Critical Care Nursing Commons^™

Maternal Distress In The Neonatal Intensive Care Unit, Morgan A. Staver

Theses & Dissertations

Maternal distress in the NICU is a common and potentially harmful phenomenon for mothers with a sick infant. The overall purpose of this dissertation was to describe maternal distress and to examine maternal distress among mothers who have infants greater than or equal to 34 weeks of gestation at birth in the NICU. This was accomplished by first conducting a concept analysis of maternal distress in the NICU. Next, an integrative review of the literature was done to assess maternal distress and associated variables in response to infant hospitalization in the NICU. Finally, a mixed methods study was done to …

Everyday Ethics And Equity At The Bedside, Shika Kalevor, Angie Knackstedt

Research Days

Background: Traditional bioethics training, although important, may not be completely suited to the nursing role. In contrast to traditional clinical ethics, which focuses on healthcare dilemmas, everyday ethics focuses on routine clinical encounters between clinicians, patients, and families and may be better suited to help nurses address issues such as bias and racism at the bedside.

Objectives/Goal: This study aims to provide a data-backed approach to ethics education for nurses as it pertains to improvements in the understanding of Diversity, Equity, & Inclusion (DEI) efforts in healthcare. This study also provides an opportunity for the field of bioethics to provide …

The Impact Of Simulation-Based Mastery Learning For Central Venous Catheter Dressing Changes With Staff Nurses At A Nebraska Critical Access Hospital, Paige Pavlik, Michaela Haddock

Doctor of Nursing Practice Projects: College of Nursing

Abstract

Purpose

The purpose of this pilot feasibility study was to assess if a simulation-based mastery learning (SBML) intervention on central venous catheter (CVC) dressing changes by staff nurses at Nemaha County Hospital could further develop staff nurses’ central line care skills by increasing their knowledge of a central line dressing change, improving their comfort level and learning self-efficacy with central line care, determining if there is a relationship between knowledge, learning self-efficacy and comfort in the clinical area, and assessing nurses’ satisfaction on the SBML intervention. The clinical research questions being explored are, “Will nurses in a Nebraska critical …

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Transferring Patients To A Higher Level Of Care, Chiquita Rockiemore Rn, Msn, Olubunmi Osinloye Bsn, Rn, Angela Uta Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

The purpose of this study is to determine whether the transfer of critically ill patients, who require a higher level of care, to another facility impacts morbidity and mortality within 24-72 hours post transfer

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner

The Eleanor Mann School of Nursing DNP Capstone Projects

Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …

The Impact Of Psychological Interventions Given To Icu Patients To Help With Pain Management, Kelly Liu

Nursing | Senior Theses

Pain management among the critically ill population is a significant issue in the intensive care setting. Whether the pain is acute or chronic, nurses tend to be the first-hand responders to help with pain management in the intensive care unit (ICU). With barriers ranging from patients’ inability to verbalize pain to nurses’ experience with obstacles to assessment such as sedation, confusion, or other concerns, pain management is a serious issue. Although pharmacological interventions such as opioids and analgesics help with pain control, in this thesis, we will focus on the impact of nonpharmacological and psychological nursing interventions and how it …

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased …

An Overview Of Extended Ventilation Requirements Related To Comorbidities., Kaitlyn Horrell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Mechanical ventilation is a machine that that allows patients to breathe when they are unable to adequately do it themselves. This could be due to illness or injury. Ventilators pump oxygen into the lungs through a tube that travels through the trachea. When a patient is put on a ventilator, they will be placed in the Intensive Care Unit. While ventilation is typically a short-term intervention, some patients require ventilation for extended periods of time, and some may not come off the ventilator, eventually dying. Dozens of patients were ventilated in the ICU at Mercy, and most of them spent …

Weight Management Program Using Myfitnesspal© In A Rural Primary Care Setting, Taylor Rittman

The Eleanor Mann School of Nursing DNP Capstone Projects

Obesity is a growing health concern that is linked to the development of chronically debilitating physical and mental illnesses. Obesity is a result of a long-term positive imbalance between energy intake and energy expenditure. Evidence has shown more than one third of U.S. adults suffer from obesity. Primary care providers in the United States report being overburdened in treating obesity, citing a lack of time, structured approach, and structured resources. Furthermore, the disparities in obesity are even more prevalent in rural areas where older adults are the fastest growing part of the population at risk for this disease. Evidence indicates …

Colorectal Cancer Screening In The Latino Population At A Family Medicine Clinic: A Quality Improvement Project, Michael S. Vinson

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Colorectal cancer (CRC) is a preventable and curable disease that affects all genders, races, and ethnicities, and its impact on society can be reduced with early screening. The Latino population is at greater risk compared to groups or ethnicities due to social determinants and health disparities within the community. Review of Literature: Language barriers, low education levels, persistent social stressors, poor healthcare navigation, and structural barriers make it difficult for this population to be properly screened at appropriate intervals. Purpose: This quality improvement (QI) project was designed to combat reduced screening rates seen in the Latino population. The target …

Necrotizing Enterocolitis Rates In Preterm Infants, Alexis Howard

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breast milk and donor human milk is used in the prevention of necrotizing enterocolitis (NEC) in preterm infants born prior to 37 weeks gestation and those with very low birth weight. This process occurs through direct breast feeding and tube feeding. The aim of this study was to compare the use of breast milk and donor milk to the use of formula feed in preterm infants. A systematic review was conducted using articles collected from CINAHL and PubMed and was guided by PRISMA guidelines. A total of 15 studies that met criteria were analyzed by purpose, variables, study design, population …

Pediatric Specific Assessment Modalities In Pediatric Blunt Trauma Cases: A Literature Review, Haley Ranne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

With unintentional injury being the number one cause of death of children in the United States, it warrants the need for successful, cost effective ways to improve identification of severe injury and prevent mortality in children. The purpose of this review is to compile literature related to pediatric specific trauma assessments in the instance of blunt trauma. Twenty peer-reviewed articles that were published in notable journals were analyzed to include in this review. There are several assessments that are being utilized in pre-hospital and hospital emergency settings today, such as the Shock Index (Pediatric Age Adjusted), Pediatric BIG Score, and …

Civility And Communication Interventions To Improve Patient Outcomes, Lane Denney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Communication in health care is vital for the successful care of patients and their outcomes while they are hospitalized. Healthcare workers are responsible for communicating patient information whether it is between change of shifts or reporting to a patient’s provider. It is important that this information is communicated effectively. This review evaluates how nurses communicate in shift- report and how this affects patient outcomes and civility between nursing units and teams. Overall, bedside shift reports promoted the best patient outcomes and increased teamwork on hospital units.

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Biomarkers And Factors Related To Risk Of Acute Kidney Injury, Mary Ann David

Dissertations

Background: Acute kidney injury (AKI) is associated with increased mortality, morbidity, length of hospital stay, and in-hospital cost. Timely intervention is needed to prevent disease progression, but the delay in diagnostic process often results in delayed treatment. Recent studies show a significant increase in novel urine biomarkers (UB), TIMP-2 and IGFBP7, has been linked to an increased risk of AKI.

Objectives: The purpose of this study was to examine the relationships among participants’ sociodemographic and clinical characteristics, including select biomarkers, care management processes, treatments, and patient outcomes in a sample of hospitalized critically ill patients in southern California.

Findings: Study …

Tiny Tusks Internship: Barriers To Breastfeeding Surrounding Neonatal Intensive Care Units, Brianna Purser, Quinn Owen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

It is known that breastfeeding is beneficial to mothers and their children, and it is recommended that mothers exclusively breastfeed for the first six months of their infant's life. Despite this, in the United States only 1 in 4 infants is exclusively breastfed for the first six months. After being an intern for Tiny Tusks Breastfeeding and Infant Support, a program designed to facilitate and educate about breastfeeding, we have seen firsthand the barriers to breastfeeding. The goal of this literature review was to investigate barriers to breastfeeding specifically surrounding neonatal intensive care units (NICU) and how to address those …

Effects Of Inadequate Nurse Staffing And Need For Standard Nurse-To-Patient Ratios To Increase Patient Safety In Acute Care Settings, Macey Schwenker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This study includes articles including research regarding the effects of the current nursing staff shortage and overtime on patient care and outcomes. A systematic review of research was conducted guided by PRISMA guidelines and consists of articles collected from PubMed. Studies were taken place in the United States, England, Taiwan, Singapore, United Kingdom, Brazil, South Korea, Sweden, India, and Australia involving hundreds of thousands of participants. Methods include mean ratio, regression models, surveys, and questionnaires. Nurse staffing shortages, overtime, and inadequate staffing increased the risk of patient mortality and decreased overall patient safety and quality of care in acute care …

Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño

Doctoral Projects

A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses' Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses' confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Quality Improvement Initiative To Improve Door To Needle Time In Acute Stroke Patients, Lauren N. Trace

ONU Student Research Colloquium

Problem: A stroke is when a blockage occurs in the blood vessels to the brain or when a blood vessel bursts in the brain, creating a lack of oxygen supply to keep the brain functioning effectively. The earlier a stroke patient is treated, the better the outcomes will be. Door to needle time is the time difference between when the patient arrives to the time treatment is given.

Purpose: The purpose of this project is to determine if implementing a one call notification system can decrease door-to-needle (DTN) time.

Methods: A quasi-experimental approach will be used for this study. Five …

Sotrovimab: Neutralizing Antibody To Combat Covid-19, Aya Allam, Steven Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Are Antipyretic Medications Compatible With Sars-Cov-2 Vaccines?, Sharanya S E Santhi, Niguma Rayamajhi, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

To Use Or Not To Use Oxygen For Mi Benchmark Study, Alexia Celaya

MSN Capstone Projects

It is a common practice for emergency personnel to administer oxygen for a patient diagnosed with a myocardial infarction. It is a well-known practice to place the patient on supplemental oxygen even if they are not hypoxic. The use of supplemental oxygen has been a cornerstone in the treatment of myocardial infarction. The rationale behind the administration of oxygen therapy is to increase oxygen delivery to the myocardium, therefore limiting the infarct size and future complications (Hofmann et al., 2017). The use of supplemental oxygen on normoxic patients has been challenged due to the possibility of causing further injury to …

The Effects Of Nursing Overtime Work Hours On Medication Errors And Patient Safety, Camilla Byrd, Halle Borgel, Mykayla Stephens, Jena Killian, Mya Kinney

Symposium of Student Scholars

Abstract

Background: The recent global pandemic has uncovered health care inequities among nursing professionals. The nursing shortage has placed pressure on overworked nurses to perform higher level critical care under dire and unsafe conditions. The stress of overworked nurses is a culprit for medical errors that affect the quality and effectiveness of patient care. Methods: Kennesaw State Library, PubMed, 35 articles screened. After thorough screening of various articles addressing this topic, we examined the quantitative and qualitative studies performed in all areas of nursing. Results: Research suggests that nurses working overtime versus full-time hours experience physical, mental, and emotional exhaustion …

Post-Operative Delirium: Can Retraining On The Cam-Icu Tool Increase Nurses’ Confidence In Patient Assessment?, Alison Farraher

Symposium of Student Scholars

Background: Delirium is defined as an acute condition consisting of confusion, altered mental status, and disorganized thought processes. Patients who develop delirium have higher mortality rates, increased lengths of stay in the hospital, worse clinical outcomes, and place a higher burden on hospital staff. Affecting up to fifty percent of cardiac surgery patients, delirium is recognized as a major post-operative complication highlighting the importance of early detection. The Confusion Assessment Method for the ICU (CAM-ICU) is a widely accepted screening tool used to detect delirium in the ICU setting. Despite being clinically validated, many nurses lack adequate training on how …

Monthly Debriefing Sessions For Critical Care Nurses: Evaluating Nurse Burnout And Retention, Emilei Ison

Symposium of Student Scholars

Nurse burnout and retention is an ongoing issue in the trauma/surgery ICU, especially following COVID-19. Critical Care Societies Collaborative (CCSC) recently held a summit to address the issue of burnout among critical care professionals and call for action to implement change and promote research. Studies have shown that increased burnout amongst nurses is associated with increased healthcare associated infections, increased patient mortality, and decreased perceived quality of teamwork. With the cost of turnover being 1.2 to 1.3 times an RN’s salary, preventing burnout is a major issue for healthcare organizations. The purpose of this evidence-based practice project is to address …

A Project Proposal: The Effects Of Standard Protocols During Cpr On Hospital-Acquired Infections Of Post-Open-Heart Surgery Patients In The Cvicu, Jessica Monahan

Symposium of Student Scholars

Abstract

A Project Proposal: The Effects of Standard Protocols during CPR on Hospital-Acquired Infections of Post-Open-Heart Surgery Patients in the CVICU

Background: Hospital-acquired infections (HAIs) are one of the most common complications post-cardiac surgeries and are associated with longer hospitalizations, elevated use of healthcare resources, and increased morbidity and mortality. The effects of HAIs after cardio-pulmonary resuscitation (CPR) in recent post-open-heart surgery patients remains largely unexplored. Therefore, the purpose of this project was to determine, in the CVICU does implementing standard protocols during CPR on recent post-open-heart surgery patients reduce HAIs?

Literature Review: HAIs during CPR can be acquired through …

Reducing Catheter-Associated Infections Through A Two-Nurse Protocol, Jennifer Balagani

Symposium of Student Scholars

Catheter-associated infections related to Foley catheter insertion and maintenance is a current problem in my practicum unit and across the United States. Although we are only in the third month of 2022, my practicum unit has already documented three cases of catheter associated infections occurring this year. Unfortunately, these cases are not outside of the norm, in the United States, catheter-associated infections are the second most common hospital acquired infection (Zurmehly, 2018). The purpose of this project is to propose trial interventions at Kennestone Hospital that have been effective in other hospitals like the Shepherd Center to reduce the occurrence …