Critical Care Nursing Commons^™

Code Blue Debriefing, Micaela Herbst-Bialke

Nursing Posters

Situation and Assessment:

Opportunities to improve code blue events have been identified by comments received on code blue critiques and results from a survey completed by 120 code blue team members.

Background:

As referenced by the American Heart Association along with Get with the Guidelines, post code debriefing is a key element to promote continuous quality improvement in patient care. Post-event debriefings are a foundational behavior of high performing teams in improving individual and team performance.

The Impact Of Nursing Education On The Implementation Of Kangaroo Care: Neurodevelopment Outcomes In Preterm Infants, Giana Usac

Nursing | Senior Theses

Preterm birth poses a significant risk to the normal trajectory of brain development, particularly in the cortex, which is responsible for higher cognitive functions, motor control, and socio-emotional processing. However, Kangaroo Mother Care (KMC) has emerged as an important early intervention capable of improving neurodevelopmental outcomes in preterm newborns. This quantitative research proposal aims to assess the influence of nurse education on KMC practices, identifying pivotal periods in infancy when KMC has the most significant impact on neurodevelopment outcomes in preterm infants. The literature critique focuses on the efficacy of nursing education, the optimization of KMC regarding duration and frequency, …

Standardizing The Discharge Process To Reduce Copd Readmission Rates, Kristine Doligosa

Doctor of Nursing Practice Scholarly Projects

Background: Frequent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can lead to unfavorable patient outcomes and costly readmissions. Inadequate patient support during discharge and an inconsistent discharge process are factors contributing to high readmissions in this population.

Purpose: This quality improvement project aimed to reduce COPD-related hospital readmissions by standardizing the discharge process for patients admitted with AECOPD and identify patient risk factors for readmission.

Methods: Following a quantitative and quasi-experimental design, this project standardized the discharge process for patients admitted with AECOPD using the Re-Engineered Discharge Toolkit components and a discharge care bundle. The project was …

Understanding The Importance Of Administrative Mental Health Support For Frontline Nurses Post Covid-19, Sarah Mah

Nursing | Senior Theses

During the peak of the COVID-19 pandemic, intensive care units and critical care units were overwhelmed with the number of patients that were on the floors. It was during this time that nurses were experiencing the most mental health decline.

Several factors can be associated with the rapid decline of nurses’ mental health. However, these issues could ultimately stem from the lack of action taken by healthcare administration. This includes increased workload and the lack of PPE, resources institutional support. Because these units played such a vital role during the pandemic, it is imperative that healthcare administrators do what they …

Neuroprognostication In Patients With A Subarachnoid Hemorrhage: A Quasi-Review Of Anti-Inflammatory Agent Administration Versus Blood Pressure Management, Julia Gabalski, Marcie Mcmahon

Soaring: A Journal of Undergraduate Research

A subarachnoid hemorrhage (SAH) is a type of stoke where a blood vessel bursts and causes the subarachnoid space to become filled with blood. Traditional nursing management of SAH includes close monitoring of blood pressure goals in order to prevent complications such as vasospasm. Vasospasm causes delayed cerebral ischemia and neurological deficits secondary to the initial injury. Recent research has expanded understanding of the underlying mechanisms behind the neuroinflammatory cascade that occurs after a SAH. In this study, a methodical search was conducted through the CINAHL and PubMed databases to form a quasi-review of current research. The comparison of traditional …

Individualizing Patient Education To Reduce Heart Failure Readmissions, Melissa M. Andersen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) is a chronic condition with high readmission rates, often due to inadequate patient knowledge about home care and symptom management. Individualized patient education combined with standardized approaches could improve patient outcomes.

Objective: This project’s goal was to determine if using individual patient knowledge to create a personalized education along with standard HF education would improve patient HF knowledge, improve home management and decrease HF readmission rates.

Methods: This pilot quality improvement (QI) project was conducted in an acute care hospital using a convenience sample of 29 patients admitted due to a HF exacerbation using pre-posttest design. …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn Jansen

Nursing | Senior Theses

Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Senior Theses

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Senior Theses

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Nursing Care During Natural Disasters, War Zones, And Mass Casualty Incidents: Implications For An Educational And Professional Overhaul, Erin N. White

Undergraduate Honors Theses

Emergency situations around the world are inevitable. Any nurse who practices for any period of time is sure to encounter situations like these. Their hospital may be flooded with traumatic and severely life-threatening patient cases where supplies can become scarce. In these situations, a nurse and all other healthcare personnel are expected to act effectively, efficiently and in a highly organized way. Despite this need, many hospitals fail to implement effective disaster preparedness programs and plans. This leaves healthcare workers at a loss for how to treat patients, communicate within and outside of the hospital, coordinate transport, and all the …

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Student Research Posters

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Impact Of Nursing Education On Kangaroo Mother Care: Neurodevelopment Outcomes In Preterm Infants, Giana Usac

Nursing | Student Research Posters

Preterm birth poses a significant risk to the normal trajectory of brain development, particularly in the cortex, which is responsible for higher cognitive functions, motor control, and socio-emotional processing. However, Kangaroo Mother Care (KMC) has emerged as an important early intervention capable of improving neurodevelopmental outcomes in preterm newborns. This quantitative research proposal aims to assess the influence of nurse education on KMC practices, identifying pivotal periods in infancy when KMC has the most significant impact on neurodevelopment outcomes in preterm infants. The literature critique focuses on the efficacy of nursing education, the optimization of KMC regarding duration and frequency, …

Preparing Nurses For Medical-Assistance In Dying: The Role Of Comprehensive Education And Training, Keira O'Reilly

Nursing | Student Research Posters

Medical-assistance in dying (MAID) is a process in which a physician prescribes lethal medications that the consenting patient will self-administer with the intention of ending their life. By April 2024, medical-assistance in dying was legal in 10 states as well as the District of Columbia (“Death with Dignity,” 2024). With an evolving legal landscape around MAID, healthcare professional training on this procedure is often overlooked and inadequate (Winters et al., 2022). This is especially true for ICU nurses who manage critical and often end of life cases. This lack of education leaves nurses underprepared for the legal, ethical, and emotional …

Assessing Disparities In Culturally Competent Care In Ethnic Burn Patients, Min Kang

Nursing | Student Research Posters

One of the most debilitating injuries one can suffer is a burn. It is even worse when certain individuals can not access the high quality care such as immigrants. With immigration rates increasing over the last several decades, these populations often lack the proper medical care that they deserve. The overarching theme in this population is that they face challenges in attaining positive patient outcomes due to cultural differences.

• Lack of Culturally Competent Care in Burn Care
• Addressing Cultural Safety and Quality of Care in Burn Injury Management
• Analyzing Disparities in Access to Culturally Competent Burn care

Optimizing Discharge Education For Hf Patients, Connie-Rose Pangan

Nursing | Student Research Posters

Heart failure is a chronic condition in which the heart cannot adequately provide blood and oxygen to tissues in the body. Heart failure patients account for the highest 30-day readmission rate in Medical-Surgical conditions (Nair et al., 2020). It is the leading cause of hospitalization in adults over 65 years old in the US. Constant readmission is costly, and therefore additional interventions must be done to prevent it. Due to the severity of heart failure, these patients require a copious amount of information at discharge to understand the pathophysiology of their disease, their medication regimen, and important lifestyle changes needed …

Impact Of Personal Continuous Glucose Monitor Use During Hospitalization On Rates Of Hypoglycemia And Provider Confidence, Rebecca Longo

DNP Scholarly Projects

Continuous Glucose Monitors (CGMs) are an essential tool for managing diabetes in the outpatient setting, helping individuals achieve glucose goals. However, CGMs are not currently FDA-approved for use in the hospital setting. Despite this limitation, many individuals continue using their personal CGM during hospitalization or begin using them prior to discharge if the care team believes the technology will support glucose management during and after leaving the hospital.

This project aimed to evaluate whether individuals using personal CGMs during hospitalization experienced less hypoglycemia and whether reviewing CGM data could improve provider confidence in insulin dosing. While initiating CGM use during …

Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, Laura K. Marcum

DNP Projects

Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction.

Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction.

Methods: New graduate nurse …