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Improving Lead Screening In A Pediatric Practice: A Quality Improvement Project, Audrey Myers

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Background: Detectable lead levels in children’s blood have been associated with increased cognitive difficulties, attention deficits, and poorer academic performance. Children enrolled in Medicaid have higher rates of elevated blood lead levels, yet requirements to test all children at age 1 and 2 who are enrolled in Medicaid are not being met. Nationally, 34% of children enrolled in Medicaid do not undergo proper blood lead level screening. The aim of this project was to increase required blood lead level screening rates for children with Medicaid insurance at a private pediatric practice in the Shenandoah Valley in Virginia.

Methods: The …

Improving Nursing Adherence To Pediatric Pain Management Bundle Using The Pdsa Cycle, Stephen W. Lovern

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Given the current standards, pediatric post-operative pain management can be a distressing outcome to the patient and family. Adequate management of post-op pain in this population is a challenge despite the availability of evidence-based interventions combined to form care bundles. Tonsillectomies are common procedures in the pediatric population and often include moderate to severe pain with ineffective pain relief. Inadequate pain management leads to unplanned admissions, longer post anesthesia care unit (PACU) stays, slower oral intake, and longer recovery periods. In this project, two interventions were tested using the plan-do-study-act (PDSA) model for rapid cycle improvements. The first intervention was …