Pediatric Nursing Commons^™

Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

Only 50% of pediatric patients presenting with significant pain receive any form of analgesia while in the emergency department (ED). The American College of Emergency Physicians endorses the use of triage protocols to improve the speed and consistency of analgesia in the ED. However, given the unique needs of the pediatric population insufficient evidence exists, if any, to support the use of triage protocols for their treatment in the ED. After a review of the literature it is concluded that triage pain protocols are a safe and effective method for providing pediatric analgesia in the ED. However, the variability in …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

A Pediatric Respiratory Care Curriculum For Emergency Department Nurses, Luzmaria Alcala-Van Houten

Doctoral Projects

As pediatric visits to community hospitals increase, the Institute of Medicine (IOM) and the Pediatric Emergency Care Network (PECARN) recommend that staff be provided improved education, protocols, and resources to improve patient outcomes (Emergency Medical Services for Children, n.d.). Acute respiratory disorders are the most commonly seen complaints in children aged 0–24 months, with an average of 2–4 visits a year. The purpose of this Doctor of Nursing Practice (DNP) project is to create a pediatric respiratory care curriculum for emergency department nurses in the Kaiser Permanente Central Valley Area (CVA) and to have it evaluated by a group of …

A Correlation Between Parental Visitation Neglect And Pediatric Intensive Care Unit Psychosis: An Integrative Literature Review, Alia Mohammad

Grace Peterson Nursing Research Colloquium

Abstract

Background: Pediatric intensive care unit psychosis is a serious disorder where patients experience anxiety, hallucinations, delirium, and other symptoms, setting them back in their recovery process during their hospital stay.

Purpose: This study is an integrative literature review aimed at the use of evidence based practices to establish the most effective solution in preventing ICU psychosis in pediatric patients, and discovering if parental presence is a factor to successful recovery.

Methods: WorldCat.org, MEDLINE, ABI/INFORM Complete, Academic Search Complete, OAlster, PsycARTICLES, ERIC, Business Source Complete, and Computers & Applied Sciences Complete were searched using the keywords pediatric, intensive care unit, …

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

Outcomes Of Family Presence During Resuscitation (Fpdr) In The Acute Care Setting: A Review Of The Literature, Audra M. Corn

Honors Undergraduate Theses

Family Presence During Resuscitation (FPDR) remains controversial and is not consistently implemented during resuscitation events or invasive procedures. Evidence has demonstrated positive outcomes produced by implementation of FPDR; such as, decreased rates of post-traumatic stress symptoms, decreased symptoms of anxiety, and depressive symptoms were not significantly different. Unfortunately, use of FPDR in the acute care setting is not widely accepted or readily implemented. The primary purpose of this integrative literature review is to evaluate the use of FPDR in the acute care setting. The secondary purpose is to evaluate the health care professional's level of perceived value associated with the …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Peer Accountability Improves Performance For Daily Chg Bathing To Reduce Clabsis, Sara Crawford, Stacy Pennington, Jeremy Affolter, Kathlyn Baharaeen, Paul N. Bauer, Tara Benton, Shekinah Hensley, Tiffany Mullen, Michelle Waddell

Posters

No abstract provided.

The Lifecycle Of A K-Card: Improving Data Collection While Improving Bundle Reliability, Tara Benton, Barb Haney, Lacey Bergerhofer, Susan Burns, Yolanda Ballam, Kaitlyn Hoch

Posters

No abstract provided.

Pediatric Delirium: Development Of A Standard Of Practice In A Cvicu And Picu Setting, Frances Gililand

DNP Projects

Pediatric delirium remains a significant cause of morbidity in pediatric critical care resulting in longer lengths of stay and increased healthcare costs that may extend beyond critical illness. Prevalence rates of pediatric delirium in pediatric intensive care settings are 20%. Not all children’s hospitals regularly assess for pediatric delirium. At the time of this project, the assessment of pediatric delirium was not a standard of practice at John Hopkins All Children’s Hospital (JHACH). Examining provider’s experience, knowledge and self-efficacy of pediatric delirium was the primary aim of this project. The secondary aim was to use information obtained through the first …

2017-2018 Graduate Studies In Nursing Handbook, Otterbein Office Of Graduate Programs

Graduate School

A graduate handbook for the Graduate Studies in Nursing programs at Otterbein University.

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Pediatric Intensive Care Unit Skin-Care Team, Anna Therianos Konstantin

Master's Projects and Capstones

In the United States, pressure injuries (PIs) cost $9.1–$11.6 billion per year and claim more than 60,000 patient lives. The large Northern California hospital where this CNL project was conducted has had an 8.33% incidence of hospital-acquired PIs at or greater than stage two in the pediatric intensive care unit (PICU). Pressure injury prevention was not a high priority for the nursing staff; nurses were unaware of current PI prevention protocols or the PI prevalence in the PICU. The goals are to reduce PIs by 20% in 3 months, increase PI nursing education, and improve patient outcomes. Nursing skin-care rounds …

Post-Intensive Care Syndrome: Comparison Of Educational Interventions To Educate Parents Of Children Hospitalized In The Pediatric Intensive Care Unit At St. Louis Children’S Hospital, Stephanie A. Esses

Dissertations

Background: Family members of children hospitalized in the pediatric intensive care unit (PICU) can develop cognitive, psychological, and physical manifestations of post-intensive care syndrome (PICS). Targeted education to help parents/caregivers recognize the signs and symptoms of PICS may result in better awareness of the syndrome and greater willingness to seek and receive support during their child’s PICU admission.

Objective: to evaluate three targeted PICS educational interventions to increase PICS awareness among parents/caregivers in the St. Louis Children’s Hospital (SLCH) PICU.

Results: A total of 62 parents/caregivers received one of three educational interventions: informational brochures (n=22), scripted informational conversation (n=20), or …

Improving New Graduate Critical Care Nurse Practitioner Knowledge And Retention Using A Dedicated Orientation And Mentoring Program, Katherine Huffer

Dissertations

Abstract

Background: There has been a significant amount of research into the many challenges that nurse practitioners (NPs) face as they transition from school to practice, however, there is limited research on how to improve this transition. Regardless of the setting in which the NPs are working, novices NPs alike report feelings of being unprepared and experiencing high levels of stress, anxiety, fear, and frustration. New research suggests that a comprehensive NP orientation and residency programs may provide a way to integrate the new NPs into their practice environment successfully.

Method: Kern’s Six Step Approach to Curriculum Development for Medical …

The Acute Care Pediatric Nurse Practitioner In Missouri: An Analysis Of Needs Assessment, Jessica L. Mann

Dissertations

Introduction: Due to an increasing number of acutely ill pediatric patients and changing healthcare demands, there is an even greater need for nurse practitioners (NPs) to work in the area of pediatric acute care (AC). There is a lack of alignment of education and certification with the scope of practice of the AC Pediatric Nurse Practitioner (PNP). The development and implementation of a graduate level AC PNP program in Missouri will support the alignment of education, clinical training, and certification with the scope of practice of the AC PNP and improve access to a quality program for nurses that currently …

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

Posters

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. …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects and Capstones

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes so …

Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard

Senior Honors Projects, 2010-2019

Age and developmental stage directly influence the grieving individual's ability to understand and process death. Adolescents are especially vulnerable to developing negative coping skills such as substance abuse, self-destructive behaviors, and eating disorders. After a loss occurs, nurses can use their role as a caregiver who is neither a parent nor a peer to provide adolescents with an opportunity to express their grief. Nurses can educate grieving adolescents on the differences between positive and negative coping skills and can therefore reduce the number of future hospitalizations related to ineffective coping mechanisms.

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

The Efficacy Of Non-Pharmacological Pain Management Methods Amongst Premature Neonates In The Neonatal Intensive Care Unit (Nicu), Hannah R. Martinez

Honors Undergraduate Theses

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

Cardiovascular Intensive Care Unit Patient Transition, Jenna-Lynn Stewrat

Master's Projects and Capstones

With no designated cardiovascular step-down unit at Phoenix Children’s Hospital, patient transitions to acute care are inconsistent following admission to the Cardiovascular Intensive Care Unit (CVICU). We aim to improve CVICU patient continuum of care through transferring patients to a step-down telemetry unit starting October 13^th, 2014 exemplified by a 95% patient satisfaction of care provided by January 1^st, 2015. The progression of the project was influenced by Lippitt’s theory, which includes seven phases in the change process. To accommodate post CVICU patients, the acute care unit was transformed to include cardiac monitors, telepacks, a central …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

A Study Of Emergency Room Utilization Related To Poorly Controlled Asthma In Pediatrics, Leistey T. Wortman

Nursing Theses and Capstone Projects

Asthma is a disease of the respiratory system, which causes swelling and narrowing of the airways. Asthma is commonly seen in children. It is the leading cause of hospital stays and school absences. Hospitalization accounts for the single largest portion of the direct health care costs for asthma, estimated at nearly $18 billion a year (Everage, et al, 2010). Children with asthma may be able to breathe normally most of the time but when they encounter a substance that can cause problems (a "trigger"); an asthma attack (exacerbation) can occur (PubMed Health, 2011). The purpose of this study is to …

System-Wide Deployment Of Color Coded Pediatric Resuscitation Carts Supported By In Situ Simulation, Deborah Arnold Msn, Rn, Cmsrn, Jayne Febbraro Msn Rn Crnp, William Bond Md, Ms, Michele Dunstan, Margaret J. Chorazak, Melissa B. Walsh Bs, K Walker, T Dietz

Department of Education

No abstract provided.

Knowledge And Practice Gaps Among Pediatric Nurses At A Tertiary Care Hospital Karachi Pakistan, Rozina Roshan Essani, Tazeen S. Ali

School of Nursing & Midwifery

The advancement in medical science has created health care environments that require nursing professionals who posses specialized clinical knowledge and skills to provide care and deal with critically and acutely ill children. This study explored gaps between knowledge and practice as perceived by the registered nurses of pediatric units by further recommending the changes suggested by them. A descriptive exploratory Study Design under the quantitative research methodology was utilized using universal sampling of all pediatric nurses working at a tertiary care hospital in Karachi, Pakistan. The gaps between knowledge and practice, as perceived by the participants, were categorized into five …