Medicine and Health Sciences Commons^™

Educating Pediatric Registered Nurses On The Administration Of Prolonged Intravenous Antibiotics, Kasandra Rezler

Master's Projects and Capstones

Abstract

Problem According to Children’s Hospital A's incident reporting system, 50% of problems related to prolonged intravenous antibiotics were classified as administration issues. When mistakes are made in this process, the antibiotic is then delivered at the wrong rate or the wrong time, which is problematic. Additionally, findings from a needs assessment survey highlight a critical need for targeted interventions, such as an educational video, to reduce administration errors associated with prolonged IV antibiotics. Context Within Children’s Hospital A, the microsystems targeted by this quality improvement project consist of inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s …

A Peer-Mediated Art Program For Secondary Education Students: An Occupation Based Approach, Kjersten B. Sievers

Occupational Therapy Capstone Presentations

The purpose of this 14-week capstone project was to explore the impact of a peer-mediated art program on the social and occupational experiences of students with disabilities. This program was designed and implemented to promote inclusion of students with disabilities by providing an opportunity to interact with typically developing peers within their school-context. The 7-week peer-mediated art program was embedded into a startup peer-program at a high school. A total of 10 participants (4 from special education) were recruited to complete the study. Students met for three 45-minute sessions and one 90-minute session each week as part of the program’s …

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Pediatric Trauma-Informed Care And Implications For Occupational Therapy Practitioners, Quaneka Hoskin-Chase

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners are provided a wealth of knowledge through school and professional fieldwork experiences to understand and skillfully address the needs of children who have been exposed to trauma. Therapists are competently prepared to provide holistic and client-centered care that is dedicated to meaningful and volitional engagement (Lynch et al., 2021). However, many therapists still lack the confidence and awareness of their role related to trauma-informed care in the pediatric environment (Piller, 2022). Trauma compromises each domain of occupation (Lynch et al., 2021). As early intervention specialists, the lack of responsiveness to children’s trauma can have devastating and enduring …

Occupational Therapy Services In Pediatric Mental Health, Hallie Jerome

Occupational Therapy Capstone Presentations

Children and youth experiencing mental health concerns often have limited or decreased engagement in meaningful occupations. Additionally, children and youth who experience mental health concerns at an early age are more likely to experience negative health outcomes such as poor occupational engagement, academic achievement, adverse childhood experiences (ACES), maltreatment/abuse/neglect, family and peer conflict/rejection, low self-esteem, early substance use, and many others impacting their overall health and well-being. My capstone project aimed to administer occupation-based interventions in a pediatric mental health program while I advance my skills working with an interdisciplinary team. The literature and needs assessment indicated a need for …

Animal-Assisted Therapy In An Outpatient Pediatric Occupational Therapy Setting, Peyton N. Stolle

Occupational Therapy Capstone Presentations

The use of animals to assist in the healthcare industry has been around for some time now, however, only recently have those in the occupational therapy industry begun looking at the effects that it would have on patients within their scope of practice. Animal-assisted therapy (AAT) has various uses, and recent studies have shown that the use of dogs within a healthcare setting can greatly increase patient motivation and well-being. However, prior literature shows that there are limited studies on the effects of AAT in a pediatric occupational therapy (OT) setting, specifically an outpatient setting. My capstone project aimed to …

Final Scholarly Project: Implementation Guidelines Of Ultrasound-Guided Regional Anesthesia In Pediatric Cardiac Surgical Patients, Matthew Hall

Doctor of Nursing Practice Scholarly Projects

In the United States, around 40,000 surgeries are conducted on pediatric patients yearly to address congenital heart disease. These surgeries involve a variety of complications beyond cardiovascular problems, including pain management. Traditional pain management involving intravenous opioids has drawbacks such as sedation, respiratory depression, and prolonged recovery times. As the healthcare industry moves away from opioid-centric pain management, the use of multimodal analgesia, including ultrasound-guided regional anesthesia, is being utilized. Regional anesthesia techniques, such as the transversus thoracis muscle plane block and the thoracic erector spinae block, are being considered for the ability to provide adequate pain relief while reducing …

Strategies Over Knowledge: Training Gaps Present In Caring For Patients With Autism Spectrum Disorder For Pediatric And Student Nurses, Jasmine E. Johnson

Honors Thesis

With Autism Spectrum Disorder (ASD) prevalence ever increasing among the pediatric population, nurses can expect to see an increase in the number of autistic patients within their clinical practice settings. Previous researchers have shown that pediatric nurses are required to overcome many barriers when working with autistic patients, and adequate training is necessary to achieve genuine patient-centered care. However, parents have reported less than optimal care received by their children with ASD within the healthcare system. Therefore, research is needed to determine where training could be improved for this patient population. This study aimed to identify where training deficits are …

Recommendations For Sugammadex Administration In Standard And Special Populations, Kristen E. Mattson, Alexa Brummund

Doctor of Nursing Practice Projects

The purpose of this project was to collect evidence-based information regarding sugammadex administration in both standard and selected special populations. Special populations included renal failure, breastfeeding, pregnancy, and pediatrics. The objectives of the project were to collect and present current research to the host facility, define barriers to the use of sugammadex, and assess the participants’ knowledge of sugammadex use in special populations. A guideline for sugammdex administration was created and presented to the host facility through a poster presentation and quick reference guide. A voluntary post-implementation survey was implemented, and the results were recorded, analyzed, and displayed in the …

Factors That Influence The Prevalence Of Food Allergy In Children Born In Industrialized Countries Vs. Developing Countries: A Literature Review & Feasibility Study, Dimitri Miguel Lacson Torres

Nursing | Senior Theses

Background

Food allergy (FA) is known to be more prevalent in industrialized countries compared to developing countries. FA is a chronic disease that can cause a range of symptoms from regional urticaria to lethal anaphylaxis. FA affects 10% of the general population and is more common in children, affecting 8% of children versus 3% of adults (Seth, D. et al., 2020). It is unclear why food allergy is more common in industrialized countries versus developing countries. Research Question What are the influential factors that affect the increasing incidence of food allergy in toddlers born in industrialized countries versus those that …

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Senior Theses

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn Jansen

Nursing | Senior Theses

Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with …

Inclusive Sports Environments: Youth Gymnastics Coaches’ Perceptions On Promoting Inclusivity For Autistic Athletes, Alec D. Sheaffer

Occupational Therapy Doctorate Capstone Projects

Background: Despite the positive physical, psychological, and social benefits of sports, children with disabilities participate in sports at a lower rate than their typically developing peers. Partnerships between occupational therapists and youth sports providers can facilitate inclusive sports environments that enable equitable access to sports for all children.

Purpose: The purpose of the Capstone Project was to explore youth gymnastics coaches’ perceptions on inclusive sports participation following an educational module.

Theoretical Framework. The occupational justice framework (Townsend & Wilcock, 2004) guided the development of the project through the view that equitable participation in preferred occupations is an individual right.

Methods. …

Associations Among Psychosocial Factors, Health-Related Quality Of Life, And Adherence In Pediatric Inflammatory Bowel Disease, Cecelia I. Nelson

Graduate Theses, Dissertations, and Problem Reports

Inflammatory Bowel Disease (IBD) is a prevalent disorder among youth in the United States. IBD is one of the leading causes of chronic pain in adolescence and symptoms can lead to reduced quality of life, social embarrassment, and lower self-esteem. Adherence to medical regimens for IBD is incredibly important to prevent morbidity, mortality, and impaired health-related quality of life (HRQOL). However, adolescents struggle generally with adherence and the regimen for IBD can be complicated and include aversive side effects. Psychological factors, such as depressive symptoms, are key factors associated with non-adherence. Nevertheless, gut-specific anxiety (GSA) is a psychological factor that …

Unleashing Wellness: Exploring The Impact Of Pet Therapy On Anxiety Reduction, Quality Of Life, And Treatment Adherence In Pediatric Oncology Patients, Karina Brouwer

Nursing | Senior Theses

Pet therapy is a complementary intervention that involves the interaction between a person and animal, with the focus of improving psychological well-being within diverse populations. In particular, children with oncological disorders have increases in anxiety and stress levels, therefore it is imperative to study the impact of animal interventions within this population. This literature critique explores the impact of pet therapy interventions on anxiety, stress, and quality of life perceptions in pediatric oncology patients. This research proposal will investigate how animal therapy interactions within pediatric oncology patients influence their anxiety levels and perceptions of quality of life and how these …

Nursing Care Of The Pediatric Patient With Autism, Cayley Frolik

Honors Capstones

The purpose of this project is to help educate current and future nurses on ways to understand and better connect with pediatric patients with autism. Standard nursing curriculum tends to focus primarily on the clinical approach for mainstream patients. In one short year, I recognized a glaring need for nurses to learn how to care for those with autism, as well as how to support and educate their families to create the best environment for whole success. It is very difficult to understand the needs of these specific patients without the proper toolkit. It is my intention to research and …

Improving Access To Care For Specialty Pediatric Orthopedic Patients: Maximizing Telehealth To Achieve Outcomes, Tammy Keesey

Student Scholarly Projects

Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of …

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss no matter what age, including infants. The impact of noise at orthodox Jewish weddings, where infants are frequently in attendance, can reach extremely high and damaging levels of sound intensity. Because the hearing conservation behaviors and attitudes towards child hearing protection in this population are unknown, the objective of this study is to identify the attitudes and behaviors of orthodox Jewish wedding attendees toward child hearing conservation. A survey was developed and administered electronically to congregants of orthodox Jewish synagogues in the New York City area. …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …

Determining Care Delivery Model Feasibility Using Discrete-Event-Simulation, Tanya Scott

Doctor of Nursing Practice (DNP) Projects

Background: The need for inpatient pediatric psychiatric services to address the growing issue of pediatric mental health in a multi-state integrated hospital enterprise is straining the system’s capacity to provide timely mental health care.

Local Problem: Lack of access to specialty pediatric psychiatric treatment for dual diagnosis medi-psychiatric care management is a patient quality and safety issue. Insufficient capacity contributes to longer emergency room boarding times and inpatient length of stay for patients who have a mental illness.

Methods: Use of digital simulation methodology to analyze the behavior of a dynamic event-driven care delivery workflow and to optimize quality patient …

Medication Errors In Pediatric Care And Preventative Solutions, Tyler Tidwell

Political Science Undergraduate Honors Theses

The research presented extensively examines previous reports covering pediatric medication errors (PMEs). Utilizing specific studies into the frequency and types of medication errors along with public surveys and policy discussion, the data and suggestions here provide commentary on the scope of PMEs, suggested institutional reform, and most importantly, legislative recommended action necessary to stymie the tide of PMEs. A significant portion of the research contained fixates on the literature review to provide ample familiarity with the background and scope of PMEs, but the subsequent sections will discuss their implication. After providing details on the magnitude of the issue, regulatory and …

Measuring Outcomes Of Occupational Therapy Facilitated In Natural Settings With Young Children, Amie Smith, Deepak Dale, Brinda Saini, Zoe Peters, Amanda Laccone

Occupational Therapy | Graduate Capstone Projects

To date, there is limited evidence to support the effectiveness of Occupational Therapy (OT) services delivered outside in nature. This study explored the benefits of OT intervention in Natural Settings (NS) for children by examining development in the areas of self-regulation, social skills, sensory processing, confidence, and motor skills. A quantitative, quasi-experimental pre-test/post-test design was used in this study. Researchers partnered with a local outpatient OT clinic that offers an 8-week outdoor program. Seven children and their parents were recruited and participated in the study. A modified version of the COPM and two BOT-2 subtests, along with a novel log …

Automating The Radiation Therapy Treatment Planning Process For Pediatric Patients With Medulloblastoma, Soleil Hernandez

Dissertations & Theses (Open Access)

Over the past 50 years, pediatric cancer 5-year survival rates increased from 20% to 80% in high-income countries, however, these trends have not been mirrored in low-and-middle-income countries (LMICs). This is due in part to delayed diagnosis, higher rates of advanced disease at presentation and a growing lack of access to high quality medical personnel and technology necessary to deliver complex treatments.

The long-term goal of this study was to alleviate demanding workflows and increase global access to high-quality pediatric radiation therapy by harnessing the power of artificial intelligence to automate the radiation therapy treatment planning process for pediatric patients …

Kids And Canines: Pawsitively Impacting Occupational Therapy Outcomes, Jessica M. Simon

Occupational Therapy Capstone Presentations

Within the scope of pediatric occupational therapy, Animal-Assisted Therapy (AAT) is a new and emerging area of practice that has shown to have a positive impact in its use with pediatric clients specifically. AAT is formally defined as, “a form of therapy that includes the presence of and/or interaction with an animal to facilitate progress toward some therapeutic goal” (Hardy & Weston, 2020, p. 197). Through the completion of this Capstone, the student aimed to develop in-depth clinical practice skills related to using AAT within pediatric occupational therapy, develop professional leadership skills, and contribute meaningful research regarding the benefits of …

Interdisciplinary Approaches To Pediatric Aquatic-Based And Land-Based Therapy, Danielle E. Scheck

Occupational Therapy Capstone Presentations

With various injuries, diseases, and conditions continuing to grow and expand with our rising population size, so does the need for therapeutic intervention. To assist in the rehabilitation process, aquatic therapy may be used by multiple healthcare professionals to best benefit their clients through the aquatic medium's unique hydrodynamic and hydrostatic qualities. The aquatic medium is particularly beneficial to the pediatric population as water is usually naturally motivating and "fun." Occupational and physical therapists are among the professionals qualified to perform "aquatic-based" therapy in addition to or in place of more traditional "land-based" therapy. This project aims to expand on …

The Efficacy Of An Educational Toolkit To Enhance Knowledge Of Pediatric Reflux Management Among Occupational Therapists, Kelly Cullerton

UNLV Theses, Dissertations, Professional Papers, and Capstones

This manuscript describes a quality improvement project completed by a student in the University of Nevada Las Vegas Occupational Therapy Doctorate Program. The project tests the efficacy of an educational toolkit for occupational therapists staffed at an acute care hospital in Las Vegas, Nevada, to increase their perceived knowledge of and ability to educate families on conservative management techniques for pediatric reflux management. Results indicate that the toolkit demonstrated efficacy in achieving this objective. The toolkit provided useful staff education and parent handouts for the occupational therapists to utilize in patient care as appropriate. This project’s ultimate aim was to …

Acute Otitis Media, Allie Luther

Masters Theses/Capstone Projects

Learning about Acute Otitis Media