Other Nursing Commons^™

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

Improving Patient Flow In The Urgent Care Setting, Stephanie Carpenter

Student Scholarly Projects

Practice Problem: Urgent care clinics provide care to patients with non-life-threatening illnesses or injuries and are found to be less expensive and more convenient than emergency departments. As urgent care clinics are growing in popularity so are the patient wait times and overall length of stay times.

PICOT: The PICOT question that guided this project was in urgent care clinic patients (P), how does utilizing the Emergency Severity Index (ESI) as a patient triage tool (I) compared to using no patient triage tool (C) affect the patient flow and patient wait times (O) within 13 weeks.

Evidence: Evidence search with …

Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok

Student Scholarly Projects

CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that …

Implementation Of The National Early Warning Score Tool In The Acute Care Setting, Amanda Reyes

Student Scholarly Projects

Practice Problem: The organization arbitrarily called a rapid response or code blue call based on abnormal vital signs or intuition and needed a new process to identify early recognition of patient deterioration.

PICOT: For adult inpatients in an acute care setting in a large healthcare system (P), will implementation of the National Early Warning Score (NEWS) across the organization (I) compared to data from the last fiscal year where NEWS was not used (C) decrease code blue calls (O) within 8-weeks (T)?

Evidence: Eleven high quality studies met the inclusion criteria and found that the NEWS is a validated …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Indwelling Urinary Catheter Removal Houdini Protocol, Fatima Villacruz

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) in spinal cord injury (SCI) patients have many negative health consequences, including increased cost, increased length of hospital stays, delay in bladder training, increased associated infections, and mortality.

PICOT: The PICOT question that guided this project was: In adult SCI patients (P), does the implementation of a nurse-driven indwelling urinary catheter removal protocol (I), compared to without a nurse-driven protocol (C), decrease the indwelling urinary catheter days and the occurrence of CAUTIs (O) within six weeks (T)? Evidence: Nurse-driven discontinuation protocols are an effective method of decreasing indwelling urinary catheter (IUC) days and …

Evidence-Based End-Of-Life Comfort Care Guidelines, Myla Maranan

Student Scholarly Projects

Practice Problem: In the absence of end-of-life (EOL) comfort care guidelines, the nurses in a medical-surgical unit are apprehensive about caring for patients in their active stage of dying, which leads to abandoning the values of holistic and patient-centered care.

PICOT: The PICOT question that guided this project was: "How do acute care bedside nurses (P) who utilize the evidence-based comfort care guidelines (I) compare to not using the evidence-based guidelines (C) perceive their confidence in their capability to provide holistic and patient-centered care (O) during the active onset of the patient's end-of-life stage (T)?"

Evidence: The literature indicated …

Improving Caregivers’ Perceived Involvement In Care Through Facilitating Communication With Hospital Providers, Heather Manolas

Student Scholarly Projects

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and …

Compliance With A Nurse-Driven Hypoglycemia Protocol: Time From Hypoglycemia Event To Euglycemia, Robin A. Chappell

Student Scholarly Projects

Practice Problem: Hypoglycemia is a known complication of diabetes mellitus and is considered one of the top three adverse drug events by the U.S. Department of Health and Human Services (2019) because it is common, clinically significant, measurable, and preventable.

PICOT: The PICOT question that guided this project was: In non-critical hospitalized adult patients on medical-surgical units with documented HGEs, how does active surveillance for strict adherence to a nurse-driven hypoglycemia protocol, compared to no surveillance, affect the time from hypoglycemia to euglycemia?

Evidence: Treatment of hypoglycemia is commonly inconsistent and prolonged; however, active surveillance and monitoring of a …

Transition Of Care For Discharged Patients, Rolando Ramos

Student Scholarly Projects

Practice Problem: The 30-day readmission rate for patients discharged from the hospital and returned to their primary care in a clinical office setting (21%) was higher than the national average readmission rate (17%). The high readmission rate suggested patients were receiving transitional care that was fragmented and non-standardized. Therefore, the implementation of a collaborative transition of care practice was vital to reduce avoidable readmissions.

PICOT: The PICOT question that guided this project was, “In adult patients with chronic conditions, what is the effect of a transition of care practice, versus a non-standardized practice, on reducing 30-day readmissions, within a …

A Pain Control Optimization Pathway To Reduce Acute Postoperative Pain And Opioid Consumption Postoperatively: An Approach To Battling The Opioid Epidemic, Holly Franson

Student Scholarly Projects

Practice Problem: Healthcare providers worldwide are working to battle the opioid epidemic and reduce opioid-related harm to patients. Utilizing evidence-based acute pain management methods to reduce opioid consumption is critical to combat the problem.

PICOT: The PICOT question that guided this project was: In opioid-naïve adult patients undergoing general anesthesia for out-patient, minimally invasive abdominal wall hernia surgery, how does the implementation of an evidence-based, preventative Pain Control Optimization Pathway (POP) using a multimodal, opioid-sparing acute pain management technique and standardized procedure-specific opioid prescribing, compared to standard treatment, affect postoperative pain scores and opioid consumption, upon discharge from the …

Bedside Shift Report: A Way To Improve Patient And Family Satisfaction With Nursing Care, Audriana Pevec

Student Scholarly Projects

Poor communication during the handoff process contributes to approximately 30% of malpractice claims costing up to $1.3 billion annually (Fenner, 2017), which demonstrates the importance of evaluating the quality of information exchange between nurses, patients, and families when associating quality of care to patient satisfaction (Kullberg et al.,2017).

The following question guided this Evidence-Based Project (EBP) project. In adult, progressive care unit patients (P), does the implementation of a nursing bedside handoff (I) compared to current handoff practices (C) improve patient/family satisfaction with nursing care (O) over eight weeks (T)?

The literature revealed evidence from 10 studies answering …

The Use Of Tailored Interventions To Prevent Falls: A Quality Improvement Project In The Telemetry Unit, Roda Galang

Student Scholarly Projects

Background: Every year in the United States, hundreds of thousands of patients fall in hospitals with 30 to 50 percent resulting in injury. In Texas, the fall rate in adult patients is 33.9 percent, and in one teaching hospital in South Texas, patient fall rates have been above the national benchmark for two years (2017-2019), despite increased use of sitters for patient safety and multiple fall prevention strategies. The annual direct care cost of all fall events in the United States for individuals more than 65 years old is about $34 billion.

Practice problem: The objectives of the fall initiative …

A Patient-Centered Approach To Fall Prevention, Elmer Esguerra

Student Scholarly Projects

Practice Problem: In 2019, a rural hospital in South Texas reported 102 incidents of patient falls. Although below the corporate fall rate benchmark of 2.2/1000 patient days, the hospital recognized that it was clinically significant and aimed at improving its fall prevention outcomes.

PICOT: The PICOT question that guided this project was: Among adult patients in the acute care setting would the implementation of patient-centered interventions be more effective compared to the usual fall prevention interventions in reducing incidence of falls one month after implementation?

Evidence: Seven pertinent studies, which included a randomized controlled trial and a systematic review, recommended …

Essential Oil Therapy For Alleviation Of Discomfort In Surgical Patients, Nenhuan Huang

Student Scholarly Projects

Practice Problem: Post-surgical pain (PSP) has not been sufficiently managed despite routine opioid use. The adverse effects of opioids led to the search for non-pharmaceutical intervention.

PICOT: The PICOT question that guided this project was, "In an acute hospital surgical setting, does essential oil therapy complement pain and discomfort relief comparing to conventional pain management alone after 6 weeks?”

Evidence: Seven clinical studies, five systematic or integrative reviews, and four conference proceedings were reviewed. The evidence supported lavender essential oil for the alleviation of PSP and discomfort.

Intervention: Patients breathe through a personal lavender essential oil inhaler hourly or …

Revisiting Cauti Prevention: A Multifaceted Approach Using Lean Six Sigma, Lisa Ann Behrend

Student Scholarly Projects

This project identified gaps in policy and processes to improve patient outcomes related to workflow in the catheter-associated urinary tract infection policy and process at a 400-bed hospital in southern California. Even with an evidence-based infection prevention bundle in place, the current process was not working, as demonstrated by high catheter-associated infection rates for the last two years.

This project answers the question: Does the use of a comprehensive evaluation of the current policy and process using the Lean Six Sigma quality improvement model influence a reduction in infection rates in patients who have an internal urinary catheter over 15 …

Implementing Protocols In The Emergency Department To Improve Care For Sexual Assault Patient, Kelly Ciccone

Student Scholarly Projects

This quality improvement project answered the following question: Does implementation of sexual assault forensic examination protocols with educational training increase the number of staff who are knowledgeable and available to complete sexual assault forensic examinations and reduce wait times for individuals who present to the emergency department and have indicated that they were sexually assaulted, over no use of protocols, within a 15-week time frame? Evidence-based state protocols for performing sexual assault forensic examinations were implemented through educational training that incorporated national training criteria and hands on simulation skills practice. Evaluation of outcome measures confirmed an increase to over 80% …