Critical Care Nursing Commons^™

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 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 …

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 …

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

Continuous Renal Replacement Therapy Training In The Icu: An Evidence-Based Practice Proposal, Joseph C. Brabec

SACAD: Scholarly Activities

Continuous renal replacement therapy (CRRT) is a complex, high-risk intervention used in intensive care units (ICUs) for critically ill patients with acute kidney injury and hemodynamic instability. ICU nurses are responsible for initiating, monitoring, troubleshooting, and discontinuing CRRT while providing continuous bedside care (Richardson & Whatmore, 2015). However, variability in training frequency and competency validation remains a significant gap, potentially contributing to errors and adverse patient outcomes. Guided by the Iowa Model of Evidence-Based Practice, a literature review was conducted to identify best practices for CRRT training. A proposed evidence-based practice (EBP) project was developed to implement a standardized CRRT …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Evaluation Of Hyponatremia Management Pathway, Mahmoud Ammar Pharmd, Jonathan M. Siner, Mary Judson, Christopher Winterbottom

Abstracts

Society of Critical Care Medicine's (SCCM) 2025 Critical Care Congress:

Evaluation of Hyponatremia Management Pathway Implementation in a Large Academic Health System

Submission Number: 1894079

Patients with severe hyponatremia managed using the Care Signature pathway were more likely to receive hypertonic saline and had lower mortality rates compared to those not managed with the pathway. These results suggest that the pathway can improve clinical outcomes and reduce resource use. Further studies are needed to evaluate its impact on other patients’ outcomes and long-term effectiveness.

Implementation Of A Cascade Training Model To Enhance Emergency Care Capacity Of Healthcare Workers During The Covid-19 Outbreak In Uganda, Sulaiman Bugosera Wasukira, Carl Trevor Kambugu, Judith S. Nanyondo, Emmanuel Candia, Stephen Emmanuel Aporu, Cliff Asher Aliga

School of Nursing & Midwifery, East Africa

Introduction

Methods

Reducing Alarm Fatigue, Christina Smith

2025

Alarm fatigue refers to the phenomenon of excessive alarms in the healthcare system leading to staff ignoring or not hearing alarms that need clinical intervention (Bosma & Christopher, 2023). Healthcare staff experiencing alarm fatigue and desensitization leads to patient harm events up to and including death (Dee et al., 2022). Several interventions have proven effective to reduce non-actionable alarms or alarms that do not require action by the clinician. Combining these evidence based interventions into a bundle of nurse led interventions provides increased effectiveness in reducing alarm fatigue. This evidence-based practice (EBP) project aimed to evaluate the effectiveness of bundle …

Perception Of Spirituality By Intensive Care Unit Nurses, Adejoke Felicia Ogidan

Nursing Dissertations - Archive

ICU nurses are identified as a population of nurses with a high risk of experiencing psychological stress due to the nature of their job in the ICU (Lyndon, 2015; Welp et al., 2015). Psychological stress is detrimental to nurses' mental health and the quality of patient care.

According to Watson’s Transpersonal Human Caring Theory, the spiritual perception of the nurse influences the nurse’s spiritual care practice, which in turn affects their self-care and care provided by the nurse to patients (Watson, 2021)This research explored the ICU-Ns' perception of spirituality and its relationships with spiritual care practices and self-assessed competency in …

Improving Pediatric Delirium Assessment Documentation And Nursing Knowledge In A Pediatric Cardiovascular Intensive Care Unit, Heather E. Herrera

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Pediatric delirium is prevalent in the Pediatric Cardiovascular Intensive Care Unit (PCICU). It is associated with longer PCICU stays, extended hospital stays, prolonged duration of mechanical ventilation, and higher hospital costs (Mallick et al., 2022). It has also been associated with increased mortality risk and decreased quality of life after hospital discharge (Rohlik et al., 2021). Due to the adverse sequelae associated with pediatric delirium, routine screening with a validated screening tool is recommended (Flagg & Mauney, 2023). Despite consensus guidelines advocating routine screening for pediatric delirium, routine screening is not being completed (Flagg & Mauney, 2023).

The Effect Of Length Of Nursing Shift On The Development Of Medical Errors, Andrew J. Hom

Nursing | Senior Theses

The relationship between extended nurse work hours and increased clinical errors is a growing concern in nursing and healthcare systems. This issue has only grown more pronounced since the pandemic, which exacerbated staffing shortages and placed unprecedented demands on the nursing workforce. Longer shifts often lead to fatigue, impaired decision-making, and decreased cognitive performance, creating challenges for both nurses and patients. To better frame the analysis, this thesis relied on The Swiss Cheese Model to better conceptualize risk management. This thesis examined the correlation between consecutive hours worked and the frequency of errors made by nurses while also exploring the …

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

Exploring The Barriers To The Implementation Of Acute Care Nurse Practitioner Roles, Madeline Wd Mcnulty

2025 Fall Honors Capstones Projects - Archive

Acute care nurse practitioners (ACNPs) are associated with improved patient outcomes and are among the fastest-growing professions in healthcare. However, this growth is accompanied by barriers to the ACNP role. Despite this expansion, limited research has examined these barriers or identified strategies to reduce them in acute care settings. Therefore, this study aimed to identify the obstacles to ACNP practice and to describe approaches to overcoming them. A qualitative descriptive design was employed. Twenty-one pioneering ACNPs participated in semi-structured interviews. Data were analyzed using the “Sort and Sift, Think and Shift” method. We identified nine themes in the study: four …

Reframing Recovery: Comparing Music Interventions And Traditional Rehabilitation Methods For Cognitive Function In Traumatic Brain Injury Patients, Laura Velez

Honors Undergraduate Theses

Traumatic brain injury (TBI) affects millions annually, often resulting in long-term cognitive deficits that hinder independence and quality of life. While traditional rehabilitation methods address many physical and functional limitations, cognitive impairments—such as deficits in attention, memory, and executive function—often persist. Emerging evidence highlights music-based interventions as a promising complement to standard therapies, yet comparative research remains limited. This integrative literature review examined the effects of music interventions versus traditional rehabilitation methods on cognitive function in adults with TBI. Using a systematic search of databases including MEDLINE, CINAHL Ultimate, APA PsycInfo, and Music Index, eight peer-reviewed studies were selected for …

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Impact Of Nurse-Led Environmental Controls On Insomnia In Elderly Acute Care Inpatients, Tyler G. Van Note, Lindsay V. Garay, Ava R. Eisenhart

SPARK Symposium Presentations

The Impact of Nurse-Led Environmental Controls on Insomnia in Elderly Acute Care Inpatients

Research Question: Does teaching nurses to control the patient environment (I) in acute care in-patients aged 65+ (P) reduce insomnia compared to current practice (Q1H rounding) (C) from 67.4% to less than 30% as measured by the Insomnia Severity Index (ISI) (O)?

Background and Significance: 67.4% of hospitalized patients report experiencing insomnia from sleep disturbances, which can significantly impact their recovery and overall health outcomes. Nurses can address these disruptions by monitoring noise, light exposure, and staff interruptions.

Sample methods: The literature review search keywords were sleep …

Prepared To Protect: Improving Cardiac Emergency Response Through Education And Action Planning In Youth Club Sports, Melissa Garcia

Nursing | Senior Theses

Sudden cardiac arrest (SCA) is the leading cause of death in youth sports, illuminating the essential demand for adequate emergency response, including cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) usage, and comprehensive emergency action plans (EAPs). Research shows that despite the importance of prompt intervention, the majority of youth club sports programs outside of the school setting lack the training and resources needed to respond effectively to SCA incidents. This study will evaluate the effectiveness of an educational seminar that includes CPR/AED training and EAP simulation exercises in improving participants’ knowledge, skills, and confidence in managing cardiac emergencies. A quasi-experimental …