Graduate Nursing Project
 
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1 A Post-Operative Pain Management Guideline for Opioid Exposed NeonatesPabst, Erin2020Background:Neonates are commonly prescribed opioids in the NICU for pain management. Prolonged opiate exposure can lead to increased drug tolerance and/or dependence, and result in higher total opiate exposure and suboptimal pain control. Evidence suggests that the use of a standardized pain managem...
2 Are Placental Blood Samples a Proxy for Infant Blood Samples When Comparing LabVance, McKenna2020Background: Neonatal anemia is a common problem faced by infants admitted to the NICU. Admission labs to the NICU typically required 3-4 mL of blood for diagnostic purposes. Blood losses from phlebotomy draws increases the likelihood of anemia in preterm infants less than 32 weeks gestation and may ...
3 Bedside Oxygen Histogram Monitoring in the NICU for Infants at Risk for Retinopathy of PrematurityArslanian, Lindsay A.; Hamilton, Jennifer L.2022Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disease process that is exclusive to premature infants and can be exacerbated by supplemental oxygenation administration. Infants that experience hypoxia and hyperoxia are at an increased risk of developing severe ROP. Bedside oxyg...
4 The Creation and Implementation of a Neonatal Palliative Care ToolkitWarren, Charise; Bierer, Ryan; Hamilton, Jennifer2023Background: According to the March of Dimes (2020), the infant mortality rate in Salt Lake County, Utah was 5.4 per 1,000 live births, with 69% of these infant deaths occurring during the neonatal period. Advances in perinatal medicine have led to increased identification of fetuses with fatal or li...
5 De-implementing the Routine Measurement of Gastric Residual Volumes in an All-Referral Newborn Intensive Care UnitTucker, Erin B.2023Background: Routine gastric residual volume measurement has historically been the standard of care in many neonatal intensive care units to monitor for feeding intolerance and necrotizing enterocolitis. However, current evidence suggests that gastric residual volume is a poor indicator of these path...
6 Decreasing day to first skin-to-skin holding in Infants <30 WeeksHardy, Rachael; Hardin, Pamela2022Background: According to the CDC (2020) 1 out of every 10 pregnancies in the United States will result in a pre-term birth. Continued advancement of neonatal care has led to an increase in survival rates for these very preterm infants. Skin-to-skin (STS) holding has been widely studied and demonstra...
7 Decreasing the Inappropriate Use of Pain and Sedation Medications in a Level III NICUSchaeffer, Lisa2020Background: Overuse of pain and sedation medications continue to be a problem in newborn intensive care units (NICU). The use of pain and sedation medications can have harmful long term neurodevelopmental sequlae and these medications should only be used when nonpharmacological interventions are not...
8 Education on Appropriate Infant Positioning In the NICUBodamer, Peggy2020Background:Infant positioning plays a vital role in the development of neonates. Inappropriate positioning of premature infants born at less than 34 weeks' gestation increases the risk of developing positional non-synostotic head deformities (NHD) and non-congenital ear deformities (NCED). Bedside p...
9 End-of-Life Self-Efficacy Initiative for Advanced Practice Providers in the NICUTrimm, M. Rhiannon2022Background: End-of-life care is ever-present in the newborn intensive care unit, with approximately 5% of neonatal patients in the United States requiring end-of-life care annually. A scarcity of educational resources currently exists with little to no formal training offered to advanced practice pr...
10 Evaluating the Effectiveness of an Existing Late Onset Sepsis Tool in a Culture-positive Patient Subgroup at a Level III Newborn Intensive Care UnitValadez, Marta G.; Hardin, Pamela2022Background: Late-onset sepsis is an overwhelming systemic response to a bacterial, viral, or fungal infection and a leading cause of neonatal morbidity and mortality. The Surviving Sepsis Campaign has recommended each unit have a systematic sepsis screening process. Implementing a screening approach...
11 Evaluation of the Parent Experience with Home Enteral Feeding Tubes in Infants Discharged from the Newborn Intensive Care UnitMitchell, Megan I.2022Background: Infants who spend time in the Newborn Intensive Care Unit must attain full oral feedings prior to discharge. Waiting for a clinically stable infant to attain full oral feedings can considerably increase their time spent in the hospital. Allowing these infants to discharge home with a fee...
12 Exclusive Human Milk Diet for Extremely Low Birth Weight InfantsBushati, Charity2020Problem:Despite advances in nutrition, extremely low birth weight (ELBW) infants remain at high risk for extrauterine growth restriction that is correlated with adverse neurodevelopmental outcomes. To provide adequate calories and essential nutrients, fortification of human milk (HM) is necessary. T...
13 Exploring the Antecedents of Neonatal Bowel PerforationMantle, Ashley2020Background: Spontaneous intestinal perforation (SIP) occurs in 3-8% of preterm neonates before they reach two weeks of age. Early, concurrent neonatal use of Indocin and Hydrocortisone is a known association of SIP. Mothers in premature labor often receive Indocin as a tocolytic therapy for early la...
14 Exploring the Role of the Neonatal Nurse Practitioner Beyond the NICUYilaire, Renee Y.2020Background: The Neonatal Intensive Care Unit (NICU) graduate is at an increased risk of morbidities and mortality after discharge from the acute care setting of the NICU. The lack of experienced healthcare providers with specialized training and knowledge of the NICU graduate creates gaps in follow-...
15 Implementation of a Minimal Stimulation Guideline for Infants Less than 29 Weeks Gestation for the First Week of LifeOrr, Jennifer2020Background:The prevalence of prematurity is significant, with 1 in 8 live births occurring before 37 weeks gestation. More infants are surviving who are born between 22-28 weeks gestation. These infants are at high risk for adverse neurodevelopmental outcomes. Steps taken during the first week of li...
16 Implementation of a Probiotic Protocol at an Urban Level 3 NICUHalford, Tami2020Background: Necrotizing enterocolitis (NEC) is a common cause of morbidity and mortality among premature and low birth weight infants. Infants who suffer from NEC are at increased risk for death and other poor outcomes, including problems associated with prolonged parenteral nutrition, long-term gas...
17 Implementation of Feeding Guidelines for NeonatesElwood, Christine2020Background:Preterm neonates in the Neonatal Intensive Care Unit (NICU) require specialized care when it comes to their nutrition. Poor nutrition will further worsen an already complicated clinical course as well as increase morbidity, mortality, and poor neurodevelopmental outcomes. A thorough revie...
18 Implementation of The CDC's Developmental Milestone Guideline for Infants Corrected Age 2-4 Months Hospitalized in the NICUHall, Catherine A.2022Background: Every year in the United States there are approximately 360,000 babies that are born premature. In the state of Utah that number is approximately 45,700, which is almost 10% of all babies born. Preterm infants are at greater risk for developmental delays. Long lengths of stay in the Newb...
19 Implementation of Ultrasound Use for Vascular Access in the Newborn ICUNickels, Joshua D.; Chan, Belinda; Schiefelbein, Julieanne2022Background: Peripheral intravascular access (PIV) is one of the most common procedures in the Newborn Intensive Care Unit (NICU). However, it is common for neonates to undergo multiple attempts before successful PIV placement can be achieved. Ultrasound-Guided intravenous placement (USG-IV) has been...
20 Improving Adherence to an Existing Protocol for Infants at Risk for HypoglycemiaWright, Rachel2020Background: Prolonged hypoglycemia and delays in treatment correlate with poor neurological outcomes and developmental delays in infants. Research shows that infants at risk can be managed successfully with proactive intervention and management until their bodies have compensated. Protocols enhance ...
21 Improving Nurse-Provider Communication in the Special Care Nursery Through Implementation of RSBARSmith, Jessica L.2020Background: Ineffective interprofessional communication directly contributes to medical errors, adverse patient events and the deterioration of operational relationships. A Joint Commission root cause analysis found that over 70% of all U.S. hospital sentinel events were directly related to failures...
22 Incidence of Necrotizing Enterocolitis and Improvement in Growth Using a Standardized Cardiac Feeding GuidelineDunyon, Tyler2020Background.Necrotizing enterocolitis (NEC) is a gastrointestinal infection with high morbidity and mortality in the neonatal period. Ductal dependent congenital heart disease (CHD) is considered a significant risk factor for developing NEC in both term and preterm infants. These infants are also at ...
23 Increasing the use of Blood Warmers in a Level 4 NICUCanfield, Christy2020Background Blood warmers have been proven to be safe and effective in the adult population in preventing hypothermia induced from transfusions. However, using blood warmers for transfusions is not standard practice in the neonate population, except for exchange transfusions. Infusing warm fluids h...
24 Increasing Utilization of Extended-Dwell Peripheral Intravenous Catheters in the Neonatal Intensive Care Unit: A Quality Improvement ProjectShepherd, Laura2023Background: Repeated pain exposure in neonates is often associated with decreases in long-term cognitive and motor outcomes. Peripheral intravenous (PIV) catheterization attempts are a common source of pain. PIVs need to be replaced frequently given the nature of neonatal peripheral blood vessels. E...
25 Necrotizing Enterocolitis Toolkit: Quality Improvement in the Neonatal Intensive Care UnitHartvigson, Julee G.2022Background: Necrotizing Enterocolitis (NEC) is a devastating illness in the neonatal population. Despite decades of research, the pathology of NEC is not fully understood, and 90% of incidences occur in premature neonates. It is unclear if healthcare providers are aware of the risk factors that plac...
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