Medicine and Health Sciences Commons^™

Prevention Of Pediatric Mortality Associated With Malaria: An Exhaustive Literature Review, Taylor Mosley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Malaria, a disease that is preventable yet frequently fatal, disproportionately affects pediatric African populations at a rate that results in a child under the age of 5 dying every two minutes. Since 1955, the World Health Organization has contributed to a significant reduction in the morbidity and mortality of malaria; however, progress has stalled in recent years. In some countries, particularly those in sub-Saharan Africa, cases have increased since 2015. This literature review seeks to identify factors associated with this incline, as well as what interventions can have the greatest impact to prevent pediatric mortality in areas with the largest …

Type 2 Diabetes Mellitus In The Pediatric Population, Lorna Santiago

DNP Qualifying Manuscripts

The incidence and prevalence of diabetes in youth in the United States is increasing. In particular, type 2 diabetes mellitus (T2DM) is becoming more common in individuals younger than 20 years. Nurse practitioners and other primary care providers that see children should be knowledgeable about the condition and confident in participating in multidisciplinary management. Screening should begin at age 10 or at puberty, whichever comes first. Providers should screen all children who are overweight or obese or of Native American, African American, Latino, Asian American, or Pacific Islander race or ethnicity. Children of these ethnicities have a greater risk for …

Development Of An Lc-Esi-Ms/Ms Method For Determination Of A Novel Pyrrolomycin (Mp-1) And Application To Pre-Clinical Adme Studies, Wafaa N. Aldhafiri

Theses & Dissertations

A rapid, selective, and sensitive liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method was developed and validated for quantitation of a novel Pyrrolomycin (MP-1) in mouse plasma. MP-1 was extracted from plasma utilizing a structural analog (PL-3) as the internal standard (IS). Analyte separation was achieved using a Waters Acquity UPLC®BEH C18 column (1.7 µm, 100 x 2.1 mm) protected with Acquity UPLC C18 guard column. Mobile phase consisted of 0.1% acetic acid in water (10%) and methanol (90%) at a total flow rate of 0.25 mL/min. The mass spectrometer was operated at unit resolution in the multiple reaction …

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 …

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 …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Pediatric Asthma, Monica Stricklin

Nursing Student Class Projects (Formerly MSN)

Effective management of asthma will improve pediatric patient quality of life. This may be achieved through the prevention of asthma exacerbations by continuous pediatric and guardian/parent education to proper inhaler technique, appropriate medication management and the avoidance of environmental triggers. These modalities may prevent trips to the emergency department, hospital admissions and the pediatric patient can avoid missing days from school.

Mild Traumatic Brain Injury: Parental Education For An Active Child, Elizabeth W. Roth

Theses and Graduate Projects

Mild traumatic brain injuries in the pediatric population are prevalent and pervasive. Identification and recognition of concussion symptoms is complicated by variable symptom manifestation and duration. The purpose of this evidence-based DNP project was to implement a concussion education intervention to increase parental recognition and knowledge regarding pediatric concussions. Individualized, in-person education, evidence-based injury prevention, symptom recognition, and collaboration encouraged lifestyle modification to reduce childhood injuries. Evaluation of parental concerns concluded a desire for future health promotion education resulting in bimonthly meetings to further improve personal, familial, and professional health.

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

Evaluation Of An Interdisciplinary Ketogenic Diet Clinic For The Treatment Of Pediatric Refractory Epilepsy, Britt Schloemer

Graduate Theses, Dissertations, and Capstones

Pediatric refractory epilepsy affects approximately 30% of all children diagnosed with epilepsy. Childhood refractory epilepsy patients pose a challenge for traditional approaches to epilepsy management due to their complex and unique needs. Refractory epilepsy negatively impacts a patient’s ability to attend school or hold a job, and patients have a generally poor health status related to seizures as well as pharmaceutical side effects (Conway et al., 2016). The ketogenic diet (KD) is an alternative option for the treatment of pediatric refractory epilepsy due to established efficacy, manageable side effects, and reduced health care-associated costs due to reduced emergency department (ED) …

Risk Factors Associated With Pressure Injury In Pediatric Congenital Heart Disease Patients, Ashlee Shields

Electronic Theses and Dissertations

Pediatric congenital heart disease (CHD) patients have unique risk factors associated with the pathophysiology of abnormal heart function. This vulnerable population is likely at an increased risk of acquiring a pressure injury during hospitalization. There are limited studies that include congenital heart disease patients and more specifically, factors unique to these patients. The purpose of this study was to identify risk factors associated with development of pressure injury in pediatric CHD patients. This retrospective study used a convenience sample from hospital-acquired data including subjects with congenital heart disease. The results demonstrated an association between pressure injury development and variables both …

A Difficult Vascular Access Algorithm Using Intraosseous Devices In The Elective Pediatric Surgical Population, Cory R. Austin

Doctor of Nursing Practice Projects

In pediatric patients undergoing elective surgery, anesthesia is commonly induced via mask inhalation followed by peripheral IV placement before proceeding to airway management. However, IV access is often unpredictable and difficult to obtain in pediatric patients, with attempt success between 35% to 74%. During IV attempts, many dangerous clinical situations can occur amid limited options to deliver necessary medications. Failure to attain IV access may ultimately require extremes such as CVC placement or procedure cancellation. In this project, a difficult vascular access algorithm including intraosseous devices as an alternative was developed based on current evidence, existing algorithms, and implementation site …

Developing The Pedis Pediatric Obstructive Sleep Apnea Screening Tool, Steven Sumpter

Doctor of Nursing Practice Projects

Obstructive sleep apnea (OSA) is the most common type of apnea in the pediatric population. Its prevalence is 0.7%-3.0% (Garcia et al., 2016). The dangers of OSA are multiplied in conjunction with anesthesia because anesthesia resembles a state of sleeping, relaxing the airway, and requiring more intense airway monitoring. Childhood OSA includes increased risk for developing neurocognitive impairment, behavioral problems, failure to thrive, hypertension, cardiac dysfunction, systemic inflammation, and increased healthcare costs (Kothare et al., 2015). A perioperative pediatric OSA screening tool is necessary to reduce airway risks. The PEDIS screening tool is a brief, efficient, and evidence-based tool capable …

The Relationship Between Low Socioeconomic Status And Mortality Rates Of School Age Children Related To Motor Vehicle Accidents, Rubi Calderon-Rodriguez

Nursing | Senior Theses

The purpose of this study is to assess nurses’ perceptions on the relationship between low socioeconomic status and high mortality rates of children due to motor vehicle accidents(MVAs). MVAs are the leading cause of death among children four years and older. Studies reviewed in this paper support that low socioeconomic status is associated with high child mortality rates caused by motor vehicle accidents. Factors contributing to these high mortality rates include: the lack of or improper use of restraints, low parental education attainment levels, black or Hispanic race, and environmental risks of low socioeconomic areas. A mixed methods study is …

Complications And Management In Pediatric Heart Surgery, Hannah Berndt

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this literature review is to evaluate current research surrounding management of pediatric patients after cardiac surgery. Acute kidney injury (AKI) and neurodevelopmental deficits are the main discussion topics. This review analyzes the causes, risk factors, and effects of AKI. The diagnostic and management methods surrounding AKI are compared, and diagnostic approaches such as serum Cystatin C and fibroblast growth factor 23 are analyzed as potential future replacements to serum creatinine. The modality of renal replacement therapy is evaluated, and early initiation of peritoneal dialysis is preferred. This review discusses the most common causes, effects, and management of …

Home Assessments And Modifications: Researching Safety Features, Grant Opportunities, And Durable Medical Equipment Available For Tucker’S House Agency, Autumn Triggs

OTD Capstone Projects

Doctoral capstone project completed with Tucker's House, a nonprofit organization that completes home assessments and modifications for families with children with disabilities to improve accessibility and independence for the children at home. The project included: completing home assessments and providing client-centered recommendations and researching grant opportunities for Tucker's House as well as the families benefitting from the services, current durable medical equipment options, and safety features that should be included in the home assessments, recommendations, and modifications.

Champ's Triathlon Training Program, Rachael Sollman

OTD Capstone Projects

Champ's Triathlon Training Program was created to provide an adaptive fitness opportunity to the community of Nashville, TN. This program was specifically targeting children 8 to 15 years old diagnosed with Down's Syndrome and Cerebral Palsy, Gross Motor Function Classification Scale levels I, II, and III. Champ's Triathlon Training Program was an extension of the Champ's Tri My Best Triathlon hosted by a team of therapists and Vanderbilt's Pediatric Clinic, including Kelley Newman. The program aimed to increase the participants' strength, flexibility, and endurance through triathlon related activities such as running/walking, swimming, and biking. Outcomes of the program were to …

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

Implementation Of Early Mobility In The Pediatric Cardiac Intensive Care Unit, Kelly Lubbers

Doctoral Projects

Patients admitted to pediatric intensive care units and pediatric cardiac intensive care units often experience prolonged periods of immobility due to critical illnesses and surgical interventions. Many pediatric intensive care unit survivors develop physical and developmental disabilities that have long-lasting impacts into childhood and adulthood. Early mobility may be one aspect to mitigate the risks associated with pediatric intensive care unit admissions. Early mobility protocols have shown to be a safe and feasible intervention to encourage mobility in pediatric patients. This quality improvement project developed and implemented an infant holding tool to promote the mobilization of infant patients admitted to …

Development Of Hospital-Wide Policy For Pediatric Needle Procedures At An Academic Medical Center, Katherine J. Rose

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

Purpose: Needle procedures are traumatic experiences for pediatric patients, and have been linked to formation of phobias and lifelong decreased healthcare utilization.^1,2 Pain management during needle procedures and hospital wide standardization of needle procedures are known to increase patient satisfaction, while decreasing long-term adverse outcomes related to seeking health care.^3,4 The purpose of this project was to develop a hospital-wide standardized policy for pediatric needle procedures at an academic medical center.

Methods: Those performing pediatric needle procedures were electronically surveyed to identify full spectrum issues regarding adoption of a pediatric needle policy. Based on survey findings …

Occupational Therapy For A Child With Food Protein Induced Enterocolitis In An Outpatient Multidisciplinary Intensive Feeding Program: A Case Report, Kristel Ferrer

OT Student Capstones

Objective: This article presents a case report of a child with food protein induced enterocolitis,

various feeding difficulties, and poor sensory processing. It discusses the significance of occupational therapy in a multidisciplinary feeding therapy team and describes the outpatient occupational therapy-based plan and interventions during 14 weeks of an intensive feeding therapy program.

Method: Chart review of assessments and daily treatment notes and clinical observations were examined. Progress towards goals was obtained through daily treatment notes and informal parental interviews. Results: Improvement in occupational performance and participation in mealtime and play is captured through daily treatment notes and clinical observations. …

Post Chemotherapeutic Treatment Impact On Pediatric Patients With Acute Lymphoblastic Leukemia, Roaa Alfarshooti

Wayne State University Theses

Acute lymphoblastic leukemia (ALL) is the most prevalent type of leukemia among children. It is characterized by chromosomal and genetic variations and abnormalities occurring in the leukemic cells. Prognosis predictors of ALL depend on risk-based stratification and the reaction to the initial therapy. Current treatment regimens of ALL contribute to the survival of approximately 80% of pediatric ALL patients with 90% 5-year event-free survival. Based on the patient’s features impacting prognosis and risk of therapy failure, cases can be designated to receive the adequate type of treatment regimens. The higher the risk, the more aggressive, intensive, and toxic is the …

Provider Experiences Implementing Group Care: A Qualitative Study, Noureen Ahmed

Public Health Theses

Objective/Purpose: Group Well Child Care is an innovation in primary care delivery that may help meet the quadruple aim of health care. The objective of this study is to characterize Group Well Child Care providers’ experiences, perceptions, and strategies.

Introduction: In Group Care, also known as shared medical appointments, patients with similar medical needs attend appointments together. The practice of Group Care has spread, particularly where social support is beneficial (e.g., early parenting) and among those who might experience shame or stigma for their diagnosis or background (e.g., poverty). Group Care has shown promise in improving patient outcomes, such as …

Evidence-Based Pediatric Diabetic Ketoacidosis Education, Sonya Sandhu

Walden Dissertations and Doctoral Studies

Pediatric patients with diabetic ketoacidosis (DKA) are a unique subset of patients who arrive to the emergency department (ED) for care, and differ from adults regarding symptomology, treatment, and adverse effects. Nurses who will encounter this patient population must have adequate knowledge and confidence to care for them, yet research continues to show a gap in practice. The purpose of this doctoral project was to determine if a staff education project would increase ED nurse knowledge and confidence in caring for pediatric emergency patients with DKA. Utilizing Kirkpatrick’s evaluation model, an evidence-based staff education program was formulated, reviewed by an …

Increasing Medication Compliance In Pediatric Asthma Patients By Implementing A Home Medication Dosing Chart, Lindsey K. Shader

DNP Projects

Background: There are 6.2 million children under the age of 18 years who have an asthma diagnosis (Center for Disease Control and Prevention, 2017). Only 60% of children ages 7-17 years with persistent asthma maintain their prescribed inhaled corticosteroid (ICS) controller medication regimen (Arnold, Bixenstine, Cheng, & Tschudy, 2018). The purpose of this paper is to discuss a practice inquiry project that incorporated the implementation of an asthma medication dosing chart to increase compliance in pediatric asthma patients.

Method: The quasi-experimental pretest-posttest design evaluated the daily use of a medication dosing chart, which was to serve as a physical reminder …

Improving First Dose Administration Of The Hpv Vaccine For Adolescents In A Pediatric Primary Care Clinic, Scarlett Mikesell-Pierce

DNP Projects

BACKGROUND: Nationwide more than 90% of cervical cancer cases are caused by the human papilloma virus (HPV). Cervical cancer can be largely prevented by administration of the HPV vaccine for children before becoming sexually active. However, vaccination rates in the United States, remain low at 60%, and only 39.7% through series of completion, despite the strong evidence to support the effectiveness of the HPV vaccine. Research indicates a clinician’s recommendation, providing information and opportunity for discussion about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity. This study addresses the barriers to parent/caregiver intent to …

Prehospital Use Of Cuffed Endotracheal Tubes In Pediatric Patients: Thematic Analysis Of Barriers To Practice Change., Thomas E. Pearson

West Chester University Doctoral Projects

The prehospital use of cuffed endotracheal tubes has become an evidence-based practice recommendation. Uncuffed endotracheal tubes continue to be used by emergency medical services (EMS) that transport injured and ill children to Nemours/Alfred I Dupont Hospital for Children (N/AIDHC). Uncuffed endotracheal tubes are being used in infants and toddlers, but also in older children and adolescents. EMS agencies that refer patients to N/AIDHC were surveyed to determine the status of their implementation and use of cuffed endotracheal tubes. Of six services, two had fully implemented the use of cuffed endotracheal tubes. Dispositional resistance to change among the EMS administrators was …

Quality Of Life, Reading And Accommodation In Children With Low Vision, Dawn Kissner Decarlo

All ETDs from UAB

Childhood permanent, uncorrectable vision impairment (VI) is rare, yet it is a public health burden as the impairment lasts a lifetime. Vision impairment describes decreased vision that affects everyday activities. Acuity cut-points commonly used include 20/40, 20/60 or 20/70. Blindness often refers to legal blindness (best corrected visual acuity of 20/200 or worse or a visual field less than 20 degrees). Children with VI often have hereditary conditions such as albinism, optic atrophy and retinal degenerations and are different in many ways than adults with VI. The majority have conditions with onset at or near birth and as a result …

A Comparison In Pediatric Dental Website Design From A Guardian And Pediatric Dentists’ Perspective., David M. Voth

Theses and Dissertations

Purpose: This project aims to determine which aspects of pediatric dental practice websites are preferable to the guardians of pediatric dental patients and which of these aspects are currently available to guardians on the websites of pediatric dental practices across the United States. The comparison will reveal if practice websites are meeting the needs of the guardians of pediatric dental patients. Our hope is to provide meaningful guidance to pediatric dentists designing new practice websites and to provide the guardians of pediatric dental patients with an appealing online experience during their use of the aforementioned websites. Methods: A survey with …