Critical Care Nursing Commons^™

The Association Of Kangaroo Mother Care, Energy Conservation, And Bonding In Preterm Neonates, Dorothy Forde

Dissertations

Purpose:To examine the association of kangaroo mother care (KMC) on energy utilization and bonding as evidenced by reduced biochemical markers of adenosine triphosphate (ATP) degradation, hypoxanthine (Hx), xanthine (Xa), and uric acid (UA), and (allantoin), a measure of oxidative stress in preterm infants 24-36 weeks gestation. A secondary objective was to compare specific physiological parameters using bedside monitoring and perfusion and oxygenation of the gut using near-infrared spectroscopy (NIRS) during 1 hour of KMC compared to incubator care.

Study design: A randomized controlled trial (RCT) examining the effects of 1-hour of KMC or 1-hour incubator care on urinary markers …

Hospital Acquired Pressure Injury Prevention On An Inpatient Unit, Cherilyn Schumacher

Master's Projects and Capstones

Abstract

The aim of the project is to improve the process and delivery of care with established and accepted standards by implementing evidence-based change. The plan is to create a HAPI prevention plan with the main expected outcome to reduce the HAPI occurrences on the unit to zero by July 30, 2018. This will be accomplished by increasing awareness among nursing staff members through education and diligent monitoring of prevention practices and treatments.

The education portion of the plan will include reviewing basic pressure injury education and HAPI prevention and management in the form of visual aids provided by the …

Oxygen Consumption In Sepsis, Julie Graham

Dissertations

Background: Sepsis is a life-threatening condition that can lead to septic shock and death. With over 300,000 annual cases (AHRQ, 2011) costing a staggering $1.5 billion (Health Care Utilization Project Brief #185), the importance of sepsis is becoming clear. However, some basic biological mechanisms are poorly understood. Study Purpose: This study investigated the relationships between select demographics, resting energy expenditure (REE), serum lactate, SOFA score mortality index, oxygen consumption [by way of measuring net oxygen consumed, (V02) and net carbon dioxide produced (VC02)], and sepsis. Specific Aims: Aims were to describe 1) patient demographics, serum lactate, SOFA score mortality index, …

Musculoskeletal Disorders In Healthcare Workers, Josephine Lauer

Master's Projects and Capstones

Musculoskeletal Disorders (MSD) are one of the leading causes of disability in hospital nurses and nursing aids and is a high cost problem in the healthcare industry. Working in a complex environment of an acute medical floor where repetitive nature of patient handling, can lead to musculoskeletal injuries for healthcare workers. This is evidenced by work-related injuries in hospitals nearly doubling compared to private industry and hospitals are one of the most hazardous work environments in the country. Musculoskeletal injuries of healthcare workers are an ongoing problem which requires investigation due to high risk of reoccurrence. This is especially true …

Increasing Early Mobility Of Patients In The Intensive Care Unit, Wendie Gilliam

Master's Projects and Capstones

Abstract

This project occurred in a 35-bed intensive care unit at a level II trauma center in central California. The purpose of this project was to strengthen the implementation of evidence-based initiatives promoted by the Society of Critical Care Medicine. The Society of Critical Care Medicine has a set of initiatives for the intensive care units nationwide to improve the outcomes for patients. One of the initiatives is the ICU Liberation, which includes six different bundles labeled: A, B, C, D, E, & F (Society of Critical Care Medicine ,2013). Their studies showed a significant improvement in the outcomes for …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

When Disaster Strikes: A Training Intervention To Improve Nurses' Confidence And Preparedness For The Surge, Nichole M. Weber

Evidence-Based Practice Project Reports

There has been an exponential rise in mass casualty incidents (MCI) internationally. These human induced and naturally occurring events have affected over 4.6 billion people, and are not discriminatory to region or community (World Health Organization, 2011). Governing bodies require training and education, but nurses continue to report suboptimal competence and self-reported readiness, and a need for standardized, evidence-based training remains. The purpose if this evidence-based practice project is to authenticate current research supporting implementation of competency-based education, to improve nurses’ self- perceived preparedness and confidence in their ability to respond to MCI. The project results can be utilized for …

Establishing A Hybrid Wound And Ostomy Continuing Education Program, Vivian K. Wong

Faculty Publications

Wound and ostomy nurses receive specialty training and certification to provide care in abdominal stomas, ostomies, wounds, fistulas, and pressure injuries. The eight existing nationwide programs in 2011 were inadequate to meet increasing patient population demands. We developed an innovative nondegree, postbaccalaureate continuing wound and ostomy education program using a hybrid design. The program integrated interactive online classes with intensive onsite classes and skills training. The program has been granted seven-year accreditation; student evaluations have been positive.

The Impact Of Diabetes Mellitus On Burns And Standard Burn Treatments, Emma Shepard

Senior Honors Theses

Burns are complex injuries that trigger the stress response and result in increased blood glucose. Diabetes mellitus, an endocrine disorder with abnormal glucose regulation, can significantly alter the risk for burns and the treatment of burns. Pre-existing diabetes mellitus complicates burn treatments and healing ability. Diabetes mellitus may also develop directly from an unregulated stress response to the burn. The consideration of diabetes mellitus affects wound care, medications, and nutrition for burn patients. As patient advocates, nurses are responsible for caring for burn patients with awareness of endocrine complications. This paper provides a detailed overview of the pathophysiology, complications, and …

Nursing Compliance With Vap Bundle, Taylor Meadows

Scholars Week

It has been proposed that by initiating the highest percentages of nursing compliance, overall patient outcomes will improve along with a decrease in the number of ventilator-associated events (VAEs). The aim of the study is to appraise the association between nursing compliance with a ventilator bundle and a successful decline in the number of events of ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). The study also provides evidence-based direction on the best nursing practices essential to reducing the rates of VAP. Objectives include expanding the awareness of critical care staff on prevention and compliance and to improve teamwork …

Impressions Of Participants In A Chemical Mass Casualty Exercise, Ethan J. Start, Joan M. Culley, Abbas Tavakoli

Senior Theses

A mass casualty exercise was performed to investigate triage and decontamination of patients exposed to an irritant gas. Nursing students participated in two groups: emergency department triage (ED) and decontamination (DECON). While participants felt overall that the experience was valuable, DECON participants had a greater interest in emergency response and were more likely to volunteer again.

Transitioning Experienced General Care Float Pool Nurses To A Critical Care Float Pool, Troy T. Betts, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: A nationwide nursing shortage has resulted in a significant reduction in the number of qualified nurse applicants for critical care positions. Additional recruitment solutions for critical care staffing needed to be explored.

Purpose: The purpose of this project was to evaluate the effectiveness of an orientation program designed to transition experienced general care trained float pool nurses to a critical care float pool.

Methods: This descriptive study measured participants’ pre and post critical care orientation knowledge, and completion of core computerized competencies. Critical thinking questions, unit-based competencies, and measurement of participants’ individual perception of competence were also completed. Pre …

A Pediatric Respiratory Care Curriculum For Emergency Department Nurses, Luzmaria Alcala-Van Houten

Doctoral Projects

As pediatric visits to community hospitals increase, the Institute of Medicine (IOM) and the Pediatric Emergency Care Network (PECARN) recommend that staff be provided improved education, protocols, and resources to improve patient outcomes (Emergency Medical Services for Children, n.d.). Acute respiratory disorders are the most commonly seen complaints in children aged 0–24 months, with an average of 2–4 visits a year. The purpose of this Doctor of Nursing Practice (DNP) project is to create a pediatric respiratory care curriculum for emergency department nurses in the Kaiser Permanente Central Valley Area (CVA) and to have it evaluated by a group of …

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

Can Standardizing Cabg Care With Clinical Pathways Reduce Length Of Stay And Hospital Acquired Infections?, Seana Friedman

Seton Hall University DNP Final Projects

Clinical pathways are a common component in the quest to improve the quality of health. Clinical pathways are used to reduce variation, improve quality of care and maximize the outcomes for specific groups of patients (Lawal, et al., 2016). The purpose of this project is to develop and initiate a Coronary Artery Bypass Grafting (CABG) clinical pathway to reduce variation in care as a way to improve quality of care and patient outcomes for CABG patients CABG surgery is considered a high risk, high cost, yet highly profitable surgery with considerable post-operative complications that affect numerous quality metrics including Length …

A Correlation Between Parental Visitation Neglect And Pediatric Intensive Care Unit Psychosis: An Integrative Literature Review, Alia Mohammad

Grace Peterson Nursing Research Colloquium

Abstract

Background: Pediatric intensive care unit psychosis is a serious disorder where patients experience anxiety, hallucinations, delirium, and other symptoms, setting them back in their recovery process during their hospital stay.

Purpose: This study is an integrative literature review aimed at the use of evidence based practices to establish the most effective solution in preventing ICU psychosis in pediatric patients, and discovering if parental presence is a factor to successful recovery.

Methods: WorldCat.org, MEDLINE, ABI/INFORM Complete, Academic Search Complete, OAlster, PsycARTICLES, ERIC, Business Source Complete, and Computers & Applied Sciences Complete were searched using the keywords pediatric, intensive care unit, …

Organizational Behaviour During Instability: A Critical Discourse Analysis Of Shared Mental Model Through Various Forms Of Acute Care Learning Using Mixed Methods, Adam Morse, Ryan Chan

Western Research Forum

Background: The purpose of this study is to better understand nurses' performance based on training processes. This will determine if group training will increase performance compared to independent training through a shared mental model in a contextual setting of unpredictability mediated by the effects of nurses’ perceptions of patient safety climate. A mixed methods study is conducted using critical discourse analysis of organizational documentation and semi-structured interviews to determine measures of contextual setting when identifying and treating sex trade workers.

Methods: Pragmatic study will analyze two groups of 125 nurses each determining the impact of group and individual …

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

The Effect Of Individualized Nurse Report Cards And Unit Case Reports On The Awareness And Attitudes Of Nurses Towards Clabsi Contributing Factors, Shannon K. Hawkins

Nursing Theses and Capstone Projects

This DNP project examined the effect of unit case reports and individualized nurse report cards on nurses’ awareness of and attitudes toward central line-associated bloodstream infection (CLABSI) contributing factors. This project also sought to determine whether CLABSI incidences differed across units and if that was affected by nurses’ awareness of and attitudes toward CLABSI contributing factors. A convenience sample of registered nurses (RNs) across four medical units was included in this project. Of the 79 RNs who participated in providing feedback on this project, 48 RNs completed pre-implementation surveys, resulting in a response rate of 61%, and 53 completed post-implementation …

Outcomes Of Family Presence During Resuscitation (Fpdr) In The Acute Care Setting: A Review Of The Literature, Audra M. Corn

Honors Undergraduate Theses

Family Presence During Resuscitation (FPDR) remains controversial and is not consistently implemented during resuscitation events or invasive procedures. Evidence has demonstrated positive outcomes produced by implementation of FPDR; such as, decreased rates of post-traumatic stress symptoms, decreased symptoms of anxiety, and depressive symptoms were not significantly different. Unfortunately, use of FPDR in the acute care setting is not widely accepted or readily implemented. The primary purpose of this integrative literature review is to evaluate the use of FPDR in the acute care setting. The secondary purpose is to evaluate the health care professional's level of perceived value associated with the …