Critical Care Nursing Commons^™

Neurological Outcomes In Induced Hypothermic States (Post Cardiac Arrest Resuscitation), Shonna Lee Bible

Nursing Theses and Capstone Projects

International studies indicate that induced hypothermia in successful Post Cardiac Arrest Resuscitation improves cerebral perfusion resulting in improved neurological function. Patients undergoing a neurological exam prior to induction of hypothermia may indicate potential mortality prognosis in this population. Literature Review indicated the use of the Glasgow-Pittsburg Cerebral Performance Categories for evaluation of neurological status in this population, but most institutions seem to utilize Glasgow Coma Scoring (GCS) in all patient populations for neurological examination. The purpose of this study was to determine if a neurological evaluation prior to and during the Induced Hypothermia state would affect the mortality outcomes in …

Emergency Departments And Stemi Care, Are The Guidelines Being Followed?, Dawn W. Hendren

Nursing Theses and Capstone Projects

The purpose of this study examined if an Emergency Department (ED) in a small rural hospital in western North Carolina is compliant with the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for obtaining Electrocardiogram's (ECG's), administering fibrinolytics, and performing Primary Percutaneous Coronary Intervention (PCI) on patients with chest pain diagnosed with ST-Elevation Myocardial Infarction (STEMI). The national standards for ECGs is less than 10 minutes from arrival to first medical contact (FMC) with triage nurse; for fibrinolytics, less than 30 minutes from arrival to FMC; and for FMC to PCI, less than 90 minutes. The …

Critical Care Nursing Interventions And Incidence Of Ventilator Associated Pneumonia In The Trauma Population, Kelli R. Moore

Nursing Theses and Capstone Projects

Ventilator Associated Pneumonia (VAP) in the Trauma Intensive Care Unit is the most commonly encountered infection in the intensive care unit and can be linked to increased morbidity, increased mortality, increased mechanical ventilation days, increased hospital length of stay, and increased cost. A retrospective, correlational study examined the effect of compliance with a ventilator bundle protocol in the Neuro-Trauma Intensive Care Unit on aggregate VAP rates. The study's primary focus was to determine if interventions performed by critical care nurses reduced the incidence of Ventilator Associated Pneumonia (VAP) in the Trauma Intensive Care Unit. The study utilized the retrospective collection …

Open Visitation Effects On The Critically Ill Individual, Melissa Mcneilly

Nursing Theses and Capstone Projects

The Intensive Care Unit has been known to be fast paced, stressful, and at times a loud atmosphere. Being a nurse in the ICU can be intimidating and being a patient can be frightening. Critically ill patients require close monitoring and supervision by the nursing staff. Many different aspects of care are crucial to the patients' recovery. Family members are an important part of a critically ill individual's recuperation. Different factors have an effect on the level of stress that a patient may experience while in the hospital. Critical Care Nurses were given a questionnaire to determine the beliefs and …

The Family Experience Of Participating In An Icu Support Group: A Pilot Study, Rebecca Marie Scharpe

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to describe the experience of family members participating in an intensive care unit support group. The family experience of an adult family member's critical illness is filled with emotional distress, suffering, and difficulty coping. Few family nursing interventions to care for family members of ICU patients have been researched. Research is inconsistent regarding the value of a support group in the ICU setting of a hospital. A qualitative design, using hermeneutic phenomenology was chosen. Five interviews were conducted with seven family members. The experience of participating in an ICU support groups was analyzed within …

Program...Validate...Infuse: Developing An Iv Infusion Validation Tool, Nancy Humes Bsn, Rn, Nicole Zimmerman Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

The Relationship Between Staff Nurse Perception Of Nurse Manager Leadership Behavior And Staff Nurse Job Satisfaction In A Hospital Applying For Magnet Recognition Status, Lorraine B. Bormann

Nursing Faculty Publications

Hospitals are challenged to understand factors related to staff nurse retention in the context of the nursing shortage slowdown (Huselid, 1995; Mancino, 2008; Mancino, 2009). Leadership is a major factor in organizational success (Gandossy & Guarnieri, 2008; Gettler, 2003; Wooten & Crane, 2003) and nurse managers are the direct link between the executive nurse leaders and the registered nurses (RN) in the staff position (Taunton, Boyle, Woods, Hansen, & Bott, 1997).

Studies show that nurse manager leader behaviors influence staff nurse job satisfaction (Blegen, 1993; Irvine & Evans, 1995; Lashinger & Finegan, 2005). A primary role of the nurse leader …

Code Simulations And Death: Processing Of Emotional Distress, Jane D. Leavy, Calvin J. Vanderhoff, Patricia K. Ravert

Faculty Publications

It is important for nursing students to be exposed to critical patient care scenarios because high stress clinical situations, such as patient codes, occur unexpectedly and infrequently in the clinical setting. In addition, it is important for nursing students to be exposed to the reality of patient death in order to help them overcome fears associated with death and to develop effective coping strategies. Students may or may not have an opportunity to deal with patient codes or patient death in the clinical setting, therefore simulation labs provide students with the opportunity to practice important clinical skills and discuss emotions …

System-Wide Deployment Of Color Coded Pediatric Resuscitation Carts Supported By In Situ Simulation, Deborah Arnold Msn, Rn, Cmsrn, Jayne Febbraro Msn Rn Crnp, William Bond Md, Ms, Michele Dunstan, Margaret J. Chorazak, Melissa B. Walsh Bs, K Walker, T Dietz

Department of Education

No abstract provided.

Knowledge And Practice Gaps Among Pediatric Nurses At A Tertiary Care Hospital Karachi Pakistan, Rozina Roshan Essani, Tazeen S. Ali

School of Nursing & Midwifery

The advancement in medical science has created health care environments that require nursing professionals who posses specialized clinical knowledge and skills to provide care and deal with critically and acutely ill children. This study explored gaps between knowledge and practice as perceived by the registered nurses of pediatric units by further recommending the changes suggested by them. A descriptive exploratory Study Design under the quantitative research methodology was utilized using universal sampling of all pediatric nurses working at a tertiary care hospital in Karachi, Pakistan. The gaps between knowledge and practice, as perceived by the participants, were categorized into five …

Protocol Adherence During Inter-Facility Transfer Of Acute Ischemic Stroke Patients Treated With Iv Rtpa, Robin Reed Jones

Nursing Theses and Capstone Projects

Stroke is a common and serious health disorder, affecting approximately 795,000 people in the United States every year. Intravenous recombinant tissue plasminogen activator (IV rtPA) is the only FDA approved thrombolytic for treating acute ischemic stroke within 3 hours of symptom onset. Patients treated at rural health centers are often transported within hours to the closest primary stroke center. The purpose of this study was to evaluate the structure, process and outcomes related to the inter-facility transport of ischemic stroke patients treated with intravenous rtPA. The Quality-Caring Model© was the guiding framework.

A quantitative, retrospective, non-experimental analysis of inter-facility transport …

Diabetes Understanding Among Staff Nurses: Examining The Actual Versus Perceived Knowledge In The Acute Care Setting, Rebecca B. Ledbetter

Nursing Theses and Capstone Projects

Diabetes is the fourth leading cause of death world-wide claiming a staggering 3.8 million lives globally each year to related complications (World Health Organization, 2011). Diabetes complications account for 20% of all acute care admissions or 1 in every 5 patients have a diabetes-related condition (American Diabetes Association, 2011). Patient education in the areas of lifestyle modification, healthy eating habits, and proper medication administration is research-supported to clinically decrease the likelihood of acute complications. Bedside, acute care nurses are at the front line of patient education delivery and have the opportunity to determine behavioral stages related to a patient's readiness …

Monitoring Congestive Heart Failure Across The Healthcare Continuum, Katrina E. Walker

Nursing Theses and Capstone Projects

Congestive heart failure is a chronic condition where the heart no longer pumps adequate blood and oxygen to bodily organs. CHF is a chronic condition that affects millions of people on a yearly basis. Common diseases that cause CHF are coronary artery disease, high blood pressure, and diabetes. CHF patients face many compilations that affect their daily activities. Along with morbidity CHF has major financial implications because much of the cost associated with CHF healthcare is avoidable. The purpose of this study is to evaluate the effects of monitoring congestive heart failure across the healthcare continuum with application to the …

Effects Of Early Initiation Of Induced Therapeutic Hypothermia, Frank Castelblanco

Nursing Theses and Capstone Projects

Cardiac arrests are responsible for about 325,000 deaths annually in the United States (Heart Rhythm Foundation, 2010). The majority of these cardiac arrests occur outside the hospital setting, with a dismal national survival rate of 8% (American Heart Association, 2010). The Bernard (2002) and HACA (2002) studies demonstrated that by initiating therapeutic hypothermia as a treatment modality for cardiac arrests the survival rate could be as high as 49% and 55% respectively. Therapeutic hypothermia can be initiated in many different settings. The question remains, does the setting of the initiation of therapeutic hypothermia effect patient outcomes? The purpose of this …

Preparing The New Graduate Nurse Entering Critical Or Progressive Care Practice Areas: What Is The Effect Of Blended Orientation Approaches On Their Level Of Self-Confidence And Satisfaction With Current Orientation Methods?, Jennifer L. Forbes

Nursing Theses and Capstone Projects

The transition from student nurse to professional nurse is often difficult for the new graduate especially if transitioning into critical or progressive care areas of practice. It is imperative for new graduates to receive a clinical orientation that meets their educational and transitional needs. The orientation process should provide them with a strong foundation in critical or progressive care practices. Educators are challenged to provide educational opportunities while accommodating diverse learning needs and continuing to maintain competency that ensures the highest quality of patient care and improved patient care outcomes.

New graduate nurses hired into the critical or progressive care …

The Nurse's Knowledge Of Blood Conservation As A Part Of Blood Management, Lindsey Putnam Austin

Nursing Theses and Capstone Projects

Medicine has historically regarded blood transfusion as an integral component of major surgery or illness. However, clinical studies have shown that allogeneic blood transfusions are associated with increased morbidity and decreased survival. Knowledge of this research and the concepts of blood conservation so as to avoid unnecessary blood transfusions is needed in order to deliver holistic care and serve as patient advocate. This knowledge reaches every specialty of nursing care.

This study of the nurse's knowledge of blood conservation as a part of blood management utilizes The Conservation Model developed by Myra E. Levine in 1973. Levine's work is a …

The Effect Of Emergency Department Length Of Stay On Clinical Outcomes For Critically Ill Or Injured Patients, Sheila Radcliff

Nursing Theses and Capstone Projects

The purpose of the study was to identify the effects of the emergency department length of stay on clinical outcomes for critically ill or injured patients in the regional referral community hospital. Delays in transfer have been associated with increased mortality rates, prolonged length of stays, and poor outcomes. Emergency departments are designed to respond to immediate life or limb threatening emergencies.

A quantitative, descriptive, retrospective design was used in this study. Data was collected from APACHE II, trauma databases, and ED logs. The study was conducted in a 752 bed hospital in the western North Carolina. Data was analyzed …

Teamstepps Communication And In Situ Simulation Training To Improve Individual And Team Performance During Handoff Of The Immediate Post-Operative Cardiovascular Surgical Patient, Stacy Lynn Jepsen

All Graduate Theses, Dissertations, and Other Capstone Projects

The aim of this pilot study was to identify if establishing a reliable framework for consistent use of TeamSTEPPS communication would improve the team communication and performance during the critical handoff of the cardiac surgical patient from the OR team to the ICU team. Breakdown in handoff communication has been attributed as the cause of adverse health events, delays in treatment, inappropriate treatment, increased length of stay, and increased costs and inefficiencies from rework. Standardizing handoff communication is a Joint Commission National Patient Safety Goal, and immediate postoperative cardiac surgical patients are a high-risk population needing consistently high quality communication …

Empathy Of Nurses And Family Needs In The Intensive Care Unit, Jolene Marie Tietz

All Graduate Theses, Dissertations, and Other Capstone Projects

Introduction: Patients and patients' families are in crisis when the patient is in the Intensive Care Unit. There have been studies demonstrating the importance of recognizing patient and family needs, and meeting those needs. This study explored what needs families rank as important and if the nurse met their needs, and what effect nurse empathy had on meeting family needs. Methods: Families in the Intensive Care Unit were given questionnaires to complete that addressed which needs they felt were important, if their needs were met, and the level of empathy they gauged their nurse to have. The tools utilized in …

Critical Illness Myopathy, Salima Moez Meherali, Yasmin Parpio, Tazeen Ali

School of Nursing & Midwifery

Critical illness myopathy (CIM) is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit (ICU). This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive …