Pediatrics Commons^™

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operations Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …

Improving Communication Access With Deaf People Through Nursing Simulation: A Cross-Disciplinary Collaboration, Jamie L. Mccartney Ph.D., Tracy Gidden, Jennifer Biggs, Kathy Geething, Karl Kosko Ph.D.

Journal of Gender, Ethnic, and Cross-Cultural Studies

Baccalaureate nursing and sign language interpreting students participated in a pediatric discharge simulation with a deaf person playing the role of the baby’s parent. At the conclusion of the simulation, participants were emailed a consent letter and a link to a 17-item questionnaire developed by the authors. Responses were analyzed both quantitatively and qualitatively, whereby nonparametric statistics were calculated to examine Likert-scale items. A Mann-Whitney test statistic was calculated, instead of an independent samples t-test, given the smaller sample in the current study (n = 26). A question was posed to participants that evaluated their self-perception of the effectiveness of …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski

Evidence-Based Practice Project Reports

Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …

Development Of An On-Job Mentorship Programme To Improve Nursing Experience For Enhanced Patient Experience Of Compassionate Care, Alma Arshad Hookmani, Naureen Lalani, Noureen Sultan, Aly Zubairi, Ayesha Hussain, Babar Hasan, Muneera A. Rasheed

Department of Paediatrics and Child Health

Background: Evidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited.
Objective: The objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses' experience and thus enhancing patient experience in a tertiary care …

Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren

Evidence-Based Practice Project Reports

The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …

A Standardized Web-Based Nursing Curriculum On Safe Infant Sleep Practices – A Vermont Statewide Initiative, Jace Nebeker

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background/Purpose: In Vermont and across the country, infants continue to die from Sudden Unexpected Infant Death Syndrome (SUIDS), which in most cases is preventable. Best practice recommendations to safe infant sleep education are available; however, ensuring dissemination of this new information to parents has been challenging. The purpose of this Doctor of Nursing Practice project was to develop an evidence web-based nursing curriculum on safe infant sleep practices for registered nurses working in Vermont community birthing hospitals.

Methods: Current literature on safe infant sleep practices, adult learning principles and nursing education strategies were incorporated into the development of an evidence …

Optimizing A Pediatric Dka Protocol In A Tertiary Care Hospital System In Northern West Virginia, Jennifer L. Burky

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body compensates for insufficient insulin, producing dangerously high levels of ketones. Without proper treatment, DKA can be fatal. For that reason, staff in the pediatric intensive care unit (PICU) at a tertiary care hospital in northern West Virginia expressed concerns about the complexity of and lack of adherence to a poorly referenced and dated DKA treatment protocol.

Objective: The purpose of this project was to assess the feasibility and sustainability of optimizing the DKA protocol in the PICU. The primary objective was to implement an updated, …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

You're Not Forgotten: Effects Of Screening For Postpartum Depression Within A Pediatric Setting, Marrisa S. Culver

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is depression that occurs in women following childbirth occurring during the postpartum period and affects 1 in 7 women (The United States Preventive Services Task Force, 2019). The American Academy of Pediatrics [AAP] (2019), recommends that pediatric healthcare providers utilize their position to screen for PPD. The purpose of this evidence-based practice (EBP) project was to implement a PPD screening intervention within a pediatric healthcare setting using the Edinburgh Postnatal Depression Scale (EPDS). The Academic Center for Evidence-Based (ACE) Practice Star Model guided this EBP project with evidence-based interventions developed after a comprehensive literature search. Implementation of …

Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger

Evidence-Based Practice Project Reports

Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Improving Communication Between Child Life Services And Nursing On An Inpatient Pediatric Unit, Sherryann St. Pierre, Elizabeth Shaughnessy, Bethany Kay, Barbara Bush Children's Hospital, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

IMPROVING COMMUNICATION BETWEEN CHILD LIFE SERVICES AND NURSING ON AN INPATIENT HOSPITAL UNIT

Effective communication between patient caregivers has been shown to reduce stress and trauma related to hospitalization and subsequent improved outcomes. An HCAHP score for a 30 bed acute inpatient pediatric unit illustrated the confusion faced by children as a result of nursing and care life specialists not working together as a team.

A root cause analysis identified a number of issues as to why patients were not benefitting fully from child life services. Several counter measures were instituted with the goals of improving the HCAHP score and …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Nurses' Perceptions Of Barriers To Pediatric Patient Advocacy In End-Of-Life Care, Layla J. Eaton

Honors College

Nurses responsible for caring for pediatric patients during end-of-life care find themselves in any number of ethical dilemmas as they attempt to balance providing care, educating family and patients spanning a large developmental spectrum, working collaboratively with extensive medical teams, ensuring proper therapy and bereavement services for parents and siblings, as well as advocating for the voices of their patients who do not yet have legal authority to make decisions regarding their care. These issues are multifaceted and require considerations from multiple disciplines if proper assessment of potential barriers to patient advocacy is desired. This thesis explored the barriers perceived …

Anomalia Anorretal: Relato De Caso Clínico / Anorectal Malformations: A Case Report, Everton Fernando Alves, Jucélia Lins Dos Santos Oliveira, Maria Do Rosário Martins

Everton Fernando Alves

A Anomalia Anorretal é uma importante causa de obstrução gastrintestinal, com alta taxa de morbi-mortalidade em recém-natos. Há diversos mecanismos patológicos possíveis para explicar esta malformação e duas explicações clássicas de sua gênese são um defeito de recanalização do tubo intestinalou uma interrupção no suprimento sanguíneo durante a vida intra-uterina, entretanto a causa ainda é desconhecida. Desta forma, o presenteestudo tem por objetivo descrever um caso clínico de uma criança internada em um Hospital do Município de Maringá-PR, portadora de uma anomalia anorretal (Ânus imper-furado). Para este estudo, foram coletados dados do prontuário da criança, exame físico e uma entrevista …

A View From The Sun Parlor: A History Of Pediatrics In Portland, Maine, J Daniel Miller

Histories

Publication includes a written history, posters, photographs, and charts pertaining to the early years of pediatrics in Portland, Maine.