Pediatric Nursing Commons^™

Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Expert Panel Report -3 (EPR3) NAEPP 2007 evidence-based clinical asthma guidelines were developed to provide evidence-based high-quality patient care that leads to improved outcomes. A literature review showed that healthcare providers do not routinely follow the asthma guidelines. The purpose of this project was to develop and implement an evidence-based asthma electronic health record (EHR) template in a pediatric office to improve provider compliance to the guidelines resulting in improved outcomes for children with asthma. The study was conducted over a period of four months from January - April 2016. An EHR asthma protocol template and training for providers …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

Enhancing Vegetable Intake In Infants And Toddlers Through Parental Complementary Feeding Education, Sophia Testa

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This research project investigated the outcomes of educating parents of infants between the ages of 6 months and 12 months on the importance of including vegetables in complementary feedings on the infant’s vegetable consumption. The efficiency of teaching was measured by comparing physical measurements and quantity of vegetables consumed by infants whose parents received education with the same data from infants whose parents did not receive education on inclusion of vegetable in complementary feedings. The results found contributed to Dr. Shreve’s research on childhood obesity in the Northwest Arkansas population and to the knowledge of parental education with regard to …

Intergenerational Hispanic Perceptions Of Childhood Obesity, Janelle Weiss

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Childhood obesity is on the rise in the United States especially among minority families. This study investigates how Hispanic parents perceive their child's weight based on years of acculturation, education level, age, child’s gender and 1^st or 2^nd generation status.

Objective: To assess if there are differences in perception between more acculturated Hispanic immigrants and their less acculturated counterparts.

Methods: Data were collected using the Child's Body Image Scale. Participants were asked to arrange the images based on a series of questions inquiring about their perception of their child and health in general. BMI's were then …

Processing Information After A Child's Cancer Diagnosis-How Parents Learn., Cheryl C. Rodgers, Kristin Stegenga, Janice S. Withycombe, Karen Sachse, Katherine Patterson Kelly

Manuscripts, Articles, Book Chapters and Other Papers

Parents of a child newly diagnosed with cancer must receive an extensive amount of information before their child's initial hospital discharge; however, little is known about best practices for providing this education. An interpretive descriptive study design was used to describe actual and preferred educational content, timing, and methods among parents of children newly diagnosed with cancer prior to their child's first hospital discharge. Twenty parents of children diagnosed with various malignancies participated in individual interviews 2 to 12 months after their child's diagnosis. Data were analyzed using constant comparative analysis. Education delivery occurred in a telling manner at diagnosis …

Inside Pediatrics Wins Emmy Award . . . Again!, Children's Mercy Hospital

Our Story Continues

'The Heart of Children's Mercy' garners hospital's second trophy for programming excellence.

Once again, Inside Pediatrics has been recognized with a prestigious Emmy award for outstanding programming by the National Academy of Television Arts and Sciences. At the awards event Saturday night, the fifth episode (titled “The Heart of Children’s Mercy”) of the show’s second season won for Best Public/Current/Community Affairs Program or Special.

Last year, Season 1 of Inside Pediatrics won an Emmy in the same category.

Mapping The Literature Of Pediatric Nursing: Update And Implications For Library Services, Carol L. Watwood

DLPS Faculty Publications

Objective

The purpose of this study was to identify core journals and other types of literature cited in four major pediatric nursing journals and to characterize coverage of these resources in major bibliographic databases. The study was part of the “Mapping the Literature of Nursing Project” of the Medical Library Association's Nursing and Allied Health Resource Section. It updates a similar analysis published in 2006 and determines whether citation patterns have changed over time.

Methods

Cited references from articles published in 4 pediatric nursing journals between 2011 and 2013 were collected. Cited journal titles were ranked according to number of …

Development Of A Breastfeeding Class Specifically For Working Moms, Maryleah S. Needels

Master's Projects and Capstones

Successfully breastfeeding mothers who are planning to return to work and remain exclusively breastfeeding their infants have a knowledge deficit as to the federal law protecting their rights along with the basic skills for pumping, storing, and bottle-feeding of breast milk. There is a significant drop in breastfeeding rates at both the 3 and 6-month marker, which coincides with maternal return to employment. After attending the Working Moms Breastfeeding Class, 100% of mothers reported an increase in knowledge surrounding the law and the CDC’s basic skills for handling pumped breast milk based on a pre/post questionnaire. Bandura’s theory of self-efficacy …

Implementing Change To Decrease The Emergency Department Visits For Pediatric Clients Referred To Mental Health Services, Diane Sandoval

Master's Projects and Capstones

The purpose of this clinical nurse leader (CNL) internship project is to implement an improvement intervention to decrease emergency department visits or psychiatric emergency services visit rates for pediatric clients receiving mental health services through the ambulatory clinic. The goal is to increase client safety by preventing harm to themselves or others and improving quality of care provided through timely nursing telephone triage. The project is taking place in a county run pediatric ambulatory clinic. We will participate in a shared leadership team to make recommendations for improvement at the microsystem level. Team members include the charge nurse, clinic manager, …

Effects Of Pediatric Emergence Delirium Education On Analgesic Administration By Pacu Nurses, Melinda C. Nwanganga

Evidence-Based Practice Project Reports

Emergence delirium (ED) is a behavioral disturbance as a result of general anesthesia that commonly occurs in pediatric patients. Adverse effects of ED lead to a complicated recovery from anesthesia due to the risk of self-inflicted injury of patients, the disturbance of surgical incisions, the development of postoperative maladaptive behaviors, and the increased use of sedatives and analgesics resulting in prolonged recovery time and delayed discharge from the post-anesthesia care unit (PACU). Due to the multiple ramifications of ED, appropriate care is needed to promote a safe recovery from anesthesia and an optimum perioperative experience for these patients. As PACU …

Repetitive, Pre-Anesthetic Fasting And Malnutrition In A Pediatric Oncology Population Undergoing Radiation Therapy, Laura P. Santibáñez

Dissertations and Theses (Open Access)

Background: Pediatric oncology patients often experience nutritional status changes, particularly malnutrition, which may adversely affect their outcomes. Although the consequences of malnutrition are elucidated, its causes remain unclear. A possible cause of malnutrition in pediatric oncology patients is repetitive, pre-anesthetic fasting prior to non-invasive procedures and treatments, such as anesthesia-assisted radiation therapy (AART). This exploratory study investigated the association between repetitive, pre-anesthetic fasting and non-fasting days and malnutrition in pediatric oncology patients receiving AART.

Procedure: A retrospective cohort of 138 pediatric oncology patients (£ 10 years of age) who received any type of radiation therapy (RT) with or without anesthesia …

Type 1 Congenital Pulmonary Airway Malformation: The Most Common Lung Lesion In Newborns., Delilah Penn

Nursing Student Class Projects (Formerly MSN)

A poster project on Type 1 Congenital Pulmonary Airway Malformation: The most common lung lesion in newborns.

Health Care Transition Program For Adolescents With Spina Bifida, Teresa M. Scavone

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project was to evaluate the feasibility of implementing an NP facilitated formal transition program for adolescents with Spina Bifida. There is an increased awareness of the need for health care transition for youth with special health care needs (YSHCN) due to the 2009-2010 Maternal Child Health Branch National Survey findings that only 40% of YSHCN receive adequate support for transition that meets the core outcome measures. Recent studies have investigated transition in youth with chronic disease specific conditions such as diabetes, cystic fibrosis, and congenital heart defects, and provide valuable insight into possible strategies for …

Increasing The Awareness Of Trauma Informed Care In The School Setting: Giving Practitioners The Tools To Actively Participate In Trauma Related Care, Rebekah L. Sypniewski

Doctor of Nursing Practice (DNP) Projects

Of the approximately 15 million children and adolescents who have a mental health disorders that are interfering with their functioning, a mere 25% seek medical advice or treatment (Melnyk, Kelly, & Lusk, 2014). Furthermore, two thirds of youth report experience at least one traumatic event by age 16 (Suarez, Belcher, Briggs, & Titus, 2012). School health practitioners have regular contact with children and adolescents as they typically attend school five days a week, nine months out of the year. The consistent presence of the relationship between the practitioner and student creates an ideal environment for discussing the sensitive topics necessary …

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects and Capstones

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes so …

Preventing And Reducing Clabsi With Daily 2% Chg Wipes, Karen Ha

Master's Projects and Capstones

This project aims to decrease central line associated bloodstream infections in pediatric patients my microsystem hospital. The process begins re-enforcing daily CHG (2% Chlorhexidine Gluconate) wipes to 100% compliance rates on our patients with central lines tailored to their age and body weights. The process ends with reducing the CLABSI rates of our unit and the entire hospital to 0. By working on the process we expect personal and organizational commitment to transform the culture of safety through integration of standardized communication, issue escalation, non punitive response to errors, rounding by all leaders, and culture of continuous improvement. It is …

Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard

Senior Honors Projects, 2010-2019

Age and developmental stage directly influence the grieving individual's ability to understand and process death. Adolescents are especially vulnerable to developing negative coping skills such as substance abuse, self-destructive behaviors, and eating disorders. After a loss occurs, nurses can use their role as a caregiver who is neither a parent nor a peer to provide adolescents with an opportunity to express their grief. Nurses can educate grieving adolescents on the differences between positive and negative coping skills and can therefore reduce the number of future hospitalizations related to ineffective coping mechanisms.

Identification Of Student Nurses’ Knowledge And Attitudes Regarding Pediatric Pain Management, Jessica Laprise

University Scholar Projects

Background

To determine existing knowledge and attitude gaps about pain assessment and management in junior and senior nursing students at the University of Connecticut (UConn), School of Nursing, Storrs, CT.

Methods

Student nurses were recruited through in person presentation of the study in the classroom setting on three separate occasions over a 20-day period. An email with information included during the presentation as well as the link to the online survey were sent through the School of Nursing listserv. A flyer was attached in the initial email and shown to participants during the initial recruitment meeting. As an incentive, sixty …

The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a screening tool to measure body fat that is calculated based on the height, weight, age, and gender of a child. Being overweight as a child is defined as having a BMI between the 85^th and 95^th percentiles. Obesity is defined as having a BMI at or above the 95^th percentile (“Basics About Childhood Obesity,” 2012). Having a high BMI comes with an increased risk of multiple co-morbidities, both physical and psychosocial (Pulgarón, 2013). Birth weight has been presumed to play a role in the prevalence of obesity in children. The purpose …

Therapeutic Listening Communication In Children With Autism And Hyperacusis, Jennifer Margaret Hughes

Doctoral Projects

Hyperacusis, or auditory hypersensitivity, is defined as abnormally sensitive hearing and in some cases an extreme sensitivity, where normally tolerated sounds are perceived as excessively, even painfully loud. This is a debilitating condition for children with autism, causing activity limitations and participation restrictions, also leading to peer isolation and habitual sound avoidance behaviors.

This research explores a means of modifying the auditory environment of a child with hyperacusis in a safe, effective way for the purpose of improving attention span and facilitating learning. The small pilot study (n=4) was a single-subject, multiple-baseline design, conducted with school-aged children in the special …

Using Focus Groups To Identify Ways To Reduce Infant Mortality In Kalamazoo, Leah Dries

Honors Theses

Study goals were to explore maternal perceptions of possible ways to reduce infant mortality in Kalamazoo County, with specific regards to the infant mortality rates of non-Hispanic African American babies versus non-Hispanic Caucasian babies. Two focus groups were conducted of voluntary, anonymous, participants from the YWCA domestic violence shelter and clients of home visiting services provided by the Kalamazoo County Department of Health and Community Services. The focus groups were guided allowing women to voice their opinions about ways to prevent infant mortality in Kalamazoo. Women were also asked to respond to the goals created by a community planning committee …

The Presence Of Stem Cells In Human Breast Milk And Research Implications, Melody (Brooke) Peterson

Senior Honors Theses

Stem cell therapy research is an expanding area of study as stem cell therapy is believed to have the potential to provide treatment options for numerous disease processes. Currently, embryonic stem cell research is the method of choice to evaluate the potential for stem cell therapy. The use of human embryos for stem cell research raises moral and ethical controversies. Stem cells are found in a variety of mediums, but until the recent discovery of stem cells in human breast milk, the most versatile stem cells have been those found in the human embryo. Human breast milk stem cells could …

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …

Nursing Knowledge And Perceived Comfort Level In Acute Infusion Reactions From Antineoplastic Agents, Andrea L. Maiorini

Honors Undergraduate Theses

INTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused by antineoplastic agents.

METHODOLOGY: An original survey was created to test nursing knowledge and assess comfort level. Nursing knowledge was broken down into six subscales: general knowledge of acute infusion reactions, …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Behavioral Interventions Versus Pharmaceutical Interventions To Reduce Preoperative Anxiety In School Aged Children, Jennifer J. Cline

Honors Undergraduate Theses

Surgical procedures that require general anesthesia can be stressful and create needless anxiety for school-age children. Interventions aimed at reducing preoperative anxiety can improve cooperation and enhance postoperative outcomes by lowering anxiety levels prior to induction of general anesthesia. The purpose of this study was to examine the effects of behavioral interventions versus drug therapy in reducing pre-operative anxiety in children. The secondary purpose was to compare methods used to integrate anxiety reduction interventions into pre-operative care and to evaluate the most widely used and effective strategy for clinical practice. A literature review exploring behavioral based stress reduction interventions and …

Dosing Accuracy When Administering Oral Medications, Chelsea Hughes

Honors Undergraduate Theses

Inaccurate dosing of children’s liquid medication is a major problem that causes adverse effects for children every year. In order to prevent these errors, education for at risk parents is essential. A survey and observational study was done in order to identify parents/caregivers who make dosing errors when measuring out liquid medication for their children. A total of 25 parents/caregivers with children admitted to Arnold Palmer Hospital were included in this study. Study participants completed a survey that included demographic data as well as parenting experience. The parents were directly observed measuring a dose of corn syrup using Children’s liquid …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Alexandra Smola, Lauren Hurley

Williams Honors College, Honors Research Projects

Therapeutic horseback riding (THR) has positive health related outcomes in children with developmental disabilities. The purpose of this study was to determine the effect of a 10-week THR intervention on balance and task-specific self-efficacy in children with developmental disabilities. Bandura’s social cognitive theory and the physical stress theory guided the quasi-experimental study. A pre-test post-test design (N=20) was implemented with a 10-week THR class at a riding center in Midwest United States. The first research question was: In children with developmental disabilities ages 5 to 18, does one 10-week session of THR affect balance? With time 1 balance mean at …