Medicine and Health Sciences Commons^™

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Journal Articles

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

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 …

The Use Of Distraction Techniques During Injection In Pediatric Patients, Sara Mollner

Master of Science in Nursing Family Nurse Practitioner

Do distraction techniques provide adequate pain management in the pediatric population? If so, what is the importance of this topic? Children can develop negative emotional connections to healthcare workers and procedures if they are constantly put through painful experiences. Making these experiences less painful can ensure better healthcare for the future.

Postpartum And Pediatric Education Program For Mothers, Lacie T. Ellithorpe

Department of Occupational Therapy Entry-Level Capstone Projects

My capstone experience included the focus area(s) of Clinical Practice Skills and Education. The aim of this capstone project was to create an ergonomic education program to address new motherhood and their occupations of health management and maintenance, sleep and rest, breastfeeding and other baby care, community mobility, and leisure. My Capstone Mentor was Dr. Kari Rasmussen, OTD, OTR/L. Becoming a new mother is considered a major life event, due to significant role changes that impact a mother’s everyday occupations. The population I served was new and expectant mothers in order to provide ergonomic education as they relate to the …

Utility Of Av Nodal Characteristics In Identification Of Atrioventricular Nodal Reentrant Tachycardia And Risk Of Recurrence, Kimberly M. Decarr

Longitudinal Scholar's Project

Background: Catheter ablation of the slow atrioventricular (AV) nodal pathway is a safe and effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). While AVNRT occurs frequently in both children and adults, pediatric patients experience higher rates of AVNRT recurrence.

Objective: The purpose of this study was to characterize changes in AV nodal conduction properties following catheter ablation and correlate these properties with AVNRT recurrence in pediatric patients.

Methods: This was a retrospective review of patients aged(AVRT) at a single tertiary care center between January 01, 2010 and September 01, 2021. Demographics, pre- and post-ablation ECG intervals, and AV nodal conduction …

Pediatric Palliative Care Training To Advance Nurses’ Knowledge And Increase Patient Referrals, Whitney Lynn Stone, Lisa Merritt, Tammy Childers

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

Objective: The purpose of this evidence-based practice quality improvement project was to implement an educational intervention to improve pediatric palliative care services in a Pediatric Intensive Care Unit (PICU). The goal was to improve nurses’ knowledge of palliative care and increase the number of palliative care consults.

Methods: Educational sessions were created using the End-of-Life Nursing Education Consortium (ELNEC) Pediatric Curriculum. Participants included 46 PICU nurses. Knowledge of palliative care was measured at three timepoints; pre-, immediately post- and four weeks post-intervention. The number of palliative care referrals were measured at two timepoints; three months pre- and three months post-intervention. …

Pediatric Anxiety - A Guide For Parents, Paul Mccleary

Family Medicine Clerkship Student Projects

As of April 2022, the United States Preventive Services Task Force (USPSTF) recommends that all children age 8-18 be screened for anxiety. Whether this recommendation is due to the many changes and stress stemming from Covid-19, the community was left with a need for insight into properly addressing this issue. Whether it be for parents at home or physicians in the clinic, clear educational pamphlets identifying alarm signs and home recommendations will benefit the community.

Equipping Advanced Practice Providers: Interprofessional Pediatric Airway Management Course, Kenton M. Schrock

Graduate Theses, Dissertations, and Problem Reports

Background: Developmental differences between pediatrics and adults requires intervention adjustments for airway management. Segregated intraprofessional training and limited provider exposure could result in poor collaboration and low-quality management. Patient outcomes depend on the proficient collaborative application of skill and knowledge. Purpose: The interprofessional pediatric airway management course paired unique airway considerations with interprofessional training strategies to equip providers to deliver safe airway management. Intervention: The course was delivered as a 3-hour training session. Participants completed team simulations and skill/concept stations. Pre- and post-intervention competency and confidence scores were measured and analyzed. Methods: Baseline confidence and competency scores in managing a …

A Randomized Controlled Trial Of An Online Immunization Curriculum., Barbara A. Pahud, S Elizabeth Williams, Brian R. Lee, Kadriye O. Lewis, Donald B. Middleton, Shannon Clark, Sharon Humiston

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Immunization education for physicians-in-training is crucial to address vaccine concerns in clinical practice. Vaccine education is not standardized across residency programs. The Collaboration for Vaccination Education and Research (CoVER) team developed an online curriculum for pediatric (Peds) and family medicine (FM) residents.

METHODS: A cluster randomized controlled trial (RCT) was performed during the 2017-2018 academic year to evaluate the CoVER curriculum. A convenience sample of residency institutions were randomly allocated to the intervention or control group, with stratification by residency type. The intervention, the CoVER curriculum, consisted of four online modules and an in-person training guide. Control sites continued …

Inpatient Motivational Interviewing For Adolescent Type 1 Diabetics With Poor Glycemic Control Is Ineffective, Andrew L. Roberts

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Wang Y-C, Mackenzie M, Nakonezny PA, et al. A randomized controlled trial comparing motivational interviewing in education to structured diabetes education in teens with type 1 diabetes. Diabetes Care. 2010;33(8):1741-1743. https://doi.org/10.2337/dc10-0019.

Implementation Of Interventions To Reduce Pediatric Pain Associated With Vaccination: A Quality Improvement Initiative, Kelly Snyder

Nursing (graduate) Student Scholarship

Background: Routine vaccination is an important component of pediatric preventative care but for many children, the experience can be painful and anxiety provoking, potentially leading to a cascade of negative events. Problem: Under-recognition of the pain that children experience during vaccination leads to an under management of such pain in ambulatory care settings. Methods: The Face, Activity, Legs, Cry, Consolability (FLACC) scores of a convenience sample of children ages 2 months to 7 years at a small, rural family practice clinic were evaluated throughout the vaccination process over a three-month time period. Intervention: Two evidence-based interventions - distraction techniques and …

Joint Statement On Pediatric Education At Schools Of Pharmacy, Christina L. Cox, Timothy J. Todd, Lisa Lubsch, Kristin C. Klein, William A. Prescott, Chad A. Knoderer, Peter N. Johnson, Rachel Meyers, Justin W. Cole, Joseph M. Larochelle, Mary A. Worthington, Katherine Smith

Pharmacy Practice Faculty Publications

Providing health care for children is a unique specialty, and pediatric patients represent approximately 25% of the population. Education of pharmacy students on patients across the lifespan is required by current Accreditation Council for Pharmacy Education standards and outcomes; thus, it is essential that pharmacy students gain a proficiency in caring for children. A collaborative panel of pediatric faculty members from schools and colleges of pharmacy was established to review the current literature regarding pediatric education in Doctor of Pharmacy curricula and establish updated recommendations for the provision of pediatric pharmacy education. This statement outlines five recommendations supporting inclusion of …

The Use Of Animal-Assisted Therapeutic Interventions In The Hospital Setting During The Covid-19 Pandemic, Alicia Cesare

MSU Graduate Theses

Handlers of therapy and/or facility dogs working within hospital settings have experienced various barriers and challenges within their practice during the COVID-19 pandemic. Animal-assisted interventions, specifically therapeutic working dogs, are a valued source of support to individuals, communities, hospital settings, and disaster sites during times of community distress. The purpose of this study was to identify barriers and solutions to the continued use of animal-assisted therapeutic interventions in support of patients and families within the hospital setting during the COVID-19 pandemic. This researcher’s position within the research is the knowledge and experience of being a facility dog handler within the …

Review Of Pediatric Care Online, Terri Gotschall

Faculty Scholarship and Creative Works

This guide to scholarly activities provides early- and mid-career health sciences librarians with a path to immersing in scholarly activities. The four levels walk librarians through increasing stages of scholarship. Early-career librarians will begin at the first level, navigating from discovering mentors and areas of research interest to level two, publishing a resource or book review and finding their first public speaking opportunity. More experienced librarians will find where they are on the path and continue to build their scholarship all the way to conducting and publishing original research and becoming leaders in their field.

Supporting Nurse Education In The Implementation Of A Pediatric Delirium Assessment Protocol In The Pediatric Intensive Care Unit, Lucy Camarena, Rn, Bsn, Cnl, Cpn, Phn

Master's Projects and Capstones

Delirium has historically been under studied, more so in the pediatric population, despite its long term effects on patients’ health. The deficit in knowledge of delirium leads to an increase in hospital stays and unnecessary unit expenses. My intention with this change project is to increase the awareness of delirium in the pediatric delirium by providing an educational intervention to the PICU nurses. After conducting a root cause, SWOT and cost analysis, I determined that successful education of the PICU nurses about delirium could substantially decrease its incidence. Using Ronald Lippitt’s Change Theory and the CNL competencies as guides I …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Promotion Of Skin Protection In Children In Waterbury, Vt, Kelsey M. Sullivan

Family Medicine Clerkship Student Projects

Background: Vermont has among the highest rates of skin cancer in the nation. Between 2001 and 2005, Vermont had the highest incidence of melanoma of any state, 63% higher than the national average. It is also estimated that if children under 18 regularly used sunscreen of at least SPF 15, the incidence of squamous and basal cell carcinomas would decrease by 78%. Modeling by the EPA and CDC suggests that recommended sun protection measures could prevent 11,000 cases of skin cancer, 50 deaths, and $30 million in cancer treatment costs nationwide. Intervention: To create an information sheet on skin protection …

The Effect Of Trauma-Informed Care Training On The Knowledge And Awareness Of Medical Professionals At Kentucky Children’S Hospital, Laura Broughton

DNP Projects

Background: Many children who present to the hospital require treatments and procedures in their medical care that can be potentially emotionally traumatic for themselves and their families. Medical professionals caring for these children may also experience emotional trauma symptoms related to their work. A trauma-informed care approach to medical care may help to lessen these negative consequences in both patients and medical professionals. Purpose: The objective of this study was to assess the effectiveness of a one-hour training on trauma-informed care to nurses at Kentucky Children’s Hospital. Methods: Nurses participated in a one-hour interactive seminar and completed pre- and post-measures …

Fluoride Varnish Application In The Pediatric Population, Ellen Gnaedinger

Doctor of Nursing Practice (DNP) Projects

Purpose: The United States (U.S.) has a persistent problem of dental caries in primary teeth with a greater prevalence of dental caries found in minority and poor children. The majority of children in the U.S. experience dental caries in their primary teeth by age eight. This problem could be addressed by primary care providers applying fluoride varnish (FV) to children's teeth starting at the age of primary tooth eruption. The causes of dental caries in children’s primary teeth are multifactorial and therefore require multiple interventions. Around the world providers are utilizing FV as an effective and easily administered strategy. This …

Pediatric Tooth Care And Fluoride Exposure In Maine, Lucas Grover

Family Medicine Clerkship Student Projects

Maine is a large and rural state with limited access to fluoridated drinking water and consistent health and dental care. There is little information and guidance for parents regarding the importance of home pediatric dental care, early dentist visits, and home testing for fluoridated drinking water. Parents and primary care providers must engage in a dialog regarding proper tooth care to identify child specific risk factors that can lead to childhood caries and chronic tooth decay if not addressed early and aggressively.

Pediatric Lipid Screening Guidelines: Information For Patients And Families, Erin R. Pichiotino, Mph

Family Medicine Clerkship Student Projects

Universal Pediatric Lipid Screening Guidelines are currently based on expert opinion only. Bright Futures/American Academy of Pediatrics currently recommends screening all patients ages 9-11 and again at ages 17-21. The US Preventive Services Task Force (USPSTF), however, concludes the evidence is insufficient to recommend for or against routine screening. This discordance leaves ambiguity for implementation in Family Medicine practices in Vermont. A survey of providers at Milton Family Practice showed that only 14% of providers at Milton Family Practice regularly perform lipid screening on their pediatric patients.

Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser

DNP Projects

CAPSTONE INTRODUCTION

Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.

Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …

Learning On Line Using Wiki Technology: A Pilot Study In A Pediatric Clerkship, Anthony J. Frisby, J Lindsey Lane

The Selected Works of Anthony J. Frisby, PhD

Methods Students on the Pediatric Clerkship at Jefferson Medical College research case-vignettes in 20 topic areas and discuss their answers in small group with a faculty facilitator to achieve the learning objectives. Using the Blackboard course management system and Learning Objects TeamsLx software one topic area, with 10 case vignettes, was transferred to on line learning and piloted by 14 students divided into 5 groups. Instructions for use of the WIKI communication forum were provided on-line. Each group was assigned 2 case-vignettes. Outcomes data was obtained from questionnaires and student interviews.

Results: No student had prior experience with online learning. …