Critical Care Nursing Commons^™

Compassion Satisfaction And Compassion Fatigue Among Critical Care Nurses, Tara L. Sacco, Susan M. Ciurzynski, Megan Elizabeth Harvey, Gail L. Ingersoll

Nursing Faculty/Staff Publications

BACKGROUND Although critical care nurses gain satisfaction from providing compassionate care to patients and patients’ families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life.

OBJECTIVES To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics.

METHODS In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction.

RESULTS Nurses (n = 221) reported …

Designing An Effective User Interface For A Mobile Application, Cynthia N. Kim

Graphic Communication

The purpose of this study was to determine the best user interface design practices for an iOS mobile application created for Pre-R, a local start-up company that offers physician house calls and telemedicine services throughout San Luis Obispo. The study included initial background research on best user interface design practices, mapping out and implementing the entire process of designing for mobile applications, conducting usability tests on potential users, and making changes according to the test results. Usability tests allowed for a greater understanding of the effectiveness of Pre-R’s mobile interface design prototype. Results from the usability tests have indicated a …

Hospice Care In Malaysia: Knowledge, Attitude And Time Of Discussion, Shanthi Ellen Solomon

Loma Linda University Electronic Theses, Dissertations & Projects

Despite available and adequate hospice care resources, fewer terminally ill patients in Malaysia use hospice care services than one might reasonably expect. It is reported that only around 10% of patients who die of terminal illness in Malaysia, die in hospice care (Devaraj, 2003). The projected number of individuals that should receive palliative care in Malaysia is 17 to 27% (Connor & Sepulveda Bermedo, 2014). In order to study why hospice care is not accessed as expected, nurses and doctors in Penang and Sabah completed a survey measuring knowledge of current hospice practices, attitude toward caring for the dying, personal …

Vap Prevention In The Cticu, Pres Lorenzo

Master's Projects and Capstones

The Agency for Healthcare Research and Quality (2015) has cited ventilator-associated pneumonia (VAP) as the most common infection in the ICU. In 2014, four episodes of VAP were identified in the 25-bed adult cardio-thoracic ICU (CTICU), a dynamic clinical environment within an academic medical center in Northern California specializing in complex cardiac surgery patients, including heart and lung transplants. In early 2015, the CTICU embarked on an evidence-based project to decrease the number of episodes of VAP to zero. Using the ACE Star Model of Knowledge Transformation as the theoretical framework and the CUSP (Comprehensive Unit-based Safety Program) standards as …

Implementing A Rib Fracture Management Pathway And Pic Scoring Tool To Reduce Icu Readmissions, Susan Mastroianni

Master's Projects and Capstones

The purpose of the project was to improve the management of patients with rib and or sternal fractures in a 413 bed Level I Trauma Center. The pathway included best practice guidelines paired with clinical expertise to reduce Intensive Care Unit (ICU) readmissions, costs, complications and length of stay (LOS). Analysis of the data revealed 55% of ICU readmissions were due to respiratory causes. The timeline guided the creation, deployment, and evaluation of the project over a two phase, one and one half year period. Methods included analysis of the data, meetings with lead team members to define the scope …

Improving Hand Hygiene Compliance To Reduce Clabsi Rate In Oncology Icu, Lorenzo D. San Pedro

Master's Projects and Capstones

The aim of this project is to reduce the rate of central line associated blood stream infection (CLABSI) occurrence in oncology ICU by 50% by the last quarter of 2015. This study was conducted in ICU to assess adherence to the facility’s hand hygiene (HH) protocol among the staff nurses and allied healthcare workers. The facility is best known as a non-profit cancer treatment center and designated as a Comprehensive Cancer Center. Evidence showed that hand hygiene is the most effective way of preventing CLABSI, one of the most common types of infection in ICU microsystem. The project utilized The …

Improving Patient Safety: Reducing Medication Errors In The Microsystem, Erica M. Dent

Master's Projects and Capstones

In a 72-bed for-profit long-term acute care hospital located in an urban setting, there has been a fifteen percent increase of medication errors that the pharmacy department has detected across nursing, and pharmacy departments, as well as with physicians from both day and night shifts. Over the last month there has been a total of twenty-eight medication errors including the transcription, administration, evaluation, and documentation processes. The microsystem consists of a telemetry/medical-surgical unit as well as a small intensive care unit consisting of ten beds.

The prospectus details a project implemented to reduce medication errors within the microsystem. The steps …

The Pupillometer In Practice: Identifying And Overcoming Barriers, Audrey Lee Paulson

Doctoral Projects

Problem: The pupillometer is an assessment tool that provides an accurate assessment of pupil reactivity. It is appropriate for patients who are neurologically impaired due to injury or illness. This tool, available and in use at a local community hospital, has minimal perceived importance in the Neuroscience Intensive Care Unit (NSICU), due to a disconnect experienced by the staff. The hypothesis was that understanding the pupillometer information was insufficient and that improving the knowledge would increase the perception of usefulness. Method: Conduct a survey to determine the cause of the lack of interest and use of the pupillometer. Once the …

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

University Scholar Projects

Abstract

Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical.

Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge.

Method:

This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA) …

The Effectiveness Of A Standardized Positioning Tools And Bedside Education On The Developmental Positioning Proficiency Of Nicu Nurses, Arlene Spilker

Doctoral Projects

Developmental positioning for preterm infants is an essential skill for neonatal intensive care unit (NICU) nurses. The benefits of developmental positioning are evident in the literature, but less is known about how NICU nurses learn about developmental positioning. This study examined the effect of the Infant Position Assessment Tool (IPAT) and informal education on the developmental positioning skills of NICU nurses. This quasi-experimental study measured IPAT scores before and after an educational intervention, and found a statistically significant increase in the means of the two groups. The use of the IPAT and bedside education is useful for improving the developmental …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

Statins And Kidney Failure, Rebekah Pemberton

Senior Honors Theses

Use of the HMG-CoA Reductase Inhibitors, also known as statins, in patients with renal dysfunction is laden with controversy. Studies on statin use in renal patients have given varying reports. Some research has indicated that these medications may exacerbate existing renal dysfunction and induce further progression of renal disease. Furthermore, some researchers have suggested statins may actually cause some cases of renal dysfunction through the effects of rhabdomyolysis, acute interstitial nephritis, or necrotizing immune-mediated myopathy, while other researchers have asserted that the statins can have nephroprotective effects. The use of statins is believed to be ineffective in patients who are …

Perceptions Of Neonatal Nurse Practitioner Role Among Nicu Nurses, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

Purpose: The purpose of this project was to examine Neonatal Intensive Care Unit (NICU) nurses’ perceptions of the NNP role and barriers to entering the role.

Background: A shortage of neonatal nurse practitioners (NNPs) exists. Hiring NNPs from outside the current NICU staff has resulted in turnover and additional cost. If current nursing staff prepared as NNPs, the organization would benefit; yet few nurses have done so. Reasons that dissuade nurses from pursuing the NNP role have not been adequately examined. Knowing how nurses perceive the NNP role may help to decrease barriers and inform plans to address the problem.

Implementation Of Interprofessional Education And Physician Order Set Improves Compliance With Early Recognition And Treatment Of Maternal Sepsis, Lori Susan Olvera

Doctoral Projects

Septic shock is rare in pregnancy; however, sepsis remains an important contributor to maternal mortality. The perinatal patient can appear deceptively well before rapidly deteriorating to septic shock. There is a need for protocols regarding early recognition and management of maternal sepsis. The Surviving Sepsis Campaign developed guidelines to provide guidance for the clinician caring for patients with severe sepsis or septic shock. The purpose of this doctoral project was to evaluate compliance with early goal directed therapy before, during, and following the implementation of a standardized physician order set and interprofessional education for nurses and physicians in the perinatal …

The Impact Of Self-Care Education On Heart Failure Patients With A High Risk For Readmission, Neil Williams Ii

Nursing Theses and Capstone Projects

The purpose of this Capstone Project study was to answer the question: Does self-care education improve knowledge and decrease 30 day readmission rates in a class of heart failure patients that are at high risk for exacerbation? The study used a randomized control design with a pre-test/post-test. A convenience sample of 50 African Americans diagnosed with heart failure were entered; control group (n=25) and experimental group (n=25). Both groups received the Heart failure Pre/Post Test developed by the researcher during the initial interview and four weeks post discharge. The experimental group received a phone call weekly over the four weeks …

Implementation And Evaluation Of A Team Simulation Training Program, Yvonne Rice

Doctor of Nursing Practice Projects

Trauma care, characterized by complex, shifting priorities, presents many challenges to providers. Traditionally, immediate trauma care has been provided in emergency departments. It has recently been recognized that severely injured patients receive better care with improved outcomes when they bypass the emergency department and are admitted directly to the trauma surgical intensive care unit (TSICU). To assure that TSICU nurses and interprofessional staff are prepared to handle such patients, all new registered nurses in the TSICU of a Level I Trauma Center participate in a one-day Trauma Boot Camp. Originally, the focus of the Trauma Boot Camp was solely on …

Incorporating Simulation Into Advanced Cardiac Life Support, Lorraine Calwile

Nursing Theses and Capstone Projects

The knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Cardiac Life Support (ACLS) are among the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Every year there are millions of healthcare workers that dread coming to ACLS class for fear of failure of the written exam or the mega code. Many of these participants haven’t participated in a code situation since they left class the previous two years. Participants sit in class for two days listening to lectures and going through practice mega codes to prepare them for the final mega code. …

Stop Cautis: A Unit-Based Education And Leadership Bundled Approach, Jennifer Healy Msn, Rn, Ccrn, Jennifer O'Neil Bsn, Rn, Danielle Moody Rn, Leigh Jimmie Bsn, Rn, Anne M. Aquila

Posters

1. The CAUTI Prevention committee recognized a continued opportunity to reduce CAUTI occurrences in the MICU
2. A sub-group developed and implemented an evidence-based educational program which was completed in October 2014
3. The MICU Team has decreased their CAUTI rate from 12 occurrences (Sept. 2013- Aug. 2014) down to 3 occurrences (Sept 2014-Aug 2015)
4. The team continues to use an auditing process and the insertion checklist as ongoing quality improvement

Incontinence And Skin Integrity In Immobile Populations, Frederick Green, Alyssa Starr

Nursing Student Work

No abstract provided.