for health care professionals to know to prevent an increase of mortality and morbidity rates. This quality improvement project aimed to increase sepsis bundle checklist awareness to the staff and compliance in the Intensive Care Unit to improve the sepsis cases.
Context: Clinical Nurse Leader students completed a microsystem assessment of the Intensive Care Unit at Hospital X in San Mateo County. This unit cares for patients with sepsis, septic shock, severe sepsis, organ failure, …
Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis
Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis
MSN Capstone Projects
The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).
Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …
Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell
Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.
LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …
Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider
Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
BACKGROUND: Current recommendations to reduce pain associated with mechanical ventilation is the administration of opiate and benzodiazepine infusions for Pediatric Intensive Care Unit (PICU) patients. If these infusions are weaned too quickly, iatrogenic withdrawal syndrome (IWS) often occurs. IWS symptoms include tachycardia, hypertension, diaphoresis, fever, irritability, tremors, clonus, hyperactive reflexes, vomiting, and diarrhea. Untreated IWS can lead to life-threatening complications.
LOCAL PROBLEM: The PICU at the project site contains fourteen beds and treats critically-ill pediatric patients. There was no standardized withdrawal assessment tool in practice. The purpose of this project was to implement the Withdrawal Assessment Tool-Version 1 …
Massive Transfusion And Shock Index, Kasey House
Massive Transfusion And Shock Index, Kasey House
MSN Capstone Projects
Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.
While initiating an MTP …
Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner
Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner
MSN Capstone Projects
Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …
Moral Distress In Critical Care Nursing: A Literature Review, Anna Tindell
Moral Distress In Critical Care Nursing: A Literature Review, Anna Tindell
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Moral distress is a pressing concern in the healthcare field with significant implications for all areas of nursing and patient outcomes. However, those within the specialty of critical care nursing experience moral distress more frequently than those in other specialties. It arises from the complex ethical dilemmas nurses in critical intensive care units face as they work in these high-pressure environments. The purpose of this literature review is to discuss moral distress in critical care nursing and how it affects a nurse’s ability to provide quality care. Furthermore, this review will determine factors contributing to moral distress and potential interventions …
Block Charting For Hemodynamic Unstable Patients, Tasha Walker
Block Charting For Hemodynamic Unstable Patients, Tasha Walker
Student Scholarly Projects
Practice Problem: The intensive care unit poses many challenges for nurses. Nurses are placed in a position to decide on dosing and administration, which could conflict with their scope of practice, and documentation needs to coincide with orders. The accuracy of nursing documentation plays a vital role in measuring the outcomes, and failure to document accurately could result in noncompliance with scope of practice or a medication error.
PICOT: For intensive care nurses (P), how does block charting of vasoactive medications (I) compared to current documentation practices (C) affect the accuracy of nurses' documentation (O) within 4 weeks?
Evidence: Nursing …
The Role Of Safety Interventions In Decreasing Unplanned Extubations In Pediatrics: A Benchmark Study, Wesley Bray
The Role Of Safety Interventions In Decreasing Unplanned Extubations In Pediatrics: A Benchmark Study, Wesley Bray
MSN Capstone Projects
Unplanned extubation (UE) is the removal of an endotracheal tube from a patient any time before their planned extubation. In layman’s terms it is when a patient loses their airway before they were ready. These events lead to longer hospital stays, cost hospitals thousands of dollars for each case and can cause severe complications for the patient including death. Pediatric patients are a population that are at risk of UEs more so than the general population due to their inability to understand what is going on in the hospital due to their age and development, as well as their ability …
Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg
Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg
Capstone Experience
Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, …
Ultrasound-Guided Intravenous Access As A First-Line Approach By Nurses: A Quality Improvement Project, James Austin Burkhart, Pamela Hardesty, Melissa Mcdonald
Ultrasound-Guided Intravenous Access As A First-Line Approach By Nurses: A Quality Improvement Project, James Austin Burkhart, Pamela Hardesty, Melissa Mcdonald
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
Background: Up to 9% of patients admitted to EDs (Emergency Departments) have difficult intravenous insertion access issues (DIVA). This creates delays in patient care that includes interruptions for physicians providing medical emergency care. Often the utilization of RNs to perform US (ultrasound) IV insertions is limited related to lack of training and supportive policies.
Local Problem: The site for this project was an ED Level 1 Trauma Center associated with a large teaching hospital located in the southeastern U.S. Prior to the implementation of the process improvement project, there was no formal education of RNs in the use of US …
Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz
Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz
Dissertations
The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …
Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust
Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust
Electronic Theses and Dissertations
This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …
Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske
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. …
Sustaining Care Team Engagement Using A Hierarchy Of Needs Framework, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Natalia Johnson, Rebecca A. Brookes
Sustaining Care Team Engagement Using A Hierarchy Of Needs Framework, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Natalia Johnson, Rebecca A. Brookes
Operational Transformation
Cardiology Intensive Care & Cardiovascular Interventional (CICU & R9 West) teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of physical and mental health wellbeing, as well as care team engagement in order to continue to provide outstanding care to patients. CICU/R9 West Leadership looked for ways to improve team engagement and ensure that care team members’ needs are met and sustained.
Acute Care Staff Interactions With Chaplains To Discuss Personal, Non-Work-Related Stressors, Gary Weisbrich, Teresa Rangel
Acute Care Staff Interactions With Chaplains To Discuss Personal, Non-Work-Related Stressors, Gary Weisbrich, Teresa Rangel
Central Division Nurse Clinical Inquiry Conference
No abstract provided.
Moral Injury, Moral Resilience, And The Healthy Work Environment Among Icu Nurses: A Secondary Analysis, Angie Shemwell, Sarah Sumner
Moral Injury, Moral Resilience, And The Healthy Work Environment Among Icu Nurses: A Secondary Analysis, Angie Shemwell, Sarah Sumner
Central Division Nurse Clinical Inquiry Conference
No abstract provided.
A Team Mentor Project To Reduce Turnover On A Cicu, Sarah Evans
A Team Mentor Project To Reduce Turnover On A Cicu, Sarah Evans
Central Division Nurse Clinical Inquiry Conference
Abstract:
Background
From 2022-2023, a 28-bed cardiac care intensive unit (CICU) employing 120 Registered Nurses (RNs) hired 63 RNs, including 3 new graduates and 32 new-to-specialty, following significant turnover. Nurses in the CICU frequently face complex situations, leading to emotional distress and potential turnover if coping resources are not provided. Research suggests that pairing a new CICU nurse with an experienced mentor to help cope with complex situations can significantly increase confidence and resiliency and reduce emotional distress and turnover. On our CICU, nurses are assigned a preceptor for 12-20 weeks to orient to CICU-specific competencies without an emphasis on …
Preventing Pressure Injuries In Critical Care Settings, Chassidy Eddlemon, Cassady Coomes
Preventing Pressure Injuries In Critical Care Settings, Chassidy Eddlemon, Cassady Coomes
Scholars Week
2.5 million people develop a hospital-acquired pressure injury each year, and 60,000 of these result in death as an outcome. Nationwide, hospitals have policies in place to prevent HAPIs, but that does not always stop them from occurring. For this project, we looked at one hospitals policy regarding prevention of pressure injuries. In this powerpoint, we outlined the products we found throughout our research to aide in prevention, as well as our recommendations for practice.
Risks Vs. Benefits Of Animal-Assisted Interventions For Icu Induced Psychosis, Cecily Christie, Hadley Mayes
Risks Vs. Benefits Of Animal-Assisted Interventions For Icu Induced Psychosis, Cecily Christie, Hadley Mayes
Scholars Week
For our senior Nursing Evidence-based practice project, we conducted our own research to evaluate the risks and benefits of animal-assisted intervention (AAI's) being used in intensive care units, in the hopes to encourage nurses and healthcare staff to implement these in patient care facilities.
Benefits Of Bedside Report, Konner Spalding, Hannah Mattingly
Benefits Of Bedside Report, Konner Spalding, Hannah Mattingly
Scholars Week
No abstract provided.
L’Unité Virtuelle De Soins Pour Le Développement De Compétences Relatives À La Surveillance Clinique En Contexte De Soins Critiques : Une Étude Qualitative Descriptive, Daniel Milhomme, Annie Perron, Josyane Pinard, Julie Houle, Dominique Therrien, Gabriela Peguero-Rodriguez, Sylvie Charette, Bob-Antoine Jerry Ménélas, Dominique Labbée, Fernanda Ribeiro, Roxanne Laverdière, Mylène Trépanier, Stéphane Bouchard, Frédéric Banville
L’Unité Virtuelle De Soins Pour Le Développement De Compétences Relatives À La Surveillance Clinique En Contexte De Soins Critiques : Une Étude Qualitative Descriptive, Daniel Milhomme, Annie Perron, Josyane Pinard, Julie Houle, Dominique Therrien, Gabriela Peguero-Rodriguez, Sylvie Charette, Bob-Antoine Jerry Ménélas, Dominique Labbée, Fernanda Ribeiro, Roxanne Laverdière, Mylène Trépanier, Stéphane Bouchard, Frédéric Banville
Quality Advancement in Nursing Education - Avancées en formation infirmière
Résumé
Introduction : La réalité virtuelle (RV) est une méthode pédagogique de plus en plus utilisée pour favoriser l’acquisition de certaines compétences chez les personnes étudiantes en sciences infirmières. Le jugement clinique lors de la surveillance d’une personne soignée en soins critiques est une compétence pouvant être développée grâce à la RV. Toutefois, avant d’intégrer cette méthode pédagogique à la formation infirmière, il est important de s’assurer de l’acceptabilité et de la faisabilité dans un contexte de formation en sciences infirmières. But : Cette étude décrit l’expérience vécue par des personnes étudiantes en sciences infirmières lorsqu’elles ont utilisé l’UVS pour …
Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta
Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta
Doctor of Nursing Practice (DNP) Scholarly Project
Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.
Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.
Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …