Pediatric Nursing Commons^™

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.

Stress And Coping Strategies Adopted By Mothers Of Children Admitted In Pediatric Intensive Care Unit., Anisha P. R, Remya U R

Manipal Journal of Nursing and Health Sciences

Introduction: Planned or unplanned hospitalization increases the family’s stress and anxiety level. Hospitalization creates stress as they interrupt normal routines and place increased demands on parents who must further divide their time between the normal responsibilities and their hospitalized child. Many parents feel a lack of control and sense of powerlessness when their child is hospitalized. Objectives: The objectives of the study were to identify the stressors and coping strategies adopted by mothers of children admitted in pediatric intensive care unit and to determine the co-relation between stressors and coping strategies adopted by mothers of children admitted in PICU. Methods: …

Psychosocial Impacts On Parents Of Mentally Challenged Children At Mangaluru, Sooraj Kookal Mr

Manipal Journal of Nursing and Health Sciences

Abstract

Introduction: Intellectually disabled children upset the mental, physical, social, and financial outlooks of the family in terms of their rearing and future. The support systems surrounding the parents of mentally retarded children play a vital role to lessen the burden associated with their special child. This study brings up some light on the psycho-social impacts on parents of Mentally challenged children who were attending special schools at Mangaluru. Objective: The main objective of the study was to assess the psychosocial impacts on parents of mentally challenged children. Further, to find the association between the psychosocial impact on …

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Garden-Based Nutrition Education For Low Income Hispanic School Children, Larry Bui

Nursing | Student Research Posters

Background: Childhood obesity is a pressing public health concern in the United States, with rates continuing to increase in recent years. This problem disproportionately affects Latino children as well as those from low socioeconomic status. It's well established that nutrition knowledge deficiencies and resulting poor dietary habits are some of the most common contributing factors to childhood obesity. Garden-based nutrition education programs have been introduced as a way to remedy this knowledge deficit, however a gap remains as to whether or not this model can be viable for low-income, culturally diverse populations. Aim: The purpose of this literature review is …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Risk And Protective Factors To Well-Being In Foster Care Youth Prescribed Psychotropic Medication In A Wraparound Program Of Care, Ann Reali Stratton

Dissertations

Background: Youth in foster care are prescribed psychotropic medications at higher rates and are more likely to experience disruptions to their medical care. Wraparound models of care have been shown to improve outcomes for youths on psychotropic medications, however, these methods have proved difficult to replicate in the foster care population. Government policies have called for better oversight in the foster care population and in response programs have been implemented, however, there remains little research for these programs. Objective: This research will evaluate the characteristics of foster care youth as they enter a Wraparound model of care and the predictive …

Reducing Burnout Among Pediatric Oncology Nurses, Karlie Devore, Madison Jarvis

Scholars Week

No abstract provided.

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

Nursing | Student Research Posters

No abstract provided.

Clinical Practice Panel: Improvements In Pediatric Food Insecurity Screening; A Qi Project To Increase Pediatric Food Insecurity Screening, Casey Katzman, Brandy Rachel Frye, Hsiang-Fen Su

2023 South Division Nursing Research Conference

No abstract provided.

Educational Intervention On Pediatric Concussions For Providers, Melissa Callaway, Robert Cornette

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

The purpose of this project was to find a gap in care within my community and fill the need with evidence-based practice. The process of evidence-based practice requires systematically searching and grading existing literature and basing a recommended practice change based on what is discovered. The recommendation is then applied translated to clinical practice. For the purposes of this project, the community which I am a part of needed improvement on the education of healthcare providers regarding post- concussive care in the pediatric population. Regardless of the explosion of research in concussions- translation to practice remains deficient. Concussions remain a …

How Nurses Perceive Their Task Load When Caring For Behavioral Mental Health Patients In The Pediatric Emergency Department, Emily Cameron, Robert Cornette

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

Abstract

Introduction: Pediatric behavioral mental health patients are being seen more frequently in the emergency department setting. With this ever-growing number of cases comes the need for trained staff, including registered nurses, to care for these children during a mental health crisis. With this increase comes increased stress of nurses’ workload. The purpose of this project was to identify nurses’ perceptions of their workload when completing three identified tasks: communication, procedures, and initial intakes. Methods: The National Aeronautics and Space Administration (NASA) Task Load Index tool was used to measure nurses’ perceptions of how difficult each task was to complete. …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Mandatory Child Abuse And Neglect Reporting Behaviors Among Registered Nurses In New Mexico: A Statewide Comparative Study, Ingrid Ann Wilson

Nursing ETDs

Child abuse and/or neglect (CAN) is a global problem. Although nurses are mandated CAN reporters, a lack of reporting has been an issue. New Mexico (NM) is faced with higher child poverty and CAN-related substance-abuse compared to other U.S. states. This quantitative study aimed to explore factors influencing intended/actual CAN reporting behaviors among NM registered nurses (RN)s, examine relationships of these factors, and compare differences in reporting behaviors between rural and urban locations. A survey to a sample of RNs (N=146) showed factors associated with CAN reporting intended behaviors were work status (r=.21, p < .05), cues to action (r=.20, …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Implementation Of A Mindfulness Intervention To Increase Adolescent Resilience In An After-School Program: A Quality Improvement Project., Katie Thomas

Doctor of Nursing Practice Papers

Background: Globally, fourteen percent of adolescents ages 10 to 19 years old suffer from mental health problems (World Health Organization, 2021). Resilience is a fundamental concept of the mental health promotion framework (CAMH, 2022).The WHO (2020) “Guidelines on Mental Health Promotive and Preventive Interventions for Adolescents” includes the recommendation that universal interventions to promote mental health and reduce mental disorders should include social and emotional learning (SEL), such as emotional regulation, mindfulness, stress management, problem solving, and interpersonal skills. Mindfulness-based interventions (MBIs) are one evidence-based method of accomplishing this goal (Sapthiang et al., 2018). Purpose: The purpose of …

Development Of A Comprehensive Staff Development Program About Outpatient Diabetes Clinic Care For Patients With Type 1 And Type 2 Diabetes Mellitus, Cynthia G. Sanders

Electronic Theses and Dissertations

The purpose of this DNP project was to evaluate if focused staff education about the many aspects of outpatient diabetes care has the potential to increase knowledge and impact attitudes about diabetes in staff providing care to patients with type 1 and type 2 diabetes mellitus. Diabetes is a disease with wide ranging implications, in terms of cost, consumer health, and quality of life, for populations worldwide, including the United States. It is critical that staff who participate in the care of patients with diabetes mellitus have a role-specific educational foundation to support their contribution to patient care. The researcher …

Effectiveness Of An Evidenced-Based Cognitive Behavioral Therapy Intervention For Adolescents In A School Setting, Sarah Ellen Gray, Kimberly Michaela Carter, Amanda Harper

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

Abstract

The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is …

Vaccine Hesitancy, Provider Time, And Decision To Vaccinate, Kenneth Shackelford

Dissertations

Problem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?

Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from …

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Implementation Of A Situation, Background, Assessment, Recommendation (Sbar) Patient Handoff Tool In The Electronic Medical Record (Emr), Kristen L. Chandler

Dissertations

Abstract

Purpose and Problem: Handoffs that are poorly conducted are implicated in 80% of preventable adverse events in healthcare facilities. Within a Pediatric Rehabilitation Facility in Maryland Heights, Missouri it was observed that nurse handoffs were not conducted and lacked the use of a standardized evidence-based tool, resulting in nurse dissatisfaction with the handoff process and miscommunication. Recognized by the World Health Organization, The Joint Commission, and Agency for Healthcare Research and Quality, the Situation, Background, Assessment, Recommendation (SBAR) evidence-based tool is effective in improving handoff communication, improving nurse satisfaction, reducing adverse events, and promoting patient safety. The purpose of …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

Implementation Of A Structured Discharge Checklist For Children Admitted To The Hospital With Acute Asthma, Nicholas Fleming

Dissertations

Abstract

Problem: The transition process from a hospital setting to home is critical for pediatric patients and their families. However, there is no standardized process to ensure asthma discharge orders and asthma action plans are printed at the time of discharge

Methods: This observational quality improvement project utilized a pre-and-postimplementation of the Kamishibai Card (K-Card) process for pediatric discharge checklist compliance in an inpatient pediatric general medicine unit. This project used a sample of all children aged 2 years to 21 years with an asthma diagnosis admitted to the inpatient general medicine pediatric unit. This project included an …

Screening For Food Insecurity In A Suburban Pediatric Urgent Care, Rachel Foutz

Dissertations

Problem: Screening for Social Determinants of Health (SDOH), including food insecurity (FI) should be done on a regular basis at a child’s pediatrician. Many children in the state of Missouri do not have a pediatrician or do not regularly see their pediatrician and are therefore never being screened for FI.

Methods: This observational descriptive quality improvement (QI) project utilized a prospective observational analysis to implement a voluntary FI screening tool in a pediatric only urgent care. The project sampled pediatric patients aged two days to 21 years of life. All participants were given local resources after completing the screening. The …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Evaluation Of A Substance Abuse Screening Tool In The Pediatric Emergency Room, Jody Sims

Dissertations

Abstract

Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance …