Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Pulmonary Embolism Response Team In Acute Care Settings: A Scoping Review Of The Evidence, Tia Glover Bsn, Rn, Leslie Asplund Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Pulmonary embolism (PE) is a critical cardiovascular emergency associated with high morbidity and mortality. Despite its prevalence, traditional PE management often lacks cohesion, leading to suboptimal outcomes. Pulmonary Embolism Response Teams (PERTs) offer a multidisciplinary approach aimed at improving patient outcomes by streamlining diagnosis, facilitating timely interventions, and promoting evidence-based treatment. This scoping review evaluates the evidence supporting PERT efficacy across various clinical and resource-related outcomes with the aim to decrease mortality rates, shorten inpatient length of stay, improve cost efficacy, and minimize adverse events from treatment modalities.

Methods

A comprehensive literature search was conducted using PRISMA guidelines across …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Improving Communication And Job Satisfaction: Utilizing Team Strategies And Tools To Enhance Performance And Patient Safety (Teamstepps) For Interventional Service Areas, Sukhbinder Kaur Sangha

Doctoral Projects

Purpose: Improved communication and job satisfaction among staff are essential for those working in high-stress critical care environments like the cardiac catheterization laboratory (Cath Lab). The purpose of this investigation was to utilize the quality improvement initiative Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve attitudes and job satisfaction in the Cath Lab. Method: A total of 30 subjects participated in a TeamSTEPPS educational intervention. After obtaining informed consent, a demographic survey, a pre- and post-test TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Job Satisfaction Survey (JSS) were administered. The post-test included open-ended questions for feedback …

A New Approach: Evaluating The Effectiveness Of Artificial Intelligence Developments For Trauma Triage In The Emergency Department, William C. Anoka

2025 Spring Honors Capstone Projects - Archive

Triage in emergent situations occurs when patients are assigned to areas of the hospital with different levels of care according to the perceived risks determined by their signs and symptoms. The variability of current triage protocols substantially increases the proportion of lower acuity patients who die unexpectedly due to improper risk stratification. However, recent artificial intelligence (AI) developments have been applied to trauma triage situations to improve accuracy and patient outcomes. To further evaluate the effectiveness of this new tool, this study used various AI models to assess the presenting assessments of multiple situations and determine the appropriate level of …

Stress And Burnout Among Icu Nurses, Jaspreet Kaur

2025 Spring Honors Capstone Projects - Archive

Burnout is a significant occupational hazard for Intensive Care Unit (ICU) nurses. High patient acuity, staffing shortages, and long shift hours increase stress and diminish well-being among nurses, affecting patient care outcomes. This study examined the prevalence of stress and burnout among ICU nurses to identify contributing factors and potential interventions. An anonymous online survey was conducted among 110 ICU nurses, utilizing the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale(PSS). Findings revealed that 42.5% of nurses reported high emotional exhaustion, while 37.5% felt they had little to no control at work. The most frequently cited workplace stressors were …

Identification Of Subarachnoid Hemorrhage: The Impact Of A Nurse Led Screening Tool Utilizing The Ottawa Rule, Chandra Brower, Shannon Krumvieda, Shalana Bolton

Nursing Posters

The ETC lacked a formal tirage process for identification of Subarachnoid Hemorrhage (SAH), which can lead to delayed treatment and suboptimal patient outcomes. Data showed SAH patients who presented to the Emergency Trauma Center (ETC) with headache (HA) and hypertension frequently had long wait times before evaluation by a provider.

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Reducing Hapis In The Icu With A Turn Team, Taylor Guadiz

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose: The purpose of this quality improvement (QI) project was to decrease hospital-acquired pressure injury (HAPI) rates within an Intensive Care Unit (ICU) by implementing a two-nurse turning and repositioning schedule.

Background: The QI project was implemented in a 24-bed Medical-Surgical ICU at a for-profit community hospital in Northwest Houston, Texas, in the United States of America. The project was developed and initiated at the project site because there was an increase in the HAPI rate above the organization’s target rate of zero.

Methodology: Baseline HAPI rates and turning charting compliance were obtained. A baseline Likert scale survey was …

Central-Line Dressing Protocols: The Effectiveness Of A Standardized Dressing Change Protocol In Reducing Central-Line Associated Bloodstream Infections (Clabsi) In Critically Ill Patients Requiring Central Lines, Cody Jones, Melissa Marino, Ryan Mcfarland, Asia White, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

In the Intensive Care Units (ICU), central lines are an essential way of life. However, central lines have risks such as central line-associated bloodstream infections (CLABSI), which increase hospital stays and mortality. CLABSI significantly impacts patient outcomes in critical care, increases mortality and morbidity, increases medical costs, increases hospital-acquired infections, and reduces hospital reimbursements. Typically, antimicrobial dressing has been associated with decreased mortality and improved CLABSI rates. The scoping review will evaluate the literature and examine the effectiveness of various antimicrobial dressing strategies on CLABSI rates. This study aims to synthesize these findings to develop improved CLABSI prevention protocols …

Improving Nursing Processes To Reduce Hospital-Acquired Venous Thromboembolism In Adult Surgical Patients, Stephanie Masson

Doctor of Nursing Practice Final Project Abstract

INTRODUCTION Hospital-acquired venous thromboembolism (VTE) is a preventable outcome that can increase morbidity and mortality. This quality improvement (QI) project aimed to evaluate and improve the nursing prophylaxis processes to reduce the VTE outcome. The project was implemented in a Level I Trauma Center in the Texas Medical Center, Houston, Texas.

METHODOLOGY The QI project was structured using the Lean Six Sigma methodology. Data was collected and analyzed from reports built within the electronic medical record (EMR). A multidisciplinary team evaluated the current state of clinical practice and the electronic workflow for mechanical VTE prophylaxis. The team worked to redesign …

Facilitating The Use Of Sbar By Nursing Staff For Handoff Communication, Amarillis L. Tompkins

Student Scholarly Projects

Practice Problem: Clear communication during shift handoffs is crucial to minimize errors and ensure patient safety in intensive care. The current SBAR framework used in the MICU is constrained by limited documentation space, which led to communication inefficiencies and heightened risks for patient care.

PICOT: The PICOT question that guided this project was: In the NFSG VA MICU, will staff nurses (P) using a revised SBAR communication tool with a checklist (I), compared to the current outdated SBAR tool without a checklist (C), improve the accuracy and completeness of patient handoff communication (O) over eight weeks (T)?

Evidence: The project …

The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy

Theses and Graduate Projects

BACKGROUND: In 2020 a pandemic created dangerous workloads leading to many nurses quitting their careers due to chronic stress. This project will create the green room, which is the name of this recharge room, where staff can go to experience a moment of peace to decrease their stress levels. This room had a spa aesthetic with comfortable seating and green plants. METHODS: This quality improvement project follows the plan-do-study-act model. When participants arrived, they filled out a questionnaire before using the room. They were then shown all the things they could do to utilize the room. After they were done …

Improving End-Of-Life Care In The Medical Intensive Care Setting Of A Midwest Hospital Through Nursing Practice Analysis And Education, Hannah Myers

Doctor of Nursing Practice Scholarly Project

The acuity of patients within the intensive care setting compounded by comorbidities and illness complications can lead to death in a large percentage of ICU admits annually. Increased mortality rates translate into end-of-life care being a prominent part of the critical care scope. Using a mixed methods approach the project looks to examine barriers, supportive measures, interdisciplinary communication, procedures, and leadership styles that determine quality end-of-life care. A comprehensive literature review revealed a number of barriers reported by nurses including a lack of interdisciplinary communication, disagreements on care plans, and a lack of communication with patients and their families about …

The Sound Of Survival: The Effect Of Personalized Music Selection On Cpr Performance And Anxiety Levels, Carmin A. Dotario

Nursing | Student Research Posters

No abstract provided.

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Preeclampsia: Implementation Of The American College Of Obstetricians And Gynecologists Standardized Protocol, Sheila Harwell

Electronic Theses and Dissertations

Preeclampsia is a significant medical condition that affects the perinatal population, posing risks to both the mother and fetus. Complications associated with preeclampsia include stroke, seizure, placental abruption (premature separation of the placenta from the uterus), fetal growth restriction (impaired growth due to reduced blood flow through the placenta), premature birth, and low-birth-weight infants with associated developmental issues. Because there is no cure for preeclampsia, the current management involves the timely administration of intravenous antihypertensives to reduce the risk of stroke and seizure. The gap in practice identified was the obstetrical department’s lacking a standardized protocol, compared to adopting the …