Critical Care Nursing Commons^™

Increasing Pulmonary Artery Catheter Education Among Ccu Nurses: A Quality Improvement Project, Kayla Marie Fisher Rn, Bsn

Doctor of Nursing Practice (DNP) Scholarly Projects

Executive Summary

Title: Increasing Pulmonary Artery Catheter Education Among CCU Nurses: A Quality Improvement Project

Background and Significance: Among the patient population in the Cardiac Care Unit (CCU) at a large academic medical center in Seattle, pulmonary artery (PA) catheters are commonplace. PA catheters are invasive central venous access devices with the ability to measure hemodynamic parameters that reveal information about the functionality and cardiac output of the heart. Should values obtained from PA catheters be incorrectly measured, serious complications could arise. Appropriate management of this device requires specialized expertise which is usually limited to cardiac critical care and surgical …

The Rise Of Virtual Nursing, Sumaya Tasnim

ONU Student Research Colloquium

The Rise of Virtual Nursing

Problem: There is an increased demand for nursing professionals in hospitals and other healthcare facilities. Increased workload and high demand can lead to nursing burnout. To decrease the nursing workload of bedside nurses and nurse burnout, non-bedside nursing staff need to be part of the care team. Non-bedside, virtual nursing is a new method to reduce primary nurse workload. Virtual nurses assist the bedside nurse by participating in the patient admission and discharge process, performing hourly rounding, and completing care plans and patient education.

Purpose: The purpose of this research is to compare nurse satisfaction …

Improved Bonding & Maternal Self-Efficacy In The Nicu: A Scoping Review​, Alexandria Sneed Nauert Bsn, Rnc-Nic, Mckenleigh N. Hill Bsn, Rnc-Nic, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Mothers of infants admitted into the neonatal intensive care unit (NICU) are at risk for developing anxiety, depression, and post traumatic stress disorder (PTSD) related to their child’s hospitalization which impedes the mother-infant bonding and attachment process. Research shows that children of mothers suffering from these issues are more likely to develop their own behavioral, emotional and cognitive problems later in life. The purpose of this scoping review is to analyze the literature regarding methods to improve bonding and attachment between NICU patients and their mothers to improve long-term outcomes for the whole family.

Methods

The authors conducted a …

Implementing An Acute Stress Disorder Screening Tool In The Trauma Intensive Care Unit Setting, Sierra Bridgers

Epsilon Sigma at-Large Research Conference

This is a quality improvement project that focuses on implementing screening for acute stress disorder using the Acute Stress Disorder Structured Interview–DSM-IV tool in a Trauma Intensive Care Unit (ICU) at a Level 2 Trauma Center in Nashville, TN. Currently, at this hospital there is not a screening process implemented for these patients. Every trauma patient meets the criteria for acute stress disorder. Starting the process early aims for patients to be properly educated about their trauma and gets them the resources they need to heal mentally from the trauma.

During the 6-week implementation period of this project, the trauma …

Dnp Final Report: An Evidence-Based Initiative To Reduce Risk Of Ventilator-Associated Events, Bailey Dee Burge

DNP Final Reports

Ventilator-associated events have been considered an outcome metric for quality patient care. Ventilator-associated events are associated with unnecessary medical expenses. These events are multifactorial, yet bedside nurses can help decrease this nosocomial infection through proper oral care. A PICOT question was constructed to search the evidence systematically. The systematic literature search evidence was appraised to provide recommendations for the bundle of care process regarding ventilator-associated event prevention, specifically oral care. The body of evidence was comprised of five articles reporting statically significant outcomes. The evidence-based oral care protocol was implemented for a quarter of a year in patients with mechanical …

Formal Unit-Based Shared Governance To Improve Nurse Engagement, Tracey A Larsen

Student Scholarly Projects

Practice Problem: Nurse engagement is a key driver of nurse satisfaction and nursing retention. Shared governance is an evidence-based practice proven to increase nurse engagement through shared decision-making and results in higher work satisfaction.

PICOT: The PICOT question that guided this project was (P) in an ambulatory nursing clinic (I) what is the effect of a shared governance unit-based committee (C) compared to current practice (O) on nurse engagement (T) over 10 weeks?

Evidence: An exhaustive literature search resulted in 61 peer-reviewed articles. Eleven studies were included after filtering for duplicates and keywords and evaluating for strength and quality …

The Benefits Of Family Presence During Resuscitation, Abigail Harris, Payton Hale, Audrey Jeziorski

Scholars Week

The research provided analyzes the benefits and fears concerning Family Presence During Resuscitation (FPDR) as a standard practice in healthcare facilities. Evidence is available that FPDR supports increased familial satisfaction and psychological outcomes as well as benefits to the patient and healthcare team involved in resuscitation efforts, however this practice is not consistently implemented in healthcare facilities. Three main studies were analyzed throughout this research in order to determine the causation of inconsistent and absent policies regarding FPDR. The analysis of these studies determined that there is a lack of guidelines, education, and policies resulting in absence of family members …

Clabsi Prevention Methods, Noah Heine, Talon Cockrel

Scholars Week

Infection and the risk thereof is one of the major concerns regarding patient outcomes in the health care facility. One of the interventions with the highest causes of infection is the use of central lines. These lines provide necessary venous access for medication administration but can cause infections called CLABSI or Central Line Acquired Bacterial Infection. The purpose of our article was to research CLABSI prevention methods and provide a new policy using these safe effective methods. These new methods include the use of stat locks for central line securement, using antimicrobial lines, and flushing/locking the central line with a …

Dnp Final Report: Preventing Critical Care Nurse Burnout: An Evidence Based Approach To Raising Awareness, Trendalyn S. King

DNP Final Reports

Burnout has affected nurses nationally and globally for decades. Burnout in nurses is characterized by emotional exhaustion, depersonalization, and lack of feelings of personal accomplishment. Consequences of burnout include physical and emotional suffering in nurses, poorer patient outcomes, and lost revenue and increased cost in healthcare organizations. Burnout is prevalent in many healthcare settings, but 81% of critical care nurses have reported severe symptoms of burnout, Because of the high risk of burnout in critical care nurses, raising awareness about burnout and its prevention in those nurses was imperative. The following PICOT question guided the search for evidence to support …

Implementation Of An Artificial Airway Communication Tool, Grace Thacker, Macy Damron

Scholars Week

This evidence based practice research project evaluated the use of communication tools for patients with artificial airways in the hospital setting. It was determined through clinical experiences and article research that no standard communication tool has been recommended for this patient population. Moreover, research has suggested that patient satisfaction has improved with the use of new communication methods. Given the lack of a solution to this issue, we have suggested the implementation of a new hospital policy concerning the use of a communication tool. This communication tool is an eight and a half by eleven laminated piece of paper that …

Why Bladder Training Prior To Foley Catheter Removal Is Not Best Practice, Emily Winstead, Sydny Tucker

Scholars Week

Several studies have been completed on bladder training prior to foley catheter removal via intermittent clamping. While this practice initially appears to be beneficial to patient care, the studies we have researched all found the practice to be insignificant or not indicated for patient care. As we researched, we were able to compile evidence from multiple sources that support bladder training prior to catheter removal is not best practice. After compiling those results, we were able to gather a better understanding of the reasons this practice is not indicated and what risks it will pose to patients. In conclusion, we …

Implementing A Pressure Ulcer Bundle, Amy D. Johnson, Pamela Hardesty, Janice Zimmer, Patricia Moore

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: A quality improvement DNP project in a rural southern hospital was implemented to improve hospital-acquired pressure ulcers by implementing an evidence-based pressure ulcer prevention policy and education. Framework: The Evidence-Based Practice framework utilized in the project's development, implementation, and evaluation was the John Hopkins Evidence-based Practice Model. Local Problem: The hospital had no pressure ulcer bundle in place. Design: Quality improvement project utilizing the plan-do-study-act cycle. Methods: An educational presentation on pressure ulcers and the steps to implement a bundle. A pre-and post-test using Pieper's Pressure Ulcer Knowledge Test, modified from Agency for Healthcare Research and Quality (AHRQ) website. …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Development Of A Rn Clinical Coach Program To Improve Retention Of Icu Residents And Fellows, Megan Jones, Sarah Sumner, Kristen Mayberry

Providence Nursing Research Conference 2023 – Present

Development of a RN Clinical Coach program to improve retention of ICU residents and fellows

Background:
The COVID-19 pandemic caused contributed to significant increases in ICU nurse turnover. To restore the ICU nursing workforce and rebuild a healthy work environment, evidence-based strategies are needed to provide social support and ongoing clinical skills development for large cohorts of ICU residents and fellows.

Purpose:
The purpose of the Clinical Coach program was to increase retention of ICU residents and fellows and foster a healthy work environment at a ministry in Southern California.

Methods:
In September 2021 the ICU manager at Providence Saint …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Coronary Care Unit Nurses’ Experiences Of Care Management Self-Efficacy: A Qualitative Content Analysis, Fatemeh Mansouri, Parand Pourghane, Maryam Rajab Pour Nikfam, James C. Oleson

The Qualitative Report

Recognizing various aspects of the self-efficacy concept in specialized medical units such as intensive care units (ICUs) and coronary care units (CCUs) has the potential to help nurses improve their quality of care. Therefore, we conducted a qualitative content analysis study in 2018 in hospitals of the Guilan Province, northern Iran, to help explain nurses’ perceptions of self-efficacy in care management within CCU wards. Thirty-four semi-structured interviews were conducted with nurses from CCUs. Using Graneheim and Lundman’s (2004) analytical techniques, we extracted three main themes and nine sub-themes from the data: decline in self-efficacy (e.g., time constraint, high work pressure, …

Parental Contextual Factors And Decision-Making Related To Periviable Birth: An Integrative Review, Amy L. Wright, Elizabeth Mens, Gausiha Rathitharan

The Qualitative Report

Parents facing a periviable birth, or birth before 25 weeks of gestation, commonly engage in antenatal consultation with healthcare providers to determine a plan of care. Parents’ pre-existing contextual factors, beliefs, and values influence their decisions regarding birth and the care of their infant. This study aims to understand the role of parental contextual factors and best-practices to their integration during antenatal consultation The Whittemore and Knafl (2005) approach to conducting an integrative review along with thematic analysis was employed to determine and present the findings. Results describe three themes related to how contextual factors influence parental decision-making: personal values …

Effectiveness Of A Multimodal Educational Program In Increasing Understanding And Utilization Of Tele-Icu Resources By Critical Care Nurses: A Pilot Study, Olga Vulakh

DNP Projects

Background. Integration of tele-intensive care units (tele-ICUs) into healthcare systems is associated with improved patient outcomes and organizational performance. Inadequate bedside nurses’ knowledge about tele-ICU is associated with poor communication and lack of trust between bedside and tele-ICU teams. These problems might diminish tele-ICU’s ability to maximally impact patient outcomes.

Purpose. The purpose of this project was to create a multimodal educational program with the goal of improving knowledge, attitudes, and skills related to tele-ICU among critical care nurses and to assess the effect of the educational intervention on tele-ICU utilization among bedside nurses as evidenced by the number of …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …