Critical Care Nursing Commons^™

Preventing Insulin Storage And Administration Errors, Makena Reddick

Scholars Week

■The research problem was discovered when nurses were observed storing and administering insulin improperly. The objectives of this project were to find the correct policies for these procedures, obtain research that backed these policies, and present this information to nurses to create a safer habit. In researching, it was found that reducing the physical distance between a person completing work and the materials required to do so increased compliance (Gibbs & McLernon, 2017). In a second study, the delivery of safe, effective and high-quality care for patients with diabetes in the community is dependent upon (district) nurses having appropriate knowledge …

Exploring Saudi Emergency Room Nurses’ Perceptions About Their Disaster Preparedness, Fadiyah Alshahrani

Seton Hall University Dissertations and Theses (ETDs)

Background: Disasters can overwhelm the capacities of health care facilities quickly. In recent years, the world has been affected by an increasing number of significant disasters. These include natural disasters such as earthquakes, hurricanes, floods, tornados, storms, fires, and epidemic outbreaks. There are man-made disasters such as terrorist attacks, transportation accidents, and stampedes at mass gatherings. The resulting deaths and property damages have enormously affected countries’ economies, particularly on a health care system’s preparedness. In a major disaster, health care professionals must respond, manage, and prevent additional harm to victims. Nurses are the largest group of health care professionals …

Implementation Of Telephone-Based Medication Adherence Conferences To Improve Health Outcomes Of Heart Failure Patients, Diana Marie Broadway

The Eleanor Mann School of Nursing DNP Capstone Projects

Cardiovascular disease (CVD) has been a significant health problem worldwide and is the leading cause of death globally. Heart failure (HF) is a chronic progressive form of CVD that affects millions of adults in the United States. The treatment for heart failure is very complex and requires an ongoing regimen of medications. In heart failure, many patients report nonadherence to their medication regimens, which leads to a magnitude of preventable deaths annually. With frequent medication nonadherence of the HF patients, there must be an intervention used to combat this problem. The use of telephone-based interventions (TBI) can modify nonadherent medication-taking …

A Systematic Review Of Acuity-Based Staffing In Acute Healthcare Environments, Demitria Idella Stafford

Electronic Theses and Dissertations

Nursing leadership is responsible for considering the equity of patient care assignments when providing nursing care. Nursing leadership is responsible for assuring the delivery of patient care assignments with the intent to offer nurses an unbiased, evenly distributed patient load. Effective distribution of patient care assignments ensures patients receive the safest, most efficient, and highest quality of care. The purpose of this project was to provide nursing leadership with an executive summary of a systematic review of evidence-based research on the structure and process of making patient care assignments, and it provided evidence on how those patient care assignments affect …

Improve The Risk Of Central Line-Associated Bloodstream Infections With Central Line Dressing Changes Through A Team Approach, Jessica Comstock

Student Scholarly Projects

Practice Problem: Central Line Associated Bloodstream Infections (CLABSI) are a preventable hospital acquired infection which contributes to patient morbidity, mortality and rising healthcare costs.

PICOT: The PICOT question that guided this project was: In adult inpatients with central venous catheters, does the use of a two-person dressing change team, compared to a single person procedure, decrease the rate of central line associated bloodstream infections over the course of 8 weeks?

Evidence: The prevention of CLABSI is most effective when multifaceted line maintenance bundles are implemented and adherence to these bundles nears 100% (Schreiber et al. 2018).

Intervention: A two-person, …

Generating Evidence Of Critical Care Nurses' Perceptions, Knowledge, Beliefs, And Use Of Music Therapy, Aromatherapy, And Guided Imagery, Annie Heiderscheit, Shawna Vernisie, Wendy L. Magee, Helen Shoemark

Faculty Authored Articles

No abstract provided.

Statins And Women, Debra Schulte

Rural Health Professions Projects

Low-density lipoprotein (LDL) elevation is a primary risk factor for atherosclerotic cardiovascular problems such as heart disease and stroke. Heart disease is the leading cause of death in the United States and stroke is the fifth leading. Earlier LDL reduction improves morbidity and mortality. Literature indicates fewer women start statin medications compared to men.

Effect Of Emergency Severity Index (Esi) Annual Competency Assessment On Mistriage Rates, Stefanie Hoffman

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: In order to accurately assign an Emergency Severity Index (ESI) acuity level to patients who present to the emergency department (ED) triage area, it is essential triage nurses remain competent in the ESI triage tool. In addition, effective use of the ESI triage tool is critical in preventing patients from being mistriaged.
Objective: The purpose of this quality improvement project was to determine the effect of an ESI annual competency assessment in an ED for triage trained registered nurses (RNs).
Methods: Triage trained RNs completed an ESI competency assessment composed of 25 patient scenarios in competency assessment A, and …

A Lesson Involving Nursing Management Of Diabetes Care: Incorporating Simulation In Didactic Instruction To Prepare Students For Entry-Level Practice, Elizabeth A. Moxley, Larry Maturin Jr., Desale Habtzghi

Faculty Articles, Papers, and Other Scholarship

Background: Diabetes is a global health problem requiring nursing students demonstrate a thorough understanding for NCLEX^® and entry-level practice, although clinical opportunities are increasingly limited, especially for Associate Degree Programs.

Method: A Simulation-based Education was incorporated in a didactic lesson to improve diabetes nursing care. Knowledge, confidence, application and relevance were measured using Wilcoxon signed-rank, Chi-square and Kruskal-Wallis analyses.

Results: Student (n=46, 85% female) perceived knowledge of glycemic management (post > pre, p < 0.0001), confidence administering insulin (post > pre, p < 0.0001), and clinical relevance improved. Confidence increased among three cohorts per Kruskal Wallis H test (² = 7.76, p = 0.021). Increased confidence correlated with relevance (² = 30.965, p = 0.009) and prior understanding of therapy ( …

Improving Emergency Department Quality Of Care, Carmen Smith

Doctor of Nursing Practice Projects

Emergency department (ED) crowding can cause an extended length of stay (LOS) and high rates of patients who leave without being seen (LWBS). This quality improvement ED project sought to reduce LOS and LWBS by implementing a triage (PIT) team. The design included an outcomes evaluation with available data and a staff pre and posttest. Length of stay and LWBS rates were compared before and after implementation. Results indicated a reduction in the average LOS and LWBS rates for the 30 days of project implementation compared to the 30 days before the project initiation. The overall goal of the PIT …

The Evaluation Of An Amino Acid- Oral Re-Hydration Solution (Enterade®) To Improve Quality Of Life In Solid Tumor Cancer Patients By Reduction Of Chemotherapy Related Diarrhea, Holly Chitwood

DNP Projects

Background: Chemotherapy related diarrhea (CRD) is a common adverse effect of many chemotherapy agents used to treat cancer. CRD negatively affects quality of life (QOL) for cancer patients and often results in treatment delays, hold, dose reductions, and hospitalizations affecting morbidity and mortality. Proper management of CRD with novel therapeutics is needed to improve the quality of life and patient outcomes for this population.

Purpose: The purpose of this study was to evaluate the use of a proprietary amino acid-oral rehydration solution (AA-ORS) known as Enterade® to reduce the severity of CRD, to improve patient reported QOL among patients over …

Developing An End-Of-Life Discussion Protocols, James Hawley

Rural Health Professions Projects

End of life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a provider-patient communication protocol that would shift advanced directive conversations proactively back into the local rural primary care setting.

Examining Rural Acute Care Clinical Nurse Specialist Roles, Jessica Camp, Jessica Baltz, Amanda Mcmillon, Christopher Zumbach, Angie Smith, Michael Anderson

Rural Health Professions Projects

Clinical Nurse Specialists are extremely valuable healthcare team members that may be underutilized in times of crisis. This case study examines how the role of the clinical nurse specialist proved worthy and evolved to meet the demands of the COVID-19 pandemic as it impacted one rural hospital in the southern United States of America.

Atrial Fibrillation In Covid-19: A Descriptive Study Of Incidence, Mortality And Related Factors, Diana L. Taylor

DNP Research Projects

Abstract

This scholarly project determined the relationship of atrial fibrillation (AF) occurrences in COVID-19, as it is the most frequent arrhythmia in the U.S. and is driven by inflammatory pathology. In COVID-19 positive patients with AF occurrences understanding the relationship between these conditions could help identify patients with poor prognosis, higher morality, and other factors earlier in the hospital course.

This single-center scholarly project was a retrospective descriptive chart review to determine the relationship between AF and COVID-19 over a 6-month timeline in Chattanooga, TN. Of the 565 hospitalized COVID-19 positive patients included, 82 (14.5%) had AF occurrences. A higher …

Lyme Disease Essentials For Healthcare Workers, Donita Blanken-Little

DNP Research Projects

No abstract provided.

Improving Multidisciplinary Adherence To A Daily Goals Checklist In The Icu: A Quality Improvement Initiative, Chelsea Mccarty

DNP Projects

Abstract

Background: In November 2019, the University of Louisville Hospital merged and assumed operations of all KentuckyOne facilities. During the transition, a spike in hospital acquired infection rates ensued at Jewish Hospital, notably amongst the critical care units. In January 2020, a daily checklist was introduced to the critical care department. A Daily Checklist is a tailored communication tool designed to reduce communication error and improve adherence to patient safety measures. There continues to be a gap in adherence to the U of L daily checklist from both nurses and providers. Purpose: The purpose of this project was to improve …

A Multi-Faceted Intervention To Reduce Low Value Diagnostic Studies In A Medical Intensive Care Unit., Jessica Caicedo

DNP Projects

Routine daily chest x-rays (CXRs) and laboratory studies have been identified as low-value care practices that contribute to the rising cost of healthcare without improving quality or outcomes. There is a large body of evidence as well as recommendations from multiple professional organizations for providers to not order unnecessary daily or routine diagnostic studies. Rather, these should be ordered in an on-demand fashion as a response to a specific clinical query. Despite the strength of recommendations, practice remains variable across the U.S. The reasons for resistance to practice change as well as the most effective strategies for implementing sustainable change …

Evaluation Of A Spontaneous Breathing Trial Extubation Protocol On Patient Outcomes, Joshua Caldwell

DNP Projects

Background: Evidence correlates better patient outcomes with shorter ventilator days therefore, without contraindications, patients should be removed from continuous mechanical ventilation as soon as safely possible. Exactly how to assess readiness to extubate and when to extubate is still up in the air.

Purpose: Evaluation of a 30-minute spontaneous breathing trial extubation protocol on patient outcomes and to also evaluate staff education of the 30-minute spontaneous breathing trial extubation protocol on adherence and patient outcomes

Methods: This is a retrospective and prospective evidence-based quality improvement project comparing patient outcomes before and after staff education as well as patient outcomes between …

S.A.F.F.E.R. Airway Management: Evaluating The Effectiveness Of Checklist Implementation On Reducing Peri-Intubation Complications In An Air Medical Transport Service, Rachael M. Croley

DNP Projects

Background: Advanced airway management via endotracheal tube placement in the critically ill and injured is tenuous and presents a multitude of challenges that threaten patient safety. The potential for procedure-associated hypoxia, hypotension, and cardiac arrest during the peri-intubation period can be detrimental to overall patient outcomes. Purpose: The purpose of this project is to evaluate the effectiveness of the Standardized Airway Flow For Engineered Resuscitation (S.A.F.F.E.R.) checklist in reducing peri-intubation complications and provider perception of checklist implementation when performing advanced airway procedures.

Methods: A case-control analytical observational design study which included retrospective and prospective electronic medical record review to determine …

End-Of-Life Nursing Consortium To Improve The Gap In Palliative Care, Emma Kroger

DNP Projects

Abstract

Objective: The purpose of this project is to implement a palliative care education intervention with a pre- and post-survey to assess knowledge, emotional preparedness, and confidence in undergraduate nursing students at the University of Kentucky.

Aim: The aim of this project is to address the gap in palliative care education by increasing professional knowledge, emotional preparedness, and confidence levels in regards to palliative care of future nurses at the University of Kentucky.

Background: The terms “hospice” and “palliative” are often used interchangeably in the healthcare setting. However, palliative care focuses on symptom management in all stages of acute, chronic, …