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 …

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Effect Of Virtual Reality Intervention Of Postoperative Pain In Pediatric Surgical Patients, Tara L. Kempker

Dissertations

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

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 …

It's (Not) Raining Men: Exploring The Themes Surrounding Low Male Presence In Pediatric Nursing, Marcin Janczak

Honors Projects

Background: Men remain underrepresented in nursing, with an even smaller presence in pediatric nursing. Purpose: To examine pediatric-specific themes that may contribute to the low presence of men in pediatric nursing, and strategies to counteract these potential barriers. Methods: CINAHL Ultimate and Google Scholar were searched for primary research published from 2015 to 2025 related to male nurses, male nursing students, gender bias, pediatric care, and clinical experiences. Findings: Four major themes emerged: gender stereotypes and the feminization of pediatric nursing, sociocultural barriers and gender bias, fear and distrust toward male nurses, and psychological and professional impacts on men in …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

A Quality Improvement Initiative Evaluating Factors Influencing Patient Experience With Virtual Reality During Awake​ Interventional Radiology Procedures, Quynh Dao-Payne

Doctoral Projects

Procedural anxiety and pain are common among pediatric patients undergoing awake interventional radiology (IR) procedures and may negatively affect patient comfort, cooperation, and overall patient experience. Virtual reality (VR) has emerged as a promising nonpharmacologic intervention to reduce anxiety and improve patient-centered outcomes. The purpose of this quality improvement project was to evaluate patient-reported experiences and perceived outcomes associated with VR use during awake pediatric IR procedures at Children’s Hospital Los Angeles.​ A qualitative descriptive quality improvement design was utilized. Twenty pediatric​ patients ages 10–21 years undergoing awake IR procedures with VR as part of standard clinical​ care completed structured …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

A Program Evaluation Of A Family-Based Healthy Weight Program For Overweight And Obese Children And Their Families, Ashley Heimbouch, Margaret Platel, Kelly Betts

Doctor of Nursing Practice Projects: College of Nursing

This project’s purpose was to complete a program evaluation of the Building Healthy Families (BHF) program to determine its effect on children and their families’ health outcomes. The specific aims of success were 1) an improved perception of health-related quality of life for children and parents and 2) decreased body mass index (BMI) percentiles for age and sex in children from baseline measurements and scores compared to measurements and scores at 3 months and 6 months of program completion. The project was completed in a community setting on the University of Nebraska Medical Center’s Western Nebraska campus, and the population …

Tiny Tusks Internship: Factors That Affect Breastfeeding In Public, Caroline E. Bene

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this review was to explore factors that impact women’s decision to breastfeed in public or not. The PICOT question used was: ‘What Factors Affect Women’s Decision to Breastfeed in Public or Not?’ Two platforms, EBSCOhost and The National Library of Medicine, were used to identify 15 peer-reviewed journal articles on factors affecting women’s decision to breastfeed in public or not. The factors that impact a women’s decision on whether it is acceptable to breastfeed in public stems from the media stigmatizing that breastfeeding should be a private action. Research done yielded results of both positive and negative …

Tiny Tusk Internship: Gut Instincts: A Review Of Literature On The Impact Of Breastfeeding On The Infant Gut Microbiome, Rayla Payne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to investigate both the short- and long-term benefits that breastfeeding has on the infant gut microbiome. The PICOT question was: In full-term infants, how does exclusive breastfeeding compared to mixed or formula feeding influence the diversity and composition of the gut microbiome throughout the first 12 months of life? For this research, EBSCOhost, CINAHL, and the National Library of Medicine databases were searched to find relevant studies and systematic reviews. Terms such as “breastfeeding and infant gut microbiome” were used to conduct the search. Other terms used included “breastfeeding OR formula feeding”, “human …

Improving Pneumococcal Immunization Counseling In Children With Systemic Lupus Erythematous, Sarah Dettmann

Doctoral Dissertations & Projects

Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.

Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.

Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.

Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.

Results: Pre-implementation PCV counseling was documented …

Understanding How Nurses Could Utilize Child Life Specialists, Paige Perkins

Honors Projects

Do pediatric nurses notice improvement in patient education levels when they use the resources of Child Life Specialists, understand their role, and utilize their resources to educate their patients, compared to hospitals without Child Life Specialists?

Program Evaluation Of A Digital Outreach Initiative For Improving Well-Child Visit Engagement Among Children And Adolescents Aged 3–21 Years, Eseoghene Odhu

Doctoral Dissertations & Projects

Background: Well-child visits are essential to pediatric preventive care because they support immunizations, developmental screening, anticipatory guidance, and early identification of health concerns (Abdus & Selden, 2022; Theunissen et al., 2022). Despite their importance, engagement in recommended visits remains inconsistent across healthcare systems.

Purpose: This program evaluation examined the impact of a digital outreach initiative on well-child visit engagement among children and adolescents within a Midwestern faith-based healthcare organization.

Methods: A pre–post evaluation design was used with de-identified electronic health record data from periods before and after implementation of the initiative. Outcomes included patient enrollment, scheduled visits, completed visits, no-show …

Reducing Humpty Dumpty Syndrome In Pediatric Inpatients, Jeanene Burns

Electronic Theses and Dissertations

The Doctor of Nursing Practice project examined pediatric inpatient falls. The healthcare agency involved in the project identified concerns regarding pediatric inpatient falls. Data were collected on pediatric inpatient falls that occurred on two nursing units at this agency based on the Generalized Risk Assessment for Pediatric Inpatient Falls and the Humpty Dumpty Falls Prevention Scale. Results from the project indicated marginal statistical significance, with approximately a 60% reduction in falls after the implementation of the Humpty Dumpty Falls Prevention Scale. A recommendation for future research is a comparison of the two pediatric fall risk assessment tools after the Humpty …

Pediatric Simulation And Emergency Nurse Confidence, Katherine E. Wright

Student Scholarly Projects

Practice Problem: Nurses working in a general emergency department (GED) with a low (3.3%) pediatric patient volume expressed a lack of confidence caring for complex pediatric patients.

PICOT: In general emergency department nurses (P), how does participating in a pediatric simulation event (I), compared to current practice (C), affect nurse confidence scores caring for pediatric patients (O) over 6 weeks (T)?

Evidence: A review of over 17 evidence-based resources found good quality evidence that suggested participating in a simulation event can improve nurse confidence.

Intervention: Over six weeks, GED staff members participated in a pediatric simulation event. The simulation utilized …

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. …

How Social Media And Cyberbullying Correlate To Eating Disorders In Adolescents, Nicoli A. Panelo

Nursing | Senior Theses

Background: Social media is very prevalent in today’s society, particularly in adolescents. This time period is crucial for this age group in terms of developing a sense of purpose and identity. Although social media may keep many of our children entertained, they also can create negative impacts on them and ultimately hinder their overall development both mentally and physically through negative body image and unrealistic self-expectations. Purpose: The purpose of this study is to find the correlation between social media use and the rise of eating disorders in adolescents. Doing so would allow us to find ways to lower the …

The Impact Of Parental Mental Health On Infant Outcomes In The Neonatal Intensive Care Unit: Length Of Stay, Feeding, Bonding, And Developmental Progress, Andee L. Plaskett

Nursing | Senior Theses

Background: The neonatal intensive care unit (NICU) can be a highly stressful environment for both infants and their parents. Poorer infant outcomes, including longer hospital stays, feeding difficulties, and delayed developmental progress can all be a reflection and outcome of elevated parental distress. Currently, mental health distress and infant screening tools are used in most NICUs but are not seen in all practices, it is also important to provide interventions based on the screening results. Screening tools are used to identify a problem but interventions should be implemented to try to alleviate the problem. Objective: By implementing a standardized screening …

Blister Packaging Versus Bottles: Caregiver Accuracy And Child Safety In Pediatric Medication Gummy Administration, Paolo Olimpiada

Nursing | Senior Theses

The safety of medication in pediatric settings has become an increasing concern as gummy-formulated medications have gained popularity in children’s care. Gummy-formulated medications have a close resemblance to candy, and this may mislead children to ingest additional doses or more than what was prescribed. Children also depend a lot on their caregivers for medications. Therefore, the design of packaging would be impactful in supporting medication dosing accuracy. And studies have evaluated safety features of packaging related to adherence, misuse, and unintended administration. However, limited studies have examined the influence of medication packaging on the dosing accuracy at the time of …

Short Time, Lasting Impact: Teaching Pediatric End-Of-Life Care In One Day, Mckenzie Taliaferro

Honors College Theses

Background: Pediatric nurses working in specialties that experience terminal diagnoses, death, and post-mortem care, often feel unprepared for the emotional toll and lack adequate support systems (Camera et al., 2024). Nurses report feeling under prepared due to a lack of hands-on opportunities before graduation (Richoux, et al., 2022). Pediatric death is a traumatic experience for families and nurses. Previous studies have shown that hands-on education increases nurses' confidence in caring for patients at the end of their lives (Cole & Foito, 2019; Noyes et al., 2023). Method: A one-day, hands-on multidisciplinary workshop on pediatric end-of-life (EOL) was created and offered …

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Improving Asthma Management In Schools: A Comprehensive Approach To Education, Environmental Enhancements And Asthma Action Plans, Yesenia Trevino

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Asthma contributes to school absenteeism, especially in underserved communities. This project aimed to enhance asthma management at a South Texas elementary school through staff and student education, monthly air filter changes, and personalized Asthma Action Plans (AAPs).

Methods

A quality improvement project at a South Texas elementary school involved 40 asthmatic students over eight weeks, using the Plan-Do-Study-Act (PDSA) framework. It included staff and student education, air filter maintenance, and facilitation of Asthma Action Plans (AAPs). Pre/post surveys, custodial logs, AAP audits, and attendance were analyzed, with paired t-tests used to assess changes (N=32).

Results

There was 71.9% …

Starting Strong: Improving Mmr Vaccination Rates In Kindergartners, Regina Bryan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

During the 2023–2024 academic year, measles, mumps, and rubella (MMR) vaccination coverage among kindergarten students in this school district did not meet the Healthy People 2030 target, thereby elevating the risk of disease outbreaks. This quality improvement project aimed to improve MMR vaccination initiation and completion through coordinated, school-based interventions.

Methods

Guided by the Plan-Do-Study-Act framework, an eight-week immunization bundle was implemented across 14 elementary schools in South Texas. Interventions included reminder calls, multilingual education, districtwide communication, and a partnership with a nonprofit clinic that provides free or reduced-cost vaccines through on-site and community clinics. Pre- and post-intervention …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Advancing Safe Medication Administration During Pediatric Emergency Care Through Nurse Education: A Quality Improvement Project, Ciera Hunter

Master's Theses and Capstones

Background: Due to the increased complexities of pediatric medication administration, preventable errors occur at a higher rate than in general adult populations. Rural emergency departments (EDs) often see fewer pediatric patients and have less specialized support available on-site. Nurse continuing education is an evidence-based intervention to reduce medication administration errors making it vital to supporting patient safety and maintaining pediatric readiness.

Local Problem: The microsystem is a rural, critical access hospital in northern New England. In 2021, the microsystem scored 66/81 on the National Pediatric Readiness Project’s (NPRP’s) ED Assessment. In 2026, the score dropped 11 points to 55/81. Contributing …

Increasing Patient Feedback Survey Completions Through Patient-Centered Nursing Communication: A Quality Improvement Project, Lindsey E. Pawlowski

Master's Theses and Capstones

Background: Patient feedback is essential to providing the best possible nursing care. Positive patient experiences can impact overall patient satisfaction, loyalty, and trust.

Local Problem: On a pediatric unit at a New England hospital, an assessment of the microsystem revealed that there was a low number of monthly patient feedback survey completions, which limited insight into patient experiences.

Aim Statement: The primary aim of this project was to increase the number of monthly National Research Corporation (NRC) surveys to ten by June 30, 2026.

Methods: This quality improvement project was guided by the Plan-Do-Study-Act (PDSA) model. The first stage of …