Pediatric Nursing Commons^™

The Role Of Reassurance Messages In Pediatric Oncology, Isabelle Faller

Doctoral Dissertations

Despite decreasing mortality rates, the high prevalence and incidence of pediatric cancer necessitate the need for advancements in the treatment of psychological concerns, specifically the reduction of patient distress and anxiety. A more comprehensive understanding of current reassurance messages in clinical practice can aid in developing a standardized framework for providing reassurance in pediatric oncology. Qualitative Content Analysis was employed to examine the types of messages nurses use to reassure patients (to reduce their anxiety about a future health-related event) and how effective nurses perceive these messages to be in relieving patients' anxiety. The adult participants, located at hospitals throughout …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

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 | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

The Effects Of Strong Parental Support And Societal Support Compared To Low Or Absent Support In Lgbtqia+ Youth, Kassandra Bautista

Nursing | Senior Theses

Background: LGBTQIA+ youth with unsupportive backgrounds face negative outcomes in their mental health. Past studies share that LGBTQIA+ youth have increased symptoms of mental illness including depression, anxiety, and suicidal thoughts and behaviors related to unsupportive environments among parents, peers, and society. Objective: By advocating for this minority group through education and culturally competent care, healthcare providers can reduce negative outcomes in the mental and physical well-being of the youth. Purpose: The purpose of this study is to address the impact of parental and societal support in LGBTQIA+ mental health, and to implement interventions and increase awareness of this issue. …

The Impact Of Mindfulness Therapy To Reduce Disruptive Behavior In High School, Wendy Peters

Electronic Theses and Dissertations

The aim of this project was to determine the impact and effectiveness of Gina Biegel’s mindfulness techniques for stressed teens method on adolescent anxiety and the disruptive symptoms that lead to high school adolescents being assigned to detention. This project described a quantitative correlational design research project that investigated a small adolescent sample size, with a goal of decreasing the number of local high school adolescent students who are repeat detention offenders, by implementing Gina Biegel’s mindfulness techniques for stressed teens method on those high school adolescents who were assigned to detention. This was achieved by collecting demographic data from …

Screening For Bullying In A Middle School Setting, Paige Bernau

Dissertations

Problem: Bullied youth are two and a half times more likely to experience depression and three times more likely to experience anxiety and suicidal ideation than their peers (Li et al., 2024). Schools represent a key access point for mental health support and treatment for youth (Duong et al., 2020). Despite this, schools typically do not have formal bullying screening integrated into student support services.

Methods: This program evaluation used a descriptive, observational design to evaluate a bullying screening program in a suburban middle-school. This program used the California Bullying Victimization Scale (CBVS) to assess for bullying victimization (BV) followed …

The Impact Of Physical Activity On Mental Health Disorders In Children, Brianna E. Ryan

Research & Creative Achievement Day

Purpose - The purpose of this project is to highlight the effects physical activity has on children's mental health and to provide evidence-based insights on ways physical activity can and should be incorporated into the developmental stages of children's lives. Ultimately, the goal being to promote healthier and improved mental health statuses for the younger populations.

Introduction - The mental health crises among children are on the rise as more children each year are diagnosed with mental health conditions. It has been found that around 20% of children ages five through seventeen regularly experience symptoms of mental health disorders and …

Improving Adherence In Adolescent Kidney Transplant Recipients, Kaylen Munoz

Nursing | Student Research Posters

Background: Adolescent and young adult (AYA) kidney transplant recipients face unique challenges in maintaining long-term graft function and overall health. Nonadherence to immunosuppressive therapy and difficulties transitioning from pediatric to adult care contribute to the increased risk of graft failure in this population. Despite proposed tools identifying adherence barriers, there is a lack of implementation and targeted interventions addressing the barriers AYA transplant recipients face. Purpose: This study aims to evaluate the effectiveness of a structured transition program that utilizes an adherence barrier tool and adherence-promoting interventions in improving health outcomes for adolescent and young adult (AYA) kidney transplant recipients. …

The Psychosocial Effects Of Chemotherapy On The Adolescent Population: Implementing Community Building Programs, Kareena Jakhu, Princess Kyra R. Anicete

Nursing | Student Research Posters

Background: During the adolescent stage (13-18), individuals go through role confusion and seek much of their validation from their fellow peers. Forming a strong sense of community is crucial in this stage of development as it helps with creating a foundation for who they want to become. Chemotherapy strips this aspect of socialization due to its ability to suppress the immune system. When socialization is taken away, adolescents face loneliness, which greatly impacts their development. Purpose: The purpose of this research is to look into the adolescent population undergoing chemotherapy and help them aid the lack of socialization caused by …

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 …

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 …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Evaluating Implementation And Barriers To Sustainability Of An Asthma Clinical Quality Improvement Project, Holly Uphold Phd, Ms, Diane Liu Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Purpose and Objectives

Asthma is an important public health issue in Utah and quality asthma care is essential to addressing the burden of asthma. The purpose of this initiative was to evaluate clinical asthma quality improvement (QI) program delivery formats and identify barriers to sustaining QI processes.

Intervention Approach

The focus of the intervention was to improve clinical asthma care through reducing variation in clinician knowledge about recommended asthma care and facilitating process improvements in asthma care delivery using Academic Detailing (AD) and Learning Collaboratives (LC) QI delivery formats.

Evaluation Methods

A pre/post-test design was used to compare improvements between …

Nurse-Initiated Treatment Reduces Costs For Acute Asthma In A Pediatric Emergency Department, Michael D. Johnson Md, Ms, Minkyoung Yoo Phd, Richard E. Nelson Phd, Amanda K. Nielson Md, Lauren Allen Mas, Nanette Dudley Md, Brandon Andersen Rrt, Amanda Orme Dnp, Cpnp-Ac, Cameron Mcfarland Np-C, Michael Mundorff Mba, Mhsa

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized …

Outcomes Of Asthma Quality Improvement In Pediatric Patients, Kathryn M. Murray Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. The Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ) and Utah Department of Health (UDOH) Asthma Program Learning Collaborative is a quality improvement initiative designed to standardize asthma care in pediatric patients and improve the overall assessment and patient education process for both healthcare providers and patients. The aim of the Asthma QI Project was to improve the diagnosis and management of asthma for patients in the state of Utah by implementing a standardized approach to the identification and treatment of patients with asthma.

Methods. Patients scheduled to see a healthcare provider at our pediatric clinic were screened for …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Physician Assistant Global Advancement Through The Use Of Medical Relief Organizations, Kara Crafts Pa-C, Sarah Mistrot Pa-C, Mary Henningsgaard Pa-C, Kaley Morris Pa-C, Tamarrah Oliver Pa-C, Kevin Tran Pa-C, Trevor Crafts Md

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Objectives: The physician assistant (PA) model has been adopted by many nations to alleviate health care disparities. The objective of the project is to understand how medical relief organizations are utilizing physician assistants and contributing to the advancement of the career globally.

Methods: A search was conducted to create a list of all U.S. based medical relief organizations. An 18-question online survey was sent to 493 organizations that met inclusion criteria.

Results: Total response rate of the survey was 56.2%. 75.6% of organizations reported using PAs on their medical relief projects, and PAs were used in clinic/hospital/and operative settings.

Conclusions: …

A Child's Experience Working Through Grief: A Booklet For School Aged Children Navigating Their Grief Journeys, Alyssa Johnson

Senior Honors Projects

The term grief describes the feelings you experience in response to the death of a person in your life, while the term mourning represents the period in which you feel or express signs of grief or sorrow. A child’s grief experience after the death of a significant person in their life is an often overlooked and understudied topic. The importance of being open and honest with children as they navigate their grief journey is at the forefront of this project. Using research regarding how children process, express, and understand grief, I created, “A Person In My Life Has Died, What …

Retention Of Physician Assistants Within A Specialty After Completion Of A Postgraduate Training Program, John Ansiaux Pa-C, Carly Farrell Pa-C, Kathryn Hess Pa-C, Aubrey White Pa-C, Charlotte Peeters Pa-C, Jill Schulten Pa-C, Ryan Krasnosky Mpas, Pa-C, Dfaapa, Drph

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: The advantages of a specialized training program have led to over 84 postgraduate training programs for Physician Assistants (PAs) covering over 25 specialties. Employee lateral mobility is more prevalent within the PA profession, which allows PA providers to switch between medical specialties. The versatility of PAs promotes higher turnover rates compared to physician counterparts. These high turnover rates can result in increased institutional burden. Postgraduate PA programs provide pre-employment exposure to more in-depth medical training, enabling a well-rounded knowledge base of the PA’s roles and responsibilities, minimizing turnover rates.

Purpose: The goal of this survey study is to identify …

Survey Analysis Of Overall Job Satisfaction Of Physician Assistants, Clare Lookian Pa-C, Claire Keaton Pa-C, Kasey Keane Pa-C, Erin Schulte Pa-C, Abby Atchley Pa-C, Edwin Welsh Pa-C, Devon Gersh Pa-C, Jack Carter Pa-C, Ryan Krasnosky Mpas, Pa-C, Dfaapa, Drph

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Over the last three decades, the physician assistant (PA) profession has seen an increase in the number of women in the profession, a decline in the age of new PA graduates, a movement toward specialty practice, and an exponential growth in the workforce as a whole. Historically, surveys reveal the majority of PAs are satisfied with their career choice and current job. Although a majority of PAs report high job satisfaction, career burnout is still significant within the profession. Career burnout among health care providers continues to rise due to the strains of the US healthcare system, growing patient …

Utilization And Workforce Integration Of Physician Assistants, Tara Harkins Pa-C, Jason Thomas Pa-C, Brian Fontenot Pa-C, Joseph Day Pa-C, Marielle Faraone Pa-C, Alexandra Borden Pa-C, Megan Lomax Pa-C, Darius Dranginis Pa-C, Ryan Krasnosky Mpas, Pa-C, Dfaapa, Drph, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: The healthcare field is experiencing rapid growth in the number of advanced practice providers (APPs) with projections that demonstrate that this trend will only continue. Even though the number of APPs is growing, the development of facility-specific APP management infrastructure often grows at a slower pace. Specific policies and procedures on APP utilization and clinical efficiency metrics are lacking. This can lead to deficiencies in the understanding of the education and practice boundaries of APPs.

Objective: Our study aimed to analyze the growth and utilization of physician assistants (PAs) in several hospitals located within Texas Medical Center (TMC) …

Reducing Pulmonary Function Testing Procedure Times In Pediatric Patients, Kathleen Richards Rrt, Shontae Hill Rrt, Kaylynn Bernardo-Stagg Rrt, Heather Miller Rrt, Daniel Barker Rrt, Kailee Perkins Rrt, Michael Richards Mba, Mha

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Problem. The Pulmonary Function Test Time Project (PFT Project) is a quality improvement (QI) initiative designed to decrease PFT testing time and PFT total time in pediatric patients and improve the overall process for both providers and patients. Patients scheduled to see a pulmonary provider were also scheduled for a PFT prior to the provider’s visit. Data showed that the length of time to perform a pulmonary function test (PFT) was causing: (1) a delay in the pulmonary provider seeing patients at the intended appointment time, (2) a disruption to clinic workflow, resulting in scheduling difficulties, and (3) a decreased …

Incorporation Of Surgical Cadaver Lab Training In A Physician Assistant Fellowship Program, Jacqueline Guarino, Jordan Rodriguez, Ming Zhang Phd, Ryan Krasnosky, Kristina Marsack

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Physician Assistants (PAs) are licensed medical professionals who provide health care under the supervision of and in collaboration with physicians. PAs can specialize in any field of medicine or surgery with additional on-the-job training while some PAs participate in a postgraduate training program in order to increase their knowledge in a certain subspecialty area. This paper describes the incorporation of a cadaver lab curriculum into a postgraduate PA surgical training program. The description of the development, implementation, and evaluation of the cadaver lab experience can assist other programs to implement this hands-on educational experience for a variety of medical providers, …

Understanding The Context Of Healthcare Utilisation For Children Under-Five With Diarrhoea In The Drc: Based On Andersen Behavioural Model, Siyu Zou, Xinran Qi, Keiko Marshall, Maria Asif Bhura, Rie Takesue, Kun Tang

Department of Paediatrics and Child Health

Background: Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC.
Methods: Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey …

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed …

Nicu Experiences Of Adoptive Parents & Desired Preparation, Catherine J. Howe

Graduate Theses/Dissertations

Parents who have newborns admitted into the Neonatal Intensive Care Unit (NICU) have multiple experiences and emotions. Additional social and emotional layers are experienced by adoptive couples when the infant they wish to adopt needs specialized care. This research study was completed to find out what adoptive parents experience in the NICU and what preparation would have been helpful. The method included semi-structured, open-ended interviews with seven couples who adopted a newborn at a Midwestern adoption agency within the past three years and had a NICU experience. The results described adoptive couples’ experiences on the unit, bonding and attachment, fears …

"More Accessible And Easier To Deal With": A Qualitative Inquiry Of Leaders' Perceptions Of The Evolving Roles And Responsibilities Of Advanced Practice Providers At Texas Medical Center, Athena Krasnosky Msn, Aprn, Cpnp, Jessie Marcet-Gonzalez Msn, Aprn, Cpnp, Jordan Rodriguez Bs, Natalie Cormier Smith Msn, Aprn, Np-C, Brenda Chesley Msn, Aprn, Cpnp-Ac/Pc, Linda Brock Msn, Aprn, Cpnp, Heena Narsi Prasla Msn, Aprn, Cpnp, Geran Barton

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background. With over 10 million patient encounters a year at Texas Medical Center (TMC), Advanced Practice Providers (APPs) are being incorporated into health care delivery models. Moving beyond the narrow “scope of practice” debates that frequently surface when talking about APPs, this inquiry instead seeks to broaden the discussion and take a more comprehensive view of how APPs are being incorporated into health care delivery models that span across several TMC institutions.

Methods. This study uses a thematic analysis study design to analyze structured interviews collected from a small convenience sample of Advance Practice Provider Program Directors at Texas Medical …

Outcomes Of A Positive Patient Id Campaign At A Pediatric Quaternary Care Center, Taylor Kim Md, Arjun M. Dangre Bds Mph, Andrea L. Davis Mph Cic, Betty J. Reeves Mha, Mt (Ascp), Omobola T. Durojaiye Msn, Rn-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. Positive patient identification (PPID) is critical to safe and accurate labeling of patient lab specimens. Accurate PPID is also an important priority of The Joint Commission’s National Safety Goals. Inadequate PPID compromises may lead to waste of time and resources, and in the worst-case scenario can lead to significant patient morbidity and mortality. With a focus on PPID, this initiative examined the occurrence of mislabeled and unlabeled lab specimens as well as compliance with wearing ID bands in a cohort of hematology/oncology and bone marrow transplant inpatients at a large pediatric quaternary care center.

Methods. Using the Plan-Do-Study-Act Model, …

Pediatric Wound Care: Establishing A Consensus Group To Develop Clinical Practice Guidelines, Ryan Krasnosky, Geran Barton, Linda Highfield, Sheila Martinez, Stephen Linder, Edward Buchanan, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. Wound care practices for neonatal and pediatric patients have created a lack of standardized evidence-based guidelines for treatments in clinical practices. Unfortunately, published clinical guidelines for the evaluation and management of wounds in pediatric populations is limited. Consensus groups are used to develop clinical guidelines which define key aspects of the quality of health care, particularly appropriate indications for interventions. The aim of this initiative was to conduct the first two steps of the guideline development process, and to report on the findings from the expert consensus group for pediatric wound care.

Methods. The goal was to recruit a …