Pediatric Nursing Commons^™

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: …

Establishing Guidelines To Promote Best Practice For Common Ailments In School-Based Health Clinics, Kaitlin Sweeney, Rachael Schaefer

Doctor of Nursing Practice Projects

The COVID-19 pandemic exposed the gap in access to medical care of school-age children and identified a need for community-based health clinics to aid in its minimization. Evidence shows the creation of school-based health clinics (SBHCs) in public school districts provides a pathway for students to receive high-quality care in an easily accessible manner. Therefore, patient care guidelines for common ailments seen in SBHCs for a local federally qualified healthcare center (FQHC) were developed in conjunction with the FQHC goal to build and operate a SBHC located in southern Illinois. Eight guidelines were created to analyze the most common chief …

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 …

Caregiver Satisfaction Of Telehealth Initiatives For Developmental Surveillance And Evaluation In Pediatric Autism Spectrum Disorder, Aashiyana Patel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

PURPOSE: To examine parental satisfaction of a telehealth program aimed to improve the identification and diagnosis of pediatric ASD in Northwest Arkansas.

DESIGN/METHODS: caregivers referred to the Access for Autism clinic received a satisfaction survey regarding the telehealth practices the clinic employs. This 5-point Likert scale survey was designed to measure six different constructs associated with telehealth satisfaction: assurance, empathy, reliability, responsiveness, usability, and patient satisfaction

CONCLUSIONS: Telehealth is a suitable alternative to attending medical appointments. The key finding indicated that 40% of caregivers believed the level of care received to be equal in telehealth and in-person appointments.

Pediatric Seizure Management With Ketogenic Diet, Lydia Beller

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Seizure disorders can be life altering and debilitating, especially for developing children. Children who have seizure disorders often require social, emotional, educational, and behavioral adjustments for children. Most medication regimes do not achieve complete management of seizure frequency and intensity. For children, seizure disorders can lead to unsuccessful education experiences, low self-esteem, severe injury, and difficulties with social skills and engagement. Discovering that a dietary means can reduce their frequency and intensity is groundbreaking. The ketogenic diet is a high protein, high fat, and almost no carbohydrate diet. The ketogenic diet is an effective non-pharmacological method for treating epilepsy (Karimzadeh, …

The Nutritional Management And Glycemic Control In Adolescents With Diabetes, Jennifer Durham

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this literature review is to explore the relationship of nutritional management on glycemic control amongst adolescents who have diabetes. The adolescent population has significant negative or positive peer influence on the management of their diabetes (Yang, 2018, p.104). These peer perceptions can include empathy, curiosity, knowledge seeking, enthusiasm, fearfulness, and bullying (Yang, 2018, p.104). These influences directly affect nutritional management, blood glucose levels, and insulin management. When the peer influence is negative the individual is less inclined to acknowledge their medical condition (Yang, 2018, p.105). Other influences on the management of diabetes include technology, physical exercise, and …

Tiny Tusks Internship: Barriers To Breastfeeding Surrounding Neonatal Intensive Care Units, Brianna Purser, Quinn Owen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

It is known that breastfeeding is beneficial to mothers and their children, and it is recommended that mothers exclusively breastfeed for the first six months of their infant's life. Despite this, in the United States only 1 in 4 infants is exclusively breastfed for the first six months. After being an intern for Tiny Tusks Breastfeeding and Infant Support, a program designed to facilitate and educate about breastfeeding, we have seen firsthand the barriers to breastfeeding. The goal of this literature review was to investigate barriers to breastfeeding specifically surrounding neonatal intensive care units (NICU) and how to address those …

Positively Waiting: Technology As The Preferred Distractor In A Pediatric Outpatient Setting, Timothy Ernest, Victoria Maddex, Arnaldo Mejias, Lindy Davidson, Donna Ettel-Gambino

Patient Experience Journal

Visiting any pediatric outpatient clinic as a child may be considered a stressful and anxiety-inducing experience. The literature suggests that positive distractions, such as pet therapy and single-user electronic devices, may aid in reducing anxiety and maximizing patient satisfaction throughout the patient’s experience at a pediatric outpatient clinic. The aim of this pilot quality improvement project was to determine which positive distractions patients experienced and whether single-user electronic loaner devices should be provided to patients at pediatric outpatient facilities. A quantitative causal comparative approach was utilized in identifying patient exposure to key positive distraction techniques that may significantly decrease anxiety. …

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 …

The Implementation Of A Validated Csec Screening Tool For Youth Age 11 - 17 In A Pediatric Emergency Room, Julie Clark, Josie Doss, Krystal E. Canady, Yameika Head Md

Graduate Research Showcase

Abuse of children is a public health issue covering a range of inflicted harm from neglect to physical to sexual abuse. A severe form of child sexual abuse is the Commercial Sexual Exploitation of Children (CSEC). This phenomenon involves sexual crimes against children, including exploitation for gain. High-risk indicators are noted throughout the literature to aid in identification, but some children are vulnerable because of their young age. Perpetrators can be family, friends, or acquaintances and choose their potential victims by recognizing a child’s vulnerabilities. Inevitable physical and mental health consequences are associated with CSEC involvement; hence these youth seek …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

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 …

Implementing 2nd Milk’S Use Of The World Health Organization Standardized Growth Charts To Better Track The Growth And Development Of The Malnourished And Orphaned Infants In Their Supplemental Nutrition Program In Malawi, Allie Wycoff

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article considers the history and implications of the World Health Organization (WHO) standardized growth charts as well as the significant impact that growth chart utilization may have on 2^ndMilk’s ability to understand and track the nutritional status of the malnourished orphaned infants in their formula program. Specifically, this literature review examines whether or not the WHO growth charts are a meaningful tool for 2^ndMilk to adopt into their monthly baby assessments. The WHO growth charts are calibrated to express an accepted international “norm” for what an adequately nourished child looks like. In a recent service-learning …

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, …

Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel

Doctor of Nursing Practice Final Manuscripts

Abstract

Background

Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.

Methods:

Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

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 …

The Youthful Pandemic, Brook Sahlemariam

Nursing | Senior Theses

This paper attempts to examine the neurological, physical, and societal effects of e-cigarette use among youth and young-adults in North America. Furthermore, the paper investigates the parallels between e-cigarette users, tobacco users, and dual users in regard to behavioral patterns, reasons for use, and age of initiation.

Use Of The Cameo Ii Acuity Tool To Decrease Burnout For Nurses Working In A Pediatric Intensive Care Unit, Frances Lynn Feria-Clement

Electronic Theses and Dissertations

The World Health Organization (WHO) reported registered nurse burnout is an occupational hazard resulting in serious consequences for patients, healthcare organizations, and individual registered nurses (Woo et al., 2020). The purpose of this project was to see if the Complexity Assessment and Monitoring to Ensure Optimal Outcomes II (CAMEO II) Acuity Tool, used as an intervention for staffing and scheduling, would have a positive effect against nurse burnout in a pediatric critical care setting in a pediatric medical center. Maslach’s Burnout Inventory- Human Services Survey for Medical Personnel (MBI-HSSMP) was used as a pre- and postsurvey to measure the emotional …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Evaluation Of An Advanced Quality Improvement Program, Arjun M. Dangre Bds Mph, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Texas Children’s Hospital implemented the Advanced Quality Improvement and Patient Safety Program (AQI) in 2009, designed to train clinicians and staff to develop leaders in quality improvement to improve patient care, lower costs, change culture, and lead improvement initiatives at the organization. Evaluations of the AQI programs measured the program’s effectiveness in achieving its goals and objectives. This paper describes the Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety program (AQI,) the program’s evaluation processes, and show the results of the evaluation of the AQI programs using evaluation surveys completed by QI participants over the span of 13 successful …