Medicine and Health Sciences Commons^™

Early Identification Of Depression In Patients With Pediatric Epilepsy, Erin Fecske, Paul Glasier, Lines Vargas Collado, Elizabeth Rende

Posters

Describes the use of the Neurological Disorders Depression Inventory-Epilepsy-Youth (NDDI-E-Y) in adolescent patients in a comprehensive epilepsy center to identify patients who need referral for mental health care.

Oxcarbazepine Overdose In A Polysubstance Related Suicide, Melissa Beals, Robert J. Krumsick, C. Clinton Frazee Iii, Lindsey J. Haldiman, Uttam Garg

Posters

Introduction
Oxcarbazepine is a derivative of carbamazepine that is used primarily in the treatment of epilepsy, and experimentally as a mood-stabilizer in adjunctive therapy for the treatment of bipolar disorder. Oxcarbazepine is converted through oxidation to its pharmacologically active metabolite 10-OH-Carbazepine, which is thought to be responsible for most of the anticonvulsant action of the drug. Adverse effects of oxcarbazepine are generally dose-dependent and may include fatigue, somnolence, dizziness, diplopia, nystagmus, and ataxia. Additive sedative effects have been noted when oxcarbazepine is used in combination with other CNS depressionproducing medications. Furthermore, oxcarbazepine and 10-OH-Carbazepine are powerful CYP2C19 inhibitors, potentially increasing …

Developmental Intervention Patters In A Level Iv Neonatal Intensive Care Unit (Nicu), Grace Winningham, Cy Nadler, Sarah Nyp, Eugenia K. Pallotto, Ashley Sherman

Posters

Background: There are no evidence-based standards for if/when developmental interventions should be initiated while an infant is in the neonatal intensive care unit (NICU), or these services yield incremental benefit. To support future prospective studies evaluating the neurodevelopmental benefits of NICU-based services as well as standardizing protocols for developmental interventions in the NICU, a thorough descriptive investigation of current developmental intervention practices is necessary. Objective: To describe trends in the delivery of developmental interventions [physical therapy (PT), occupational therapy (OT), speech-language therapy (ST), child life (CL), and music therapy (MT)] in high-risk infants in a large level-IV NICU. Methods: Electronic …

Social Work Triage In A School District For The School Year 2017-2018, Libby Milkovich, Briana A. Woods-Jaeger, Allison Zoromski Phd

Posters

Purpose: One in 7 children ages 2-8 have a behavioral, mental or developmental diagnosis. The prevalence of mental health disorders increases in adolescence to over 20%. Only 36% of youth who have a mental health disorder in their lifetime receive treatment. School-based services can address barriers to care. The purpose of this study was to determine the frequency and indication of referrals for students to 19 hospital-employed clinical social workers placed within a school district during one academic year (2017- 2018) and how the indication varies with level of schooling.

Methods: Students were referred to social workers by self, classmates …

Developmental Intervention Patterns In A Level Iv Neonatal Intensive Care Unit (Nicu), Grace Winningham, Cy Nadler, Sarah Nyp, Eugenia K. Pallotto, Ashley Sherman

Posters

Background: There are no evidence-based standards for if/when developmental interventions should be initiated while an infant is in the neonatal intensive care unit (NICU), or these services yield incremental benefit. To support future prospective studies evaluating the neurodevelopmental benefits of NICU-based services as well as standardizing protocols for developmental interventions in the NICU, a thorough descriptive investigation of current developmental intervention practices is necessary. Objective: To describe trends in the delivery of developmental interventions [physical therapy (PT), occupational therapy (OT), speech-language therapy (ST), child life (CL), and music therapy (MT)] in high-risk infants in a large level-IV NICU. Methods: Electronic …

Review Of Karyotypic Data From Low Grade Glial Brain Tumors, Specifically Pilocytic Astrocytomas, And Correlation Of Genetic Aberrations With Tumor Recurrence., Linda D. Cooley, Scott C. Smith, Lisa Warren, Melissa Gener, Kevin Ginn, John Herriges

Posters

Abstract: Brain tumors are the most common solid tumor of childhood. Approximately 50% of pediatric CNS tumors are low grade gliomas (WHO grade I or II) and Pilocytic astrocytoma (PA) is the most common accounting for 33% of all gliomas in children 0-14 years and ~18% of all childhood brain tumors. Prognosis with this slow-growing tumor is excellent; 10 year overall survival of ~95%. However, event free survival averages ~50%. Patient age and extent of tumor resection are key prognostic factors; tumor location and size impact resection and outcome. Histopathological features indicate PA is a benign tumor and rarely are …

Facilitating The Everyday Steward: Impact Of Mandatory Antimicrobial Indication/Duration And A 48 Hour Time Out, Ann L. Wirtz, Alaina N. Burns, Brian R. Lee, Tammy Frank, Laura Fitzmaurice, Richard Ogden, Brian O'Neal, Jennifer Goldman

Posters

Introduction: Required indication, duration, and a 48-hour antimicrobial timeout are an integral part of antimicrobial stewardship standards; however, limited data are available to demonstrate an effect on antimicrobial utilization and antimicrobial stewardship practice. Therefore, we evaluated the impact of mandatory declared indication/duration along with a pharmacy-driven 48-hour timeout on antimicrobial utilization and antimicrobial stewardship interventions.

Methods: We performed a retrospective evaluation of ASP interventions and antimicrobial use following implementation of mandatory antimicrobial indication/duration at the point of computerized physician order entry (CPOE). A pharmacist-driven 48-hour antimicrobial timeout was introduced on the same date. This study was conducted at Children’s Mercy …

Implementing Daily Management System Huddle Boards To Improve Communication Across Satellite Laboratories, Sean Tucker

Posters

Background

In a laboratory setting with fast-paced changes and heavy demands on staff, day-to-day communication across departments is challenging, yet paramount to resource sharing and real-time problem solving. Children’s Mercy Hospital Kansas City (CMH) has implemented system-wide lean practices focused on clinical and operational excellence. Our laboratory mission, or True North, is to produce clinically relevant laboratory results and information to assist in the diagnosis, treatment and prognosis of patients in a timely manner, by: �� Reducing Errors – Pre-analytical, Analytical & Post-analytical �� Making encounters with the laboratory extraordinary �� Reducing turnaround times �� Maximizing employee engagement and productivity …

Guided Mentorship: Enhancing Pediatric Resident’S Skills In Cardiopulmonary Resuscitation, Alyssa Stoner, Kadriye O. Lewis, Jennifer Flint, Shekinah Hensley, Brian Lee, Jenna Miller

Posters

Literature supports multiple aspects ofsimulation-based training1-5to impart technical skills and behavioral skills

Effects of different pedagogies have not been investigated in simulation

Pediatric residents have minimal exposure to pediatric cardiopulmonary resuscitation (CPR) due to restrictions in work hours and increasing quality and safety initiatives6

Code LITE(Low-tech, Internal, Training Experience) is a simulation environment for our residents utilizing a guided mentorship approach, known as cognitive apprenticeship

Residents completed pre and post rotation surveys and participating residents were observed during their simulation experience Just-in-time, in-situ simulation program

10 minute specific scenario with 10 minute debriefing session

Interprofessionalteam: nurses, respiratory therapists, pharmacists, attending …

Code Lite: Developing Pediatric Residents’ Resuscitation Knowledge And Skills Using A Guided Mentoring Approach, Alyssa Stoner, Jenna Miller, Jennifer Flint, Shekinah Hensley, Brian Lee, Kadriye O. Lewis

Posters

Background: Simulation-based learning is a popular training method in healthcare education. Literature supports multiple aspects of simulation-based training for technical skills and behavioral skills, however the effects of different pedagogies have not been investigated in this educational method.

Objective: Examine the effects of guided mentorship during simulation on pediatric residents’ learning experience.

Implementation Of A Guideline-Based Nontuberculous Mycobacteria Management Algorithm, Claire Elson, Ellen Meier, Douglas Swanson, Christopher M. Oermann

Posters

Nontuberculous mycobacterial (NTM) disease is a challenge to manage in patients with cystic fibrosis (CF). Diagnosis of NTM pulmonary disease is complex. Effective treatment requires long term, multi-drug therapy delivered by several routes. Consensus recommendations published in 2016 were developed to guide CF providers in NTM screening, diagnosis and management. Primary Outcomes. Children’s Mercy-Kansas City (CMKC) developed an NTM working group to facilitate implementation of standardized NTM management. Methods. NTM working group: Pulmonologist (CF Center Director), Infectious Diseases specialist, nurse practitioner (CF Center Coordinator), and pharmacist. Sought expertise from the Director of Microbiology Laboratory regarding susceptibility testing. Developed NTM Management …

P16-Ki67-Hmb45 Immunohistochemical Profiling May Help Discriminate Between Spitzoid Melanoma And Atypical Spitz Nevi, Robert E. Garola, Vivekanand Singh

Posters

Background

When Spitz nevi have increased vertical thickness (>1.5 MM), show ulceration and deep seated mitosis, the differential diagnostic considerations of atypical Spitz nevus (ASN) or a Spitzoid melanoma (SM) enter into consideration. While expert consultation from a dermatopathologist is most often sought to resolve the differential diagnosis, it could be expensive and time consuming. Recently, the use of molecular genetic testing has also been advocated in the work group up of atypical melanocytic proliferations. On the contrary, immunohistochemistry is a more routinely used technique in most pathology centers may be more simple to apply. A single immunohistochemical marker …

Reducing Discard Blood Draw Volumes From Subcutaneously Implanted Ports (Port) In Patients With End Stage Renal Disease (Esrd), Uttam Garg, Tyson Moore, Renita Trujillo, Penny Monachino, Amy Wiebold, Angela Ferguson, Gabor Oroszi, Vimal Chadha

Posters

Background
•To monitor clinical status, dialysis and transplant patients with ESRD frequently require blood draws.
•To preserve their veins and to avoid frequent intravenous access, these patients, especially young children, require PORT placement.
•The PORT is flushed with saline and filled with heparinized saline to prevent blood clotting between blood draws.
•To avoid contamination from PORT fluids, a fixed amount of blood is withdrawn and discarded before the blood sample is drawn for laboratory analyses. Currently, the recommended discard blood volume is 5 mL (five times the reservoir volume of most PORTs and attached catheters.)
•The volume of discarded blood …

Implementation Of Bedside Huddle To Improve Communication When Coordinating Care For Picu Patients With Newly Diagnosed Anterior Mediastinal Masses, Laura Mccarthy, Pam Nicklaus, Paul Sheeran, Tara Benton, Jenna Miller, Douglas C. Rivard, Melissa Gener, Susan Whitney, Keith August

Posters

No abstract provided.

Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger

Posters

No abstract provided.

Financial Stewardship Through Appropriate Critical Care Documentation, Shobhit Jain, Nirav Shastri, Gregory P. Conners, Irene Walsh

Posters

No abstract provided.

A Ninja Initiative At Children's Mercy, Richard Ogden, Bradley A. Warady, Vimal Chadha, Wendy Hoebing

Posters

No abstract provided.

Implementing Lean Daily Management System To Improve Cvor First Case On-Time Starts, Haley Borchers, Kelly Fehlhafer, Barbara Mueller, Jessica Nichols, Sarah Talken, Mary Hunter, Kenneth Sam

Posters

No abstract provided.

Venous Thromboembolism Risk Stratification Via Electronic Medical Record Classification, Shannon L. Carpenter, Laura Miller-Smith, Brittney Hunter, Ashley Duty, Justin Sheets, Yuri Tupa, Kate Gibbs

Posters

No abstract provided.

A Healthcare Improvement Initiative To Increase Multidisciplinary Pain Management Referrals Of Youth With Sickle Cell Disease, Rae Ann Kingsley, Gail Robertson, Lynne Covitz, Areli Ramphal

Posters

No abstract provided.

Improving Pneumococcal Polysaccharide Vaccination In Children With Cystic Fibrosis, Adam Van Mason, Wendy Estrellado-Cruz, Kristi Williams, Ellen Meier, Elizabeth Elson, Stephanie Duehlmeyer, Paula Capel, Jessica Banks, Christopher M. Oermann

Posters

No abstract provided.

Decreasing Cardiac Arrests In The Pediatric Intensive Care Unit, Jeremy Affolter, Kathlyn Baharaeen, Mari Hanson, Lisa Laddish, Amy Bohm, Lindsey Bradbury, Megan Mcghee, Anne Leroy, Hannah Cunningham, Michelle Waddell, Tiffany Mullen, Kimberly Lucas, William Douglas, Angel Pope, Marita Thompson, Paul N. Bauer, Erica Molitor-Kirsch, Tara Benton, Laura Miller-Smith

Posters

No abstract provided.

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Resident Great Catches: Recognizing Resident Physicians Who Promote A Safe Environment For Patients, Kristin Streiler, Susamita Kesh

Posters

No abstract provided.

The Relationship Between Vitamin D Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Vitamin D deficiency has recently been posited as an important factor in the pathogenesis of restless leg syndrome.

•We evaluated the association between vitamin D deficiency and limb movements and sleep architecture in a pediatric sample.

Methods

•This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and 25-OH vitamin D within 60 days of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr or Obstructive Apnea Hypopnea Index >2/ hr) were excluded. Results •There were a total of 83 children …

Quality Improvement: Implementing A Foot Exam To Improve Care For Patients With Diabetes Mellitus, Emily Paprocki, Ryan Mcdonough, Tiffany Musick, Joseph Cernich

Posters

No abstract provided.

The Headache Champion Program, Courtney Wellman, Kristin Allender

Posters

BACKGROUND

Approximately 10% of school age children suffer from migraines, making migraines one of the top five health problems experienced by youth today

School nurses often are the first healthcare provider seen by youth with migraine; visits to the school nurse for headaches amounted to one-third of the enrolled student population in a large local school district. (see reference)

Empowering school nurses through education and resources to identify and manage migraines therefore may have significant benefits to children with migraines and their families.

OBJECTIVE

To improve migraine care in the community through establishing a headache specialist mentorship program for select …

Significant Loss Of Blood Amino Acids And Free Carnitine In Newborns Receiving Continuous Renal Replacement Therapy (Crrt), Uttam Garg, Marita Thompson, Bradley A. Warady, Vimal Chadha

Posters

Background

•Newborns with acute kidney injury (AKI) or end-stage kidney disease (ESKD) often receive prolonged CRRT when the early initiation of peritoneal dialysis is either contraindicated or unable to be performed. •These patients often receive total parenteral nutrition (TPN) to meet their nutritional goals. •Little to no information exists on the loss of blood amino acids (AA) and carnitine during CRRT in these patients. •The objective of this study was to determine the amino acids and carnitine losses in newborns receiving prolonged CRRT and TPN. Material and Methods

•Three newborns who received prolonged (> 2 weeks) CRRT and TPN were …

Pressure Injury Prevention For Urology Surgical Procedures: A Qi Initiative, Azadeh Wickham, Pat Clay, Kate Gibbs

Posters

No abstract provided.

Medication Timeliness In Emergency Department In Pediatric Sickle Cell Disease Population Presenting With Vaso-Occlusive Episode, Derrick Goubeaux, Kaitlyn Hoch, Gerald Woods, Julie Routhieaux, Maureen Guignon, Valerie Mcdougall Kestner

Posters

No abstract provided.