1734 research outputs found
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Sticks and Stones May Break My Bones, But Words Can Hurt Me Too: Psychological Safety and Microaggressions
Get PDFTo foster a healthy work environment, address reports of microaggressions, and improve psychosocial safety within the SCH Telemetry teamhttps://digitalcommons.centracare.com/nursing_posters/1170/thumbnail.jp
Technology Decreases Treatment Decision Times
Get PDFPatients who experience a stroke while hospitalized have a higher mortality rate than those who present to the emergency department. Our plan is to utilize technology to allow the stroke provider to evaluate the patient while in their hospital room, instead of waiting until the patient is in the CT scanner. Utilizing technology of an iPad for inpatient code strokes will allow for quicker assessment of the patient, resulting in faster treatment decision for this population.https://digitalcommons.centracare.com/nursing_posters/1169/thumbnail.jp
Immunotherapy Serum Mixing: 2023 Best Practice Changes
Get PDFBackground Story:
CentraCare - Plaza Allergy & Asthma Clinic compounds immunotherapy serum with advanced training of licensed nurses. Effective November 1, 2023, USP (797) Pharmaceutical Compounding guidelines were updated and endorsed by the American Academy of Allergy, Asthma & Immunology (AAAI). The Allergy Clinic completed a gap analysis to determine what process needed to change to comply with these latest guidelines.https://digitalcommons.centracare.com/nursing_posters/1171/thumbnail.jp
You\u27ve Got to Move It, Move It!
Get PDFAn increase in reportable hospital acquired pressure injuries (stage 3, 4, or unstageable) was found to be associated with patients refusing to participate in the prevention plan of care.https://digitalcommons.centracare.com/nursing_posters/1175/thumbnail.jp
Barriers to Implementation of Practice Guidelines against Fluid Restriction in Heart Failure
Get PDFThe overall goal was to support best practice around fluid restriction in care of the patient with heart failure.https://digitalcommons.centracare.com/nursing_posters/1174/thumbnail.jp
EYE CODE Protocol
Get PDFPurpose of EYE CODE: Retinal artery occlusion (RAO) is a rare but detrimental adverse effect of cosmetic facial filler injections. Requires prompt treatment and reversal to avoid patient blindness. EYE CODE is a new protocol in place to avoid this complication. Assist staff during a high stress event. •Improve patient safety & staff confidence. Way to receive continuing education credits through the clinic.https://digitalcommons.centracare.com/nursing_posters/1166/thumbnail.jp
Professional Development in Practice: Enhancing the NPD Role
Get PDFInquiry:
The problem this project is addressing is a lack of knowledge related to NPD scope and standards in the organization. The education department is largely decentralized, with staff reporting to various leaders outside of NPD department. Some areas within the organization lack support and continuing education specific to NPD.https://digitalcommons.centracare.com/nursing_posters/1177/thumbnail.jp
Transitions to Normal Saline ONLY for CVADs
Get PDFPurpose Statement:
The purpose of this project is to implement a practice change throughout the system to remove heparin flushes for Central Venous Access Devices (CVADS) pending a successful pilot on Medical Oncology.
Synthesis of Evidence: Shama et al (2019) conducted a systematic review and meta-analysis including 886 participants that revealed no clear differences in CVC patency between heparin and NS. Klein et al (2018) conducted a pilot study on a 30-patient bone marrow transplant unit, each patient had a new CVC and were divided into two groups. Among 698 catheter-associated events overall incidence of central line issues were similar in both heparin and normal saline group. Egnatios & Gloria (2021) studies 37 patients receiving clinical trial infusions, they divided the study into two phases. During heparin phase there were 302 port accesses and four alteplase orders, during the NS study there was 261 accesses and seven alteplases orders. Alteplase was successful every time it was used. Zhong et al (2017) performed systematic [sic] review on use of heparin v. flushing protocols. Ten randomized control trials involving 7,785 participants were included in the meta-analysis. No general differences found between heparin v. NS in maintaining patency. Goossens et al (2013) oncology patients were randomly selected from 2009-2011. 382 were ultimately selected for normal saline group, and 283 for heparin group. All nurses were trained in proper pulsatile technique before study, it was found intimately heparin was not superior in comparison to NS in maintaining the patency of CVC.https://digitalcommons.centracare.com/nursing_posters/1164/thumbnail.jp
SCH ICU Expanding PICS Throughout CentraCare
Get PDFPurpose:
Sharing information about Post Intensive Care Syndrome (PICS) to all in CentraCare. PICS symptoms do not appear until weeks to months after a critical care illness so patients at home may not know what to do with their symptoms.
Future Plans: May 2023 - introducing CICU to the PICS process during their Nurse Practice meeting. May 2023 - updating the Hospital Medicine Section CNS Fall 2023 - meeting with the Ambulatory Work Cabinet group to see if our system of notification is working What opportunities do we have with teaching Progressive RNs about PICS and our Diaries? How can we reach out to our patient population even more: MyChart messages, community education, etc?https://digitalcommons.centracare.com/nursing_posters/1163/thumbnail.jp
Residual Pulmonary Vascular Obstruction Following Mechanical Thrombectomy for Submassive Pulmonary Embolism: A Single-Center Analysis
Get PDFBackground:
Residual pulmonary vascular obstruction (RPVO) following pulmonary embolism (PE) is associated with residual dyspnea, recurrent venous thromboembolism, and chronic thromboembolic pulmonary hypertension. Historically, acute PE treated with anticoagulation alone results in high rates of significant RPVO. Contemporary treatment of submassive PE often involves catheter-based interventions, including mechanical thrombectomy (MT), although their relation to RPVO is not characterized. In this study, we aimed to evaluate the rate of greater than or equal to 10% RPVO in patients treated with MT.
Methods:
Twenty consecutive patients with submassive PE in a single center underwent MT and subsequent planar ventilation/perfusion scintigraphy scan at a median of 4 months after thrombectomy. A quantitative perfusion score was calculated for each planar ventilation/perfusion scintigraphy study to provide a % perfusion defect. Complete hemodynamic data were collected during the procedure and Miller score was calculated using prepulmonary and post-pulmonary angiography. Echocardiographic data were collected prior to, 24 to 48 hours after, and 30 days after the procedure.
Results:
Four of 20 patients (20%) had greater than or equal to10% RPVO at a median of 4 months follow-up. Following MT, the mean Miller score decreased from 24.5 plus/minus 2.9 to 15.8 plus/minus3.3 (P less than .001) and mean pulmonary artery pressure decreased from 36.1 plus/minus 4.8 mm Hg to 26.8 plus/minus 5.4 mm Hg (P less than .001). Right ventricle-to-left ventricle ratio decreased from 1.44 plus/minus 0.2 to 1.05 plus/minus 0.24 by 24 to 48 hours (P less than .001) and 0.85 plus/minus plus/minus 0.1 at 30 days (P less than .001) and right ventricular systolic pressure decreased from 63.2 plus/minus 10 mm Hg to 42.1 plus/minus 9.8 mm Hg at 24 to 48 hours (P less than .001) and 31.9 plus/minus 10.4 at 30 days (P less than .001).
Conclusion:
In this prospective study of patients with submassive PE treated with MT, favorable rates of RPVO were noted in comparison to prior studies of anticoagulation alone along with expected acute hemodynamic and echocardiographic improvements. While this study was small in scope, the results suggest the potential for long-term benefits of MT in acute PE in addition to the acute benefits previously described