Critical Care Nursing Commons^™

Implementation Of The National Early Warning Score Tool In The Acute Care Setting, Amanda Reyes

Student Scholarly Projects

Practice Problem: The organization arbitrarily called a rapid response or code blue call based on abnormal vital signs or intuition and needed a new process to identify early recognition of patient deterioration.

PICOT: For adult inpatients in an acute care setting in a large healthcare system (P), will implementation of the National Early Warning Score (NEWS) across the organization (I) compared to data from the last fiscal year where NEWS was not used (C) decrease code blue calls (O) within 8-weeks (T)?

Evidence: Eleven high quality studies met the inclusion criteria and found that the NEWS is a validated …

Respite For Acute Care Nurses With The Use Of A Resilience Room, Marisella Perales

Doctor of Nursing Practice

Background and Significance of the Problem. Nurses are exposed to higher levels of occupational stress in acute care units when compared to other departments within the hospital (Faraji et al., 2019). A qualitative assessment identified a need for resources to be provided for acute care nurses experiencing occupational stress. Purpose. To establish an area for respite and increase nurses’ knowledge about a Resilience Room and a support system to manage occupational stress. Objectives. To educate 75% of acute care nurse on respite care, have 50% of the nurses report utilization of Resilience Room, and increase the nurses use of a …

The Impact Of Mindfulness-Based Stress Reduction Techniques On Nurse Burnout In An Icu, Heather L. Vincent

Student Scholarly Projects

Practice Problem: Burnout among nurses has been linked to turnover, negative patient safety and quality outcomes, and higher costs for institutions.

PICOT: The PICOT question that guided this project was, in ICU nurses (P), what was the impact of the use of MBSR techniques (I), versus the current state in which no MBSR techniques are practiced (C), on self-reported BO (O), over the course of eight weeks (T).

Evidence: A total of 14 studies were identified in the literature that directly support the implementation of this project. Themes from the literature show that mindfulness-based stress reduction techniques such as meditation, …

Measuring Serum Lactate In Sepsis, Ouafae Bouziane

Dissertations

Problem: Sepsis is the leading cause of hospitalized deaths in the United States and the leading cause of hospital readmissions. Each year, approximately 1.7 million Americans develop sepsis, and nearly 270,000 die due to sepsis. The purpose of this quality improvement project was to evaluate the acquisition time of initial and repeat lactate levels once a sepsis bundle was activated.

Methods: This quality improvement project used an observational, descriptive design utilizing a retrospective medical record review and the Plan-Do-Study-Act (PDSA) to evaluate code sepsis activations in a Midwestern, suburban, Level II trauma ED from November 1^st, 2020, through …

Preventing Ocular Surface Disease In The Pediatric Intensive Care Unit, Emily Mallette

Dissertations

Preventing Ocular Surface Disease in the Pediatric Intensive Care Unit

Problem: Ocular surface disease in the Pediatric Intensive Care Unit is a significant problem in intubated patients due to altered eye protective mechanics, leading to exposure of the eye surface and dry eye. The purpose of this quality improvement project was to evaluate how an eye care protocol affected the frequency of artificial tear ointment administration.

Method: A descriptive, cohort design utilizing a retrospective chart review with convenience sampling of intubated children in the PICU from two cohorts was used. Comparisons were made between the preintervention cohort in 2020 and …

Disseminated Intravascular Coagulation (Dic), Kahl Knapke

Nursing Student Class Projects (Formerly MSN)

Disseminated intravascular coagulation (DIC) is a rare medical emergency that can have profound and potentially life-threatening conditions. DIC has a hypercoagulability phase that simultaneously leads to a hypocoagulability phase due to depletion of clotting factors. DIC is secondary complication stemming from an underlying condition. Trauma, malignancy, severe infection, reaction to a transfusion, obstetric complications, etc. are a few conditions that are commonly linked to DIC. The primary method of treatment is early identification and resolving the underlying medical condition. The management of DIC requires nursing and medical staff with keen knowledge and understanding of precursor signs of DIC and the …

Disseminated Intravascular Coagulation, Kahl Knapke

Nursing Student Class Projects (Formerly MSN)

Disseminated intravascular coagulation (DIC) is a rare medical emergency that can have profound and potentially life-threatening conditions. DIC has a hypercoagulability phase that simultaneously leads to a hypocoagulability phase due to depletion of clotting factors. DIC is a secondary complication stemming from an underlying condition. Trauma, malignancy, severe infection, reaction to a transfusion, obstetric complications, etc. are a few conditions that are commonly linked to DIC. The primary method of treatment is early identification and resolving the underlying medical condition. The management of DIC requires nursing and medical staff with keen knowledge and understanding of precursor signs of DIC and …

Sepsis Initiative: Champion Series, Ashlie Barnes

Doctor of Nursing Practice Projects

Sepsis is defined as a life-threatening organ dysfunction syndrome caused by a dysregulated host response to infection. Septic shock is defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a higher risk of mortality than with sepsis alone. Each year, more than 1.7 million people are diagnosed with sepsis in the United States, and at least 270,000 Americans die. There is no confirmatory diagnostic test to diagnose sepsis. Therefore, clinical judgment based on evidence of infection and organ dysfunction is key.

Despite thousands of articles and hundreds of trials, sepsis plays …

Using Infographics To Improve Completion Rates Of The Sepsis Protocol Bundle, Stephen Newbern

Doctor of Nursing Practice Projects

Hospitals have sepsis protocols that must be implemented when a patient shows positive signs and symptoms of a septic infection. Nurses learn about sepsis in nursing school and rarely further their education beyond this basic understanding of the disease. So, when nurses fail to comply with organizational instructions outlined within a defined sepsis protocol bundle, this often leads to a progression of severe sepsis in a patient and, most likely, increased cost for the healthcare facility. Multiple sepsis protocol bundle failures negatively impact organizational ratings established by The Joint Commission for patient care and are highly associated with increased sepsis …

Efficacy Of Handoff Education For Icu Nurses When Transferring Patients To The Operating Room, Sandra Ruth Horace

Doctor of Nursing Practice Projects

Background: The transition of care from the Surgical Intensive Care Unit (SICU) to the Anesthesia team in the Operating Room (OR) is a vulnerable time for patients. There is currently no formal process for the patient transitioning from the Surgical ICU to the OR. The disarray of this transition can lead to serious omissions in communication and be harmful to the patient.

Purpose: Currently, there is no formalized or universal process for handoff communication between the SICU team and the Anesthesia team. This project aimed to provide handoff education for SICU nurses when sending a patient from the OR. This …

2020 Nursing Annual Report, Children's Health System Of Texas

2020

No abstract provided.

Preventing Central Line Associated Bloodstream Infections In An Adult Intensive Care Unit, Monica Shaw

Master's Projects and Capstones

Central line associated blood stream infections (CLABSI) are considered preventable healthcare acquired infections, and are associated with significantly increased morbidity, mortality, and length of hospital stay. The CLABSI rate in an inpatient unit is a meaningful metric in relation to the safety and quality of care in that microsystem. This quality improvement project examines the efficacy of a CLABSI prevention bundle in reducing CLABSI events and improving adherence to central line care policy within a medical surgical adult intensive care unit. The target areas the bundle aimed to improve were unit processes, awareness of CLABSI and central line policies, and …

It’S Their Lifeline: Preventing Central Line Associated Blood Stream Infection In An Adult Intensive Care Unit, Jacenda Lee Rangel

Master's Projects and Capstones

Problem description: Central line associated blood stream infection (CLABSI) is one of the deadliest types of hospital acquired infection and blood stream infection, raising patient mortality by 12-25% and accounting for 28,000 deaths annually in the United States. CLABSI also increases morbidity, length of stay, and costs hospitals an average of $48,000 per case. Effective measures for CLABSI prevention are needed for an adult intensive care unit (ICU) of an urban hospital to decrease the financial burden of CLABSI, improve quality of care, and prevent patient harm.

Setting: The microsystem of focus is a 36-bed high acuity ICU. Patients of …

Methods Leading To Best Outcomes For Elderly Patients Presenting With Chest Pain In Emergency Departments., Philip Choo, Seth Bristol, Jacob Sharer, Hannah Wilson

Symposium of Student Scholars

Abstract

Background: Hospitals today currently face many health disparities among patients. There are many factors that contribute to these health disparities such as the decision-making process. Objective: The goal of this systematic review was to identify how computerized risk prediction models compared to a set of decision rules influence health outcomes during emergency room stay of older adult patients with chest pain.

Method: We searched databases such as, CINAHL, EBSCOHost, and PubMed to identify barriers influencing health outcomes of older adults with chest pain in the emergency department.

Results: There were seven articles included in the review indicating the effectiveness …

Nurses' Perspectives On Pain Management In The Emergency Department, Elizabeth Fitzgerald

Seton Hall University Dissertations and Theses (ETDs)

Over 130 million people seek care in emergency departments (ED) in the United States annually. Most patients who seek treatment in emergency departments are experiencing a painful condition, and as such, ED nurses should have a deep understanding of pain management in the ED. There is limited qualitative research which explores pain management from the nurses’ perspective. The purpose of this study is to describe pain management from the nurse’s perspective. Thorne’s (2005) method of Interpretive Description guided this qualitative inquiry. New knowledge describing the nature of pain management in the ED provides insight into elements which support and impede …

Nursing Assignment: Understanding Covid-19 Vaccines: Specific Strategies To Encourage And Educate Your Patients, Regina G. Lama

Open Educational Resources

Understanding Covid-19 Vaccines: Specific Strategies to Encourage and Educate Your Patients

This assignment focuses on the difference in Covid-19 vaccinations. The nursing student will discuss the different vaccinations and form a teaching plan for the patient in order to encourage the vaccination process. The student will then explore the patients expectations concerning vaccination.

As a presentation the students will be able to evaluate, share and reflect on teaching method.

Post-Operative Nursing Care Of The Renal Transplant Patient, Emily Smith

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Kidneys are the most commonly transplanted organ in the United States. All patients who receive a renal transplant must be on lifelong immunosuppressants to prevent rejection of the donor organ. The majority of patients do not take their immunosuppressant medications as instructed, making noncompliance a huge issue for medical professionals. The purpose of this literature review is to explore what evidence-based techniques nurses should employ to increase the long-term compliance of immunosuppressants in renal transplant patients. A literature review was performed of fifteen studies to identify interventions that nurses can employ to increase immunosuppressant compliance. CINAL and Medline were …

The Effects Of Covid-19 On Healthcare Workers: An Exploration Of Burnout, Cherise Fernandez

Nursing | Senior Theses

The healthcare workplace has been challenged with the SARS-CoV-2 corona virus (COVID-19) for majority of the year 2020 and it has posed a number of challenges for healthcare workers (HCWs). Due to the increased workload and demanding work hours, the prevalence of physician burnout has increased amongst this population. The escalation of burnout may lead to negative effects on physical and mental health. This poses a health concern amongst patients because the increase of burnout affects patient care, safety, and quality of care. Various surveys have been sent out to HCWs in order to determine if burnout has increased within …

Altruism And Self-Concept In Pediatric Intensive Care Unit Nurses: Is There A Relationship With Reports Of Workplace Violence?, Minnette Markus-Rodden

Seton Hall University Dissertations and Theses (ETDs)

Incidents of workplace violence (WPV) are pervasive in healthcare settings. WPV in the US occurs four times more frequently in the healthcare sector than in the private sector. However, the true incidence of WPV in healthcare settings is thought to be much higher secondary to significant under-reporting. The American Nurses Association (2019) reports, while one in four nurses are assaulted, only 20-60% of the incidents are reported. This extensive range is due to the lack of an accepted definition of what constitutes WPV, variable reporting mechanisms, and an overall perception by healthcare workers that WPV is “part of the job”. …

The Effects Of Dexmedetomidine On Preventing/Decreasing Severity Of Delirium When Given To Surgical Intensive Care Unit Patients: A Systematic Review Of Randomized Control Trials, Lindsey Hettish

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to integrate research evidence from studies published from 2010 to 2020 on the relationship between administration of dexmedetomidine and severity/prevalence of postprocedural delirium in patients in the surgical intensive care unit. In this review, clinical trial studies were recovered by searching the MEDLINE Complete and PubMed databases and utilizing MeSH terminology search. The MeSH terms utilized to search for applicable articles on PubMed included: “intensive care units” or “critical care” or “critical care nursing”, and “delirium”, “dexmedetomidine”, and “surgical procedures, operative”. On MEDLINE Complete, the search terms utilized were “ICU or intensive care …