Pediatric Nursing Commons^™

The Time It Counts: Counting Policy In The Perioperative Setting, Lauren Kober, Kendall Williams

2021

No abstract provided.

Block The Barf: Using A Validated Scale To Measure Nausea., Jane Choe, Lauren Maloy

2021

No abstract provided.

Essential Oils For Alternative Pain Therapy, Joy Debinski, Alex Garay, Dalia Albanna

2021

No abstract provided.

Limb Alert: Increasing Staff Awareness And Communication, James Waldie, Azeezat Fabian, Fafa Apedo, Jessica Kovacs

2021

No abstract provided.

Standardized Labeling Of Iv Infusions To Decrease Medication Errors And Increasing Nurse Workflow Efficiency, Tayyiba Shaik, Vikltoria Gudmundsson, Skyelar Hester, Veronica Pacheco

2021

No abstract provided.

Why Can't I Drink? A Look At Npo Guidelines At Children's Health, Hanna Boehm, Elizabeth Brewer, Rebekah Hockaday, Joy Villaflor

2021

No abstract provided.

Improving Patient Safety Through Increased Awareness Of Alarm Fatigued9 Pulmonology & Our Children’S House, Alli Mcdaniel, Marissa Reyes, Nabat Sheriff

2021

No abstract provided.

Are Er Parents In On What Infiltration Means?, Ashley Lee, Andrew Taylor, Carley Torres

2021

No abstract provided.

Acting With Tlc Splint, Jade Deckard, Karen Esquivel, Adriana Guerre

2021

No abstract provided.

L.A.P.S. Not Apps: Evaluating The Use Of Electronic Devices In A Level 4 Nicu, Madyson Roehrig, Karen Barajas, Priscilla Aponte

2021

No abstract provided.

Sharing Is Caring:Decreasing Caregiver Stress For Pediatric Patients Undergoing Inpatient Surgerythrough Visual Communication, Abigail Holman, Jaime Kilmer, Brandon Shipley

2021

No abstract provided.

Put Me In Coach: The Benefits Of Establishing A Dedicated Cvl Access Team To Improve Patient Safety And Nurse Satisfaction, Mae Selassie, Janie Alberto, Diamond Wright

2021

No abstract provided.

2021 Nursing Annual Report, System Of Texas Children's Health

2021

No abstract provided.

Exploring Nurse Beliefs And Perceived Readiness For System-Wide Integration Of Evidence-Based Practice In A Large Pediatric Health Care System, Lindsey Patton, Mayra Garcia, Virginia Young, Jerithea Tidwell

2021

Background: Implementation of evidence-based practice within healthcare leads to improved patient outcomes, high quality care, job satisfaction, reduced nursing turnover, professional autonomy, and validates nursing practice. Although there is a plethora of research focusing on implementation of EBP, little attention has been given to assess organizational readiness for integration.

Aims/ Methods: The primary aims were to explore nursing beliefs and attitudes about EBP using the Evidence Based Practice Beliefs Scale (EBPB) and the culture and readiness among pediatric nurses for system wide integration of EBP using the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice (OCRSIEP).

Results: Overall …

How A Crew Of Experts Can Pave The Road To Quality Improvement Inpreventing Central Line-Associated Bloodstream Infections, Ginny Leinweber, Angie Morris, Kendra Shotts-Fraser

2021

Purpose

To improve outcomes for PICU patients with central lines by reducing central line-associated bloodstream infections (CLABSIs) and meeting a 2021 goal rate of < 1.3 infections per 1000 central line days.

Background

PICU CLABSI rates increased from 2.2 in 2019 to 2.6 in 2020. Despite this increase, Quality and Safety data showed high compliance to CLABSI prevention bundles and no evident trends to inform improvement efforts.

Methodology

PICU leadership and CNS met to discuss quality improvement solutions to supplement routine safety cards and decrease CLABSI rates. This team developed a plan for a group composed of designated bedside staff and unit leaders who would focus on reducing …

Squashing Superbugs: Using Procalcitonin Levels Toidentify Bacterial Infections To Direct Antibiotic Therapy, Janna Berg, Tera Holland, Krista Westbrook

2021

The current standard in diagnosing and treating pediatric infections is obtaining cultures, interpreting complete blood count results, and following the trends of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Infection triggers an inflammatory response; if untreated or mistreated, this microbe invasion can lead to sepsis. The purpose of this submission is to address the promising use of procalcitonin levels (PCT) as a superior marker in the early detection of bacterial infection via a scholarly literature review. 

Studies involving PCT are more readily found in the evaluation of the neonatal population and in adults with respiratory illnesses. Pediatric studies are …

Exploring Child Anxiety And Family Satisfaction In Thepre Anesthesia Clinic, Ann Johnson, Bonita Conley, Brenda Fields

2021

Studies show that families experience anxiety in the perioperative period. From the child’s perspective, coping with stressful experiences varies according to their appraisal of the situation, their experience and cognitive stage. Child stress or anxiety is best ascertained by self-report, and there is lack of evidence about the child's perspective during the pre-anesthesia period, as well as factors that relate to child anxiety. Purpose: The purpose of this project was to explore child report of anxiety during the pre-anesthesia clinic visit prior to a scheduled procedure with general anesthesia in a sample of patients ages 7 to 17 years. We …

Picu Team Member Innovative Support Planintentional Caring Practices To Mitigate Moral Distress, Secondary Trauma, Andburnout In The Intensive Care Unit., Ginny Leinweber, Kendel Richards, Jessica Roumillat

2021

Situation:

PICU staff frequently verbalize feelings of moral distress, anxiety, and exhaustion related to repeated exposure to complicated, ethically challenging situations and the intense nature of work in the PICU. Stressors associated with complex long term patient cases, deaths, medical errors, and adverse events are compounded by factors like the pandemic, high patient acuity, and instability of staffing. Collectively, these situations increase the risk of burnout and decreased job satisfaction.

Background:

Research shows that cultivating resiliency practices can improve overall well-being of the individual and lessen burnout and turnover. Though the hospital offers a program (RISE) that promotes resilience, integrated …

Promoting Patient Safety Using Virtual Safety Huddles, Rachael Burris-Alcala, Julie Baker, Ann Gosdin

2021

Background: Staff Safety Huddles have been shown to improve communication and to help make patient safety a priority. Conducting daily safety huddles in Plano ACS are difficult because of how each nursing unit is structured. There are four units with 12 beds in each unit. The units are separated from each other and only have one charge nurse for all four units. Finding a solution to conduct daily huddles was a priority. Safety huddles occurred daily on both day and night shifts. Although the safety huddles helped identify safety concerns, it did not solve the problem of the entire …

Improving Pediatric Healthcare Workers Personal Safety Through The Implementation Of A Behavioral Rapid Response Team, Jennifer Brown, Diana Montoya

2021

From 2017 to 2018, a metropolitan pediatric hospital noted a 62.6% increase in calls to security for uncooperative patients related to physical aggression and acute behavioral decompensation. Even with annual de-escalation and restraint training, a 2019 survey conducted by clinical educators discovered only 27% of staff felt safe when handling an aggressive patient. This drove a collaborative initiative to formulate a multidisciplinary Behavioral Emergency Response Team (BERT) to standardize care, emergently respond in behavioral situations, and act as a resource to staff. Nurse professional development (NPD) specialists were used to create and develop a multifaceted education approach including instructor-led training, …

Improving Catheter Associated Urinary Tract Infection Rates Of Pediatric Patients Through Standardization Of Catheter Care, Shelby Beyers, Jenna Buys, Hayden Dutton

2021

Background/Significance: Pediatric patients with urinary catheters are at an increased risk for developing Catheter Associated Urinary Tract Infections (CAUTI). Standardization of urinary catheter care improves CAUTI rates. At Children’s Health, the CAUTI rate increased from 2 infections to 10 infections from 2018 to 2019. Review of organizational policy revealed that urinary catheter care practices were not standardized. Bedside staff performed catheter care with soap and water but utilized different methods and supplies, leading to variability in practice.

Purpose/EBP Question: The purpose of this Evidence Based Practice (EBP) project was to standardize catheter care throughout Children’s Health. Nurse resident sought …

Decreasing The Risk: Early Discontinuation Of Urinarycatheters Through Nurse Led Removal Program, Valerie Tidwell, Victoria Washington, Ginger Young

2021

Purpose- Improve outcomes and safety for PICU patients through an Evidence Based Practice (EBP) approach to reduce catheter associated urinary tract infections (CAUTI)

PICO For pediatric patients in the ICU does a nurse driven urinary catheter (UC) program with discussion in rounds decrease urinary catheter utilization as compared to current practice?

Background There was an increased rate of CAUTI in the PICU between 2018 and 2019. UC necessity was not often discussed in rounds. The cost of a CAUTI is estimated to be between $1000- $13,793 per episode. Also associated with CAUTI are increased LOS (approximated at 2.3 days), excess …

Improving Patient Safety By Predicting Early Deterioration In Thepediatric Pulmonary Population, Christina Smith, Lindsey Patton, Peng Chen

2021

Background: The inpatient pulmonary unit (D9) utilizes a modified pediatric early warning score (PEWS) to identify deteriorating patients. D9 emergency team activations and code event reviews found PEWS documentation discrepancies and inaccuracies. 66% of D9 nurses reported PEWS scores are inaccurate for the pulmonary population and this is a major barrier to using PEWS. The Iowa model was used to identify a different tool, compare psychometrics, and measure nurses’ perceptions to establish the best early warning tool for pediatric pulmonary patients.

Methods: Inclusion criteria was patients admitted to D9 with baseline tracheostomy, oxygen, or invasive/non-invasive ventilation. Literature review revealed no …

Initial Results Of The Asq (Ask Suicide Questions)Patient Questionnaire Inplemented At Children’S Health, Jane Miles, Karla Hutcherson, Jennifer Brown

2021

OBJECTIVE

Our goal was to assess the outcome of recently implemented hospital wide questionnaire ,Ask suicide Screening Questions (ASQ), for all patients seen at Children’s Health ER from April to December 2018.

BACKGROUND

Suicide is the second leading cause of death in youth ages 10-24 and is a significant public health problem. Early identification and treatment can have an impact on the number of youth suicides.

METHOD

Due to demand, a specific workflow was created and implemented hospital wide. ASQ questionnaire consists of 5 questions. If patient answers “no” to first four questions, the fifth question is not asked. If …

After Discharge Call Management Utilizing A Centralized Call Hub, Susan Webber, Ann Gosdin

2021

Practice Problem
No clearly defined process exists for clarification of discharge instructions or other parental concerns after discharge. Follow-up appointments with the primary care provider or a subspecialist are listed on discharge instructions with the main hospital number to call after discharge. Hospital operators send calls to inpatient units where the patient was most recently discharged. This causes disruptions for nursing floor staff and unnecessary emergency room visits. No literature was identified for calls to a centralized call center after discharge. Literature shows the most frequent reason for calling after discharge were common concerns such as fever, ENT, respiratory and …

Ir Unplanned Line Removals, Toni Haynes

2021

Problem
In 2020, the Hematology/Oncology unit noticed an increased trend in Intravascular Access Devices (IVADs) needing to be removed due to infection or dehiscence of the incision.

Key EBP Practices
A Clinical Nurse Specialist, Central Line Nurse, Bone Marrow Transplant Doctor, and four Interventional Radiologist Surgeons came together to discuss potential causes of the increase in line removals. Team decided to track unplanned line removals. Unplanned line removal criteria are met when a central line is removed within 30 days of placement from an infection or dehiscence. Evidence shows studies looked at 30-day periods for line removals, and line removals …

Nurse: Are You In Pain? Patient: (No Answer), Katie Mclaurin

2021

Many infants and children admitted to the pediatric intensive care unit (PICU) have difficulty self-reporting pain requiring nurses to score pain utilizing the FLACC scale. However, when surveyed, PICU nurses at Children’s Health expressed dissatisfaction with the FLACC scale because it did not accurately assess pain in the PICU population (mean=4.1). An extensive literature review was conducted to determine the best behavioral pain scale to use for nonverbal patients in the PICU. Based on the literature, the COMFORT-B scale was selected. The COMFORT-B scale is a behavioral pain scale validated in the PICU in children 0 to 10 years and …