Critical Care Nursing Commons^™

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Nurse-Driven Infusion Protocols In Diabetic Ketoacidosis: A Scoping Review, Nicholas Morrell Pierce Msn, Rn, Cen, Ccrn, Mary Cassandra Scott Bsn, Rn, Ccrn, Cen, Alvertis Demetreis Warren Bsn, Rn, Ccrn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Diabetic ketoacidosis (DKA) is a high-risk acute emergency requiring timely insulin titration, intensive monitoring, and coordinated interdisciplinary care. Traditionally, management relies on provider-driven insulin infusion adjustments, which may introduce delays and workflow inefficiencies. Emerging nurse-driven insulin infusion protocols aim to standardize care, improve safety, and enhance clinical efficiency. The purpose of this scoping review was to evaluate existing evidence comparing nurse-driven versus provider-driven insulin infusion protocols in the management of adult patients with DKA.

Methods

A scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From August 2023 through November 2025, …

2025 Nursing Annual Report, Children's Health System Of Texas

2025

No abstract provided.

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

A Pilot Project On Improving Icu Nurses’ Confidence In Early Defibrillation, Adetutu Obadina

Doctoral Projects

Early recognition of shockable cardiac rhythms and timely defibrillation are critical components of effective resuscitation during in-hospital cardiac arrest. Despite established guidelines from the American Heart Association (AHA), nurses may experience uncertainty or reduced confidence when identifying shockable rhythms and delivering timely defibrillation during cardiac arrest events. The purpose of this project was to examine whether a structured educational intervention incorporating simulation-based training could improve intensive care unit (ICU) nurses’ confidence and knowledge in recognizing shockable rhythms and performing timely defibrillation. A pre-and post-intervention design was implemented among ICU nurses at a large academic medical center between September and October …

The Relationship Between Mc1r Gene Variants For Red Hair And Clinical Responses To Anesthesia, Analgesia, And Pain: A Systematic Review Of The Literature, Mary Clark Allen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Genetic variations of the melanocortin-1 receptor (MC1R) are commonly associated with red hair and pale skin. Research has linked MC1R variants with alterations in anesthetic response, pain perception, opioid sensitivity, and pain-related fear. Existing literature presents inconclusive findings, highlighting the need for further investigation.

Purpose: This review aims to synthesize current evidence concerning the role of MC1R variants in altering physiologic responses.

Methods: A systematic literature review was conducted by accessing CINAHL, MEDLINE, and PubMed through the University of Arkansas Libraries OneSearch platform. After applying inclusion and exclusion criteria, a total of 20 peer-reviewed articles were extracted for review. …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

The Impact Of Structured Family Meetings In The Intensive Care Unit, Loyce T. Mofor

Doctor of Nursing Practice Final Project Abstract

The Impact of Structured Family Meetings in the Intensive Care Unit (ICU)

Purpose

Train providers at an academic institution in a large metropolitan area to conduct family meetings using a structured approach and evaluate this intervention's impact on family satisfaction with communication in the ICU.

Background

Inadequate communication between families and healthcare teams leads to lower family satisfaction, heightened feelings of guilt, and diminished capacity for making clinical decisions.

Methodology

VitalTalk training was utilized to improve providers’ communication skills. Structured family meetings were conducted for Surgical and Thoracic ICU patients with an ICU length of stay of > 5 days or …

Improving New Graduate Nurse Clinical Readiness Through Interprofessional Collaboration And High-Fidelity Simulation, Alyssa M. Starkey

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement (QI) project was to enhance new graduate nurse (NGN) clinical readiness through an interprofessional high-fidelity simulation focused on recognizing and responding to patient deterioration during nurse residency onboarding.

Background

New graduate nurses often feel uncertain about recognizing clinical deterioration and communicating. Research shows that simulation-based and interprofessional training improve judgment, teamwork, and communication. This project aims to achieve at least a 10% increase in NGN clinical readiness following the implementation of a high-fidelity simulation program.

Methodology

A pre–post QI study based on Kolb’s Theory and PDSA principles was conducted in a nurse residency …

Implementing The Abcdef Bundle In A Rural Critical Care, Kayla Hubbard

Epsilon Sigma at-Large Research Conference

Patients admitted to the critical care unit are at risk of debilitating adverse outcomes including Delirium, Post intensive care syndrome (PICS), debility, wounds, depression, and both mental and physical impairments. Complications related to ICU care can easily be combatted by using a multidisciplinary approach. The ABCDEF bundle serves to incorporate all aspects of a critically ill patients care in a simple, easy to follow bundle focusing on assessment of pain (A), both spontaneous awakening ang breathing trials (B), choice of sedation/analgesic (C), delirium (D), early mobility (E), and family involvement (F). A quality improvement project was designed and piloted in …

Health Is Where The Huddle Is, Lyndsey Anthony, Anna E. Komistek, Philip C. Pritchett, Emma K. Swanson

SPARK Symposium Presentations

“Health is Where the Huddle Is”

Huddles are an evidence-based strategy to facilitate a culture of safety within nursing teams. A review of 158 huddle studies found that 44.3% reported improved clinical outcomes and 24.3% showed fewer medical errors when huddles were implemented (Pimentel et al., 2021). Currently, a local hospital’s 13-bed ICU lacks an effective system for nursing staff to huddle due to staffing constraints and the absence of monitor technicians, creating safety concerns when nurses leave monitors unattended. This project aims to implement an effective, nurse-led shift huddle that maintains continuous patient monitoring while also strengthening patient safety …

Optimizing Central Line Discontinuation In The Surgical Intensive Care Unit: A Quality Improvement Initiative Using A Visual Aid To Reduce The Risk Of Central Line-Associated Bloodstream Infections, John Quyen D. Van

Doctor of Nursing Practice Final Project Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline …

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

When The Caregiver Becomes The Wounded, Gracelin L. Young

ATU Scholars Symposium

Burnout among critical care nurses (CCNs) is a substantial threat to nurse well-being, patient safety, and workforce stability. The aim of this paper is to identify risk factors contributing to burnout in CCNs using evidence-based articles. An organized literature search was conducted using CINAHL with key terms including critical care nurses, burnout, risk factors, compassion fatigue, and work environment. Five recent peer-reviewed studies meeting inclusion criteria were chosen. The results validate that risk for burnout is vastly influenced by emotional exhaustion, chronic workplace stress, high patient acuity, sleep disturbances, compassion fatigue, insufficient support, and organizational strain. Findings suggest that burnout …

Implementing A Noise Reduction Protocol To Reduce Perceived Noise In The Icu – An Evidence-Based Practice Project, Soh Jeon

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims:

This project aims to reduce perceived noise in the ICU and promote a healing environment through a multi-interventional noise-reduction protocol and nursing staff education.

Rationale/Background:

The World Health Organization (WHO) recommends that hospital noise levels remain below 35 decibels during the day and 30 decibels at night. However, ICU noise often exceeds 50-70 decibels. Increased noise levels are primarily caused by conversations, monitoring alarms, and routine care activities, such as cleaning and procedures. These high noise levels directly affect patients’ sleep, which is essential to recovery. Insufficient rest can lead to immunosuppression, prolonged mechanical ventilation, and elevated stress …

Scrub Up For Success: Transforming Infection Control In Transplant Patients Through Microlearning Video And Poster – A Quality Improvement Project, Wendy Dio

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Healthcare-associated infections (HAIs) threaten patient safety, affecting about 1 in 25 hospitalized patients. Clostridium difficile infection (CDI) is a significant contributor, impacting both high-risk groups and the general population. Proper hand hygiene is crucial for preventing CDI transmission. In the U.S., hospital-acquired CDI costs over $1.5 billion annually and causes nearly 500,000 cases and I15,000 deaths each year. California reported 3,526 CDI cases in acute care hospitals, with Loma Linda University hospitals accounting for 16 cases, or 23% of their health system's infection rate.

Methodology

Nurses in the 6A West-Transplant Unit received a PowerPoint presentation on when …

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

The Use Of A Safety Screening Tool To Improve Sedation Holiday Compliance And Nurse Confidence, Shelby Marchisio

Doctor of Nursing Practice Final Project Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation …

Improving Patient Satisfaction In The Emergency Department Waiting Room Through Enhanced Communication Strategies: A Quality Improvement Initiative, Wael P. Karaki

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to improve ED waiting room experience by standardizing communication to increase transparency and expectation management, targeting an increase in Net Promoter Score (NPS) from 33.5 to ≥35.4 within three months.

Background: ED waiting room dissatisfaction is driven by uncertainty (unclear wait times, inconsistent updates, and limited understanding of triage and ED flow), supporting structured communication over individual clinician delivery.

Methodology: A 3-month, single-site QI project in an urban ED used iterative PDSA cycles and included all ED encounters (n=17,444). The bilingual intervention included orientation pamphlets (print/QR-based), standardized triage verbalization of …