Pediatric Nursing Commons^™

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Student Research Posters

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

Investigating The Impact Of Outpatient Mental Health Follow-Up Care On Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal, Kimberly Feifel

MSN Capstone Projects

The escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.

The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and …

Perception Of Pediatric Readiness Across A Health System's Emergency Departments, Rebekah L. Sabo

Doctoral Dissertations

The recent pandemic and pediatric respiratory syncytial virus surge have reinvigorated pediatric care readiness conversations. National strategies and associations exist to guide health systems in improving the quality of emergency care offered to pediatric populations by first assessing readiness for care. These research strategies center on survey implementation and staff engagement in general emergency departments with the goal to improve staff readiness to care for pediatric patients that may present for treatment. What impact would developing a consolidated pediatric readiness program that includes: pediatric emergency care coordinator designation for each emergency department, pediatric readiness education and committee engagement have on …

Promoting The Use For Sugammadex In Robotic- Assisted Surgeries:, Amr Ali

Scholars Week

No abstract provided.

Implementation And Evaluation Of Iron Deficiency Anemia Content In Prenatal Education Classes, Jasmine N. Walker Bsn, Erin M. Morris Bsn, Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn, Mary K. Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this quality improvement project is to provide and increase educational awareness and knowledge regarding iron deficiency anemia (IDA) in pregnant patients at an urban primary care clinic in Memphis, TN. This project is intended to decrease the number of individuals with IDA in pregnancy while decreasing the occurrence of IDA-related complications in pregnancy. The study aimed to introduce a cost-effective approach to help decrease or eradicate complications related to IDA during pregnancy.

The World Health Organization (WHO) estimates the prevalence of anemia-complicating pregnancies to be more than 40 percent. Pregnant women with IDA residing in low …

Strategies Over Knowledge: Training Gaps Present In Caring For Patients With Autism Spectrum Disorder For Pediatric And Student Nurses, Jasmine E. Johnson

Honors Thesis

With Autism Spectrum Disorder (ASD) prevalence ever increasing among the pediatric population, nurses can expect to see an increase in the number of autistic patients within their clinical practice settings. Previous researchers have shown that pediatric nurses are required to overcome many barriers when working with autistic patients, and adequate training is necessary to achieve genuine patient-centered care. However, parents have reported less than optimal care received by their children with ASD within the healthcare system. Therefore, research is needed to determine where training could be improved for this patient population. This study aimed to identify where training deficits are …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Senior Theses

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

Unveiling New Realities: An In-Depth Analysis Of Virtual Reality's Impact On Postoperative Adolescents, Julia Tolentino

Nursing | Senior Theses

The traditional approach to postoperative pain management heavily relies on opioids, but there’s been a surge in their misuse and adverse effects, leading to a significant public health concern. This has led healthcare providers to incorporate a multimodal approach aimed at reducing opioid dependence. This proposal introduces an immersive component, virtual reality (VR), not as a replacement for opioids but as a complementary tool offering distinct advantages for enhancing postoperative pain management. By immersing patients in a virtual environment, VR effectively distracts them from pain and discomfort, allowing for reduced opioid dosages and mitigating the risk of opioid misuse. Additionally, …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Senior Theses

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

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 Jansen

Nursing | Senior Theses

Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with …

Unlocking Vr Magic: Duration Of Anxiety Relief For Pediatric Needle Procedures, Anna Angelica Guzman Mendoza

Nursing | Senior Theses

There have been various studies that show the effectiveness of virtual reality (VR) being used as a non-pharmacologic and distraction method on school-aged children ranging from 6-12 years old. Despite this research, there has not been a follow-up with the use of VR and its duration of effect between each patient visit within this certain population. This study focuses on measuring the participants’ anxiety and pain levels during the needle-related procedure. The assessment tools that will be used to measure these important variables are the Children’s Fear Scale and Wong-Baker’s FACES scale. The participants of this study will be placed …

Chronic Atopic Dermatitis: Symptom Management Using Moisturizers Among Asian American Pediatrics, Ethan J. Brillantes

Nursing | Senior Theses

Background: Atopic Dermatitis (AD), also commonly known as eczema, affects 31.6 million (10%) of the United States Population, with 13% being Asian American or Pacific Islander. A cure is not present for AD; however, the best way to treat AD is with symptom management. While there are many pharmacological treatments that aid with symptom management such as topical or oral corticosteroids, there are also non pharmacological treatments such as moisturizers that can aid with symptom relief of AD as well. Objective: The literature review explores moisturizer use and other non pharmacological methods for symptom management of AD and provides understanding …

Enhancing Athletic Participation: Continuous Glucose Monitoring For Pediatric Type 1 Diabetes Athletes, Danielle Santiago

Nursing | Senior Theses

The difficulties that children and teenagers with Type 1 Diabetes Mellitus (T1DM) encounter are discussed in this thesis, with a focus on how fear of hypoglycemia (FOH) and actual hypoglycemia associated with this chronic illness affects their ability to engage in physical activities, especially organized sports. A common challenge for children diagnosed with T1DM is meeting the daily recommendation of 60 minutes of daily moderate to vigorous physical activity. The purpose of the proposed study is to evaluate if participation in structured exercise (physical education classes and after-school sports) increases among school-aged children who wear continuous glucose monitors (CGM) when …

Furry Friends & Brighter Futures: Enhancing The Life Skills Of Toddlers With Autism Through Animal Assisted Therapy, Abigail Rosales Tolentino

Nursing | Senior Theses

Autism Spectrum Disorder (ASD) encompasses a broad spectrum of challenges that impact social interaction, communication, and behavior. While Applied Behavior Analysis (ABA) stands as a common therapeutic approach, there is a growing recognition of the need for personalized interventions. Animal Assisted Therapy (AAT) emerges as a promising avenue for enhancing social interactions. This study focuses on the utilization of dogs in AAT for toddlers aged 12 to 36 months with confirmed ASD diagnoses. The experimental group will undergo a combined intervention involving standard ABA therapy alongside weekly AAT sessions, whereas the control group will receive standard ABA therapy alone. Pre- …

Diabetes Management In Adolescents: Insulin Pump Therapy Versus Insulin Injection Therapy, Candice J. Ryder, Chantal Connelly, Lindsay Clements, Keri Hebert

Non-Thesis Student Work

Understanding the compliance of different insulin delivery methods among adolescents with diabetes is crucial for bettering their outcomes as they grow into adulthood. Adherence to insulin regimens can be influenced by many factors, including education provided to the adolescent from caregivers and providers, utilization of diabetes educators, peer influence, and stereotyping. The two methods of insulin delivery focused on for this review are insulin pumps and daily insulin injections. These authors pose the question: in adolescents, aged 13-18 years with type 1 diabetes mellitus (T1DM), does the use of an insulin pump therapy compared to insulin injection therapy lead to …

Distraction Interventions And Play Therapy: Decreasing Fear And Anxiety In Hospitalized Patients Less Than 12 Years, Terence J. Olds, Jordan Conroy, Rebecca Rider, Julia Good, Hannah Peacock

Non-Thesis Student Work

Hospitalization can be a frightening experience for pediatric patients. Addressing these negative emotions greatly impacts their experience, wellbeing, and recovery process. It is crucial to understand and implement strategies that alleviate these negative emotions and promote healing during hospitalization. The authors will review two safe, effective, and reliable methods of alleviating fear and anxiety in hospitalized children under 12 years old; distraction techniques and play therapy. A literature search was conducted on CINAHL and PubMed using the following search criteria: child, youth, kid, play therapy, therapeutic play, anxiety disorders, generalized anxiety, hospital, acute setting, inpatient, and distraction. A total of …

Post-Discharge Malaria Chemoprevention In Children Admitted With Severe Anaemia In Malaria-Endemic Settings In Africa: A Systematic Review And Individual Patient Data Meta-Analysis Of Randomised Controlled Trials, Kamija Phiri, Carole Khairallah, Titus Kwambai, Kalifa Bojang, Aggrey Dhabangi, Robert Opoka, Richard Idro, Kasia Stepniewska, Michael Boele Van Hensbroek, Chandy C John

Paediatrics and Child Health, East Africa

Background: Severe anaemia is associated with high in-hospital mortality among young children. In malaria-endemic areas, surviving children also have an increased risk of mortality or readmission after hospital discharge. We conducted a systematic review and individual patient data meta-analysis to determine the efficacy of monthly post-discharge malaria chemoprevention in children recovering from severe anaemia.

Methods: This analysis was conducted according to PRISMA-IPD guidelines. We searched multiple databases on Aug 28, 2023, without date or language restrictions, for randomised controlled trials comparing monthly post-discharge malaria chemoprevention with placebo or standard of care among children (aged <15 years) admitted with severe anaemia in malaria-endemic Africa. Trials using daily or weekly malaria prophylaxis were not eligible. The investigators from all eligible trials shared pseudonymised datasets, which were standardised and merged for analysis. The primary outcome was all-cause mortality during the intervention period. Analyses were performed in the modified intention-to-treat population, including all randomly assigned participants who contributed to the endpoint. Fixed-effects two-stage meta-analysis of risk ratios (RRs) was used to generate pooled effect estimates for mortality. Recurrent time-to-event data (readmissions or clinic visits) were analysed using one-stage mixed-effects Prentice-Williams-Peterson total-time models to obtain hazard ratios (HRs). This study is registered with PROSPERO, CRD42022308791.

Findings: Our search identified 91 articles, …

Strategies To Minimize Lead Exposure And Ensure Early Detection Of Elevated Lead Levels In Children Less Than 5 Years Of Age, Stephanie Massey

Non-Thesis Student Work

Exposure to lead in children can have serious long-term health implications, including cognitive and developmental delays. This systematic literature review identifies evidence-based strategies to prevent lead exposure and ensure early detection of elevated lead levels in children less than 5 years of age. The purpose of this review is to determine reliable and valid methods to prevent and screen for lead exposure in children less than 5 years of age to inform practice, research, and policy.

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 …

Implementation Of A Continuing Education Module On Triage Practices For Pediatric Emergency Room Nurses, Catherine Nicholson, Lindsey Lakas, Marian Malone

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

BACKGROUND: More than 35 million U.S. children visit the emergency department (ED) each year. Triage is the family’s first interaction with the healthcare team and a crucial component of care that directs the course of the ED visit. The use of standardized triage protocols, like the Emergency Severity Index (ESI) algorithm, is shown to improve overall patient health outcomes in the pediatric ED. For triage algorithms to be safe and effective, continuing education for pediatric ED nurses is important.

LOCAL PROBLEM: Patients at a local pediatric emergency department are being inaccurately triaged - assigned a higher or lower acuity level …

Mindfulness-Based Educational Module For Nurses Caring For Pediatric Mental Health Patients, Brianna Mai Desjardins, Katherine Marie Newnam

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

BACKGROUND: Emergency pediatric nurses have the added stress of not only caring for medical patients but must also care for patients experiencing mental health issues. Many nurses feel unprepared to care for this specialized patient population. To bridge this gap, mindfulness-based interventions (MBIs) have been shown to provide nurses with the skills needed to care for mental health patients. This same concept can be applied to pediatric patients. Pediatric-focused mindfulness-based techniques can be used to help pediatric patients manage their symptoms.

LOCAL PROBLEM: The setting for this project was an urban pediatric emergency department in East Tennessee. At the state …

Improving Human Papillomavirus (Hpv) Vaccination Rates Through Age-Based Flagging, Savannah Jo Garcia, Karen Lasater

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

DNP SCHOLARLY PROJECT ABSTRACT

BACKGROUND: Over forty million Americans are currently infected with human papillomavirus (HPV). HPV can cause life threatening cancers of the cervix, vagina, vulva, penis, anus, and throat. Only half of U.S. adolescents have completed the HPV vaccine series.

LOCAL PROBLEM: The setting for this evidence-based improvement project is a rural family practice clinic in Texas. Texas has the largest group of teenagers not protected against HPV in the country. The project’s purpose is to investigate the effect of age-based flagging on adolescent vaccination rates in a rural community through evidence-based practice.

METHODS: Project …

Pediatric Vaccine Pain Management & Perceptions Of Caregivers And Nursing Staff: An Evidence-Based Project, Madison K. Bears, Tami H. Wyatt

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

Background: In an age with many diseases controlled through immunization and herd immunity, the significance of immunization can wane in public memory. In children, injection pain is an obstacle to vaccination and can cause anxiety around medical visits, healthcare avoidance, delayed immunizations, and needle fear (McMurty et al., 2015; Shah & Sui, 2019; Taddio et al., 2022). Evidence-based vaccine pain relief techniques are described in the literature (Shah et al., 2009; Wu et al., 2022; Taddio et al., 2015), yet their use in practice is minimal (Taddio et al., 2022).

Local Problem: An evaluation of a pediatric clinic …

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 …

Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider

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

BACKGROUND: Current recommendations to reduce pain associated with mechanical ventilation is the administration of opiate and benzodiazepine infusions for Pediatric Intensive Care Unit (PICU) patients. If these infusions are weaned too quickly, iatrogenic withdrawal syndrome (IWS) often occurs. IWS symptoms include tachycardia, hypertension, diaphoresis, fever, irritability, tremors, clonus, hyperactive reflexes, vomiting, and diarrhea. Untreated IWS can lead to life-threatening complications.
LOCAL PROBLEM: The PICU at the project site contains fourteen beds and treats critically-ill pediatric patients. There was no standardized withdrawal assessment tool in practice. The purpose of this project was to implement the Withdrawal Assessment Tool-Version 1 …

A Quality Improvement Project To Improve The Management Of Group A Streptococcalpharyngitis Among Children, Tara Denise Gutierrez

Doctor of Nursing Practice

Group A Streptococcal (GAS) pharyngitis is one of the most common pediatric illnesses and accounts for more than ten million yearly medical visits. GAS is commonly misdiagnosed due to overlapping symptoms. The health care provider needs to distinguish which criteria warrant testing for GAS and the recommendations for management and treatment.

The purpose and objectives of this quality improvement project were to improve adherence to the 2021 Canadian guidelines for the management and treatment of GAS pharyngitis in a small community urgent care clinic. Anticipated outcomes for this project included a decrease in unnecessary testing for GAS pharyngitis, a decrease …

The Role Of Safety Interventions In Decreasing Unplanned Extubations In Pediatrics: A Benchmark Study, Wesley Bray

MSN Capstone Projects

Unplanned extubation (UE) is the removal of an endotracheal tube from a patient any time before their planned extubation. In layman’s terms it is when a patient loses their airway before they were ready. These events lead to longer hospital stays, cost hospitals thousands of dollars for each case and can cause severe complications for the patient including death. Pediatric patients are a population that are at risk of UEs more so than the general population due to their inability to understand what is going on in the hospital due to their age and development, as well as their ability …

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 …

Nursing Education On Pediatric Feeding Therapy, April Ng

Nursing | Student Research Posters

No abstract provided.