Critical Care Nursing Commons^™

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …

Improving Postoperative Handoff For Placenta Accreta: Implementing A Structured Handoff Communication Tool, Isabelle L. Gerrard

Doctor of Nursing Practice Final Project Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology …

Measuring Effectiveness Of A Mobility Aide On A Medical-Surgical Unit, Jamie L. Granatowicz, Laura N. Rogers, Leeza A. Struwe

Doctor of Nursing Practice Projects: College of Nursing

Purpose: To evaluate the effectiveness of a mobility aide on a medical-surgical inpatient unit to improve patients’ surgical outcomes, decrease hospital length of stay, and decrease the number of falls.

Design: A retrospective review was conducted to determine the effects of a mobility aide implemented on a medical-surgical unit. The intent was to ensure the utilization of the Enhanced Recovery After Surgery (ERAS) protocol for early mobilization before and after implementation. Two-month periods were analyzed before and after implementation.

Findings: The results demonstrated clinical significance for patients when implementing a mobility aide. The mean length of stay was 1.044 days …

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 …

Nurse-Driven Infusion Protocols In Diabetic Ketoacidosis: A Scoping Review, Nicholas Morrell Pierce Msn, Rn, Cen, Ccrn, Mary Cassandra Scott Bsn, Rn, Ccrn, Cen, Alvertis Demetreis Warren Bsn, Rn, Ccrn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Diabetic ketoacidosis (DKA) is a high-risk acute emergency requiring timely insulin titration, intensive monitoring, and coordinated interdisciplinary care. Traditionally, management relies on provider-driven insulin infusion adjustments, which may introduce delays and workflow inefficiencies. Emerging nurse-driven insulin infusion protocols aim to standardize care, improve safety, and enhance clinical efficiency. The purpose of this scoping review was to evaluate existing evidence comparing nurse-driven versus provider-driven insulin infusion protocols in the management of adult patients with DKA.

Methods

A scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From August 2023 through November 2025, …

2025 Nursing Annual Report, Children's Health System Of Texas

2025

No abstract provided.

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

The Relationship Between Mc1r Gene Variants For Red Hair And Clinical Responses To Anesthesia, Analgesia, And Pain: A Systematic Review Of The Literature, Mary Clark Allen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Genetic variations of the melanocortin-1 receptor (MC1R) are commonly associated with red hair and pale skin. Research has linked MC1R variants with alterations in anesthetic response, pain perception, opioid sensitivity, and pain-related fear. Existing literature presents inconclusive findings, highlighting the need for further investigation.

Purpose: This review aims to synthesize current evidence concerning the role of MC1R variants in altering physiologic responses.

Methods: A systematic literature review was conducted by accessing CINAHL, MEDLINE, and PubMed through the University of Arkansas Libraries OneSearch platform. After applying inclusion and exclusion criteria, a total of 20 peer-reviewed articles were extracted for review. …

The Impact Of Structured Family Meetings In The Intensive Care Unit, Loyce T. Mofor

Doctor of Nursing Practice Final Project Abstract

The Impact of Structured Family Meetings in the Intensive Care Unit (ICU)

Purpose

Train providers at an academic institution in a large metropolitan area to conduct family meetings using a structured approach and evaluate this intervention's impact on family satisfaction with communication in the ICU.

Background

Inadequate communication between families and healthcare teams leads to lower family satisfaction, heightened feelings of guilt, and diminished capacity for making clinical decisions.

Methodology

VitalTalk training was utilized to improve providers’ communication skills. Structured family meetings were conducted for Surgical and Thoracic ICU patients with an ICU length of stay of > 5 days or …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

A Pilot Project On Improving Icu Nurses’ Confidence In Early Defibrillation, Adetutu Obadina

Doctoral Projects

Early recognition of shockable cardiac rhythms and timely defibrillation are critical components of effective resuscitation during in-hospital cardiac arrest. Despite established guidelines from the American Heart Association (AHA), nurses may experience uncertainty or reduced confidence when identifying shockable rhythms and delivering timely defibrillation during cardiac arrest events. The purpose of this project was to examine whether a structured educational intervention incorporating simulation-based training could improve intensive care unit (ICU) nurses’ confidence and knowledge in recognizing shockable rhythms and performing timely defibrillation. A pre-and post-intervention design was implemented among ICU nurses at a large academic medical center between September and October …

Improving New Graduate Nurse Clinical Readiness Through Interprofessional Collaboration And High-Fidelity Simulation, Alyssa M. Starkey

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement (QI) project was to enhance new graduate nurse (NGN) clinical readiness through an interprofessional high-fidelity simulation focused on recognizing and responding to patient deterioration during nurse residency onboarding.

Background

New graduate nurses often feel uncertain about recognizing clinical deterioration and communicating. Research shows that simulation-based and interprofessional training improve judgment, teamwork, and communication. This project aims to achieve at least a 10% increase in NGN clinical readiness following the implementation of a high-fidelity simulation program.

Methodology

A pre–post QI study based on Kolb’s Theory and PDSA principles was conducted in a nurse residency …

Implementing The Abcdef Bundle In A Rural Critical Care, Kayla Hubbard

Epsilon Sigma at-Large Research Conference

Patients admitted to the critical care unit are at risk of debilitating adverse outcomes including Delirium, Post intensive care syndrome (PICS), debility, wounds, depression, and both mental and physical impairments. Complications related to ICU care can easily be combatted by using a multidisciplinary approach. The ABCDEF bundle serves to incorporate all aspects of a critically ill patients care in a simple, easy to follow bundle focusing on assessment of pain (A), both spontaneous awakening ang breathing trials (B), choice of sedation/analgesic (C), delirium (D), early mobility (E), and family involvement (F). A quality improvement project was designed and piloted in …

Health Is Where The Huddle Is, Lyndsey Anthony, Anna E. Komistek, Philip C. Pritchett, Emma K. Swanson

SPARK Symposium Presentations

“Health is Where the Huddle Is”

Huddles are an evidence-based strategy to facilitate a culture of safety within nursing teams. A review of 158 huddle studies found that 44.3% reported improved clinical outcomes and 24.3% showed fewer medical errors when huddles were implemented (Pimentel et al., 2021). Currently, a local hospital’s 13-bed ICU lacks an effective system for nursing staff to huddle due to staffing constraints and the absence of monitor technicians, creating safety concerns when nurses leave monitors unattended. This project aims to implement an effective, nurse-led shift huddle that maintains continuous patient monitoring while also strengthening patient safety …

Optimizing Central Line Discontinuation In The Surgical Intensive Care Unit: A Quality Improvement Initiative Using A Visual Aid To Reduce The Risk Of Central Line-Associated Bloodstream Infections, John Quyen D. Van

Doctor of Nursing Practice Final Project Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline …

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

When The Caregiver Becomes The Wounded, Gracelin L. Young

ATU Scholars Symposium

Burnout among critical care nurses (CCNs) is a substantial threat to nurse well-being, patient safety, and workforce stability. The aim of this paper is to identify risk factors contributing to burnout in CCNs using evidence-based articles. An organized literature search was conducted using CINAHL with key terms including critical care nurses, burnout, risk factors, compassion fatigue, and work environment. Five recent peer-reviewed studies meeting inclusion criteria were chosen. The results validate that risk for burnout is vastly influenced by emotional exhaustion, chronic workplace stress, high patient acuity, sleep disturbances, compassion fatigue, insufficient support, and organizational strain. Findings suggest that burnout …

Improving Patient Satisfaction In The Emergency Department Waiting Room Through Enhanced Communication Strategies: A Quality Improvement Initiative, Wael P. Karaki

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to improve ED waiting room experience by standardizing communication to increase transparency and expectation management, targeting an increase in Net Promoter Score (NPS) from 33.5 to ≥35.4 within three months.

Background: ED waiting room dissatisfaction is driven by uncertainty (unclear wait times, inconsistent updates, and limited understanding of triage and ED flow), supporting structured communication over individual clinician delivery.

Methodology: A 3-month, single-site QI project in an urban ED used iterative PDSA cycles and included all ED encounters (n=17,444). The bilingual intervention included orientation pamphlets (print/QR-based), standardized triage verbalization of …

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

The Use Of A Safety Screening Tool To Improve Sedation Holiday Compliance And Nurse Confidence, Shelby Marchisio

Doctor of Nursing Practice Final Project Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation …

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 …

The Standardization Of Protocols For Lines And Drips In Complex Cases, Allee A. Rudolph

Scholars Week

Medication errors occur far too often, yet many can be prevented through simple measures such as intravenous line labeling. Clear, highly visible labels enable quick identification reducing the response time in critical situations. The incorporation of color-coding and icons can only enhance the ability to distinguish between the lines with confidence.

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 …

1. Utilizing Virtual Rns To Decrease Length Of Stay On An Acute Care Unit, Sarah Culbert, Lillian Embree

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Improving Door To Ekg Time In The Emergency Department, Juleene J Mcgowan

Providence Nursing Research Conference 2023 – Present

References:

Yiadom, M. Y., Gong, W., Patterson, B., et al. 2022.

Fallacy of Median Door-to-ECG Time: Hidden Opportunities for STEMI Screening Involvement.

Journal of American Heart Association. Https://doi.org/10.11161/JAHA.121.024067

Yiadom, M. Y., Gong W., Bloos S., et al. 2024.

Shorter Door-to-ECG Time is Associated with Improved Mortality in STEMI Patients.

Journal of Clinical Medicine. 2024, 13, 2650. https://doi.org/10.3390/jcm13092650

Resuscitating Rapid Response And Code Blue Education, Danielle Fogel

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Integrating Licensed Vocational Nurses (Lvns) Back Into The Acute Care Setting, Mindy Luebs, Amanda Espinosa

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Evaluating The Impact Of Early Mobilization Education On Nurse Confidence And Length Of Stay In An Intensive Care Unit, Kimberly Melendez, Crystal Solis, Karis Pickett, Lillie Chung

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Establishing Bedside Report In The Emergency Care Center, Alexandra Rowen

Providence Nursing Research Conference 2023 – Present

No abstract provided.