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UNR Orvis student evidence--based poster presentations.

Is Hand Sanitizer or Hand Washing More Effective in Preventing Healthcare-Associated Infections?

Laura Allen, Josi dos Santos, Victoria Mischel, Amanda Salmonsen, and Juliee Tibbits

The assignment was to discover evidenced based practice on the effectiveness of hand sanitizer verses hand washing in decreasing the rate of Healthcare-Associated Infection. The research has shown that hand sanitizer and hand washing are both effective. Hand sanitizer is effective because of the higher rates of compliance. Some research discussed the amount and the concentration that should be used. The amount of hand sanitizer used should cover the palm of the hand to provide an ample amount and should dry completely. When using hand sanitizer, the thumbs and the back of the hands were places that were most often forgotten. The alcohol-based hand rubs that have a 50-70% concentration of alcohol were the fastest and most effective in reducing bacterial counts on the skin. The highest compliance rate coincided with the hand sanitizer that was 62% alcohol with a citrus smell. At higher concentrations, there are complaints of irritating the hands of the workers, which decreases the rate of compliance. All forms of hand sanitizer such as gel, foam, and wipes have been proven to be effective against Influenza A. Although hand sanitizer has a higher compliance rate, when it comes to enteric bacteria and viruses such as C. difficile and Norovirus, hand washing was superior to hand sanitizer. Hand washing is effective, but has a lower compliance rate due to time, skin irritation, and inconvenient locations of the sinks. The sinks should be located within 10 feet of the patient care for a higher compliance. The research has shown that hand sanitizer and hand washing are both effective, but it depends on the compliance rate and the type of the organism.

How Does Intentional Rounding Impact Patient Outcomes?

Maria Durazo BS, Amber Bedillion, Eleni Monos BA, Brian Collins, Natalie Hoenig, Jacqueline Wicks

Purposes/Aims

The purpose of this research is to examine and evaluate patient outcomes resulting from implication of intentional rounding in a clinical setting.

Rationale/Conceptual Basis/Background

Patient outcomes are largely impacted by the quality of the care provided. In an inpatient clinical setting, quality care includes acknowledging and attending to patient needs for comfort in addition to management of health problems. Patients must also be assessed and checked on regularly to help prevent further health complications. This can prove challenging in a busy and fast paced environment where nurse to patient ratios push staff to their limits. Implementation of regular scheduled rounding has been presented as a solution to help improve overall quality of patient care as well as patient satisfaction.

Methods

The University of Nevada, Reno online catalog for research was used to search for relevant articles to our topic. The databases accessed included CINHAL and PUBMED. Our search was limited to peer reviewed nursing journals and of the 166 relevant articles returned 14 were selected to be included in our evaluation of the topic.

Results

The articles reviewed and evaluated found that implementation of hourly or intentional rounding has improved patient outcomes and satisfaction. There was a noted reduction of ground level falls, call light use by the patient, increase in the patients positive perception of care, and sooner discovery and intervention in health complications.

Implications

Implementation of hourly rounding in the nursing practice will greatly increase patients quality of care, thus overall patient satisfaction and health outcome.

Novice Nurses, Night shifts, and Medication Errors

Lauren Soletti, Andrea Bailey, Mandy Smith, Maebritt Hirvela

Aim

It is common practice for novice nurses to begin work on the nightshift. This research project explores evidence regarding novice nurses working the night shift and the relationship to the number of medication errors.

Background

Each patient that is hospitalized is subject to at least one medication error a day. This includes factors such as giving the medication at the wrong time, or not carrying out the proper pre-monitoring before passing the medication. There is also a need for nursing schools to produce an estimated 30,000 novices nurse per year. Finally, when comparing day shift nurses with night shift nurses, night shift nurses reported more negative working characteristics, including lower overall job satisfaction, insufficient amounts of sleep to perform adequately at work, and increased overall stress and fatigue.

Methods

To adequately research novice nurses and medication errors, articles were analyzed from CINHAL, PubMed, Ovid, and IGT Knowledge center. Key words such as: medication errors, night shift, novice nurses, new graduate nurses, adverse events, and day shift versus night shift were all searched. From this research, nine relevant articles were selected that were used throughout the project.

Results

Many factors may contribute to medication errors, including, personal neglect, miscommunication, and environmental factors. It was found that an estimated 75% of novice nurses commit medication errors, and as the hours of sleep decreased in nurses, the number of patient errors increased. Finally, working night shifts, combined with working longer hours caused issues and failures in the cognitive functions of staff.

Implications

The conduction of more level one evidence is needed in order to further examine relationships between novice nurses working the night shift who commit medication errors. For the present working environment, it appears that shifts adequately staffed with the appropriate mix of experienced nurses to novice nurses, along with adequate unlicensed staff, results in a more positive working environment. Furthermore, hospitals should have high percentage requirements of BSN prepared nurses, as it has been shown that they commit fewer medication errors. Lastly, hospital facilities and protocol should encourage a positive learning climate, in which staff learn from their mistakes and facilitate the generation of new knowledge, to further decrease the chances of future errors of the same nature.

Benefits of a Dirty Baby

Araceli Jimenez-Ruiz, Janet Jimenez-Ruiz, Jeeyun Sohn, Misty McCracken, Yessica Soto

Purpose/Aims:

The purpose of this research project is to review existing studies to validate the clinical implications and benefits of vernix.

Rationale/Conceptual Basis/Background:

Vernix caseosa is a white, waxy, cheesy substance, produced by the baby's sebaceous glands while in utero, that begins to form and cover the skin of the fetus around the last trimester of a pregnancy. This natural coating substance provides several benefits for a newborn during its transition from intra-uterine to extra- uterine life, and continues to provide those benefits throughout the first week of life, if not washed away. Vernix provides skin protection for the neonate by providing antimicrobial properties, temperature regulation, hydration, and several other benefits. So how long should we wait before washing vernix off in order to get all of these great benefits? Evidence based practice states that the vernix is most beneficial within the 24 hours post-delivery up until one week.

Methods:

Databases such as; CINAHL, PubMed, EBSCO Host, Google Scholar, and INH Gov were used to research our topic. Keywords included: Vernix caseosa, newborn skin care, neonatal and maternal factors, prevalence, and newborn. Over 600 results were generated and eight articles were selected for inclusion.

Results:

When comparing infants who retained the vernix caseosa 24 hours after birth, to infants who had it removed, evidence showed that the infants with the retention of the vernix contained higher levels of free amino acids. These infants also contained higher hydration in their skin and an increased initial and long-term recovery of disrupted skin. Studies also showed an increase of desquamation, the shedding of the outermost layer of the skin (Monteagudo et al., 2011) and toxicum neonatorum, a rash seen in about half newborn infants (2011) in infants with the absence of vernix. Furthermore, additional studies showed the prevention of infection after birth by the vernix. The vernix provides surfactant protein D and other antimicrobial particles which control the direct skin colonization by commensal flora in the immediate neonatal period, helping prevent infection.

Implications:

Since little is known about the vernix caseosa, it is important to educate mothers about the benefits of it. The vernix that presents with the newborn, helps the newborn adapt to the extrauterine atmosphere. Not only does it provide free amino acids and hydration for these infants, but it also provides antimicrobial properties. Recommending not bathing the child in their first 24 hours of life and suggesting allowing the vernix to shed on its own is important in order to get the full benefits of the vernix.

Does a patient have more phantom limb pain from an elective or a traumatic amputation?

Rebecca Gansberg, Michelle Moscove, Nicole Rinas, Shannon Roberson, Alisha Simpson

Phantom limb pain is a well-documented phenomenon occurring in roughly 50-80% of patients following an amputation. Traditionally this neuropathic pain has been treated, although not as successfully, with narcotic medication. Treatment with opioids or other traditional pain interventions have only succeeded in taking the edge off the pain without any effect on the cause of the pain. Research has been conducted that describes the effectiveness of non-pharmacological measures in decreasing the cause of the pain. Alternative therapies such as: mirror therapy, EDMR, and biofeedback have proven to be effective at minimizing the pain through targeting the cause of the pain.

The most current research on phantom limb pain has been analyzed to identify various interventions, both pharmacological and non-pharmacological aids, for methods of best practice in the hospital setting. Various studies, including randomized controlled-trials and a meta-analysis, from the years 2005-present were analyzed. The concepts of reliability, validity, and statistical analyses were utilized to ensure the research examined reflects the best evidence-based practice.
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Title Annotation:student corner
Publication:Nevada RNformation
Date:Nov 1, 2014
Words:1577
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