Pediatric Nursing Commons^™

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Student Research Posters

Children undergoing cancer treatment often experience pain and anxiety during procedures such as port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce pain and anxiety in pediatric oncology patients. Existing data from primary and secondary research articles reveal the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. This study proposes a quasi-experimental design involving 90 pediatric oncology patients aged 6–12 years diagnosed with leukemia. Participants will be placed in a nurse-led VR distraction, play …

Diabetes Device Knowledge And Confidence Among School Nurses: A Mixed Methods Study, Cassandra F. Moffitt

Nursing Theses and Dissertations

Problem: Type 1 diabetes is one of the most common chronic medical conditions in childhood. While manageable, these children may spend half of their day in the school setting and often need assistance from a school nurse to manage their care.

Theory: Bandura’s Social Cognitive Theory (1977) served as the theoretical framework for this study.

Research Questions: The research questions explored knowledge, confidence, and additional predictors of confidence related to diabetes devices.

Design/Methods: An explanatory sequential mixed methods design was used. The Diabetes Device Confidence Scale (DDCS) was used to measure device confidence, while Subscale 10 of the KAT-1 instrument …

Closing Racial And Ethnic Disparity Gaps In Pediatric Asthma Follow Up Care - A Quality Improvement Initiative, Ayodele Ayeko

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Closing racial and ethnic disparity gaps in pediatric asthma follow up care - A quality improvement initiative

Ayodele Ayeko

Introduction/Background: Inadequate management of asthma significantly contributes to poor asthma control, poor quality of life (QOL), and high hospitalization rates among pediatric patients. The Global Initiative for Asthma (GINA) guidelines offer recommendations designed to enhance asthma control and improve the quality of life for those affected (2015), including recommendations for close follow up care. At WVU Medicine Children’s Hospital (WVUMCH), insufficient asthma control has been associated with lower clinic follow-up rates and an increase in hospitalization. Although educational initiatives …

Global Standards And Protocols For Oral Care In Pediatric Cancer Patients: Systematic Review Protocol, Meghna Pandit, Baby S. Nayak, Vasudeva K. Bhat, Suneel C. Mundkur, Judith A. Noronha, Sridhar N

Manipal Journal of Nursing and Health Sciences

Introduction Childhood cancer is a global health challenge, with over 275,000 cases annually among individuals under 19 years. Cancer treatments such as chemotherapy and radiation therapy lead to significant oral complications, including mucositis, xerostomia, and infections, adversely affecting treatment adherence and quality of life. Effective oral care is essential for mitigating these complications, particularly in resource-limited settings like India.

Objectives This systematic review aims to identify, assess, and summarize global guidelines and protocols for oral care in pediatric cancer patients, focusing on the prevention and management of oral complications during treatment.

Methods The protocol adheres to PRISMA-P guidelines and is …

Implementation Of A Standardized Screening And Referral Process For Social Determinants Of Health For Families With Children Within Two Rural Health Clinics, Laura Britton Stace

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The American Academy of Pediatrics Bright Futures Guidelines recommends social determinants of health (SDOH) screening at well-child checks (WCCs). Social determinants of health are environmental factors, including food accessibility, mental health, and substance use, that can affect quality of life.

Rural health clinics (RHCs) in a county in Virginia did not routinely use a standardized screener to identify pediatric SDOH risks, nor did they have a standardized referral process for identifying SDOH risks. A hospital community needs assessment found that over 20% of the county households were below the federal poverty level. It is estimated that many children in …

Utilizing Pupper, A Social Robot Dog, To Increase Happiness And Improve Mood In Pediatric Patients Of A Cardiac Step-Down Unit, Angela Feng Wu

Master's Projects and Capstones

Objective The usage of social robots in pediatrics is an emerging field of study. Preliminary research shows that they are effective at improving the psychosocial well-being of pediatric patients. This quality improvement project focuses on Pupper, a newly developed quadruped social robot dog, and its ability in improving mood and happiness in pediatric patients of a cardiac step-down unit. Aim The aim of this project is to increase average mood scores of pediatric cardiac patients aged 3-25 years by 50% from their baseline of 3.75 to 5.63 on a six-point scale within a one-month time frame. Methods Before intervention and …

Prepared To Protect: Improving Cardiac Emergency Response In Youth Club Sports, Melissa Garcia

Nursing | Student Research Posters

Sudden cardiac arrest (SCA) is a medical emergency where the heart unexpectedly stops beating due to an electrical malfunction. A person experiencing a cardiac arrest collapses, loses consciousness, and ceases breathing (American Heart Association, 2022).

Exercise offers numerous benefits to the cardiovascular system and a person’s overall health. However, there are incidents of sports-related cardiac arrest in apparently healthy athletes, including children and young adults. Athletes may be exposed to dehydration, adrenic surges, electrolyte imbalances, acid/base disturbances, and trauma which increases their risk of experiencing a cardiac event (Wasfy et al., 2016).

Sudden cardiac arrest is the leading cause of …

An Evaluation Of The Effectiveness Of An Updated Pre-Service Midwifery Curriculum Integrated With Emergency Obstetric And Newborn Care In Kenya: A Cluster Randomised Controlled Trial, Duncan N. Shikuku, Catherine Mwaura, Peter Nandikove, Alphonce Uyara, Helen Allott, Lucy Waweru, Lucy Nyaga, Edna Tallam, Issak Bashir, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufciently prepared for their teaching role and defcient curriculum compared to international standards afect the quality of healthcare provided by the midwifery graduates. This study assessed the efectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.

Methods A cluster randomised controlled trial in 20 midwifery colleges (12 intervention, 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the …

Evaluation Of Supplemental Oxygen Use In The Acute Care Cardiology Unit And Opportunities For Standardizing Practice, Melanie Walsh, Alexandra Birely, Sarah Mahmalji, Sonali S. Patel

2024

RESEARCH

Purpose:
Oxygen delivery via nasal cannula is a standard therapy in hospitalized pediatric patients; however, it can have adverse effects in certain populations, such as infants with cardiac shunting physiology1,2. An oxygen-air blender can be used via standard nasal cannula to provide the lowest amount of fraction of inspired oxygen (FiO2) in order to reduce harm2. A recent Pediatric Acute Care Cardiology Collaborative (PAC3) Hospital Survey indicates that 88% of participating acute care cardiology units (ACCU) provide blended oxygen to patients, however, indications for use are not well-established3,4. A local ACCU nursing staff survey revealed mixed use of blended …

High Reliability Pediatric Heart Centers: Always Working Toward Getting Better, Andrea Torzone, Alexandra Birely

2024

QUALITY

Background
As provision of care reaches a new complexity in pediatric cardiology, programs are called upon to evaluate how they can bring their teams into the future of pediatric cardiac care. High reliability principles support high-quality care and improve outcomes, thus should be embraced to guide continuous improvement. Although much has been written about high reliability in healthcare, it has not been explored within pediatric heart centers. The purpose of this review is to examine high reliability through the lens of a contemporary pediatric heart center, elaborating on key concepts and proposed considerations for maintaining a high reliability heart …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guideline Update – Xi – Milk Supplement/Replacement Formulas For Infants And Toddlers With Cma – Systematic Review, Antonio Bognanni, Ramon Firmino, Stefania Arasi, Derek Chu, Alexandro Chu, Siw Waffenschmidt, Arnav Agarwal, Piotr Dziechciarz, Andrea Horvath, Rose Kamenwa

Paediatrics and Child Health, East Africa

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

A Guideline-Based Approach To Increase Early Mobilization In The Pediatric Patient Following Cardiothoracic Surgery, Kayla Keeven

Dissertations

A Guideline-Based Approach to Increase Early Mobilization in the Pediatric Patient Following Cardiothoracic Surgery

Problem: Prolonged bedrest during the post-operative period contributes to complications that lengthen hospital stay and increase mortality and medical costs. Early mobilization is recognized as safe and feasible in critically ill children. However, there is no standardized procedure nor method of identifying patients who are safe to mobilize in a pediatric cardiac intensive care unit (ICU).

Method: The quality improvement (QI) project employed a descriptive observational design utilizing a retrospective-prospective method to assess the effects of implementing an early mobilization guideline in a pediatric cardiac ICU. …

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operations Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Perception Of Pediatric Readiness Across A Health System's Emergency Departments, Rebekah L. Sabo

Doctoral Dissertations & Projects

The recent pandemic and pediatric respiratory syncytial virus surge have reinvigorated pediatric care readiness conversations. National strategies and associations exist to guide health systems in improving the quality of emergency care offered to pediatric populations by first assessing readiness for care. These research strategies center on survey implementation and staff engagement in general emergency departments with the goal to improve staff readiness to care for pediatric patients that may present for treatment. What impact would developing a consolidated pediatric readiness program that includes: pediatric emergency care coordinator designation for each emergency department, pediatric readiness education and committee engagement have on …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Development Of A Positive Urinalysis Criteria Using A Machine Learning Approach, Kari Flicker, Jessica Parrott, Tammy Speerhas, Turaj Vazifedan, Theresa Guins, Jeffrey Bobrowtiz, Anne Mcevoy, Jade Eves, Debra Conrad, Benjamin Klick

Ellmer School of Nursing Faculty Publications

Background: Urinary tract infections (UTIs) are a commonly encountered diagnosis at pediatric urgent care (UC) centers. The urinalysis (UA) is usually the initial study in UC settings used to guide decisions regarding initiating empiric antibiotics and/or pursuing urine culture. However, studies in pediatric UC settings examining the ideal threshold for a positive result are lacking.

Methods: UA result data were extracted from the records of 6,327 pediatric patients, which were collected as part of a previous QI project. Logistic regression was used to determine the predictors of positive urine cultures. Decision trees for a positive UA result for both clean …

Post-Discharge Malaria Chemoprevention In Children Admitted With Severe Anaemia In Malaria-Endemic Settings In Africa: A Systematic Review And Individual Patient Data Meta-Analysis Of Randomised Controlled Trials, Kamija Phiri, Carole Khairallah, Titus Kwambai, Kalifa Bojang, Aggrey Dhabangi, Robert Opoka, Richard Idro, Kasia Stepniewska, Michael Boele Van Hensbroek, Chandy C John

Paediatrics and Child Health, East Africa

Background: Severe anaemia is associated with high in-hospital mortality among young children. In malaria-endemic areas, surviving children also have an increased risk of mortality or readmission after hospital discharge. We conducted a systematic review and individual patient data meta-analysis to determine the efficacy of monthly post-discharge malaria chemoprevention in children recovering from severe anaemia.

Methods: This analysis was conducted according to PRISMA-IPD guidelines. We searched multiple databases on Aug 28, 2023, without date or language restrictions, for randomised controlled trials comparing monthly post-discharge malaria chemoprevention with placebo or standard of care among children (agedyears) admitted with severe anaemia in malaria-endemic …

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 …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

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

Nursing | Student Research Posters

Pet therapy is a complementary type of therapeutics in which a person and animal have a guided interaction with the purpose of helping someone cope with physical and/or mental illness. Animal-assisted therapy is used in numerous settings and has been shown to reduce stress, lower blood pressure and heart rate, and decrease anxiety and depression (Husson University, 2022). In particular, pediatric oncology patients have enormous amounts of stress in their lives, which leads to increased anxiety and decreased quality of life (Children's Cancer Cause, 2023). While evidence shows that integrating pet therapy in pediatric oncology patients produces significant benefits on …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Student Research Posters

California schools currently only screen for vision and hearing, leaving many other health concerns unaddressed. Among these, gastrointestinal (GI) health is particularly significant, as digestive disorders can lead to severe consequences, like malnutrition and stunted growth. By incorporating routine GI screenings, school nurses can promote the early detection of disease, allowing for timely intervention and improved health outcomes in children.

Based on existing literature, we have developed a novel pediatric GI screening tool for school nurses to use in routine screenings, presented below.

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

Identifying Contributing Factors For Legal Placement Status In Involuntary Commitment And Voluntary Commitment In Child And Adolescent Psychiatry, Brianna R. Perry

Honors Undergraduate Theses

Background: Psychiatric hospitalization of children and adolescents can be carried out either voluntarily or involuntarily. The aim of this form of inpatient hospitalization is to provide treatment for those who cannot manage the symptoms of their mental illnesses on their own. However, psychiatric hospitalizations of children and adolescents are costly and could lead to outcomes such as worsened mental state in former patients and distrust of the system in caregivers. It is crucial to have a solid understanding of specific components that lead to the hospitalization.

Purpose: To identify potential trends in patient admission data through the analysis …

Dance Movement Therapy For Pediatric Oncology Patients And Its Effect On Cancer Therapy-Related Symptoms, Victoria M. Trautwein

Honors Undergraduate Theses

Background: Pediatric cancer patients are susceptible to emotional distress, depression, anxiety, and physical symptoms impacting their quality of life. Dance movement therapy is a non-pharmacological method that has been shown to improve feelings of depression, anxiety, emotional, somatic symptoms, and overall quality of life. While much of cancer research is dedicated to finding cures, it is also important to focus on identifying methods for improving the symptoms and quality of life for pediatric cancer patients.

Aim: The purpose of the literature review is to examine studies that show the effects of dance movement therapy on pediatric oncology patients’ cancer-treatment related …

Improving Health Outcomes In Children And Adolescents With Asthma, Elizabeth Kate Coffey Moore

Theses and Dissertations (ETD)

Asthma is among the most prevalent chronic illnesses found in the United States, affecting millions of people under the age of 18 each year. The disease burden for affected children, adolescents, their families, and the healthcare system is immense. Finding ways to mitigate its impact is critical to improving the lives of affected children, adolescents, and their families. The three chapters included in this dissertation aimed to document the asthma triggers that children and adolescents are exposed to and strategies for reducing them and to demonstrate using Imogene King’s conceptual framework to guide nursing practice to care for and nursing …

An Educational Intervention To Improve Neonatal Icu Nurses’ Breastfeeding Support Knowledge, Self-Efficacy, And Breastfeeding Rates At Discharge, Sarah Money

DNP Projects

Background: The benefits of breastfeeding for both mother and baby are known. It is recommended that all infants be exclusively breastfed until six months (Meek & Noble, 2022; North et al., 2021). Despite this, breastfeeding rates remain low, especially in medically fragile infants requiring care in the neonatal intensive care unit (NICU) (Rollins et al., 2016). Receipt of evidence-based breastfeeding support by healthcare providers has been shown to improve breastfeeding success; however, many healthcare providers report not being comfortable or knowledgeable enough to offer support consistently (Mulcahy et al., 2022; Rollins et al., 2016).

Purpose: This study aims …

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Clinical Practice Panel: Improvements In Pediatric Food Insecurity Screening; A Qi Project To Increase Pediatric Food Insecurity Screening, Casey Katzman, Brandy Rachel Frye, Hsiang-Fen Su

2023 South Division Nursing Research Conference

No abstract provided.