Recurrent driveline infection is the most common readmission diagnosis for patients after being implanted with an LVAD. The literature shows that readmission on post LVAD implantation on average costs $35,000. Our review of literature shows that education and lifestyle changes can decrease the chance of readmission. The literature shows that certain implantation techniques can contribute to decreasing driveline infection.

Communicating is key between both patient and healthcare providers. On a neuroscience floor with the majority of patients diagnosed with stroke, the likelihood of a patient having aphasia or other communication difficulties is high. Adapting and adjusting to this new communication deficit poses unique barriers for patients in the post-stroke community. In order to improve communication between this distinct patient population and staff, a literature review was conducted from various databases in order to evaluate the effectiveness of using mobile applications as a means of improving communication. Current practices rely on using paper and pen or even communication boards. However, with modern day advances, technology has the ability to make communication seamless. Several articles have shown high satisfaction rates when using these mobile applications and an eagerness to continue to use them. However, many had mixed reviews regarding the applications’ ability to improve communication between staff. Although patients are likely to use electronic devices and have shown benefit with using them, the articles have not shown a definitive correlation in improvement of communication between patients and staff. In addition, research has found that older adults are less likely to utilize new technology. With the limitations found in these devices, there is much improvement to be made in order for electronic communication devices to be made effective in the clinical setting.

During chemotherapy many cancer patients experience episodes of nausea and vomiting. Despite the widespread use of antiemetics, nausea continues to be reported by over 70% of patients receiving chemotherapy. Ginger may be a safe and effective measure to help these patients receive comfort from these symptoms in a safe and natural way. Drinking a warm calming cup of ginger tea may provide the relief to these patients. Ginger acts within the gastrointestinal tract, by increasing the gastric tone and motility due to anticholinergic and antiserotonergic actions. It is also reported to increase gastric emptying. This combination of functions explains the widely accepted ability of ginger to relieve symptoms of functional gastrointestinal disorders, such as dyspepsia, abdominal pain, and nausea, which is often associated with decreased gastric motility. The importance of eliminating these chemotherapy side effects could make a difference to these patients. This literature review will examine studies that implement ginger products as treatment for chemo induced nausea and vomiting, providing recommendations for further research on this and other complementary and alternative medicines.

The purpose of this evidence based practice project was to complete a review of the literature, compare different violence prediction scales, and determine if it would be beneficial to implement a scale into the standard of care at our institution. “Approximately 80% of violent acts from patients are directed at nurses”. Violence against nurses leads to psychological distress and eventually nurse burnout. According to a recent report by the American Hospital Association, “workplace violence cost U.S. hospital and health systems approximately $2.7 billion in 2016”. Multiple scholarly databases were utilized to obtain evidence based research on this topic. A total of five articles were reviewed, containing 2 levels of evidence. Based on the evidence found, a pilot of the BrosetViolence Checklist prediction scale is recommended as required nursing shift documentation in an EMR.

The purpose of this project is to examine how nurses, particularly in ICUs, are at risk for moral distress and compassion fatigue, leading to factors associated with nurse burnout, as well as the resulting decreased ability to provide compassionate patient care. Moral distress is stress that occurs in situations when one knows the right course of action but is unable to carry it out due to institutional constraints. Accompanying moral distress, compassion fatigue is a feeling that results from the inability to protect or heal a patient that leads to stress and self-blame (Mattioli, Walters, & Cannon, 2018). The most commonly reported causes of moral distress surround futility of care, lack of autonomy, and institutional constraints. The experience of moral distress leads to depersonalization of care, diminished interprofessional collaboration, and increased emotional distress within the nursing profession. Although not many interventions have been put in place or tested to address moral distress, common themes involve harboring constructive interprofessional communication, “offering critical stress debriefings” (Browning & Cruz, 2018), and involving all aspects of the care team in decision making including nurses, patients, and families (Pishgooie et al.,2018).

This project explores the evidence on the preferred water used when flushing a feeding tube in an immunocompromised lung transplant patient in preventing infection risk. After conducting a survey among the staff on a medical surgical post lung transplant unit, it was found that many nurses do not know the preferred method and are unsure of any policy in place. We conducted a database search through CINHAL and PubMed to discover research articles with the best practice procedures. It was found that sterile water was the preferred method of flushing a feeding tube in immunocompromised patients and one researcher who felt that it made no difference and was a waste of money to use sterile water. One recommendation from this project is that a hospital system should implement a universal sterile water policy for feeding tube flushes in all patients, especially immunocompromised because it ensures all staff uses the same water and it is the best way to ensure our patients safety, which will prevent complications of infection and further costs.

Venous catheterization is a common invasive procedure in the hospital setting. Current standard practice in many hospitals does not include the use of any anesthetic for the process, though it is generally understood that the procedure at a minimum results in patient discomfort and can result in anxiety and severe pain. Depending on a patient’slength of stay, several catheterizations may be required, increasing this discomfort andresulting in lower patient satisfaction. The aim of this project is to explore the use of localanesthetics as a means to reduce pain and anxiety and increase patient satisfaction withhospital stays. The references utilized not only studied the effect of various painmanagement strategies, but also examined patient preferences toward decision-making as it relates to overall patient satisfaction

The purpose of the project was to observe whether or not accurate measurements of intakes and outputs in CHF patients will have correlation with improving cardiac function, reduce the length of stay in a hospital, and whether or not it would reduce hospital readmissions. The methods used for our evidence based literature review were to provide an intake and output measurement tool to CHF patients while in the hospital, and adequately keep track of how much fluid they were putting in and out of their body. Our findings suggest tracking intakes and outputs in a timely and specific manner would improve cardiovascular functions which would reduce hospitalizations, exacerbations, readmissions. -Recommendations: The RN caring for particular patient is responsible for ensuring that fluid balance charts are recorded regularly and with accuracy, using the correct notation throughout.

In 2008, the Joint Commission issued a Sentinel Event Alert regarding lateral violence as unacceptable in a culture of safety, and stated that it may have an effect on preventable negative patient outcomes. Studies have found that lateral violence is pervasive in nursing work environments, both among staff RNs and between staff RNs and management. Many different ideas as to how to address workplace violence among RNs exist, including educational programs and policies regarding the consequences of lateral violence. Nurses need to be aware of the definition of workplace violence, as well as the methods for resolving violence in a professional manner and plans to prevent workplace violence in the future.

ERAS is a protocol aimed at producing quicker recovery times and improving patient outcomes after surgery by improving pre-operative care, using techniques that reduce pre and post operative stress, pain control, and overall increasing comfort. Examples of ERAS components can include a preoperative carbohydrate drink two hours before surgery, decreasing the use of opioid pain medication, avoiding pre-operative fluid overload, avoiding postoperative nasogastric tubes, and early mobilization. The purpose of this presentation is to examine the preoperative and postoperative care nurses provide and analyze the patients’ outcomes. Based on several evidence based studies, utilizing the ERAS components has led to decreased length of stay and readmission while improving outcomes. The ERAS protocol is currently being used for abdominal surgeries but could potentially be used for various other forms of surgeries.