Critical Care Nursing Commons^™

Impact Of Spontaneous Breathing Trials On Reducing Ventilator-Associated Pneumonia In Adult Intubated Patients: A Scoping Review, Jireh R. Johnson Bsn, Rn, Hamzha Aysheh Bsn, Rn, Keianna Luckett Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background For ventilated patients in the intensive care unit, ventilator-associated pneumonia (VAP) is a major source of morbidity. It is difficult to diagnose due to many of the diagnostic criteria being subjective, its clinical signs that are broad, and its association with various respiratory disorders. Hospitals have developed varying ventilator bundles in expectation to prevent the incidence of Ventilator-associate pneumonia. We performed scoping review to determine the impact of spontaneous breathing trials (SBT) on reducing VAP.

Methods From August to November of 2021, using the MEDLINE, ScienceDirect, and Scopus databases and MeSH search terms, we identified over 20,000 articles containing …

Animal-Assisted Therapy In The Intensive Care Unit, Amanda M. Pugh

Student Scholar Showcase

This paper will explore animal-assisted therapy used in intensive care units. Patients in the intensive care unit (ICU) are at risk for developing an array of complications called post-intensive care syndrome, which can negatively affect patients’ psychological, motor, and cognitive abilities. While the widespread use of animal-assisted therapy in the ICU is still in need of improvement, studies have shown animal-assisted therapy can improve depression and anxiety, increase motor function, and strengthen patient participation in treatment. This is significant because the benefits of animal-assisted therapy can counteract the symptoms related to post-intensive care syndrome. The studies will be analyzed, and …

Communication Is Key, Stephanie Munsch, Bailey Ellingsworth

Scholars Week

Abstract

This paper is an evidence based look at the efficacy of ventilation communication in the intensive care unit (ICU) and the resources that we found to be useful in expanding said communication. This topic has become more prevalent today due to COVID-19 and the rising numbers of ICU admissions and ventilator use. We looked at various studies that found that patients on ventilators who lacked good communication with their nurses had negative mental and physical effects. Examples of this include increased rates of anxiety, depression, and post traumatic stress disorder among ICU survivors. The evidence also found that effective …

Decreasing Alarm Fatigue Through Alarm Management Training, Leah Davis, Brittany Fleming

Scholars Week

Alarm fatigue is a notable problem in the hospital setting. Alarm fatigue can decrease nurse response time and desensitize nurses to alarms. When this occurs, patient outcomes begin to be negatively affected. To combat this, we researched multiple articles on alarm fatigue and alarm management programs. These programs would be implemented and nurses would learn how to troubleshoot alarm equipment, how to recognize alarm fatigue, how to prevent alarm fatigue, and many more. Based on research articles, alarm management programs decrease alarm fatigue in nurses and the amount of alarms.

Too Loud: A Project For Sound Reduction In The Neonatal Intensive Care Unit, Peyton Cadwell, Amy Krazl

Scholars Week

Sound levels in any intensive care unit environment are significantly higher than the recommended volume. The neonatal intensive care unit (NICU) is included in this aggregate that frequently exceeds advised levels. There are consequences associated with increased sound, such as slower language development and behavior issues. Not only are babies subjected to physiological effects, but there is potential for psychological detriment as well, such as behavioral issues (Bremmer, 2003). Many solutions for this issue have been proposed, including lowering phone volumes, putting rubber shoes on furniture and switching audio alarms to visual alarms. One specific intervention that may reduce the …

Iv Infection Control, Coleman White, Hannah Oswalt

Scholars Week

Infection is one of the most discussed topics in the nursing world, and one topic that is commonly overlooked is IV tubing related to infection. The current rules on CCU/PCU include labeling the tubing, changing the tubing every 72 hours, and cleaning the site with an alcohol swab before injecting medications. While these rules in place are evidenced based, and work properly, there is more research that has been conducted stating better practice to control infection related to IV tubing. Through utilization of theoretical framework along with several quasi-experimental research, we have evaluated infection control effectiveness through “Scrub the Hub” …

How To Control Healthcare Associated Infection, Yeojin Son, Jungyoon Hur

Scholars Week

Healthcare-Associated Infections (HAI) are infections patients acquire while receiving care in hospital. The main reasons of occurring the infections are insufficient knowledge about infection control and decreased compliance with rules by hospital protocol. The purpose of this evidence-based presentation is to exemplify how to control HAI via motivating healthcare workers to comply with infection control policy.

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith

Senior Honors Theses

Anxiety before procedures can negatively impact patients by increasing cortisol levels which delays wound healing and increases infection risk, increasing pain and sedation medication needs, and increasing hospitalization time. This review was conducted to find how inhaled essential oils affect pre-procedural anxiety of adults in acute care settings. Nine databases and some gray literature were searched within the past ten years, and documented using the PRISMA flow chart. Ten articles fitting the inclusion criteria were retrieved. Nine of the articles found a significant difference between the aromatherapy group and control group and pre- and post- intervention anxiety scores, and none …

Perception Is Everything: Implementation Of A Peer Evaluation Program For Nurse Leaders In A Hospital Setting, Teruko Williams

Student Scholarly Projects

Practice Problem: A hospital in the Sacramento County area seeking the ANCC Pathway to Excellence Program^® designation determined upon performing a gap analysis that Element of Performance 2.8, a peer evaluation program, was absent, thus creating a deficiency in the fulfillment of the requirements for the designation.

PICOT: The PICOT question that guided this project was: In nurse leaders (P) how does the development of a formal peer evaluation process (I) compared to no formal process (C), influence the performance outcome score of self-efficacy (O) over 8 weeks (T)?

Evidence: The evidence demonstrated that if a …

Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

The Lived Experience Of Intensive Care Unit Nurses During The Covid-19 Pandemic, Jessica Rong

Graduate Student Research Symposium

Title: The Lived Experience of Intensive Care Unit Nurses During the COVID-19 Pandemic: A Mini-Phenomenology

Purpose: The purpose of this study is to understand the experiences of ICU nurses working at the bedside during the COVID-19 pandemic that provided care.

Research Questions: The research question for this study is, what was the lived experience of the ICU nurse working at the bedside during the COVID-19 pandemic.

Background: There is a gap in the literature regarding the experience of the ICU nurse providing care during the pandemic. Many nurses are leaving the bedside now and more must be understood about …

The Impact Of Early Goal Directed Sepsis Bundle Sets In The Emergency Department And The Impact Of Sep-1 Compliance Rates, Christie L. Ferrari

DNP Scholarly Projects

Sepsis is a medical emergency that is prevalent throughout hospitals everywhere. Due to the growing crisis, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Surviving Sepsis Campaign (SSC) adopted core measures for sepsis (SEP-1) which aim at improving overall compliance of evidence-based treatment standards for sepsis. The purpose of this Doctor of Nursing Practice (DNP) project was to determine if incorporating early goal directed sepsis bundles in a rural Midwestern ED was effective in increasing compliance with SEP-1 rates. The secondary purpose evaluated how nursing knowledge, awareness, and compliance with sepsis bundles affects SEP-1 compliance rates. …

Implementation Of An Evidence-Based Bundle To Reduce Hospital Acquired Pressure Injury Harm Rates In The Intensive Care Unit: A Quality Improvement Project, Jessica Tripp

DNP Scholarly Projects

A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based …

Patient, Surgical And Clinical Factors Associated With Longer Stay In The Post Anaesthesia Care Unit, Karen M. Briggs, Mari Botti Emeritus Professor, Nicole M. Phillips Professor, Steve Bowe A/Professor, Maryann Street Dr

Journal of Perioperative Nursing

Aim: To explore patient, surgical and clinical factors associated with readinessfor- discharge and total length of stay in the Post Anaesthesia Care Unit (PACU).

Background: Longer stay in the PACU decreases the flow of patients and is associated with increased risk of adverse events. The time to readiness-fordischarge reflects clinical parameters associated with patient flow in the PACU independent of system delays.

Methods: This retrospective cohort study included a randomly selected sample of 244 post-surgical patients admitted to a large private, Australian health service.

Results: The median and average times to readiness-for-discharge were 48 minutes and 56 minutes respectively with …

Pulmonary Post-Acute Sequelae Of Covid-19, Usman Akbar, Shivam Gulati, Johnny Zakhour Md, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Persistent symptoms have been observed in a substantial proportion of survivors of COVID-19 since relatively early in the pandemic. Among these post-acute sequelae of COVID-19 (PASC), respiratory symptoms appear to be the most prevalent.

Methods: We conducted a literature review of peer-reviewed publications in English on the clinical and epidemiological features of respiratory PASC in cohorts of 100 or more patients with a follow-up of four weeks or more after acute infection. Included studies reported the prevalence of persistent respiratory symptoms and/or the results of follow-up pulmonary function tests.

Results: On our review included 14 studies across eight countries …

Using Complex Medical Devices: Icu Nurses' Safety Perceptions, Violet Rhagnanan-Kramer

NSU REACH and IPE Day

Purpose: The purpose of this study was to gain insight into ICU nurses’ safety perceptions and explore continuing educational strategies for improving nurses’ technological competence. Background: Medical errors are the third leading cause of death in America. Over 10,000 medical errors occur daily, with an estimated financial impact of preventable mistakes is 20 billion dollars annually. Increasing the use of multifarious sophisticated medical technologies in the Intensive Care Unit (ICU) poses a risk of medical errors and unintentional harm to patients. However, limited empirical evidence exists regarding ICU nurses’ perspectives. Methods: This research featured an online mixed methods descriptive exploratory …

Exploring Palliative Care Education Needs And Desires Of Advanced Practice Providers In The Critical Care Setting, Jill Marie Clemmons

DNP Projects

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Countering Moral Distress In Ecmo Nurses With Case-Review Debriefings, Sherry D. Griggs

DNP Projects

Abstract

Background: Moral Distress occurs when nurses know the ethically correct action to take, but they are restrained from taking it. It is especially prevalent in nurses caring for critically ill patients, such as those on extra-corporeal membrane oxygenation (ECMO). Effectively addressing moral distress is crucial to the growth and health of the nursing profession, which is the cornerstone of quality and safety in healthcare.

Purpose: The purpose of this project was to evaluate the effectiveness of case-review debriefings on moral distress of ECMO nurses.

Conceptual Framework: Analysis of Moral Distress Process was utilized. This framework addresses moral distress …