Critical Care Nursing Commons^™

Reframing Recovery: Comparing Music Interventions And Traditional Rehabilitation Methods For Cognitive Function In Traumatic Brain Injury Patients, Laura Velez

Honors Undergraduate Theses

Traumatic brain injury (TBI) affects millions annually, often resulting in long-term cognitive deficits that hinder independence and quality of life. While traditional rehabilitation methods address many physical and functional limitations, cognitive impairments—such as deficits in attention, memory, and executive function—often persist. Emerging evidence highlights music-based interventions as a promising complement to standard therapies, yet comparative research remains limited. This integrative literature review examined the effects of music interventions versus traditional rehabilitation methods on cognitive function in adults with TBI. Using a systematic search of databases including MEDLINE, CINAHL Ultimate, APA PsycInfo, and Music Index, eight peer-reviewed studies were selected for …

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Post-Traumatic Stress Disorder Among Critical Care Nurses Caring For Covid-19 Patients, Marwa Abdo

Nursing

Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, with a substantial number of severe cases requiring admission to isolated intensive care units (ICUs). This unprecedented situation exposed critical care nurses (CCNs) to a highly stressful traumatic environment, placing them at increased risk for developing post-traumatic stress disorder (PTSD). Early identification and intervention for PTSD are crucial to mitigate the negative consequences for nurses' well-being, job performance, and overall quality of life. Aim: This study aimed to assess post-traumatic stress disorder among CCNs caring for COVID-19 patients. Method: A descriptive cross-sectional design with a convenience sample of 109 CCNs …

Implementation Of The Novel Nurse Intuition Patient Deterioration Scale To Assess For A Correlation Among Nurse Intuition And Patients Returning To The Intensive Care Unit, Janie L. Walsh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Adult hospitalized medical and surgical patients at an academic medical center are being transferred out of the Intensive Care Unit (ICU) to the step-down floor and having rapid response calls in less than 48 hours after the transfer. Nurse intuition is not a consideration in the decision to transfer a patient. Physiological variables such as Modified Early Warning Scores (MEWS) and vital signs are relied on heavily as indicators for escalation or de-escalation of care. There is evidence supporting the use of acknowledging nurse intuition to better predict a patient’s readiness for transitions of care.

Purpose: To evaluate the …

Implementation Of An Evidenced Based Enteral Nutrition Protocol For Mechanically Ventilated Patients: A Quality Improvement Initiative, Hannah R. Nuzum

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of an Evidenced Based Enteral Nutrition Protocol for Mechanically Ventilated Patients: A Quality Improvement Initiative.

Hannah Nuzum

Background: Mechanically ventilated patients require supplemental nutrition as an important factor for their overall recovery. Malnutrition in hospitalized patients is reported as high as 35% (Ikram et al., 2022).

Purpose: Lack of an enteral nutrition (EN) protocol has contributed to variability in initiation of EN for post-intubated mechanically ventilated patients.

Intervention: The project interventions are threefold: the development of an EN protocol, EN initiated within 24 to 28 hours for post-intubation patients, and staff understands that EN should be initiated within …

Does Education On Aseptic Non-Touch Technique Affect Nurse Knowledge On Aseptic Technique When Placing Ultrasound Guided Peripheral Intravenous Lines? A Quality Improvement Initiative, Hannah G. Keyser

Graduate Theses, Dissertations, and Problem Reports (ETD)

This Doctor of Nursing Practice (DNP) project attempted to increase nurse’s knowledge of aseptic technique when placing USG-PIVs in hospitalized adult patients after educational training on the Aseptic Non-Touch Technique Clinical Practice Framework (ANTT CPF). Implementation of the ANTT CPF in the cardiovascular intensive care unit (CVICU) at Ruby Memorial Hospital, as a didactic educational session for nurses already trained to place ultrasound-guided peripheral intravenous lines, was utilized for this DNP project. Pre- and post-surveys were employed to determine changes in knowledge scores as well as feelings of comfort and knowledge related to the CPF. Results remained stable for survey …

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

Improving Timely Palliative Care Consultation In The Micu: A Nurse-Driven Quality Improvement Initiative, Sandy Louise Gray

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Improving Timely Palliative Care Consultation in the MICU: A Nurse-Driven Quality Improvement Initiative

Sandy L Gray

Background: Early palliative care in intensive care units improves outcomes and reduces costs, yet referrals are often delayed. At J.W. Ruby Memorial Hospital’s medical intensive care unit (MICU), baseline median time to consultation was 112 hours (mean=246), exceeding recommended benchmarks and highlighting the need for a standardized process.

Purpose: This quality improvement project evaluated a nurse-driven screening tool to improve timeliness and consistency of palliative care consultations in the MICU.

Intervention: The tool was embedded in the electronic health record (EHR) …

Use Of Machine Learning Models To Predict Microaspiration Measured By Tracheal Pepsin A., Annette Bourgault, Ilana Logvinov, Chang Liu, Rui Xie, Jan Powers Phd, Rn, Ccrn, Mary Lou Sole

Nursing Publications, Posters, & Presentations

BACKGROUND: Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator of microaspiration, was found in 39% of patients within 24 hours of enteral feeding. Tracheal pepsin A is a potential biomarker of enteral feeding intolerance.

OBJECTIVE: To identify predictors of microaspiration (tracheal or oral pepsin A). It was hypothesized that variables predicting the presence of tracheal pepsin A might be similar to predictors of enteral feeding intolerance.

METHODS: In this secondary analysis, machine learning models were fit for 283 adults receiving mechanical ventilation who had tracheal and …

Effect Of Implementing An Educational Program About Post Kidney Transplant Care On Critical Care Nurses' Knowledge, Marwa Abdo, Asmaa Ibrahim Aboseda

Nursing

Background: Critical care nurses (CCNs) play a pivotal role in post-kidney transplant care, necessitating a comprehensive understanding of transplantation procedures, complications, and patient management. So, any knowledge gaps among CCNs may impact the quality of care provide to kidney transplant program. Aim: This study aimed to assess the effect of implementing an educational program about post-kidney transplant care on critical care nurses’ knowledge. Methods: A quasi-experimental study was conducted among 50 critical care nurses. A structured educational program was implemented, and nurses’ knowledge was assessed pre- program, post- program, and three months follow-up. Data was collected using a kidney transplantation …

Family Members’ Experiences Of Post-Cardiac Surgery Delirium In The Intensive Care Unit: A Narrative Inquiry, Amber Coral Mclean

Theses: Doctorates and Masters

Aim: This study explores delirium in the intensive care unit (ICU) following cardiac surgery from the perspective of family members.

Background: Delirium is a common complication affecting 28-52% of people following cardiac surgery in the ICU, which can lead to distress for both the person and their family members. While research has been conducted on clinical outcomes of family involvement in delirium care, there is a lack of understanding of how delirium impacts the family members themselves. This study seeks to provide detailed narrative accounts of families’ experience of witnessing delirium in their loved one following cardiac surgery in the …

Implementation Of An Advanced Practice Provider Into The Outpatient Neurology Clinic To Improve Access To Care And Medication Compliance, Sean O'Laughlin

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The American Association of Neurology (AAN) recommended that post-stroke and TIA patients receive follow-up care within 2–4 weeks of discharge to reduce complications, improve medication adherence, and decrease readmission rates (2023). However, in 2022, a Central Virginia neurology practice reported an average wait time of 98.66 days for outpatient follow-up appointments, significantly exceeding the AAN recommendation, while medication adherence was only 72.23%, compared to the national average of 80%. Research by the American Academy of Neurology Workforce Task Force (2013) and Woo et al. (2017) highlighted that incorporating advanced practice nurses into outpatient settings could enhance access to care and …

Improving Nursing Deployment Readiness, George Mcenroe

Doctor of Nursing Practice (DNP) Projects

Improving Air Force Nursing Deployment Readiness

Abstract

Background. Air Force nurses must be prepared for deployment to support military missions on short notice. During deployments, they may be asked to practice in demanding and austere wartime environments. The required competencies for deployment include the care of multi-trauma patients, mass casualty care, and military-specific skills.

Problem. Air Force nurses are required to maintain an annual Comprehensive Medical Readiness Program (CMRP) checklist, a list of clinical skills based on their nursing specialty. Assessing and maintaining deployment readiness is an ongoing challenge. The Air Force does not currently use any …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

Transforming Care: Elevating Oral Hygiene Compliance To Combat Nosocomial Aspiration Pneumonia In Adult Oncology Patients, Karina Larrea

Master's Projects and Capstones

Objective Aspiration pneumonia is a preventable, yet common complication in oncology patients undergoing chemotherapy, steered by suboptimal compliance with oral hygiene protocols and elevated susceptibility due to mucosal barrier injuries. Despite its major impact on healthcare costs and morbidity, compliance with evidence-based practices remains inadequate. Aim This project aimed to decrease nosocomial aspiration pneumonia rates from 1.5% to 1.3% by enhancing oral hygiene compliance from 41% to 70% over a 12-week period. Methods Proposed interventions included implementing paired oral hygiene order sets into electronic medical records, once-per-shift cues, staggered patient education sessions, and staff education on standardized protocols. Pre-intervention data …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In The Adult Oncology Population Through Improved Compliance With Oral Hygiene Protocols, Kenneth R. Brown

Master's Projects and Capstones

Objective

Oncology patients receiving chemotherapy are at risk of complications such as mucosal barrier injuries (MBI) and aspiration pneumonia, and aspiration pneumonia rates are higher than desired. Improved oral hygiene protocols and compliance in this population reduces the incidence of these complications.

Context and Background

The microsystem assessed includes six oncology units at Hospital A, a large California academic hospital. Aspiration pneumonia, commonly associated with MBI, is a life-threatening challenge that increases costs and complications in oncological treatment settings. An aspiration pneumonia task force focused on six oncology acute care units is committed to reducing the incidence of hospital acquired …

Impact Of Training For Nursing Staff In The Prevention Of Hapis, Onyinye E. Ohia, Colleen A. Anthony

Master's Projects

Abstract

Background: The incidence of Hospital acquired pressure injuries (HAPIs) have remained a problem in healthcare despite concerted efforts by hospitals and other governmental agencies to eliminate the problem via policy and emphasis on safety. There is support in literature for the training of healthcare professionals as an important tool in the prevention and management of HAPIs. Despite the existence of studies that link training of nurses to a reduction in rates of HAPIs, evidence in support of that is still piecemeal; with poorly defined outcomes.

Aims and objectives: The aim of this integrative review is to identify …

Emergency Room Nurses' Perceptions Of Medication Errors In The Emergency Department, Yasmeen Mustafa

Undergraduate Honors Theses

Medication errors (MEs) remain a pervasive issue in United States emergency departments, where emergency room (ER) nurses play a central role in the medication process. The medication process involves transcribing, prescribing, dispensing, administering, and monitoring. Proper adherence to the process ensures that the right medication is given to the right patient in the correct dose, route, and time. It also allows consideration of potential interactions and side effects, with the goal of achieving safe and efficacious therapeutic outcomes. Given the potential life-altering consequences of MEs, it is imperative to harness the unique insights and experiences of ER nurses who are …

The Impact Of Hospital Protocol For Severe Alcohol Use Disorder, Meredith Jones

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Alcohol use disorder remains a prevalent condition within current society. For a smaller, but ever growing population, alcohol use evolves into a severe, addictive disease process. Individuals managing this disorder can suffer from acute withdrawals and further comorbidities causing eventual detriment. Medical institutions attempt to combat withdrawal with varying forms of treatment, utilized to manage symptoms and further issues “as needed.” As this condition becomes increasingly more pervasive within casual society, hospitals’ fragmented attempts to manage this disease process proves to be ineffective for this patient population.

Purpose: The purpose of this systematic review is to analyze current methods …

A Proposed Instrument To Determine Mobility Eligibility Criteria And Levels For Mechanically Ventilated Patients In The Intensive Care Unit, Keira Gabrielle Miller

Doctoral Scholarly Projects & Capstones

Immobility is a problem among mechanically ventilated patients in the intensive care unit. Early mobility has been shown to benefit mechanically ventilated patient outcomes by minimizing hospital stays and costs, decreasing the risk of infection, and improving muscle strength to lead to a better quality of life. No inclusive checklists exist to evaluate patients progressing to varying levels of mobility based on specific criteria such as hemodynamics, neurological function, and disease acuity. This gap was identified after a current and comprehensive literature review on early mobilization among mechanically ventilated patients. The purpose of this project was to combine a comprehensive …