My Capstone Proposal Project will be about sleep disturbances associated with cardiac surgery patients. One of the major complaints from the cardiac surgery population is the inability to sleep at night. My proposed strategy consists of the idea that by increasing nursing education and intervention there will be a reduction in sleep disturbances for the cardiac surgery population.
Section A: Problem Identification My Capstone Proposal Project will be about sleep disturbances associated with cardiac surgery patients. I have worked on a cardiothoracic surgery stepdown unit for about a year and a half now. Cardiothoracic surgery care was my first job as a registered nurse. I instantly fell in love with cardiothoracic surgeries. For the past couple of months I have been working night shifts on my unit. One of the major complaints from my patient population is the inability to sleep at night. According to Pröpper, van Valen, van Domburg, Brunott, and Bogers
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The patients have the ability to complete a survey after their stay within the hospital. Two of the topics addressed by the HCAHPS is hospital environment and night time quietness. The cardiothoracic surgery units are generally marked as red on our balance scorecards for these topics. The red simply means that we are below satisfactory. Ahmed and Tembhurkar (2014) stated, “cardiac patients being the one who are adversely affected by noise during their hospital stay, they suffer from sleep disturbance, restlessness and disorientation” (p. 32). The Capstone Project Proposal implementation plan has the objective that through nursing education of sleep and sleep hygiene, there will be a reduction in sleep disturbances experienced by cardiac surgical patients. Another objective is that through nursing education on the subject of sleep and sleep hygiene, the HCAHPS scores will
Each year at least 40 million Americans suffer from long term, persistent sleep disorders, and an additional 20 million experience occasional sleeping problems. About 60 million Americans a year have insomnia and it tends to increase with age and affects about 40 percent of women and 30 percent of men. It is estimated that 18 million Americas are suffering from sleep apnea, 12 million have RLS, and 250,000 are affected by narcolepsy. Adults typically need between 6 and 10 hours of sleep per 24 hour period, and most people need approximately 8 hours of sleep per day. Infants generally need about 16 hours per day; whereas, teenagers require 9 hours on average. In the first 3 months of...
Fontana, C. J. (2010). Sleep Deprivation Among Critical Care Patients. Critical Care Nursing Quarterly , 75-81.
While nurses are working on a floor there are many different machines that have alarms such as IV pumps, ventilator machines, ECG’s, vital machines, call lights, and pagers. New nurses have shown a lack of response efforts to combat these alarms from a proposed desensitization and sensory overload of the alarm noise (Cvach, 2012). This is a patient safety concern due to what the alarms purpose is which in turn leads to varying amounts of potentially severe consqeunces if not answered promptly. Between 2009 and 2012 the joint commission stated that there were 80 patient deaths, 13 permanent losses of function, and 5 events that led to extended hospital stays (Horkan, 2014). It is important for nurses to recognize alarm fatigue and find interventions to help keep patients from being injured.
Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has become a major problem within the nursing community and has already had a negative impact on patient safety. Due to the adverse effects alarm fatigue is having on quality patient care, there has been a call to action to find solutions that may deter alarm fatigue. Evidence-based practices involving quality improvement initiatives have been put into effect. The problem has also gained national attention from such institutions as the Food and Drug Administration (FDA) and The Joint Commission (TJC).
As student nurses, I have many goals that would like to achieve upon completion of 150 hours of my capstone course. My plan is to use this opportunity to demonstrate competency skills, and knowledge gained through previous quarters. I have listed seven learning goals that I wanted to achieve during the capstone experience. On my first day of capstone, I have gone over each one with my preceptor and requested from her to provide me with feedbacks, so I can use them as stepping tool to work upon. These goals ranged from critical thinking decision making, culture, growth & development, legal and ethical to clinical competence safety/holistic care, evidence-based practice, and professionalism lifelong learning.
Hinkle, Janice L, Cheever, Kerry H. (2014). Brunner &Suddarth’s textbook of Medical-Surgical Nursing. Philadelphia: Wolters Kuwer/Lippincott Williams &Wilkins.
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Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
Jones, C., & Dawson, D. (2012). Eye Masks and Earplugs Improve Patient’s Perception of Sleep. Nursing in Critical Care, 17(5), 247-254. http://dx.doi.org/10.1111/j.1478-5153.2012.00501
Medeiros, Ana Ligia D., et al. “Relationships Between Sleep-Wake Cycles and Academic Performance in Medical Students.” Biological Rhythm Research. 32.2 (2001): 263-270. 2 Feb. 2004. <http://www.szp.swets.nl/szp/journals/br322263.htm>.
Battie, R. (2013). The IOM Report on the Future of Nursing: What Perioperative Nurses Need to Know. AORN Journal, 98, 227-234.
Sleep disorders are an underestimated public health concern considering that fifty to seventy million Americans are affected. Technological advances in the field of sleep have facilitated various theories to explain the need for and the purpose of sleep. Scientist have uncovered many types of sleep disorders such as insomnia, sleep apnea, and narcolepsy. Sleep disorders affect men ,women, children, the elderly, and the obese in different ways. Factors such as the number of children and the effects of menopause have been studied to determine their effects on sleep. Various treatments have been utilized ranging from non-pharmacologic to pharmacologic methods. Scientist have pinpointed areas of the brain that are involved in sleep deprivation and hormones that ultimately affect sleep.
Specific purpose: To persuade my audience to take care of our sleep duration as it may affect our daily life.
Important public policy issues have arisen in our modern 24-hour society, where it is crucial to weigh the value of sleep versus wakefulness. Scientific knowledge about sleep is currently insufficient to resolve the political and academic debates raging about how much and when people should sleep. These issues affect almost everybody, from the shift worker to the international traveler, from the physician to the policy maker, from the anthropologist to the student preparing for an exam.
Nursing is a medical profession that involves the care and management of patients majorly in the hospital setting. This paper seeks to illustrate the fact that nursing is both a science and an art. Nursing is a science because it involves evidence based practice, education of the public, lifelong learning for the nurse and administrative roles that are allocated to the nurses. Nursing is also an art because nurses depend on intuition, have the capacity to promote positive change, are understanding and culturally sensitive.