Critical Care Nursing Commons^™

Mental Health Effects Of Post-Intensive Care Syndrome In Adult Acute Respiratory Distress Syndrome Survivors Hospitalized During Or After The Covid-19 Pandemic, Brooke M. Leggiero

Honors Undergraduate Theses

Introduction: Post-Intensive Care Syndrome (PICS) is "new or worsening problems in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization.” This study examined the prevalence of PICS mental health conditions in adult ARDS survivors hospitalized between 2020 and 2025 and differences in mental health conditions between those hospitalized during and after the COVID-19 pandemic.

Methods: This retrospective, descriptive, cross-sectional study enrolled adult survivors hospitalized between 2020 and 2025 who required mechanical ventilation and were at least 1 month removed from the intensive care unit (ICU). Individuals with prior brain injury were excluded. …

The Murdock Daily Reilly (M.D.R.) Scale: A Pressure Injury Risk Assessment Scale For Critical Care, Ann Murdock, Andrea Daily, Deby Reilly, Shih-Ting Chiu, Melissa Robinson

Publications 2026-present

No abstract provided.

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Enteral Nutrition Guidelines Improve Critically Ill Patients’ Outcomes: A Quasiexperimental Study, Marwa Abdo, Sara Elsayed Hegazy

Nursing

Background: Optimal nutritional support is a fundamental element of treatment for critically ill patients. Adherence to evidence-based enteral nutrition guidelines is essential to promote patient care and prevent potential complications. Objectives: To assess the effectiveness of enteral nutrition guidelines in improving critically ill patients’ outcomes. Method: A quasiexperimental study evaluated 68 critically ill patients divided into 2 groups. The intervention group received their nutrition based on the evidence-based enteral nutrition guidelines, while the control group received their nutrition based on the unit’s routine care. The study was conducted in the surgical intensive care units of Mansoura Emergency Hospital in Egypt. …

Push Dose Vasopressors For The Treatment Of Hypotension, Jennifer Ann Dailey

Doctor of Nursing Practice (DNP) Scholarly Projects

Millions of Americans experience life-threatening hypotension. Prolonged hypotension results in acute kidney injury, myocardial injury, even cardiac arrest, and is associated with increased morbidity and mortality (Khanna et al., 2019; Schuurmans et al., 2024; Singer et al., 2022). Hypotension and its associated complications result in higher hospital costs (Keuffel et al., 2018). While there is a high incidence of hypotension among ICU patients, a smaller percentage of patients require vasopressor infusions regionally and nationally (Moin et al., 2025; Pollard et al., 2019). Local data from a community hospital within a North Texas suburb demonstrates a larger percentage of ICU patients …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Improving Timely Administration Of Scheduled Short-Acting Insulin In Hospitalized Diabetic Patients, Edward S. Qu

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to improve compliance with the administration of scheduled short-acting insulin within 30 minutes of point-of-care blood glucose testing among hospitalized diabetic patients.

Background

This project was implemented in an inpatient hospital unit caring for patients with diabetes who require scheduled short-acting insulin. Internal audit data showed that compliance with administering insulin within 30 minutes of blood glucose testing was approximately 60%, indicating an opportunity to improve workflow and care coordination.

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement method was used to guide the project. Baseline data were collected from electronic health record …

Developing Nlp-Based Open-Source Tools To Improve Titratable Infusion Order Interpretation In Ehr Systems, Benjamin Brewer, Jay Dorris

Student Scholar Symposium

This study evaluates the feasibility of using natural language processing (NLP) tools to identify errors in titratable infusion orders for Joint Commission readiness. Titratable infusions are adjusted at the bedside by nurses based on predefined parameters, such as monitoring goals, titration rate, conditions for adjustment, and maximum dose. These parameters are often documented as free text within order sets but can be inadvertently removed during the verification process. Some electronic health records (EHRs) may not prominently display this critical information, leading to potential Joint Commission violations. A synthetic dataset was generated using artificial intelligence to simulate one year’s worth of …

Effect Of Implementing Safety Nursing Measures For Maintaining Fluid And Electrolyte Balance Among Critically Ill Patients With Acute Pancreatitis, Marwa Abdo

Nursing

Acute pancreatitis is a severe inflammatory condition that affects the pancreas and causes multiple organ failure. High rates of morbidity and mortality are caused by acute pancreatitis. Early fluid resuscitation, within the first 48 hrs., remains the hallmark for acute pancreatitis management. It lowers the incidence of pancreatic necrosis. Therefore, the foundation of treating acute pancreatitis in its early stages is safe fluid resuscitation. Aim: This study aims to evaluate the effect of implementing safety nursing measures for maintaining fluid and electrolyte balance among patients. Study design: A quasi-experimental research design was utilized in this study. Setting: This study was …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Improving Dka Protocol Adherence In The Emergency Department, Anjolaoluwa Lawani

Master's Projects and Capstones

Problem There was inconsistency in implementation of the DKA protocol by nurses in the emergency department at the Hospital A. Only 58% of the nurses reported feeling comfortable following the DK protocol, and 84% of the nurses described the DKA order set as confusing. Context Hospital A is a large magnet-recognition hospital system in the Bay Area. The emergency department at Hospital A averages about 12 DKA patients per quarter. Intervention Education sessions were held during pre-shift cuddles across day and night shifts to clarify the DKA protocol and answer any questions or nurses may have. Measures Baseline surveys and …

Quality Improvement (Qi) Project Aimed At Reducing 30-Day Hospital Readmissions For Patients With Congestive Heart Failure (Chf) Through Checklist Implementation, Gary Gutierrez

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Congestive Heart Failure (CHF) remains a leading cause of preventable 30-day hospital readmissions,

especially in outpatient and transitional care settings. This quality improvement (QI) initiative was

launched within a private internal medicine practice in Essex County, New Jersey, to address this issue

by implementing a standardized CHF management checklist. The checklist focused on four key

components: (a) comprehensive medication reconciliation, (b) tailored patient education, (c) timely

follow-up appointments, and (d) improved interdisciplinary communication. By integrating evidence-

based practices into a structured workflow, the QI project aimed to improve care coordination,

empower patients to manage their condition, and reduce preventable …

Point-Of-Care Gastric Ultrasound For Preoperative Assessment Of Gastric Contents: An Objective Structured Clinical Examination, Joshua Mann, Michael Sykes

Doctoral Projects

Pulmonary aspiration remains a leading cause of anesthesia-related mortality. The current nil per os (NPO) guidelines are proving unreliable in the presence of delayed gastric emptying due to comorbidities and the increasing use of glucagon-like peptide-1 (GLP-1) agonists. Gastric point-of-care ultrasound (POCUS) use provides a non-invasive, evidence-based, and cost-effective approach to assess gastric content and volume directly. However, limited formal training exists for advanced practice registered nurses (APRNs), and this lack of training contributes to the lack of its utilization. This doctoral project evaluated the effectiveness of an educational intervention that incorporated a didactic lecture as well as a hands-on …

Implications Of Alarm Fatigue And Effectiveness Of Mitigation Strategies In Inpatient Units: A Literature Review, Kinley R. Wojick

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background

Current technology in hospitals has allowed alarm notification systems to become faster and more sensitive than ever, enabling nurses to be immediately notified regarding changes in a patient’s condition. These notifications provide nurses with real time information necessary to prioritize interventions and provide the best care for their patients. Though notifications play a crucial role in the nursing process, the constant sounding of repetitive, non-actionable alarms can contribute to desensitization and a reduction in response times known as alarm fatigue.

Purpose

The purpose of this review was to compile reported research examining the effect that various interventions, including education …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Prevention Of Burnout Among Critical Care Nurses, Jenelle Balaoing, Junela Bautista

Nursing | Student Research Posters

Background: Nursing burnout is a state of mental and physical exhaustion caused by excessive stress among nurses. Critical care nurses face challenges with direct patient care that contribute to emotional and psychological strain that are greatly influenced by workplace adversity and emotional management. Purpose: This research examines the prevalence of burnout among pediatric and adult intensive care unit (ICU) nurses, highlighting particularly high rates of burnout among those with extended years of service. Method: ICU nurses will participate in a qualitative interview that involves open ended questions relevant among burnout and resilience during shifts. Aspects specifically years of critical experience …

Reducing Emergency Department To Medical Icu Boarding Times: Implementing A Standardized Escalation Protocol At A Large Medical Center Hospital, Taylor A. Robbins-Ethridge

Doctor of Nursing Practice Final Project Abstract

Prolonged emergency department (ED) boarding of critically ill patients awaiting transfer to the medical intensive care unit (MICU) delays access to definitive care and is associated with increased mortality and longer hospital stays. This quality improvement project aimed to reduce ED boarding times for MICU patients by implementing the Bed Ready in 30: Just Say Yes escalation protocol. The Plan–Do–Study–Act (PDSA) framework guided the implementation of a structured escalation process to standardize nurse-to-nurse communication once a MICU bed was marked as ready in the electronic health record. A pre–post observational study was used to evaluate the intervention using electronic health …

Improved Patient Outcomes With Continuous Video Monitoring, Ethan Morrison, Drake May, Jack L. Rideout

Scholars Week

Improved Patient Outcomes with Continuous Video Monitoring

Objective

The use of human sitters has been the normal policy in hospitals across the United States for years. Recently, there has been an introduction to remote video monitoring systems that are aimed at replacing the need for human sitters. Our goal is to change the policy of a local hospital in our area to adjust their stance on human sitters and implement remote video monitoring.

Methods/Results

Our method of accomplishing this involved a PowerPoint presentation and an evidence-based practice paper with three different scholarly research articles that have been peer-reviewed. We presented …