Medicine and Health Sciences Commons^™

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon L. Carpenter

Posters

Background Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …

The Pediatric Ecmo Diary: Strengthening Communication, Family Coping, And Staff Engagement, Sarah P. Jimenez, Johanna I. Orrick, Kari L. Davidson

Posters

Bedside diaries have been used in Adult Intensive Care Units (ICUs) in Europe since the 1970s. These journals encourage clinicians to record a patient’s progress, illness narrative, and daily occurrences. Adult ICUs in America are beginning to implement and study the benefits of ICU journals. Bedside journals have been shown to increase staff engagement and aid in psychological recovery for patients and families following their illness. These diaries improve communication between the healthcare team and families, and help patients make sense of ICU stays by filling in memory gaps. Studies on ICU diaries have shown that a bedside diary kept …

Engineering A Novel Treg Population To Control Autoimmune Diabetes, Sofia Colon Guzman, Elly Puckett, Ryan T. Fischer, Mary Markiewicz

Posters

Purpose Type 1 diabetes (T1D) in an autoimmune disorder where T cells attack  islet cells, which are the pancreatic cells responsible for insulin production. T1D affects about 1 in 500 children in the United States and is one of the most common chronic diseases in pediatrics. Currently, insulin is the most effective treatment for T1D However, it does not change the underlying disease, and patients still experience many complications throughout their lifetimes. With a significant increase in the prevalence of T1D in children and adolescence in the past two decades, it’s important to explore therapies that alter the immune …

Viral Detection In Anterior Nasal Swabs Versus Nasopharyngeal Swabs In Children, Nicole Neeley, Abby Kietzman, Rangaraj Selvarangan, Dithi Banerjee, Jennifer Goldman, Jennifer Schuster

Posters

Background: Respiratory viruses are a significant cause of pediatric illness and healthcare utilization. Diagnostic testing for respiratory viruses is generally performed using nasopharyngeal (NP) specimens obtained by trained medical staff, limiting testing to medical settings. Evaluating additional sampling methods in children, such as anterior nasal swab (NS) specimens may expand access to diagnostic testing and aid public health surveillance. Methods: Eligible children hospitalized at Children’s Mercy Hospital in Kansas City who had a standard of care NP specimen collected for nucleic acid amplification testing for respiratory viruses were enrolled. Research NS specimens were obtained through self, caregiver, or staff collection. …

The Role Of The Apheresis Tandem Safety Timeout In Ecmo And Apheresis Therapy, Johanna I. Orrick, Debra E. Newton, Kari L. Davidson, Karen Murray

Posters

The Apheresis Tandem Safety Timeout was implemented in 2017 at Children’s Mercy Hospital (CMH) to ensure safe, coordinated care when performing therapeutic plasma exchange (TPE) alongside Extracorporeal Membrane Oxygenation (ECMO). The first tandem procedure at CMH was performed in 2013, introducing a valuable tool for treating the sickest patients in the region. However, when patients are placed on two extracorporeal circuits simultaneously, the risk of complications increases significantly. These include electrolyte imbalances, anticoagulation challenges, hemodynamic instability, and the potential for either circuit to be compromised. The ECMO and Apheresis team recognized that even minor miscommunication could lead to life-threatening complications …

Detection Of Chromosomal Mosaicism- The Importance Of Karyotyping And Fish, Allison Kalinousky, Jennifer Roberts, Madeeha Alikhan, John Herriges, Lei Zhang, Elena Repnikova

Posters

Introduction: The use of whole-exome/whole-genome sequencing for the detection of sequence-level variants and copy number variations (CNV) is increasingly being adopted as a primary testing method for genetic disease diagnosis by many institutions. Additionally, long-read sequencing is a promising technique to capture not only sequence level variants and CNVs but also structural chromosomal abnormalities. Significant progress has been achieved in this field; however, the detection of chromosomal mosaicism, including numerical gains and losses, rings, markers, and structural rearrangements – particularly those that are lineage-specific or exist at low levels – might still pose challenges with these emerging technologies. Furthermore, differentiating …

Development Of Mobility Scales For Infants And Children On Ecmo, Johanna I. Orrick, Debra E. Newton, Caroline Holton

Posters

Extracorporeal Membrane Oxygenation (ECMO) is a life-saving intervention commonly used in pediatric and neonatal intensive care; however, it presents unique challenges for maintaining patient mobility. Early mobility contributes to better long-term outcomes. Existing mobility scales by the Extracorporeal Life Support Organization (ELSO) are limited to patients aged 8 years and older, leaving a gap for younger populations. This study aimed to develop and validate mobility scales specifically for infants (< 2 years) and children aged 2-8 years undergoing ECMO therapy. Through a collaborative effort involving pediatric ECMO specialists, physicians, and critical care nurses, we adapted ELSO’s mobility criteria to be developmentally appropriate for these younger age groups. For infants, mobility benchmarks include passive and active limb movements, head control, and supported sitting. The criteria for children aged 2-8 is expanded to include sitting, supported standing, and age-appropriate gross motor activities. This scale provides graded levels of mobility that accommodate ECMO-specific safety considerations, allowing practitioners to chart interventions according to each child’s developmental and physiological capacity. The resulting scales are being pilot-tested at our large ECMO center, with data showing preliminary effectiveness at capturing the degree of mobility achieved during ECMO runs. This mobility scale fills a critical need by providing structured charting guidelines for mobilizing infants and young children on ECMO, promoting functional recovery and potential improvements in long-term developmental outcomes. Further studies are recommended to establish consistency across institutions and confirm the scale's impact on mobility outcomes in pediatric ECMO patients.

A Case Of Heterotaxy And Common Atrioventricular Canal With Bradycardia, Mohamed Aashiq Abdul Ghayum, Jenna Schermerhorn, Hayley S. Hancock, Kelsey Brattrud, Melanie Kathol, Maria Kiaffas

Posters

Background: Heterotaxy-polysplenia syndrome (otherwise known as left atrial isomerism) should be suspected in the presence of complete atrioventricular canal defect (CAVC) with interruption of the inferior vena cava (IVC), atrioventricular block (AVB), and viscero-cardiac heterotaxy. The prognosis remains dismal for the fetus with such entity, especially in the presence of major structural heart disease and high-grade atrioventricular block. Early diagnosis, close follow up, and appropriate delivery planning, allows for effective stabilization of the baby after birth and might improve survival. Methods: A 26-year-old mother at 26 weeks gestational age was referred for cardiac evaluation of cardiomegaly, suspected CAVC and bradycardia. …

Common Pulmonary Vein Atresia: A Diagnostic And Management Distinction, Adenike Adenikinju, Jenna Schermerhorn, Anmol Goyal, William Douglas, Sanket Shah

Posters

Common pulmonary vein atresia (CPVA) is an extremely rare congenital heart disease (CHD) characterized by a pulmonary vein confluence with no connection to the left atrium (LA) and no large decompressing vessel. We present a rare case of CPVA prognosticated with multimodal imaging.

D-Transposition Of The Great Arteries With Right Aortic Arch, Bilateral Ductus With Ductal Origin Of The Left Subclavian Artery And Abnormal Aortic Origin Of The Left Coronary Artery, Jenna Schermerhorn, Anmol Goyal, Param Vora, Braidyn Wells, Edo Bedzra, Sanket Shah

Posters

We present a case of prenatally diagnosed d-transposition of the great arteries (d-TGA) with intact ventricular septum (IVS), postnatally found to have bilateral patent ductus arteriosus (PDA) with potential for isolation of the left subclavian artery (LSA) and an abnormal left coronary artery (LCA) course. Isolation of the LSA is a rare occurrence and defined as an anomalous origin from the pulmonary artery via PDA and apparent discontinuation from the arch following PDA closure. It is exceedingly rare in association with d-TGA. Coronary artery anatomy is particularly important in d-TGA given most patients undergo the arterial switch operation (ASO).

Duration Of Labor And Umbilical Artery Acidosis In Critical Congenital Heart Disease, Sarah Gwazdacz, Teresa Nguyen, Henry Yeh, Mary T. Donofrio, Timothy Bennett, Amanda Mcintosh

Posters

• Background (83 words): Standard delivery protocols for most prenatally diagnosed CCHD is induction of labor at 39 weeks with aims of a vaginal delivery (VD) near a tertiary care center. There is no benefit to planned Cesarean delivery (CD) over VD for most infants with CCHD. However, longer durations of labor (DOL) in CCHD have been described as a risk factor for umbilical artery (UA) acidosis. We aim to describe the relationship between DOL and UA pH and neonatal outcomes in those with prenatally diagnosed CCHD. • Methods (150 words): Retrospective chart review of prenatally diagnosed with CCHD born …

How To Help New Nurses Deal With Anxiety And Stress, Jared Modzelewski Bsn, Rn

Posters

Background

New graduate nurses need to reduce their stress and anxiety to improve patient outcomes. Every nurse has some anxiety and stress, but new graduate nurses have been talking about it more. This change is necessary because improvement in mental health for nurses can improve their wellbeing and the overall quality of care they provide their patients.

Alarm Fatigue, Isabell Fritts-Krzyzaniak Rn, Kaitlyn Graves Rn, Kevin Lanese Rn, Keyna Morales Rn, Jill Roderick Rn

Posters

Background:

Nurses from numerous specialties have identified that they experience alarm fatigue. Alarm fatigue leads to alarm desensitization, inappropriate pauses or disabling of alarms, and other adverse events, such as patient harm.

Project Goal:

Implementation of new monitor software and educational courses such as learning modules (LMS), in-service training

Evidence-Based Solutions To The Multi-Faceted Problem Of Healthcare Burnout And Safe Staffing, Ranae Cornwall Rn, Taylor D'Amato Bsn, Rn, Elizabeth Falcigno Mba, Bsn, Rn, Sabrina Ferreira Bsn, Rn, Whitney Lascaux Bsn, Rn, Mscp, Lmt, Ryt, Olivia Okoroafor Bhs, Bsn, Rn, Lucas Peixoto Adn, Rn, Cecilia Rivas Bsn, Rn, Bsph

Posters

It is common for inpatient medical floor RNs to care for an average of 5-7 patients per assignment plus the role of charge RN or preceptor, which borders the legal limit in the state of Connecticut. We believe that by eliminating an assignment for charge RN’s, safe staffing ratios can be achieved, and RN higher retention rates could be achieved with a strategic PICO investigation.

Utilizing Technology To Change Practice And Reduce Falls, John Brennan Dnp, Rn Cphq, Sopiko Baratashvili Bsn, Rn, Kara Burdick Msn, Rn, Andrew Quito Bsn, Mba

Posters

Historically, fall prevention has been primarily reactive, averting similar events from recurring. However, recent nursing research has focused on ensuring that appropriate resources are in place (Wilson et al., 2022; Zhao et al., 2019). To complement this aspect of evidence-based literature, the hospital has invested in innovative technology and practices to prevent falls.

A Phenomenological Examination Of Spiritual Health In Cancer Patients, Cheryl Green, Lauren Thayer, Beatrice Relucio Rn

Posters

This study is a phenomenological qualitative comparative analysis of how Oncology nurses and their patients understand spiritual health as patients cope with the diagnosis and treatment of cancer.

Scheduling, Stress, And Satisfaction: How Alternative Methods Of Staff Scheduling Can Stop Nurse Burnout And Increase Nurse Satisfaction, Cythia Anicette Adn, Rn

Posters

●Traditional scheduling modalities have been identified by YNHH staff members to have a negative impact on work-life balance, eventually leading to burnout. ●Studies have shown that burnout may lead to poor patient outcomes and increased turnover rate among nurses. ●In traditional scheduling modalities, management is often in charge of creating the schedule for the entire unit with varying input from staff. ●In contrast, self-scheduling has staff collaborate with each other to create a schedule with final approval made by management. ●Self-scheduling has been found in several studies to create positive outcomes in nursing satisfaction and work-life balance. ●Due to its …

Rooming-In With The Newbies, Kiara Baguio Bsn, Rn, Allison Gomez Walker Bsn, Rn, Sydney Roth Bsn, Rn, Taylor Standring Bsn, Rn, Andriana Stewart Bsn, Rn

Posters

• Rates of bonding and breastfeeding with baby during hospital stays whether they are in a Baby-Friendly Hospital.
• How rooming-in with infant creates longer and stronger breastfeeding success rates.
• Statistics of breastfeeding and rooming-in within networks of Baby Friendly hospitals vs. non Baby Friendly.
• Change is necessary because evidence suggests that the later mothers begin breastfeeding, the higher the chances the newborn acquires an infection that can lead to death.

Healing Hands Are Clean Hands, Abigail Bruce Bsn, Rn, Katherine Benalcazar Adsn, Rn, Rosa Crespo Bsn, Rn, Dana Drywa Bsn, Rn, Maris Estevez Bsn, Rn, Erin Helge Bsn, Rn, Bilonda Kalemba Bsn, Rn, Kerryann Meggie Bsn, Rn, Amanda Silver Bsn, Rn, Jasmine Villafane Asn, Rn

Posters

• Our team identified the lack of hand hygiene throughout the department.
• Hand washing is an important part of infection prevention, and not washing hands properly or not at all, increases the rate of infections for our patients.
• Hand washing stations are out of reach or not available at all in certain areas of the emergency department, making it nearly impossible for optimal hand washing.
• Despite our efforts, hand hygiene habits can be improved throughout Bridgeport Hospital.

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

Ocd Lesions Of The Lateral Femoral Condyle And The Impact Of The Location On Recovery, Catharine Kral, Joshua Cummings, Ellie Helton, Shannon Margherio, Brian S. Harvey, Kevin Latz

Posters

Descriptive study based on Zhou, Liang, et al. we categorized the LFC OCD lesions into weight bearing and non-weight bearing lesions to assess clinical and radiographic variables and evaluate the need for progression to operative management.

Evaluation Of Pain Control In Lobectomies: Before And After The Removal Of Liposomal Bupivacaine From Formulary At An Academic Health System, Kelly Cheng Pharmd, Michael Guerra Pharmd, Rebecca Pulk Pharmd, Ms, Bsp, Amber Zaniewski Pharmd, Mba, Bcps, Ryan Brown Pharmd, Bcps

Posters

• Liposomal bupivacaine is an extended-release formulation of the long-acting traditional local anesthetic, bupivacaine.
• Yale New Haven Health system (YNHHS) removed liposomal bupivacaine from formulary in March 2024.
• This decision was based on primary research and meta-analyses showing little to no clinical or statistical benefit of liposomal bupivacaine over traditional bupivacaine in morphine milligram equivalent use (MME) and median pain score in all surgeries including lobectomies.

Identifying Current Barriers And Optimization Opportunities Of Rapid Access Pathway To Outpatient Care For High-Cost Biologics In An Academic Health System, Avani Topiwala Pharmd, Vincent Do Pharmd, Bcps, Bctxp, Joseph Rosano Bs, Pharmd

Posters

• Inpatient administration of specialty biologic agents can have significant financial impacts on a healthcare system.
• The “Never Administer Inpatient List” (NAIL) is an established reference which contains biologic infusions that should be administered in an outpatient setting when clinically appropriate.
• While outpatient administration may be clinically appropriate, there are many barriers to coordinating outpatient infusions that result in unnecessary inpatient administration. This can result in a prolonged length of stay and increased medication cost.

Discrepancy Between Hyaluronic Acid Levels And Mri-Based Measurements Of Hepatic Fat And Fibrosis, Daniel Aaron Borman, Rachel Chevalier, Jonathan Wagner, Michele T. Pritchard, Sherwin S. Chan, Nathan S. Artz, Johnston Fite, Yoon Cho, Valentina Shakhnovich, Veronica Williams, Voytek Slowik

Posters

Introduction Metabolic-dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease in children in the United States and, when left untreated, can progress to liver fibrosis. Clinicians currently utilize imaging and biopsy to assess fibrosis in this patient population as there is no validated serum biomarker available for detecting fibrosis. Previous research suggests that serum hyaluronic acid levels are predictive of hepatic fibrosis in children with MASLD. Methods Retrospective data were obtained from the Children’s Mercy Hospital Liver Lab study. Pediatric subjects with both hyaluronic acid (HA) samples and MRI evaluation within a month were identified and included for …

Tenecteplase For Acute Ischemic Stroke: Insights From A Large Community Teaching Hospital, Ithar Alsarraf, Jennifer Pilotto, Rebecca E. Baker, Emily Reich

Posters

Acute Ischemic Stroke (AIS) is a leading cause of disability and death in the United States, requiring urgent treatment1,2; earlier treatment improves patient outcomes.

Fibrinolytic agents including alteplase and tenecteplase (TNK) reduce long-term disability in AIS but are associated with hemorrhagic risks3,4.

As of January 2024, Corewell Health East hospitals updated their guidelines that TNK would be the first line agent in the treatment of AIS.

Alteplase is the only approved agent for AIS, but TNK shows similar effectiveness along with shorter preparation and administration time which may ultimately improve door-to-needle time2 .

Careful consideration of patient characteristics is important …

Variation In Provider Specialization Among 139 Non-Affiliated Real-World Data Contributors, Joshua Koni, Rose Reynolds, Janelle R. Noel-Macdonnell, Mark A. Hoffman

Posters

Oracle EHR Real-World Data (OERWD) is a national de-identified data set useful for observational findings across 139 non-affiliated healthcare systems. Data in OERWD is associated with a de-identified provider ID categorized and documented using National Uniform Claim Committee (NUCC) taxonomy codes. There are 2,421,948 providers in OERWD associated with both their specialty and contributing organization. We profile the data for overall distribution and co-occurrence of specialties, enabling research related to treatment patterns and outcomes.

A Unilateral Myopic Shift Secondary To Sturge-Weber Syndrome Results In Refractive Amblyopia Of The Fellow Eye In A Pediatric Patient, Mckenzie Stewart, Christina Twardowski

Posters

A 4-year-old patient with unilateral glaucoma secondary to Sturge-Weber Syndrome causes a myopic shift. The fellow healthy eye maintains high hyperopia resulting in anisometropic refractive amblyopia, requiring occlusion therapy. It is well documented that a glaucomatous high IOP causes an expansion of the globe due to excessive plasticity of collagen fibers in pediatric eyes. The elongated axial length induces myopic shifts. In this patient, the myopic shift in her glaucomatous eye resulted in a unilateral high hyperopic refractive error in the fellow eye with normal ocular health. This anisometropia is enough to cause amblyopia in the hyperopic eye. In past …

Terminal Ileal Intubation In Retroflexion In A Pediatric Patient, Lakshmi Kunam, Antonia Fernandez Ovalle, Thomas M. Attard

Posters

Background: Terminal ileum (TI) intubation is integral to complete diagnostic ileocolonoscopy in children. It is necessary to determine terminal ileal involvement in patients with a broad spectrum of pathologic processes. In some cases the standard method of intubation does not lead to success and retroflexion is needed. Here we describe the case of terminal ileal intubation in retroflexion on a 14 year old female. Case description: 14 year-old female patient with a past medical history of chronic abdominal pain, NAFLD, anxiety, vulvovaginitis, lichen sclerosus, depression, constipation, delayed menses, and GERD who was admitted for 2 weeks of escalating symptoms and …

But, It's Just A Uti, Gillian Long

Posters

IgA Vasculitis is a commonly seen presentation in the pediatric population. The constellation of symptoms typically includes purpuric rash, joint pain, abdominal pain and hematuria. This 12 year old female was seen by her pediatrician for rash on her legs, shortness of breath, cough and night sweats that all started around 2 months ago. Additionally, a 25 pound weight loss was noted over the past year. The rash appeared as nonblanching purpura on her lower extremities, lending suspicion to IgA Vasculitis. She was first treated for UTI with cefuroxime, and then treated with steroids. Urinalysis showed persistent hematuria and she …

Steatotic Mass Secondary To Heterozygous Hemochromatosis, A Rare Case Of Biliary Obstruction, Saddam Zaidi Md, Cheng-Hung Tai, Joanna Gibson Md, Phd, Caroline Loeser

Posters

Heterozygous Hemochromatosis (HH) is a genetic disorder that increases iron absorption. Carriers of the C282Y HFE gene mutation have a higher risk of developing nonalcoholic fatty liver disease (NAFLD). Research indicates a significant association between liver fat accumulation (steatosis) and fibrosis in HH. This case involves a 31-year-old male with HH and an uncommon biliary obstruction caused by focal fat infiltration.