Medicine and Health Sciences Commons^™

Clabsi Prevention Through Prevention Huddles And Clabsi Risk Assessment And Prevention Form In Electronic Medical Record, Tara Benton, Barb Haney, Lacey Bergerhofer, Yolanda Ballam, Kaitlyn Hoch

Posters

Our aim is to increase the awareness of high risks for central line associated bloodstream infection (CLABSI) and decrease the CLABSI rate with the implementation of CLABSI prevention huddles and an electronic medical record (EMR) "CLABSI Risk Assessment and Prevention" form.

Lighting The Way To Ensure Safe Transition Home, Barb Haney, Ashley Mirabile, Dianne Wilderson, Beckie Palmer, Ashley Lewis, Cris Mills, Eugenia K. Pallotto

Posters

All aspects of discharge (education, screenings, appointments, plans and home services" must be completed and appropriately communicated prior to discharge to ensure safe transition to home.

Goal: Standardize all aspects of discharge in a large, busy 84-bed Level IV NICU with >1000 admissions/year and >300 nurses, >60 NNPs, and >25 neonatologists.

• 95% of patients with lengths of stay >3 days have all discharge planning completed prior to discharge/Parent Care Unit overnight stay

Safe Sleep In The Nicu, Ashley Mirabile, Barb Haney, Dianne Wilderson, Beckie Palmer, Ashley Domsch, Eugenia K. Pallotto

Posters

Goal: To evaluate a staff education program on approach to improve in the rate of eligible NICU infants in safe sleep in a busy 84-bed level IV NICU.

Outcome Measures; Improve safe sleep compliance for eligible patients to 90% or greater by December 2019.

Process Measures: Audits from bedside RNs showing compliance with safe sleep.

Planned Intervention: In December of 2018 a multidisciplinary work group brainstormed and implemented best practice safe sleep education for staff and parents. September 2019 a Safe Sleep Educational Toolkit was made available for staff.

Results: Safe Sleep compliance has gone from 53% to 90% in …

Safe To Sleep In The Icn, Megan Kelly, Alexandra (Lexi) Van Noy, Molly Kruse, Megan English, Hannah Culbertson, Brianne Truitt, Ziryan Salihparkhy, Jenny Mckee, Brecklyn Findley

Posters

The CDC states that 1,545 infants passed away from SIDS in 2014. Safe sleep includes supine, in a crib, head of bed flat, firm sleep surface, tightly fitted sheet, no loose blankets, no toys or supplies in crib with infant. It is important for nurses to model safe sleep practices in the hospital setting. Current compliance with safe sleep in the Intensive Care Nursery is 50%.

AIM Statement:

By August 1, 2019 we want to increase the compliance of modeling safe sleep behaviors for patients who qualify for safe sleep from 50% to 90% in the Intensive Care Nursery.

Implementing Treat To Target Approach In The Care Of Children With Juvenile Idiopathic Arthritis, Julia G. Harris, Jamie Holland, Emily Fox, Leslie Favier, Ashley M. Cooper

Posters

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory disease seen in pediatric rheumatology. Despite advances in biologic therapy, many children with JIA will experience morbidity. Treat to Target is a treatment paradigm that involves setting a target of disease activity, using shared decision making, and incorporating clinical decision support. Our clinic aimed to set a treatment target on 50% of eligible JIA patients by December 31, 2019.

Improving Care Of The Small Baby, Beckie Palmer, Abdebayo Oshodi, Brandy Huitt, Kaylee Hurt, Pamela Kliethermes, Trudy Koons, Patricia Lanzer, Ashley Mirabile, Allyson Owen, Christian Anthony Schneider, Betsi Anderson, Steven Olsen

Posters

Hierarchy of Aims:

• Global Aim: Create a Small Baby Unit for infants admitted to our NICU that arebirth, in which 90% of our patients are admitted to F pod on day of admission, by March 2019
• Interim Aim: Staff 80% of our micropremie patients with a Small Baby Team nurse from admission until >32 weeks by May 2019.
• Sub Aim: Increase rates of developmentally appropriate care (2 person cares, kangaroo care compliance) by 50% by August 2019.

Improving Bedside Nurse Engagement In Quality Improvement (Qi) Projects, Beckie Palmer, Sarah Carboneau, Ashley Domsch, Barb Haney, Brandy Huitt, Ashley Lewis, Ashley Mirabile, Allison Ronco, Dianne Wilderson

Posters

Project Aims:

• Improve nursing engagement in QI as evidenced by increasing nurse involvement to 40% of overall staff by December 2018, with a continual increase to >50% by June 2019.
• Decrease the % of nurses who express "my opinion doesn't matter" as a reason they do not participate in QI by 30% by June 2019.

A Multifaceted Approach To Improve Quarterly Visit Rates At A Pediatric Cystic Fibrosis Care Center, Paula Capel, Jessica Banks, Micaela Mckenna, Ashley Andrews, Christopher M. Oermann

Posters

Standard quality improvement methodology was used to improve quarterly visit rates among cystic fibrosis patients at Children's Mercy Kansas City Cystic Fibrosis Center.

• A family-centered, team-based approach was adopted
• A change in culture led to sustained improvement

Improved quarterly visit rates should drive improvement in outcomes including pulmonary function and nutritional status.

Trauma Informed Care: Improving Staff Morale On 6 Henson, Kara Humphreys, Katherine Karstens, Kortney Neiderhauser, Briana Pina, Payton Tallent, Stephanie Assad, Madison Dexter

Posters

Six Henson staff reported feeings of burnout and compassion fatigue.

Aim Statements:

Decrease percentage of 6 Henson staff feeling sometimes or often "worn out because of [their] work as a helper" from 86% to 50% by August 1, 2019.

Increase the number of KUDOS cards submitted by 6 Henson staff from 2-3 per week to 10 per week by August 3, 2019.

Both aim statements were met and exceeded.

Increasing Rates Of Breastmilk Use At Time Of Neonatal Intensive Care Unit (Nicu) Discharge: An Improvement Project In A Midwest Level Iv Nicu, Kathleen Hortenstine, Teresa Fulk, Stephanie Callis, Kyla Galate, Beckie Palmer

Posters

• Breast milk is the preferred food for all infants.
• The rate of breast milk use at time of discharge was below the goal of the institution.
• A gap was identified in bedside nursing education, limiting their ability to provide resources and education to mothers. Nursing involvement ensures skilled, comprehensive, and accessible breastfeeding support.
• The aim of this project is to increase breast milk rates at time of NICU discharge to 95% of eligible patients by December of 2019.

Making The Management Of Acute Otitis Media A Snap, Cassandra Newell, Donna Wyly, Tanis Stewart, Alaina N. Burns, Brian R. Lee, Rana El Feghaly

Posters

AIM:

To improve Watchful Waiting or Safety Net Antibiotic Prescription (WW/SNAP) in children >6 months old diagnosed with acute otitis media by Advanced Practice Nurses in the Emergency Department by May 2020.

6 Hall Team Norms: It's Our Patient, Mallory Rittel, Markeyta Brown, Ron Chenoweth, Marcy Page, Chelsi Peterzalek, Amanda Woldruff

Posters

Aim Statement

6 Hall will increase NDNQI RN-RN interaction scores from 5.06 to 5.45 to meet the 2019 National Magnet Facilities benchmark b August 1, 2019.

6 Hall Team Norms

• We strive for excellence: our work is complex, mistakes will happen.
• We provide timely (<1 >week) feedback, which includes positive, learning and interpersonal feedback.
• We celebrate as a team and our environment feels like every individual matters.
• When trust is broken, we ask ourselves: how did I contribute? What can I do to make it better? We are careful in not making assumptions.
• Our behaviors are supportive and display respect. …

Increasing Kangaroo Care In A New Small Baby Unit, Dianne Wilderson, Barb Haney, Ashley Mirabile, Beckie Palmer, Jenny Heltzer, Erin Keith-Chancy Bsn,Ccrn, Brooke Smith, Christian Anthony Schneider, Abdebayo Oshodi

Posters

Project Aim: Increase the percent of eligible patients receiving kangaroo care from 19% to 30% by September 2019.

Results:

113 staff completed education

OT consults completed on all SBU patients

20 kangaroo wraps purchased

Kangaroo care rate in NICU increased from 19% (prior to SBU) to 36% (Post SBU opening).

Conclusion: Due to increased multidisciplinary awareness of importance of kangaroo care in the SBU more parents are completing kangaroo care.

Decreasing Length Of Stay In Pediatric Urgent Care With Electronic Discharge Instructions, Jennifer Wooster, Aimy Patel, Brian R. Lee, Amanda Nedved

Posters

Time spent waiting in the urgent care clinic is dissatisfying for patient and staff. This "wasted time" accounted for more than 52% of the urgent care visit at our urgent care.

The aim of our project is to decrease length of stay by 10 minutes by April 30, 2019 for all patients discharged from Blue Valley Urgent Care by offering patients a paperless depart process. To be eligible for discharge without paper families must be enrolled in the online patient portal.

Electronic discharge instructions significantly decrease length of stay and is associated with improved patient experience scores. Patients who received …

The Kanga-Croo: Nurse Resident Champions Creating Momentum For Improvement, Brett Butler, Jacob Burden, Carly Creekmore, Blair Griffin, Taylor Godemann, Taylor Hagen, Theresa Koelling, Mary Anne Kucera, Halle Magid, Makenna Miller, Monica Page, Mary Riffel, Madison Stebbins, Sarah Stokes, Skylar Suppes

Posters

Topic Summary:

Kangaroo Care (skin to skin care) is a parent-led, evidence-based intervention which improves outcomes in neonatal patients including: decreased apnea, increased weight gain, increased parent satisfaction and decreased length of stay.

Results:

Nurse resident team interventions to support parent engagement and remove barriers to Kangaroo Care (KC) through iterative PDSA cycles from January 2018 to July 2019 yielded positive results within a subset of ICN patients.

Who Codes In The Nicu: An Analysis Of Demographics And Factors That Place Neonates At Higher/Lower Risk Of A Serious Code Event And Prognosis Post-Code, Danielle N. Gonzales, Ashley K. Sherman, Jennifer Dremann, Staci Elliott, Amelia Gute, Amber Bellinghausen, Jessica Brunkhorst, Danielle Reed

Posters

This study analyzed resuscitation events in a level IV neonatal intensive care unit from 2012-2017 to determine whether there are identifiable differences between those who have a rapid response event and those with a short or long code and determine factors post-event that may impact survival to discharge.

Identifying Structural Factors Associated With Central Line-Associated Bloodstream Infections (Clabsi) Risk In A Single-Center Pediatric Academic Hospital, Elizabeth Monsees, Paul N. Bauer, Yolanda Ballam, Brian R. Lee

Posters

Objective: compare unit structure and process-related factors against unit-specific CLABSI rate.

Conclusion: CLABSI mitigation requires more than individual competence with task-related practices; the unique work ecology of each clinical area may broadly influence CLABSI as an outcome; extending analyses to consider organizational structure can inform resource allocation and recalibrate traditional prevention strategies.

Breastfeeding And How It Affects Cognitive Development, Kylie Farris, Barbara Mcclaskey

Posters

If one was asked “which is better: breastfeeding or formula feeding?” the most common answer would be “breastfeeding.” This would be the answer 9 times out of 10. It is a known fact by a wide range of people, that in general, breastfeeding is the better option. Infants who are breastfed exclusively in the first six months of life tend to have better overall health outcomes than children that are fed only iron-fortified formula or a combination of the two. Therefore, it is likely that breastfeeding will indeed also improve cognitive developmental outcomes. That is the purpose of this study. …

Spontaneous Pushing Vs Directed Valsalva Pushing, Erika Ellis, Barbara Mcclaskey

Posters

The purpose of this study is to determine if spontaneous pushing during the second stage of labor produces better maternal outcomes than the more commonly used directed Valsalva pushing. A literature review of the recent studies has been performed to determine if Valsalva pushing is simply archaic or absolutely necessary for healthier mother/baby outcomes. To recommend that women go against their primal urges to push in the man­ner that their own bodies are directing them, indicates that there must be research-based evidence to intervene in the natural order of things and use Valsalva pushing instead. When in fact, there are …

Neonatal Abstinence Syndrome, Marissa Thompson, Barbara Mcclaskey

Posters

Neonatal abstinence syndrome (NAS) is becoming more and more prevalent today. The number of women who are using narcotics while they are pregnant continues to rise. Neonatal abstinence syndrome may occur when a pregnant woman takes narcotics that cross the placenta to the fetus. The fetus then becomes dependent on the drug. When the infant is born, they are no longer receiving the drug. A large percent of these infants will go on to develop withdrawal signs and symptoms after birth. Since there has been no consistency in providing specific standardized care for treating infants with NAS, the purpose of …

A Pre And Post Survey To Evaluate Patient Perception Of Group Diabetes Self-Management Education In Rural Health Clinics, Stormy Carter, Ashleigh Heter

Posters

Diabetes is a significant clinical issue in the primary care setting. Providers struggle to overcome barriers to facilitate therapeutic interventions for populations served. The specific aim of this study was to assess group diabetes self-management education from a patient perspective. Evaluation of diabetes knowledge and self-efficacy confidence was conducted in rural primary care clinics using pre and post surveys. This study utilized a one-group pretest-posttest design to patients receiving group diabetes self-management education in Southeast Kansas rural primary care clinics by a certified diabetes educator. The surveyed population included individuals ages 18-65 with prediabetes, type I, or type II diabetes …

Co-Bedding Preterm Infants In The Nicu, Payton Moss, Barbara Mcclaskey

Posters

Providing the best possible environment for premature infants continues to be a challenge in the neonatal inten­sive care unit (NICU). The purpose of this literature review was to examine the evidence related to the care of preterm twins and whether twins benefit from co-bedding verses keeping them separated. Co-bedding is defined as caring for two or more infants in the same incubator and is considered a developmental initiative to minimize adverse effects of preterm birth. Twins share a tight space in utero and support each other as they grow. Skin-to-skin contact with preterm infants and their mothers has been shown …

Autism Screening Knowledge And Practice In Southeast Kansas, Briana Laforge, Ashleigh Heter, Janis Schiefelbein, Ananda Jayawardhana

Posters

Autism spectrum disorder (ASD) is classified as a neurodevelopmental disorder characterized by delays in social communication and interaction as well as restricted repetitive behaviors, interest, and activities. According to the most recent reports from the CDC, it is estimated that 1 in 68 children are diagnosed with some form of ASD in the United States. Research has shown that early identification and intervention can significantly improve out­comes in those individuals diagnosed. As a result of this research, the American Academy of Pediatrics (AAP) has recommended routine screening on all children for ASD at the age of 18 months and again …

Pediatric Hospital Environments: Do They Make A Difference?, Rhyan Elliott, Barbara Mcclaskey

Posters

The environment can have an extreme impact on a child’s well-being, growth and health. This should be taken into consideration especially for those children that are surrounded by a hospital environment. The healthcare system can come across as extremely intimidating and frightening to young patients. The purpose of his research study is to change this mind-set by creating a more welcoming atmosphere through child-friendly interventions such as magic, colorful art, and nature. By conducting interviews with the children of these hospitals and using visual and exploratory techniques, the essence of what keeps a child’s spirit alive can be captured to …

Use Of Workplace Incentive Programs To Increase Health Behaviors In Nurses, Sydney Harris, Barbara Mcclaskey

Posters

As the frontline and most visual health promoters in a hospital setting, nurses are to be at the top of their game in terms of their health behaviors. Unfortunately, several studies show that nurses tend to follow the trend of the general population in poor eating habits, physical inactivity, sleep habits, and smoking and alcohol consump­tion. The purpose of this study is to unveil the benefits of Workplace Health Incentive Programs in an effort to increase the overall health of those who are to be considered role models for a healthy lifestyle, the nurses who hold the seat for the …

Nurse-To-Nurse Bedside Handoff: Improving Communication And Patient Safety, Brynna M. Brouwer, Barbara Mcclaskey

Posters

Effective communication and patient safety are very crucial aspects of nursing care. The purpose of this research was to explore the evidence supporting bedside reporting with a standardized handover tool and to identify the problems that exist when no standard handover method is used. Interventions and improvements that can be implemented to bring about better outcomes in patent safety and effective communication will be identified. Bedside nurse-to-nurse change-of-shift reports as well as a standardized handover tool are effective means of increasing shared understanding while improving the quality of care and the patient’s safety. Bedside reporting with a handover tool such …

The Use Of Turn Assistance Features On Hospital Beds For Prevention Of Caregiver Injury, Trenton Tucker, Barbara Mcclaskey

Posters

In the world of nursing, caregiver injury is still a major problem. It has been reported that 44% of healthcare workers have lower back musculoskeletal pain. The purpose of this study was to examine ways to decrease injury to care providers. The methodology was a literature review focusing on turn assist technology. Education alone cannot always prevent a musculoskeletal injury, and thus the use of turn assistance features on beds is implemented. These turning functions have shown great success in helping prevent caregiver muscle strain, and in helping decrease caregiver injury. As general technology has increased, so has medical technology …

Music Therapy In Preterm Infants In The Nicu, Olivia Murdock, Barbara Mcclaskey

Posters

A neonatal intensive care unit (NICU) provides life-saving care for premature and sick newborns. However, that environment is very stressful due to the noise of equipment, alarms, and constant activity. It is important to decrease the stress for the infant as well as the parents. The purpose of this literature review was to determine if there is benefit from the use of music in the NICU. The high level of stress and anxiety that parents experience during this time may put the parent/child relationship at risk. Overstimulation and ongoing noise in the NICU may delay improvement in health and increase …

Umbilical Cord Milking At Birth, Jennifer Bowers, Barbara Mcclaskey

Posters

The World Health Organization recommends delaying cord clamping for at least 30-60 seconds after the birth of a full-term newborn. However, the recommendation on the time of cord clamping is not as clear with preterm infants or infants who need immediate resuscitation. The purpose of this study was to examine the best, most recent evidence regarding the timing of cord clamping. The methodology was a literature review. Recent research has focused on umbilical cord milking prior to cord clamping. Umbilical cord milking is described as “the unclamped umbilical cord is grasped and blood is pushed toward the infant several times …

The Decision Of Families And Hospice Nurses On Use Of Oxygen Therapy At End Of Life, Mary Gathoni, Janis Schiefelbein

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Minimal research efforts have focused on why family members make the decision to use oxygen therapy for their loved one at end of life, and the thoughts of hospice nurses who recommend the use of oxygen. Many families and nurses believe the use of oxygen therapy in palliative care is a practice endorsed by the medical community. However, this is inconsistent with existing knowledge that oxygen use at end of life contributes to comfort and decreases breathlessness or dyspnea. Dyspnea, the sensation of breathlessness or inadequate breathing, is common for patients with end of life illnesses. Dyspnea occurs when an …