During clinical shift at Baptist Health Paducah Hospital on the CCU floor the question asked was, what needs to be researched? After watching the charge nurse help patients all day I asked her what she thought needed to be researched. After thinking for a while she went on to tell me about how they are getting hit pretty hard on infections so there is no need for more research on that. After that she went on to tell me that their fall prevention protocol was lacking pretty badly. They do a fall risk assessment and based on the number decide what their chances of a fall is. They then give them fall risk bracelets and bed alarms. She said the bed alarms they have a pretty outdated and don’t work half the time they are used. There had to be newer research on better fall prevention. There protocol is lacking something that keeps the patients from not getting hurt. T It seems like it is just there for the nurse so they know that the patient is at risk for falling. This doesn’t help prevent a fall for the patient. Plus some nurses can’t get to the alarm right away so by the time they go to check the alarm it is too late. After doing some research a few articles about patient teaching and involving the patient in fall prevention popped up. The problem with the current policy is that it is lacking new evidence based practice.

ABSTRACT

Purpose: The purpose of this project was to research the most effective ways to facilitate improvement in timely communication of vital signs.

Background: The rate of healthcare assistant (HCA) or nurse’s aide turnover is a wide-spread issue causing nursing staff to have to compensate while new HCAs attain the experience to function efficiently on the floor (Weiner et al. as cited in Howe, 2014). HCAs are frequently the personnel who gather vital signs which nurses use to assess the status of patients. In order for nurses to make accurate assessments of patients, vital signs must be accurately recorded and on-time, and if a vital sign is critical HCAs must be able to interpret the need to notify the nurse immediately. Currently, research does not support that new HCAs have the training to do these things (Mok, Wang, & Liaw, 2015).

Methods: A search was made among Ebsco, Google Scholar, Medline, Pubmed, and CinHal for the most recent research and studies on education in nursing aides and vital signs reporting.

Results: Post conferences and scenario training as well as virtual and mannequin based simulation were effective in improving HCA education and reporting issues to nurses

Conclusions: Improvements can be made to HCA vital signs reporting and efficiency by incorporating scenario and simulation

This presentation will educate viewers on the proper use of a nasogastric tube as well as recommendations for future technology.

Non-opioid chronic pain management treatments were researched. Specifically, exercise, cognitive behavioral therapy, and non-steroidal anti-inflammatory drugs showed little to no efficacy in relieving complicated chronic pain. However, when a biopsychosocial approach was used, better pain management and coping was reported. This approach addresses multiple aspects of patient needs, consistent with Nursing Theorist Betty Neuman’s System Model which was used to guide research. Therefore, a biopsychosocial approach to chronic unrelieved pain management is recommended.

The objective of evidence based practices is to ensure that patients receive the best medical attention to promote optimal health and wellness. Despite this aim, consistent implementation of evidence based practices can be challenging, especially as it relates to the routine disinfection of noninvasive portable clinical devices. The overall purposes of this project is to increase compliance with the disinfection policy and reduce potential cross-contamination from pathogenic microbes between patients and noninvasive portable clinical items.

For this research paper the question posed was “Is there a hospital procedure that needs to be updated?" To answer that question data was collected from numerous nursing journals and the Center for Disease Control and Prevention to analyze the need for better hygiene of the equipment that comes into contact with the patient. Some of the items that were discussed in the research include: stethoscopes, blood pressure cuffs, thermometers, keyboards, phones, bedside tables, electrocardiogram (ECG) wires, and lab coats. From the evidence based practice research articles, it was evident that more focus needs to be placed on the daily cleaning and disinfection of equipment that receives frequent use to assess patients. It was evident after being in the facility on two separate occasions that a need for further education and reinforcement on proper disinfectant practices was needed. Some related interventions that should be included are reinforcement of proper cleaning techniques of patient care equipment on shift by shift basis, not just when the patient is being discharged or transferred. Another intervention that should be addressed is how to use correct cleaning and disinfecting products based on the patient’s needs, diagnosis, and the contamination level of the equipment. Another important factor is to consider the type of material that makes up the equipment when selecting a disinfectant solution. With all of these aspects in mind and also the concept to make cleaning of patient care equipment more routine in daily patient care is a critical topic that needs to be addressed, policies changed, and interventions implemented.

My poster presentation is a research analysis of whether to rotate the peripheral IV site every 72-96 hours or when clinically indicated. The research supported rotating the site only when clinically indicated because the risk for complications generally occur within the first 24 hours of having an IV. More research needs to be conducted to prove this produces the best patient outcomes but it currently supports clinically indicated.

Abstract:

Throughout this project, the emphasis and research was centered on the importance of vital sign monitoring of patients. The importance of vital signs is emphasized due to the pivotal role played in indicating patient clinical status, and the wide range of information vital signs provide for clinical professionals. Research aspects that were addressed when looking into the protocol for post-operative vital sign monitoring were: a specific timing schedule, whose responsibility this is, and a possible way to implement timeliness in carrying this task out. The consequences of infrequent and inadequate vital signs were also a concern when looking at the vital sign protocol.

Clinical alarm monitoring technology is used widely throughout healthcare institutions. They are intended to alert health care providers of potential clinically significant events that require intervention with the patient. Clinical alarm systems are designed for high sensitivity, which can lead to frequent false and nonactionable alarms. The intermittent noise and resulting mechanical hum in the hospital auditory environment leads to staff desensitization, or “alarm fatigue,” and causes the staff to miss, ignore, and even disable the alarm signals. If clinical alarms are not properly managed, they can compromise patient safety. It is important for health care institutions to develop a systematic and coordinated approach to clinical alarm system management. Effective implementation of a clinical alarm safety policy within the institution can shorten the length in hospital stay, improve the health outcomes of patients, and lead to measurable quality improvement in patient care.

Purpose: The purpose of this project was to research different methods for decreasing catheter-associated urinary tract infections in hospitalized patients.

Background: Catheter-associated urinary tract infections (CAUTIs) are very common in the hospital setting. These infections are very costly to the hospital and compromise patient safety by increasing rates of morbidity and mortality. In order for CAUTI rates to decrease, nurses and physicians must become more aware of the presence of catheters in patients.

Method: A search was conducted using CINAHL, Medline, and Google Scholar for current research studies regarding the reduction of catheter-associated urinary tract infections.

Results: The implementation of reminder systems, both physical and virtual, significantly reduced the number of catheter-associated urinary tract infections in hospitalized patients.

Conclusions: Rates of catheter-associated urinary tract infections can be decreased by executing paper and computer-based reminder systems to help alert nurses and physicians of the presence of catheters in their patients.

Purpose: The purpose of this evidence-based project was to discover an effective way to decrease central-line associated bloodstream infections in patients within a hospital setting.

Background: Central-line associated bloodstream infections (CLABSI) are primary bloodstream infections in patients that had a central line in place within 48 hours before the development of the infection. CLABSI are associated with significant morbidity and mortality and effective methods for their prevention are needed.

Method: A search was conducted using CINAHL, Google Scholar, and Ovid Nursing Database for current research experiments and meta-analysis regarding the reduction of central-line infections.

Results: The use of Chlorhexidine-impregnated Dressings significantly reduced CLABSI rates. With chlorhexidine-impregnated dressings, there is a significant benefit for prevention of catheter colonization, the adverse effects were also rare and minor.

Conclusions: Research has proven chlorhexidine-impregnated dressings to lead prevention measures in the reduction on central line infections. Central-line hospital policies could be enhanced by adding the 3M Tegaderm CHG dressing to clinical practice. Hospitals also benefit from these special dressings by saving money from the cost of buying the dressings and the care it would take to treat a patient with an infection caused by a central line.

This evidence-based practice research compares the outcomes of sequential compression devices and graduated compression stockings on the prevention of blood-clot related complications in the hospital.

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Minimizing movement in the cervical spine of an immobilized patient remains a big factor in the comfort and outcome of patients with spinal injuries. The log roll technique and the lift and slide technique are two common methods of moving immobilized patient, but the questions arises, which is better? In comparing the two methods, studies were done that tested both the lift and slide and log roll techniques. Research shows the lift and slide method provides the most stability with the least head motion.

When looking for a job, nurses have the opportunity to work 8 or 12 hour shifts. In todays generation 12 hour shifts are becoming more of a trend with job openings, and 8 hour shifts are becoming a thing of the past. After reviewing many evidence based research articles, the 8 hour shifts we once had, should no longer be put on the back burner. Research is stating that in those last 4 hours of a 12-hour work day, more errors are occurring, and patient safety is becoming a concern.