Four students in the University of Colorado College of Nursing Adult Gerontology Clinical Nurse Specialist master’s program are getting a taste of academic life by presenting research addressing commonly encountered problems in critical care settings. The students will present during the National Association of Clinical Nurse Specialists (NACNS) annual conference March 9 – 11, 2021 that is being held virtually.
An essential component of CU Nursing’s master’s program includes students identifying clinical problems where they work, finding a gap in care in their organizations, studying it, and providing evidence-based solutions for improvement. These commonly encountered problems in critical care settings become the basis for their evidence-based practice capstone project and presentation. “It’s an excellent way to put action into practice and to think critically and institute best practices while on the job,” said CU College of Nursing Professor and Clinical Nurse Specialist Program Director Mary Beth Makic, PhD. CU Nursing encourages students to present at conferences, write an article and submit for publication. “This provides our students with experience in addressing issues at their workplace and presenting solutions to management,” said Makic.
The four students tackled a variety of topics including how to reduce hospital acquired pressure injuries, catheter-associated urinary tract infections, and workplace violence through prevention training. The following outlines each student’s topic of research.
Title: Hospital Acquired Pressure Injury (HAPI) Bundle
Hanna Betts, BSN, RN, Nurse, United States Army
With the incidence of hospital acquired pressure injuries (HAPI) increasing nationally, the purpose of this quality improvement project is to measure practice change of a HAPI bundle and how it will impact HAPI rates when compared to current practice among adult medical patients in a 36-bed medical unit. The national practice guidelines identify prevention as the most essential element in combating HAPIs. Therefore, this literature supported, four-part HAPI bundle will aide in increasing communication, assessments, patient education, and interventions to combat HAPIs. Outcomes are still pending as implementation has been delayed due to the increased strain on staff secondary due to COVID-19.
Title: Evaluating the Impact of Workplace Violence Prevention Training for Graduate Nurses
Kristen Caldwell, BSN, MA, United States Air Force
Workplace violence creates a significant burden in healthcare. Consequences can include low morale, decreased productivity, increased employee turnover, loss of team cohesiveness, as well as various financial impacts for the victim and the healthcare system. Creating an effective workplace violence prevention program can help nurses better understand the scope and nature of workplace violence while learning how to apply individual strategies and develop skills for preventing and responding to workplace violence. The purpose of this evidence-based practice project was to investigate the implementation of Workplace Violence (WPV) prevention training for new graduate Registered Nurse’s (RNs) in the Nurse Residency Program (NRP) and its impact on perception and confidence towards aggression and/or violence perpetuated by the patient/family member/visitor. Thackrey’s Confidence in Coping with Patient Aggression (CCPA) tool was used to evaluate effectiveness of WPV training both prior to training and directly after training. Overall, post-training CCPA tool results showed a slight increase in confidence coping with aggressive patients (4.6/10 to 5.2/10). During the training, NRP RNs shared stories of their own experiences with WPV, desire for more support from management related to WPV prevention, and a desire to receive further training. Leadership should heed the desire and need for consistent WPV training in health care settings.
Title: Rounding and Quick Access Education to Reduce Catheter-Associated Urinary Tract Infections: An Initiative to Improve Quality and Safety in Healthcare
Danielle Garcia, MSN, RN, AGCNS-BC, Clinical Nurse Specialist, United States Army
Catheter-associated urinary tract infections (CAUTI) result in increased morbidity, longer lengths of stay, and higher healthcare costs. Quality of care can be improved by frequently assessing the need for a urinary catheter and removing those no longer indicated. When urinary catheters are needed, maintenance interventions should be implemented continuously. The project was conducted in two 25-bed inpatient surgical units. The team developed a badge buddy with a quick response code that contained educational resources on CAUTI prevention. Registered nurse CAUTI champions were assembled and educated on CAUTI prevention techniques. CAUTI champions rounded on patients, auditing CAUTI bundle adherence, and recommending catheter removal when no indication was identified. CAUTI rates, indwelling urinary catheter utilization, and maintenance bundle adherence were measured. The implementation of these strategies has shown to reduce CAUTI by up to 70%. However, more time is needed to understand the effect of the project on nursing practice and patient outcomes.
Title: Only YOU can prevent Pressure Injuries!
Kelly Wild, RN BSN CCRN, ICU Charge RN, Parker Adventist Hospital
Hospital acquired pressure injuries (HAPI) are not only an indicator of nursing quality, but a financial drain on the healthcare system and increase patient mortality when they occur. This evidence-based project developed a pressure injury prevention (PIP) plan for an ICU experiencing an increase in HAPI rates and implemented it using a variety of educational techniques meant to improve nursing attitudes towards PIP. Four months after implementation, HAPI rates on the unit have decreased 88%.