Enhancing Ventilator Bundle Compliance In The Cvicu To Reduce Ventilator-Associated Pneumonia, Sarah Senger

Doctor of Nursing Practice Final Project Abstract

Purpose: This project aimed to evaluate the effectiveness of an intervention to improve ventilator bundle compliance and reduce ventilator-associated pneumonia (VAP) rates in a cardiovascular intensive care unit (ICU).

Background: VAP is a major complication in mechanically ventilated patients, leading to increased morbidity and healthcare costs. Implementing evidence-based practices, such as the ventilator bundle, has reduced VAP rates. However, inconsistent compliance with these practices remains a challenge.

Methodology: A three-month quality improvement project was conducted in a cardiovascular ICU. Process measures included oral care compliance and head-of-bed elevation, which were tracked weekly through patient charts and infection prevention reports. The …

Inpatient Falls: Epidemiology, Risk Assessment, And Prevention Measures. A Narrative Review, Saptarshi Biswas, Taylor Locklear, Carsten Steinmetz, Callaham Brock, Rachel Hemsath, Anna Deal, Shannon Leonard, Alexander Holland, Jeannie Kontos

HCA Healthcare Journal of Medicine

Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such …

Effectively Addressing Hospital-Acquired Pressure Injuries With A Multidisciplinary Approach, Andrew Beal, Nicki Roderman, Shandlie Wilcox

HCA Healthcare Journal of Medicine

Background

Hospital-acquired pressure injuries (HAPIs) result in patient harm, discomfort, and even death, with an estimated 2.5 million HAPIs occurring annually in the United States. These pressure injuries from prolonged pressure on the skin and deeper tissues cause reduced blood flow and the breakdown of skin and tissues, resulting in wounds. Additionally, these injuries contribute to longer hospital stays and increased health care costs. Hospitals have programs aimed at reducing HAPIs as well as ongoing surveillance to identify new trends early on. This ongoing monitoring revealed a trend early at our institution that HAPIs were 66% higher than the national …

Use Of An Alarm Bundle To Reduce Alarm Fatigue In The Icu: A Quality Improvement Project, Blerina Petitti

DNP Projects

Significance and Background: In the critical care setting, frequent false alarms can lead to sensory overload and delayed reactions to alarms (aka, alarm fatigue). Patients are at risk because overtime staff may ignore or become desensitized to all alarm sounds, even true ones.

Purpose: The purpose of this QI project is to establish alarm management protocol in a 14-bed ICU. The goals were to reduce alarm fatigue and create a safe environment for patients and clinical staff.

Methods: The Model of Improvement (IHI, 2023) with cycles of the Plan-Do-Study-Act (PDSA) was used to implement an alarm bundle checklist that …

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

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

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 …

Facilitating The Use Of Sbar By Nursing Staff For Handoff Communication, Amarillis Tompkins

Student Scholarly Projects

Practice Problem: Clear communication during shift handoffs is crucial to minimize errors and ensure patient safety in intensive care. The current SBAR framework used in the MICU is constrained by limited documentation space, which led to communication inefficiencies and heightened risks for patient care.

PICOT: The PICOT question that guided this project was: In the NFSG VA MICU, will staff nurses (P) using a revised SBAR communication tool with a checklist (I), compared to the current outdated SBAR tool without a checklist (C), improve the accuracy and completeness of patient handoff communication (O) over eight weeks (T)?

Evidence: The project …

Implementing A Hospital-Acquired Pressure Ulcer Prevention Program, Maryann Lancaster

DNP Practice Inquiry Projects

Objective: To implement a Hospital-Acquired Pressure Ulcers (HAPU) prevention program utilizing an assessment tool to identify patients at risk, and intervene with a sacral Mepilex® dressing. Our aims are to determine if a change in nursing knowledge and change in nursing behavior after implementing our program.

Background: HAPUs are a significant problem in patient care and healthcare organizations must implement prevention protocols to reduce HAPU prevalence. Guidelines for implementing HAPU prevention programs suggest use of a validate risk assessment tool and initiating preventive interventions. One intervention found in the literature is the adjunctive use of prophylactic Mepilex® dressings to sacral …

Patient, Surgical And Clinical Factors Associated With Longer Stay In The Post Anaesthesia Care Unit, Karen Briggs, Nicole Phillips, Steve Bowe, Mari Botti, Maryann Street

Journal of Perioperative Nursing

Aim: To explore patient, surgical and clinical factors associated with readinessfor- discharge and total length of stay in the Post Anaesthesia Care Unit (PACU).

Background: Longer stay in the PACU decreases the flow of patients and is associated with increased risk of adverse events. The time to readiness-fordischarge reflects clinical parameters associated with patient flow in the PACU independent of system delays.

Methods: This retrospective cohort study included a randomly selected sample of 244 post-surgical patients admitted to a large private, Australian health service.

Results: The median and average times to readiness-for-discharge were 48 minutes and 56 minutes respectively with …

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 …