Medicine and Health Sciences Commons^™

Use Of Personalized Patient Heart Diagrams At The Bedside To Improve Quality Of Care, Melissa D. Elliott

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Title: Use of personalized patient heart diagrams at the bedside to improve quality of care

Background/Introduction: With congenital heart disease no two hearts are exactly the same. Even with the same lesion, the anatomy of the heart can be completely different. In response to a bedside nursing idea following a cardiac arrest, advanced practice nurses (APN) initiated a program to provide personalized cardiac anatomy diagrams at the bedside of every patient on the cardiology service.

Methods: When a cardiac patient is admitted to cardiology floor, the nurse will check the patients chart for an anatomy picture, then will place …

Pre-Implementation Of A Fontan Post-Operative Clinical Pathway: Summary Of 2016 Pdsa Cycles, Sarah M. Lagergren, Bryan Beaven, Suma Goudar, Megan Jensen

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Background/Introduction: Post-operative hospitalization for the Fontan procedure tends to have an extended hospital length of stay (LOS). From 2013-2014, the average LOS at Children’s Mercy for the Fontan procedure is 14 days, whereas the U.S. national reported average is 11 days. Post-operative management of this patient population is often caregiver dependent. It has been theorized that developing a more standardized post-operative management regimen tailored specifically toward the unique physiology of Fontan patients may be able to improve outcomes and decrease LOS.

Methods: A review of literature was performed and revealed three pediatric institutions have published their post-operative Fontan care guidelines. …

Therapeutic Plasma Exchange (Tpe) Performed In Tandem With Crrt And/Or Ecmo: Experience Of One Pediatric Center, Lejla Music Aplenc, Cindy George, Kimberly Marriott

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SUMMARY

The most common indications for starting tandem procedures were ASFA Category III indications, followed by un-categorized indications.

Similar to other reports in literature, hypocalcemia and hypotension were the most common complications. Transfusion reactions were rare, despite the use of large volumes of plasma.

Tandem procedures in critically ill pediatric patients require close monitoring and excellent communication between staff members.

An Expanded Role For Nurses In Laboratory Utilization, Marilyn S. Hamilton, Rangaraj Selvarangan, Michele Fix, Lynn E. Shriver

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Introduction: The majority of laboratory testing errors occur in the pre-analytical stage, including specimen collection. Children provide special challenges including small blood volumes, small veins, and an inability to cooperate. We describe collaboration between laboratorians and nursing staff to improve specimen collection and the reliability of test results.

Methods: We identified three areas for improvement: 1) Volume of blood for culture, 2) Urine collection, and 3) Appropriate blood collection through a line. Base line data was established. Guidelines for specimen collection were updated. Nurse members of the Laboratory Utilization Committee developed educational tools.

Results: Nursing education was effective at improving …

Global Health Experience In Swaziland, Anik Patel

Posters

Describes a global health learning experience at the Baylor Center of Excellence in Swaziland, where diagnosis and treatment of HIV/AIDS and TB, along with maternal health, women's health, and adolescent care are provided.

Application Of The Multi-Facet Rasch Model To Validate Chief Residents Survey: A Two-Year Study, Kadriye O. Lewis, Ross Newman

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This study compares the Chief Resident candidates' characteristics and leadership qualities within and across two years and further validates the Chief Resident peer selection instrument.

Swaziland: A Journey Into Culture And Health Care, Claire Hickey

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Describes a global health learning experience with Baylor International Pediatrics AIDS Initiative in Swaziland in 2017.

Sanibonani! A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Angie Schmidt

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Describes a global health learning experience with the Baylor International Pediatric AIDS Initiative in Swaziland.

Investigating Program Directors' Milestone Assessment Practices In Graduate Medical Education, Kadriye O. Lewis, Susan B. Hathaway, J F. Knapp, Denise Bratcher, Douglas Blowey

Posters

The purpose of this study is to investigate the current assessment practices as well as identify the needs and challenges of the Program Directors in implementing ACGME's Milestones for assessment in graduate medical education at a pediatric hospital. The ultimate outcome of this study will be to fairly deliver our support and services to all programs equally providing expertise/consulting, guiding, mentoring/advising, and distributing resources.

A Month At The Lake Clinic - Cambodia, Mara Horwitz

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Describes a global health learning experience in Cambodia on floating clinics that serve residents of remote villages of the Tonie Sap Lake and Stung Sen River.

The Scope Of Social Work Practice In Transition To Adulthood Care, Teresa Hickam

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This is a study of roles executed by social workers and nurses to address common transition planning needs in a pediatric hospital. Duties were stratified based upon tasks assigned only to social work versus those shared with nursing or other team members.

Exploring Pediatrics In The Philippines, Taylor Hansen

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Describes her learning experience in the Philippines with the Jose Fabella Memorial Milk Bank, Fabella's Kangaroo Mother Care Unit, and Talisay Health Center in 2017.

Tender Loving Care At The Lake Clinic, Cambodia, Shubra Srinivas

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Describes a global health learning experience at The Lake Clinic in Cambodia caring for children and adults in a low resource setting in 2017.

A Month In Manila, Robin M. Lund

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Describes a global health learning experience at Philippines Children's Medical Center in Manila.

South Africa: Combatting The Rise Of Hiv In Adolescents, Ryan Northrup

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Describes a global health learning experience in South Africa in 2017, focused on educating teenagers in schools about sexual health and AIDS prevention.

Focus Groups As A Method To Build Library Services And Partnerships Across The Institution, Courtney R. Butler, Megan Molinaro

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BACKGROUND: Children's Mercy is an independent, non-profit, 367-bed pediatric health system with multiple clinic locations and a strong focus on research. It offers a pediatric residency program and over 37 subspecialty fellowship programs.

New initiatives go through many steps from conception to implementation. The focus of this case study is to describe how gathering feedback from stakeholders during proposal development provided valuable insight, secured stakeholder collateral to support requests for administrative approval and funding, and marked the beginning of new productive institution-wide partnerships.

PROJECT STAGES:
Identify Needs
Identify Stakeholders
Evaluate Software
Conduct Focus Groups
Develop Fair Market Analysis/Executive Summary
Convene …

Hematuria Without Microalbuminuria, Angela Ferguson, Vimal Chadha, Amy Wiebold, Uttam Garg

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Background

Microabubiminuria is a condition in which small amounts of albumin are excreted in the urine without overt nephropathy. Based on the

American Diabetic Association classification, microalbuminuria is defined as urinary excretion of albumin of 30–300 mg per 24 hours or 20–200 mcg/min or 30–300 mcg/mg creatinine. Various conditions such as diabetes, hypertension, and impaired renal tubular reabsorption can lead to microalbuminuria. Microalbuminuria is an indicator and predictor of the development of overt nephropathy. If identified and treated early, overt nephropathy can be prevented and averted. Proteinuria and hematuria are the two most common urinary abnormalities encountered during routine urinalysis. …

Global Health Elective: Swaziland, Africa, Jane Duong

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Describes her learning experience providing care with the Baylor International Pediatric AIDS Initiative (BIPAI) in September 2017.

A Quality Improvement Project For The Evaluation And Management Of Possible Necrotizing Enterocolitis In Single Ventricle Patients, Laura Miller-Smith, Jennifer Flint, Lisa Laddish

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Background:

Infants with single ventricle (SV) physiology are at high risk for interstage complications, including necrotizing enterocolitis (NEC). The underlying pathophysiology and age at presentation differs from NEC literature described in premature infants, making NEC in SV patients challenging to diagnose and treat. We perceive significant variability in the approach to possible NEC in SV patients at our institution.

Aims:

To identify variability & standardize the approach to management of NEC

To create a management algorithm for diagnosing and treating NEC

Methods:

After review of current practice and review of medical literature, an algorithm to guide medical decision making specific …

Obstacles To Introducing A Post-Operative Feeding Protocol In The Single Ventricle Population, Lisa Laddish, Laura Miller-Smith, Jennifer Flint

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Objective:

To decrease the morbidity associated with feeding complications by implementing a post-operative feeding protocol for infants with single ventricle physiology

Passport To The Picu: A Quality Improvement Project For Resident Critical Care Education, Laura Miller-Smith, Tara Benton, Jennifer Flint, Jenna Miller, Kelly S. Tieves

Posters

The Pediatric Intensive Care Unit (PICU) has significant variability in patient numbers, acuity and disease processes represented throughout the year. This variability leads to differences in educational exposure for our residents. Prior attempts at standardizing education through a scheduled didactic program were limited by the time constraints of this high intensity and unpredictable environment. In 2015, the pediatric critical care rotation evaluation had the lowest scores for provision of didactic education. On a Likert scale of 1-5 (with 5 being excellent), the didactic scores were 3.41 (Jan - June 2015) and 3.79 (July - Dec. 2015.), lower than other rotations …

Autism Screening In Primary Care: Community Providers Incorrectly Report Adherence To Aap Autism Screening Guidelines, Jose Lopez-Lizarranga Md, Kimberly J. Reid, Sarah Nyp, Cy Nadler

Posters

Purpose: To compare community provider reports of adherence to current American Academy of Pediatrics (AAP) autism screening guidelines with their self-reported practices, including implementation of the Modified Checklist for Autism in Toddlers (M-CHAT).

Methods: An online survey was distributed to primary care providers from Kansas, Oklahoma, and North Dakota. The survey collected demographics and self-reported ASD screening practices (including M-CHAT implementation procedures) and knowledge questions.

Results: 133 providers completed the survey (50% pediatricians, 32% int. med/fam. physicians, 18% physician assistants). Of the 96 who reported routinely screening for ASD; 78% reported adhering to AAP guidelines. However, no providers correctly answered …

Knowledge Base Of Adolescents With Congenital Heart Disease, Mark Gelatt, Julie Martin, Jennifer A. Marshall, Jennifer Panuco, Jenea Schmidt, Pamela Finn

Posters

Introduction:

Most congenital heart disease [CHD] is diagnosed and treated in early childhood with parents responsible for decision-making. The adolescent assumes this role in preparation for transition to an adult congenital heart program. We studied the knowledge base of our adolescent CHD patients and their parents.

Methods:

Established CHD patients, >11 y.o. and their parents, were independently surveyed in the outpatient clinic. Participation was voluntary. Cardiomyopathy, electrophysiology and transplant patients were excluded. Scores were assessed as full, partial or incomplete.

Results:

Most (98% parents; 83% adolescents) reported that their cardiologist had provided education. Adolescents provided a full (49%) and partial …

Application Of The Many Facet Rasch Model To Validate A Survey For The Selection Of Chief Residents, Kadriye O. Lewis, Haiqin Chen

Posters

The literature does not show any established guidelines, methods, or psychometric instruments for selecting Chief Residents in academic programs. This study validates a newly designed instrument based on the characteristics and leadership qualities from the residents' perspectives. Our newly developed survey can differentiate Chief Resident candidates' performance as well as identify why a specific candidate is selected or not through MFRM. This tool can be applied to other residency programs.

Investigating Program Directors' Milestones Assessment Practices In Graduate Medical Education: Preliminary Results, Kadriye O. Lewis, Susan B. Hathaway, J F. Knapp, Denise Bratcher, Douglas Blowey

Posters

ACGME's Milestones assessment requirement placed new demands on Program Directors. This study investigates current assessment practices as well as identifies the needs and challenges of the program directors in implement Milestones for assessment in Graduate Medical Education at Children's Mercy Kansas City.

Predictive Formula For Electron Range Over A Large Span Of Energies, Anne C. Starley, Gregory Wilson, Lisa Montierth Phillipps, Jr Dennison

Posters

A model has been developed to predict the approximate penetration depth into diverse classes of materials for a broad range of energetic incident electrons (<10 eV to >10 MeV, with better than 20% accuracy). The penetration depth—or range—of a material describes the maximum distance electrons can travel through a material, before losing all of its incident kinetic energy. This model leads to a predictive formula that estimates the penetration depth for materials without the need for supporting data, but rather using only basic material properties and a single fitting parameter (Nv, described as the effective number of valence electrons). Nv …

Electron Penetration Range For Diverse Materials, Anne C. Starley, Lisa M. Phillipps, Jr Dennison

Posters

The penetration range of energetic electrons into diverse materials can be modeled approximately with a simple fit. This fit is a function of a single parameter, Nv, which describes the effective number of valence electrons. Using the Continuous-Slow-Down-Approximation (CSDA) for energy deposition in a material, a composite analytical formula has been developed which estimates the range or maximum penetration depth of incident electrons for energies from10 MeV with an uncertainty of

Knowledge Base Of Adolescents With Congenital Heart Disease, Mark Gelatt, Julie Martin, Jennifer A. Marshall, Jennifer Panuco, Jenea Schmidt, Pamela Finn

Posters

Introduction:

Most congenital heart disease [CHD] is diagnosed and treated in early childhood with parents responsible for decision-making. The adolescent assumes this role in preparation for transition to an adult congenital heart program. We studied the knowledge base of our adolescent CHD patients and their parents.

Methods:

Established CHD patients, >11 y.o. and their parents, were independently surveyed in the outpatient clinic. Participation was voluntary. Cardiomyopathy, electrophysiology and transplant patients were excluded. Scores were assessed as full, partial or incomplete.

Results:

Most (98% parents; 83% adolescents) reported that their cardiologist had provided education. Adolescents provided a full (49%) and partial …

Knowledge Gap In Adolescent Heart Transplant Recipients, Pamela Finn, Brian Birnbaum, Audrey R. Kennedy, Jennifer A. Marshall, Mark Gelatt

Posters

Background:

 Studies have reported a knowledge gap Studies have reported a knowledge gap among adolescent and young adult heart heart transplant patients upon transitioning to adult cardiology practices.

 This population is vulnerable to life-threatening complications as they progress to adult care.

Framework/Methods:

We assess the current knowledge deficit of our adolescent and young adult patients and their caregivers in order to inform pediatric providers of their unique needs as they prepare to transition.

Heart transplant patients >10 yrs and their caregivers completed a written questionnaire prior to a clinic visit. 17 questions were asked including the need for …

Stop Cautis: A Unit-Based Education And Leadership Bundled Approach, Jennifer Healy Msn, Rn, Ccrn, Jennifer O'Neil Bsn, Rn, Danielle Moody Rn, Leigh Jimmie Bsn, Rn, Anne M. Aquila

Posters

1. The CAUTI Prevention committee recognized a continued opportunity to reduce CAUTI occurrences in the MICU
2. A sub-group developed and implemented an evidence-based educational program which was completed in October 2014
3. The MICU Team has decreased their CAUTI rate from 12 occurrences (Sept. 2013- Aug. 2014) down to 3 occurrences (Sept 2014-Aug 2015)
4. The team continues to use an auditing process and the insertion checklist as ongoing quality improvement