Learn about the other scholarly projects currently being conducted by the Abramson Center of Nursing Excellence.
Other Scholarly Projects
How do Palliative Care Screening Tools Perform?: A Systematic Review
Project Team: Julia Valenziano MSN, RN, CCRN; Matt Mitchell, PhD; Robin Hermann, MSN, RN, CCRP; Rebecca Trotta, PhD, RN
Summary: Use of a palliative care-screening tool improves timeliness of and access to palliative care consultation in critical care. However, there was inadequate use of valid and reliable screening tools. The tools in this review lacked consistency across criteria to assess appropriateness of palliative care consultation. This heterogeneity prevented completion of a meta-analysis to determine effectiveness of one scale over others. Future research is needed to determine which criteria are most effective in identifying the need for palliative care consultation in the critical care population.
Status: Dissemination
How do Oncology Fall Risk Scoring Systems Perform? A Systematic Review
Project Team: Danielle Pollock, BSN, RN, OCN; Matt Mitchell, PhD, Robin Hermann, MSN, RN, CCRP, Rebecca Trotta, PhD, RN
Summary: Patient falls are a serious adverse hospital event. Consequences of falls include unintended injury, additional unnecessary treatment, and increased costs. Fall risk assessment is a mainstay of nursing practice. Despite this, oncology patients experience falls at higher than desirable rates. Limited evidence exists regarding oncology-specific fall risk assessments, and these assessments lack agreement regarding the risk factors they evaluate. Despite this, an oncology specific assessment may improve risk identification in this population. More evidence is needed to determine the factors that contribute to fall risk for oncology patients specifically.
Status: Dissemination
Nurse Driven Protocols for Antibiotic Initiation in Febrile Neutropenia: A Systematic Review
Project Team: Cristina Lusardi BSN, RN; Rian Mills BSN, RN, OCN; Samantha Schad BSN, RN, OCN; and Matt Mitchell, PhD
Summary: Neutropenic patients are immunocompromised and highly vulnerable. When they become febrile, they are at high risk for developing sepsis and other serious complications. Clinical guidelines recommend the timely initiation of broad-spectrum antibiotics. Delay in antibiotic initiation can lead to unnecessary negative consequences. Nurse-driven protocols are effective in improving the timeliness and efficiency of multiple clinical pathways in oncology care. However, the evidence for nurse-driven protocols related to antibiotic initiation in febrile neutropenia is not well understood. Implementing nurse-driven protocols to improve time to antibiotic initiation for febrile neutropenic patients can positively impact patient and organizational outcomes. They can also promote nurse autonomy to practice to the fullest extent of licensure and empower nurses to lead interprofessional care. As such, organizations should consider investing in implementation of such protocols in their clinical environments. Future work should evaluate the effects of implementation of such protocols on nurses and the practice environment. Given the evidence base has established the relationship between timely antibiotic initiation and reduction in sepsis, more research is needed to directly test the effects of nurse-driven protocols on sepsis reduction as a clinical outcome.
Status: Dissemination
Communication Strategies for Patients Who Are Non-Vocal Due to Artificial Airways: A Systematic Review
Project Team: Elizabeth (Beth) Bass MSN, RN, CCRN; Stephanie Maillie MSN, RN, PCCN, CCRN, CCNS, WCC; Robin Hermann MSN, RN, CCRP; Matt Mitchell, PhD
Summary: Hospitalized patients with impaired communication experience frustration, helplessness, anxiety, and are at high risk for adverse events. The Joint Commission endorses communication as a key aspect of quality care and advises hospitals to provide communication support during non-vocal episodes caused by mechanical ventilation or tracheostomies. However, the range of strategies to support communication and their effectiveness is unknown. The purpose of this systematic review was to summarize the evidence on communication strategies for non-vocal patients with artificial airways.
There is wide variation in types of communication aids and strategies, and insufficient evidence to conclude that any one approach is more effective than another. Overall, most communication strategies had some positive effect, but given the variation in outcomes (e.g., patient satisfaction, anxiety, ability to communicate), evidence on their comparative effectiveness is inconclusive. Clinical trials are needed to test the effectiveness of standardized interventions and conduct evaluations using comparable outcomes.
Status: Dissemination
Kangaroo Care in the Neonatal Intensive Care Unit
Project Team: Saritha Vangala MSN, RNC-NIC; Michelle Ferrant DNP, CNS, RNC-NIC; Matt Mitchell, PhD
Summary: The purpose of this project is to Identify and summarize evidence from clinical guidelines/ protocols/pathways on use of kangaroo care and implementation strategies for the uptake and sustainability of Kangaroo care (KC) in neonatal intensive care units.
Status: Analysis
Boomer Esiason Cystic Fibrosis Nurse Education Project
Project Team: Matt Walker MSN, RN, PCCN, NE-BC
Summary: This program is intended to support nursing scholarship and enhancement of the nursing workforce for the care of the cystic fibrosis patient population. Nurses can receive funds to support professional development through conference attendance, non-degree course work, and scholarly presentation or by achieving a specialty certification. Funds are also available for nursing support staff who are committed to advancing their education through enrollment in a nursing degree program.
Funding: Boomer Esiason Foundation $85,000
Status: In Development
Food for Health Project
Project Team: Sofia Carreno MSN; RN, Jessie Reich MSN, RN, ANP-BC; Terri Lipman PhD, CRNP, FAAN; Celeste Durnwald MD
Summary: Food insecurity of marginalized under-resourced communities in Philadelphia has risen since the start of the pandemic from 16.3% to 18.8% due to unemployment, poverty, and decreased access to healthy food. To help address this problem, a sustainable food delivery, education, and resource program for inpatient postpartum women at the Hospital of the University of Pennsylvania who are experiencing food insecurity has been developed. The program is called the HUP Food Farmacy for Women’s Health and the program will leverage existing technology and partnerships with community-based organizations (Philabundance and Food Connect) and Penn School of Nursing students to help combat food insecurity in this vulnerable patient population.
Funding: $10,000 Penn School of Nursing Innovation
Status: In progress
Nurse-Driven Antibiotic Initiation for Febrile Neutropenic Patients- Evidence-based Practice Project
Project Team: Samantha Schad MSN, RN, ONC, WTA-C, Rian Mills, BSN, RN, OCN, Cristina Colella BSN, RN, Rebecca Trotta PhD, RN, Robin Hermann, MSN, RN, CCRP, Daniel Landsburg, MD, Colleen Kucharczuk DNP, AGACNP-BC
Summary: The purpose of this project is to design and implement an evidenced-based nurse-driven antibiotic initiation protocol for hospitalized patients who experience their first neutropenic febrile event with the goal of ensuring antibiotics are administered within 60 minutes of their febrile event.
Funding: The Daisy Foundation $2500 Grants Funded | DAISY Foundation
Status: In progress
Contact the Abramson Family Center for Nursing Excellence at HUP.CenterforNursingExcellence@pennmedicine.upenn.edu
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