Digital Commons Network^™

Nursing Care Of The Pediatric Patient With Autism, Cayley Frolik

Honors Capstones

The purpose of this project is to help educate current and future nurses on ways to understand and better connect with pediatric patients with autism. Standard nursing curriculum tends to focus primarily on the clinical approach for mainstream patients. In one short year, I recognized a glaring need for nurses to learn how to care for those with autism, as well as how to support and educate their families to create the best environment for whole success. It is very difficult to understand the needs of these specific patients without the proper toolkit. It is my intention to research and …

Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …

Improving Access To Care For Specialty Pediatric Orthopedic Patients: Maximizing Telehealth To Achieve Outcomes, Tammy Keesey

Student Scholarly Projects

Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn H. Jansen

Nursing | Student Research Posters

This paper examines the efficacy current best developmental care nursing practices in the pediatric cardiac intensive care unit (PCICU) for children with congenital heart disease (CHD). The proposed study explores the implications of the Cardiac Inpatient Neurodevelopmental Care Optimization (CINCO) program, a recent comprehensive developmental care bundle, as a universal implementation for PCICUs.

How Nurses Perceive Their Task Load When Caring For Behavioral Mental Health Patients In The Pediatric Emergency Department, Emily Cameron, Robert Cornette

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Introduction: Pediatric behavioral mental health patients are being seen more frequently in the emergency department setting. With this ever-growing number of cases comes the need for trained staff, including registered nurses, to care for these children during a mental health crisis. With this increase comes increased stress of nurses’ workload. The purpose of this project was to identify nurses’ perceptions of their workload when completing three identified tasks: communication, procedures, and initial intakes. Methods: The National Aeronautics and Space Administration (NASA) Task Load Index tool was used to measure nurses’ perceptions of how difficult each task was to complete. …

My Happy Baby Is Back: Zero Balancing, Craniosacral Therapy And A Baby’S Journey To Becoming Mobile, Veronica Quarry

Journal of Transformative Touch

Alison began receiving ZB and CST at 13 months of age due to gross motor delays: at that age she was only able to sit somewhat rigidly. After the first session, Alison changed` from being very unhappy and seemingly frustrated to being happy and more calm. Within one month of weekly sessions, Alison was able to be on her tummy, began to crawl, became more agile in seated play, was squatting and standing and took her first steps.

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …

Determining Care Delivery Model Feasibility Using Discrete-Event-Simulation, Tanya Scott

Doctor of Nursing Practice (DNP) Projects

Background: The need for inpatient pediatric psychiatric services to address the growing issue of pediatric mental health in a multi-state integrated hospital enterprise is straining the system’s capacity to provide timely mental health care.

Local Problem: Lack of access to specialty pediatric psychiatric treatment for dual diagnosis medi-psychiatric care management is a patient quality and safety issue. Insufficient capacity contributes to longer emergency room boarding times and inpatient length of stay for patients who have a mental illness.

Methods: Use of digital simulation methodology to analyze the behavior of a dynamic event-driven care delivery workflow and to optimize quality patient …

The Rising Rates Of Pediatric Health Conditions Due To Lack Of Nutrition Education, Amanda Healy

Nursing | Student Research Posters

Statistics show that there is an increase in childhood health conditions related to nutrition. Throughout the United States, the rates of childhood obesity have drastically increased along with the rates of type two diabetes. There is correlation between these two chronic problems in pediatric patients, but not all pediatrics diagnosed with DM2 are obese. Furthermore, there is a correlation between this increase of obesity/DM2 and the lack of nutrition education in schools. The public school system in the United States does not have the funding to provide adequate nutrition education to the children which is leading to substantial health consequences. …

Implementation Of A Code Lobby Surge And The Impact On Left Without Being Seen Rates, Nicole Plouffe

Student Scholarly Projects

Practice Problem: Crowding of emergency departments contribute to higher-than-average left without being seen (LWBS) rates. LWBS patients pose risks to the hospital as well as to one’s own health.

PICOT: The PICOT question that guided this project was in a pediatric emergency department (P), does implementation of a “Code Lobby Surge” (I), compared to standard care (C), decrease left without being seen rates (O) within eight weeks (T)?

Evidence: Surge interventions and decreasing the visual of crowding have shown to decrease LWBS rates.

Intervention: “Code Lobby Surge” was implemented to decrease LWBS rates and improve throughput within the …

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

Virtual Reality Pain Intervention For Pediatric Burn Patients, Tanya Ann Hinrichs

Theses and Graduate Projects

Burns can be devasting trauma in the pediatric population, leading to lifelong physical and psychological pain and anxiety. Burn pain management is complicated and undertreated traditionally. The purpose of this scholarly project is to examine the use of virtual reality (VR) for distraction in pediatric patients who have experienced a burn to determine if VR improves pain management during painful procedures. A literature review revealed a gap in pain management in pediatric burn survivors with just traditional pharmacologic analgesia during painful procedures. Leininger’s Culture Care Theory provides a theoretical framework for this project’s purpose to determine if implementing a virtual …

Assessing And Improving Pediatric Nurses' Documentation Of Childhood Immunization Status Using The Electronic Health Record, Katherine Engalichev

Master's Theses and Capstones

BACKGROUND: Adherence to the standardized childhood immunization schedule put forth by the American Academy of Pediatrics is the gold standard for decreasing vaccine-preventable disease morbidity. The first step to improving adherence with the recommended immunization schedule is identifying children who are under-immunized. The inpatient setting offers an opportunity to screen pediatric patients for immunization status. A survey was administered to nurses working on an inpatient pediatric unit to gauge nurse self-report of Cerner™ Electronic Health Record (EHR) use for immunization documentation, their perceptions regarding EHR ease of use for documenting pediatric immunization status, attitudes towards documenting immunization status, and perceived …

Sexually Transmitted Disease Awareness Amongst Adolescents 13 To 18 Years Of Age, Ngwanma Nwokoro

Walden Dissertations and Doctoral Studies

Abstract Sexually transmitted infections or diseases (STIs/STDs) acquired through sexual activities lead to compromised sexual health. The adolescent population is at high risk of acquiring STIs/STDs due to their lack of knowledge. The gap in practice was that the nurse practitioners (NPs) were deficient in standard of care; adolescent patients lacked consistent evaluation, education, or documentation of the education in their medical records. The practice-focused question focused on the evaluation of the effectiveness of a quality improvement (QI) initiative that incorporated the use of the American Association for Pediatrics screening and Center for Disease Prevention and Control (CDC) treatment guidelines …

Evaluation Of Universal Depression Screening In A Pediatric Diabetes Outpatient Clinic With The Integration Of A Depression Screening Tool Into An Electronic Health Record, Jenna Westberry

DNP Projects

Background: Depression is a significant problem for adolescents with chronic health conditions. Prevalence rates are two to three times higher in adolescents with diabetes compared to adolescents without diabetes (Badescu et al., 2016). Routine depression screening is not transpiring at rates and frequency recommended by the American Diabetes Association for this population. Implementing use of the Patient Health Questionnaire for all adolescents over the age of twelve years with Type 1 & Type 2 Diabetes Mellitus during routine health visits may improve early identification and diagnosis of depression and improve long-term health outcomes.

Purpose: The goal of this project was …

Sexually Transmitted Disease Awareness Amongst Adolescents 13 To 18 Years Of Age, Ngwanma Nwokoro

Walden Dissertations and Doctoral Studies

Abstract Sexually transmitted infections or diseases (STIs/STDs) acquired through sexual activities lead to compromised sexual health. The adolescent population is at high risk of acquiring STIs/STDs due to their lack of knowledge. The gap in practice was that the nurse practitioners (NPs) were deficient in standard of care; adolescent patients lacked consistent evaluation, education, or documentation of the education in their medical records. The practice-focused question focused on the evaluation of the effectiveness of a quality improvement (QI) initiative that incorporated the use of the American Association for Pediatrics screening and Center for Disease Prevention and Control (CDC) treatment guidelines …

Using Family Focused-Care Solutions To Improve Child’S Quality Of Life, Joshua M. Del Sol

Nursing | Senior Theses

Chronic illness in children impacts not only themselves but their families too. Everyone in the family supports each other and provides each other with pretty much all our physiological needs including our emotional needs. Parents/caregivers are the role models for their young children and really shape the person they become because basic values and their early relationships are formed. A family provides that consistent balance in our life that is the center of our life at a young age. When children are diagnosed with a chronic illness, parents may feel responsible, ashamed, guilty, or angry. Families may turn on each …

Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton

DNP Projects

Abstract

Background/Purpose

Conversations between care providers and patients are integral to medicine and are the most performed “procedure” (Luff et al., 2016). In Pediatric Intensive Care Units (PICUs) and Pediatric Cardiac Intensive Care Units (PCICUs), children of all ages with diverse diagnoses and needs are treated for critical illnesses and traumatic events. Therefore, providers frequently have difficult conversations with patients and their families. Pediatric critical care nurses are often invited to participate in these discussions. However, their role during, and after, these conversations is not always clear. The goal of this project was to evaluate the impact of an educational …

Learning A Healthy Rhythm: An Intervention To Increase Children’S Resources For Stress Management, Kristin Haglund, Amanda L. King, Abir K. Bekhet, Mauricio Garnier-Villarreal, Karen Olson, Rashs Atshan, Angela Ortiz, Johanna De Los Santos, Ruth Ann Belknap

College of Nursing Faculty Research and Publications

This article describes a pilot test of a community engaged, culturally relevant, arts-based intervention. The purpose was to increase children’s personal protective buffering resources. Protective buffering resources help children cope with stressful stimuli, reduce activation of their systemic stress response, mitigate allostatic load, and promote optimal health. The “Learning a Healthy Rhythm” intervention included a stress management component and an ongoing Afro-Latino percussion program for 18 children ages 9–11. The stress management component included educational content about stress, self-assessment of stress symptoms, and stress management techniques. A mixed-method intervention evaluation design was used. Qualitative data, quantitative data, and biometrics including …