Critical Care Nursing Commons^™

Uncovering The Benefits Of Naturalistic Blue-Depleted Lighting In Hospitals: A Qualitative Study, Sam P. Cotton

Symposium of Student Scholars

With exponential technological advances, hospitals are tasked with prioritizing which expensive innovations truly impact as many patients as possible to give them the greatest chance of recovering and discharge them earlier. It is no surprise that most of the attention is focussed on pharmaceutical drugs and a variety of different equipment and machinery, but hospital facilities should look into simpler additions that can aid every patient admitted. The use of naturalistic blue-wavelength lighting is something that can benefit each patient’s recovery immensely. Multiple studies have proven positive effects that blue-depleted lighting compared to standard indoor fluorescent lighting has lowered stress …

Shortening Wait-Times In The Emergency Department, Laura Clark

Symposium of Student Scholars

Many Americans visit the Emergency Department (ED) every day for a variety of reasons. Some are extreme emergencies while others could be handled by a primary care provider (PCP). However, the EDs throughout the United States and other countries throughout the world are consistently known for their extended wait-times. Evidence has shown the average ED wait-time is about 145 minutes, being significantly longer in other states. In a state of emergency, 145 minutes could mean life or death. Shortening wait-times in the ED is crucial to saving lives, efficiently utilizing staff members, and satisfying patient needs. In this project, various …

Reducing Central Venous Infections, Desiree Banton

Student Scholarly Projects

Practice Problem: Patients in the hospital are 36.6% more likely to die after a diagnosis of a Central Line-Associated Bloodstream Infection (CLABSI) (Chovanec et al., 2021). The purpose of this evidence-based practice implementation is to reduce CLABSI rates in the Neurological ICU (Neuro ICU) at a private medical center through use of a CLABSI prevention bundle checklist each shift.

PICOT: In the adult neuro-ICU (P), how does implementing a CLABSI prevention bundle checklist each shift (I), compared to current practice (C), affect CLABSI rates (O) within eight weeks (T)?

Evidence: Evidence-based research supports that if clinical staff completed each part …

Early And Progressive Mobility: A Program Implementation Strategy For High Acuity Patient Care Locations, Stefani Poland

Student Scholarly Projects

Despite an increase in the promotion of early progressive mobility, its decrease in hospital-acquired complications and improvement of patient outcomes, there remains a reluctance in staff commitment to daily evaluation and implementation. This is largely due to the fact nurses or other interprofessional staff are the primary individuals responsible for this change in process. A lack of confidence in staff to correctly identify patients that meet criteria and anxiety regarding the safe transfer or mobilization of patients, particularly in high acuity settings have been identified as major barriers. The PICOT question that guided this program development of a CBO toolkit …

Breast Surgery Super-Specialization: Impact On Advanced Surgical Training And Research, Danish Ali, Sana Zeeshan, Nifasat Farooqi, Lubna Vohra

Medical College Documents

The earliest records of breast cancer (BC) date back to 3,000 - 2,500 B.C., ever since multiple curative options have been explored. First known wide margin excision was performed around 1st Century AD and a prototype of the modern-day BC surgery, Halsted radical mastectomy, was performed in the 20th Century. BC is the most common cancer in Pakistan accounting for up to 14.5% of the total cancer incidences. Accredited breast surgery fellowships were established in the UK and USA in 2002 and 2003, respectively. In Pakistan, the movement was delayed and the two-year College of Physicians and Surgeons Pakistan (CPSP) …

Élaboration Et Évaluation De L’Implantation D’Un Programme De Préceptorat Pour L’Infirmière Novice À L’Unité Des Soins Intensifs, Annie Perron, Manon Champagne, Abir El-Haouly

Quality Advancement in Nursing Education - Avancées en formation infirmière

Résumé

Contexte : Au Québec, 61 % des infirmières et infirmiers de la relève débutent leur carrière avec un niveau de formation collégiale. Les nouvelles et nouveaux diplômé(e)s commencent tôt leur carrière dans les unités de soins intensifs (USI). Or, elles et ils sont peu préparé(e)s à assumer leur rôle dans une unité de soins critiques, puisque les compétences en soins critiques sont développées dans la portion universitaire du programme intégré DEC-BAC. Un programme de préceptorat a été mis en place par le ministère de la Santé et des Services sociaux pour soutenir les novices dans leur intégration. En Abitibi-Témiscamingue …

What? Is Epstein–Barr Virus Infection Linked To Multiple Sclerosis?, Asha Mahajan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Do You Know The Pathophysiology Of Cytokine Storm During Covid-19?, Shameera Shaik Masthan, Deekshitha Turaka, Ahmed Abdelhaleem, Mounica Vorla, Steven B. Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Unit Knowledge And Practice Of Emergency Nursing Interventions At A Tertiary Public Cardiac Health Center In Uganda, Harriet Namukwaya, Cliff Asher Aliga, Grace Nakate, Judith Mutyabule

School of Nursing & Midwifery, East Africa

Background: Research suggests that many of the millions of deaths and long-term disabilities resulting from acute cardiovascular events and other emergency conditions are preventable if effective emergency care services were readily available. Effective emergency care requires trained and competent staff, including registered nurses. Most educational pathways do not adequately prepare nurses to deliver sensitive health care services for those with acute illness and injury. This includes Uganda, where few capacity-building initiatives have targeted emergency nursing care delivery, leading to knowledge and practice gaps.

Purpose: This study aimed to assess emergency nursing knowledge and clinical practice at a tertiary …

Prevention Of Post-Operative Nausea And Vomiting With Honey As A Pre-Operative Oral Carbohydrate: A Randomised Controlled Pilot Trial, Oya Gumuskaya, Ikbal Cavdar Prof., Cigdem Akyol Beyoglu

Journal of Perioperative Nursing

Background

Post-operative nausea and vomiting (PONV) is the secondmost common post-operative complication. Prolonged pre-operative fasting is common in Australia despite guidelines recommending reduced fasting to improve patient outcomes, such as PONV. Commercially prepared preoperative oral carbohydrate (OC) drinks may be used to reduce fasting time. In this study commercial products were replaced with honey, an inexpensive and common food item.

Design

Partially blinded, four parallel arms randomised controlled noninferiority trial compared pre-operative OC loading with overnight fasting.

Methods

Adult elective laparoscopic cholecystectomy and thyroidectomy patients having two or more risk factors for PONV were allocated into intervention and control groups …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Audit And Feedback For Blood Glucose Point Of Care Testing, Faith A. Onwuka

Student Scholarly Projects

Practice Problem: Patient identification errors in point-of-care testing (POCT) is responsible for test results being missed or transferred to the wrong patient’s chart. A hospital in Los Angeles County experienced a 50% compliance rate in patient barcode scanning prior to blood glucose POCT which affected the delivery of care.

PICOT: The PICOT question that guided this project was: Among emergency room nursing staff (P), how does the implementation of audit and feedback (I), when compared to random observations (C) improve compliance of patient identification with barcode scanning before performing blood glucose check (O) within ten weeks (T)? Evidence: …

The Effects Of Bundle Adherence On Ventilator-Associated Pneumonia: A Quality Improvement Project, Sara Borges, Tracy L. Brewer, Donita Beard

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

Abstract

Ventilator-associated pneumonia (VAP) is a hospital-acquired infection that affects intubated patients on a ventilator. The risk of acquiring the infection increases the longer a patient stays on the ventilator. Complications from ventilator-associated pneumonia can impact the patient physically, financially, or emotionally. Evidence-based recommendations collectively implemented to prevent VAP are referred to as a care bundle. Despite rising VAP cases in a local hospital, adherence to all elements of the VAP prevention bundle remained low. Our quality improvement project aimed to provide training to staff to increase awareness and adherence to the VAP bundle and decrease the number of VAP …

(Re) Evaluating Critical Care Nurse Support Program(S) In A Tertiary Care Hospital: Intersecting The Art And Science Of Nursing, C. Patricia Mazzotta

The Organizational Improvement Plan at Western University

There is a growing critical care nurse staffing shortage with increases in nurse vacancy rates. Moral distress has been exacerbated by the SARS-CoV-2 (COVID-19) pandemic and, in particular, impacting critical care nurses. COVID-19 is a significant contributor to staffing shortages and continued nursing crisis. Thus, the impetus for the Problem of Practice (PoP): the lack of support to address the psychological, emotional, and spiritual distress suffered by critical care registered nurses in a tertiary care hospital in Central Ontario. To comprehend the realities of working in the intensive care units, leaders must first understand nurses’ lived experiences, narratives, and what …

Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White

Patient Experience Journal

During the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve the …

Icu Liberation Bundle: A Multidisciplinary Approach, Julie Anne Snyder Amoroso

Student Scholarly Projects

Practice Problem: Patients with increased ventilator days see dramatic increases in their chances of developing healthcare-related conditions (HAC). Extended ICU stays increase the potential for problematic issues in patients' physical, mental and spiritual health with short-and-long-term consequences.

PICOT: The PICOT question that guided this project was looking at adult ventilated patients in a medical ICU (P) and what is the effect of initiating interdisciplinary ABCDEF-ICU liberation bundle rounding as (I) compared to no ICU liberation bundle rounding (C) has on the length of ventilator days (O) over eight weeks (T).

Evidence: Evidence from quality studies and backing from the …

Nursing Perspectives And Opinions On Early Or Delayed Sepsis Treatment: A Mixed Methods Approach, Pamela L. Harris

Theses and Dissertations (ETD)

Purpose. Each year at least 1.7 million adults in America develop sepsis. Sepsis can lead to life threatening organ dysfunction, severe hypotension, and death when severe sepsis or septic shock is involved. Sepsis is responsible for 50% of acute kidney injury (AKI), which is the most common form of organ dysfunction seen in critical care. Sepsis associated AKI results in loss of, or decreased renal function, is associated with adverse long-term outcomes, and carries a higher mortality rate than non-septic AKI, sepsis without AKI, or septic shock without AKI. Surviving sepsis guidelines suggests a 1-hour window from the time of …

The Utilization Of Stress Management In Critical Care Nurses To Decrease Nursing Burnout, Danny Atkins

Student Scholarly Projects

Practice Problem: Since COVID-19, nurses have felt the pressure from the pandemic on their shoulders. The practice problem has helped nurses manage stressors to decrease the symptoms of burnout.

PICOT: In critical care nurses (P), how does the implementation of HeartMath techniques for stress management (I) compared to standard practice (C) affect rates of absenteeism, request for assignment transfer, and resignations (O) over 8-weeks (T)?

Evidence: The evidence that guided this project change is based on the Johns Hopkins nursing evidenced-based-practice model.

Intervention: The intervention assisted critical care nurses in dealing with stress and fatigue by …