Medicine and Health Sciences Commons^™

Dexterity Of The Less Affected Hand In Children With Hemiplegic Cerebral Palsy, Matthew B Burn, Gloria R Gogola

Student and Faculty Publications

BACKGROUND: To determine if the "unaffected" hand in children with hemiplegic cerebral palsy (CP) is truly unaffected.

METHODS: We performed a retrospective review of manual dexterity as measured by the Functional Dexterity Test (FDT) in 66 children (39 boys, 27 girls, mean age: 11 years 4 months) with hemiplegic CP. Data were stratified by Manual Ability Classification System (MACS) level, birth weight, and gestational age at birth, and compared with previously published normative values.

RESULTS: The FDT speed of the less affected hand is significantly lower than typically developing (TD) children (

CONCLUSIONS: Both dexterity and rate of fine motor …

Special Considerations In Randomized Trials Investigating Neonatal Surgical Treatments, Martin L Blakely, Matthew A Rysavy, Kevin P Lally, Barry Eggleston, Claudia Pedroza, Jon E Tyson

Student and Faculty Publications

Randomized controlled trials (RCTs) are challenging, but are the studies most likely to change practice and benefit patients. RCTs investigating neonatal surgical therapies are rare. The Necrotizing Enterocolitis Surgery Trial (NEST) was the first surgical RCT conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN), and multiple lessons were learned. NEST was conducted over a 7.25-year enrollment period and the primary outcome was death or neurodevelopmental impairment (NDI) at 18-22 months corrected age. Surgical investigators designing clinical trials involving neonatal surgical treatments have many considerations to include, including how to …

Implementation Of Infant Driven Feeding™ In A Level Ii Nicu, Kelly Gardner

Graduate Theses, Dissertations, and Capstones

In the United States, currently, 1 in 10 babies are born premature. Due to the immaturity of their neurological, gastrointestinal, and cardio-respiratory functions, preterm infants can experience the inability to coordinate sucking, swallowing, and breathing that is essential to oral feed. Cue-based oral feeding methods are designed to give the caregiver the ability to recognize signs of readiness and respond appropriately to the infant cues to adjust the manner in which feeding intervention is performed to match the infant’s current state of physiologic tolerance. The Infant Driven Feeding™ program incorporates scales to assess readiness and quality of the oral feeding, …

Respiratory Virus Surveillance Among Children With Acute Respiratory Illnesses - New Vaccine Surveillance Network, United States, 2016-2021, Ariana Perez, Joana Y Lively, Aaron Curns, Geoffrey A Weinberg, Natasha B Halasa, Mary Allen Staat, Peter G Szilagyi, Laura S Stewart, Monica M Mcneal, Benjamin Clopper, Yingtao Zhou, Brett L Whitaker, Elizabeth Lemasters, Elizabeth Harker, Janet A Englund, Eileen J Klein, Rangaraj Selvarangan, Christopher J Harrison, Julie A Boom, Leila C Sahni, Marian G Michaels, John V Williams, Gayle E Langley, Susan I Gerber, Angela Campbell, Aron J Hall, Brian Rha, Meredith Mcmorrow

Faculty and Staff Publications

The New Vaccine Surveillance Network (NVSN) is a prospective, active, population-based surveillance platform that enrolls children with acute respiratory illnesses (ARIs) at seven pediatric medical centers. ARIs are caused by respiratory viruses including influenza virus, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), human parainfluenza viruses (HPIVs), and most recently SARS-CoV-2 (the virus that causes COVID-19), which result in morbidity among infants and young children (1-6). NVSN estimates the incidence of pathogen-specific pediatric ARIs and collects clinical data (e.g., underlying medical conditions and vaccination status) to assess risk factors for severe disease and calculate influenza and COVID-19 vaccine effectiveness. Current NVSN …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

A Pilot Study To Determine The Incidence, Type, And Severity Of Non-Routine Events In Neonates Undergoing Gastrostomy Tube Placement, Daniel J France, Emma Schremp, Evan B Rhodes, Jason Slagle, Sarah Moroz, Peter H Grubb, Leon D Hatch, Matthew Shotwell, Amanda Lorinc, Jamie Robinson, Marlee Crankshaw, Timothy Newman, Matthew B Weinger, Martin L Blakely

Student and Faculty Publications

BACKGROUND: Non-routine events (NRE) are defined as any suboptimal occurrences in a process being measured in the opinion of the reporter and comes from the field of human factors engineering. These typically occur well up-stream of an adverse event and NRE measurement has not been applied to the complex context of neonatal surgery. We sought to apply this novel safety event measurement methodology to neonates in the NICU undergoing gastrostomy tube placement.

METHODS: A prospective pilot study was conducted between November 2016 and August 2020 in the Level IV NICU and the pediatric operating rooms of an urban academic children's …

A Community Educational Intervention To Improve Firearm Safety Behavior In Families, Elizabeth G. Choma Msn, Rn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background: Every day in America children, are injured or killed from the accidental shooting of firearms. Additionally, few households with children report storing all guns unloaded and locked up. Recent evidence supports education on safe firearm storage as an effective intervention in promoting firearm safety in families with children. However, Pediatric healthcare providers often do not have enough time for firearm education during well visits.

Objective: This Quality Improvement (QI) project aimed to use an educational intervention with statistics on firearms in children and implemented the Asking Saves Kids (ASK) campaign to assess and improve firearm safety behaviors in families …

Impact Of Parent Presence On Stress In Infants In The Neonatal Intensive Care Unit, Susan M. Horner

Dissertations

The purpose of this study was to examine potential relationships between cumulative stress exposure in infants in neonatal intensive care units (NICU), as measured using a resting salivary cortisol level at NICU discharge, and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC). This descriptive study was conducted via a secondary analysis of a dataset representing 78 NICU families from a tertiary level NICU in the Midwest. Median length of stay was 33 days, and a resting salivary cortisol level collected at one month of age was used for infants not discharged …

Implementing A Robust Process Improvement Program In The Neonatal Intensive Care Unit To Reduce Harm, Klaus G Nether, Eric J Thomas, Amir Khan, Madelene J Ottosen, Lauren Yager

Faculty and Staff Publications

INTRODUCTION: Preventable harm continues to occur with critically ill neonates despite efforts by hospital neonatal intensive care units (NICUs) to improve processes and reduce harm. Attaining significant and sustainable improvements will require training including leadership support, mentoring, and patient family engagement to improve care processes. This paper describes the implementation of a robust process improvement (RPI) program in the NICU to reduce harm.

METHODS: Leaders, staff, and parents were trained in RPI concepts and tools. Multidisciplinary teams including parent members applied the training and received regular mentorship for their improvement initiatives.

RESULTS: Participants (N = 67) completed pretraining and post-training …

Supporting Premature Infants’ Oral Feeding In The Nicu—A Qualitative Study Of Nurses’ Perspectives, Evalotte Mörelius, Charlotte Sahlén Helmer, Maria Hellgren, Siw Alehagen

Research outputs 2022 to 2026

One major task in the neonatal intensive care unit (NICU) involves ensuring adequate nutrition and supporting the provision of human milk. The aim of this study was to explore nurses’ experiences of the oral feeding process in the NICU when the infant is born extremely or very preterm. We used a qualitative inductive approach. Nine nurses from three family-centered NICUs were interviewed face-to-face. The interviews were transcribed verbatim and analyzed using content analysis. Five sub-categories and two generic categories formed the main category: ‘A complex and long-lasting collaboration.’ The nurses wished to contribute to the parents’ understanding of the feeding …

Invasive Haemophilus Influenza Type B In An Infant During The Covid-19 Pandemic: The Return Of Diseases We Hoped Never To See Again…., Christy Tabarani, Stephen A Fletcher, Gloria P Heresi, Susan H Wootton

Student and Faculty Publications

No abstract provided.