Pediatric Nursing Commons^™

Identifying United States And Territory Education Requirements For Childhood Vaccination Exemptions, Lacey M. Eden, Emily G. Dunn, Karlen E. Luthy, Katelyn Wells, Janelle L. B. Macintosh, Renea Beckstrand

Faculty Publications

Background: : Children are required by law to receive vaccinations to enter school. States and territories offer exemptions for parents who refuse to vaccinate their children. Types of exemptions vary by state or territory, as does the exemption filing process. The purpose of this research was to identify the various education-related processes implemented by states and territories which allow parents to exempt children from vaccinations.

Methods: A questionnaire was distributed to immunization program managers in the 50 United States, District of Columbia, the United States Indian Health Service, and eight United States territories. Managers reported vaccination requirements for their jurisdiction …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Pediatric Intensive Care Unit Skin-Care Team, Anna Therianos Konstantin

Master's Projects and Capstones

In the United States, pressure injuries (PIs) cost $9.1–$11.6 billion per year and claim more than 60,000 patient lives. The large Northern California hospital where this CNL project was conducted has had an 8.33% incidence of hospital-acquired PIs at or greater than stage two in the pediatric intensive care unit (PICU). Pressure injury prevention was not a high priority for the nursing staff; nurses were unaware of current PI prevention protocols or the PI prevalence in the PICU. The goals are to reduce PIs by 20% in 3 months, increase PI nursing education, and improve patient outcomes. Nursing skin-care rounds …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Pediatric Hematology/Oncology Outpatient Care: The Effect Of A Standardized Collaborative Medication Reconciliation Process, Traci R. Pulliam

Evidence-Based Practice Project Reports

Pediatric patients are at an increased risk for medication errors and can benefit from processes that facilitate and promote medication safety (Stone et al., 2010). Medication reconciliation (Med Rec) is a valuable tool in improving patients’ medication safety and reducing adverse drug events (The Joint Commission, 2015). The purpose of this evidence-based practice (EBP) project was to improve the accuracy of the Med Rec process in a Midwestern pediatric hematology/oncology outpatient clinic by developing, promoting, and evaluating a standardized, collaborative Med Rec process. The Stetler EBP model guided the implementation of the intervention, with the goal of integrating current evidence …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Staff Nurse Perception Of Professional Role Modeling For Student Nurses In The Clinical Learning Environment, Tamara Montgomery

Doctor of Nursing Practice Scholarly Projects

Acute care settings continue to be the primary setting for undergraduate nursing education clinical experiences. Staff nurses in acute care settings are expected to provide nursing care with pre-licensure nursing students at their side (even though there are little to no incentives for staff nurses to provide mentoring leadership), which most often takes the form of professional role modeling. In addition, there is no clear evaluative expectation that motivates staff nurses to provide contextual role modeling. Without stated expectations, staff nurse perception of the significance of role modeling for pre-licensure non-precepted nursing students may be deficient.

Because fifty-six percent of …

Effects Of A Scripted Online Video On School Nurse Perceptions Of Concussion Management, Kathleen Holligan Schneider

Nursing Theses and Dissertations

Media attention surrounding the increased rates and serious consequences of concussions among American youths has instigated the passage of laws in all fifty states requiring improved management of concussions and the development of programs, such as the Center for Disease Control and Prevention, Heads Up to Concussion. Progress has been reported in the efficacy of concussion diagnosis and return-to-play decisions. However, there has been less progress in managing the protocols for cognitive rest and return-to-classroom. The purpose of this study was to identify significant stakeholders and factors that could improve management of cognitive rest and return-to-classroom protocols in high …

The Efficacy Of Narcotic Contracts In Preventing Drug-Seeking Behaviors In Adolescents Experiencing Chronic Pain Related To Sickle Cell Anemia, Haley Russotti

Scholarly and Creative Works Conference (2015 - 2021)

It is a primary job of a nurse to advocate for their patients. If a patient is in pain, it is the nurse who is responsible for making sure that their pain gets treated. Adolescents with sickle cell anemia experience chronic pain related to vaso-occlusive crises. Once the symptoms start, they will, “persist throughout life, and there is no cure” (Atoui, 2015, p. 425). Due to their long-term use of narcotics, these adolescents could begin to demonstrate drug-seeking behaviors. Narcotic contracts are an intervention that health care teams have created to prevent drug-seeking behaviors in patients using narcotics to treat …

Psychological And Physiological Ramifications Of Inadequate Pain Management For The Pediatric Population: Influences Of Professional Nursing Preparation, Genica-Jade Cruz Ocampo

Scholarly and Creative Works Conference (2015 - 2021)

Pain management in the pediatric population is an intricate process and many existing factors contribute to inadequate pediatric pain management. Research suggests that the preparation for the nursing profession remains unsatisfactory in managing pain experiences for pediatric patients. Nurses are essential in assessing and relieving pain in pediatric patients. It is imperative to research what determinants of professional nursing preparation influence effective pain management for the pediatric population. Additionally, how nurses describe their educational or professional development of effective pain management including the psychological and physiological aspect of undermanaged pain need to be addressed. This study is being conducted through …

Post-Intensive Care Syndrome: Comparison Of Educational Interventions To Educate Parents Of Children Hospitalized In The Pediatric Intensive Care Unit At St. Louis Children’S Hospital, Stephanie A. Esses

Dissertations

Background: Family members of children hospitalized in the pediatric intensive care unit (PICU) can develop cognitive, psychological, and physical manifestations of post-intensive care syndrome (PICS). Targeted education to help parents/caregivers recognize the signs and symptoms of PICS may result in better awareness of the syndrome and greater willingness to seek and receive support during their child’s PICU admission.

Objective: to evaluate three targeted PICS educational interventions to increase PICS awareness among parents/caregivers in the St. Louis Children’s Hospital (SLCH) PICU.

Results: A total of 62 parents/caregivers received one of three educational interventions: informational brochures (n=22), scripted informational conversation (n=20), or …

Improving New Graduate Critical Care Nurse Practitioner Knowledge And Retention Using A Dedicated Orientation And Mentoring Program, Katherine Huffer

Dissertations

Abstract

Background: There has been a significant amount of research into the many challenges that nurse practitioners (NPs) face as they transition from school to practice, however, there is limited research on how to improve this transition. Regardless of the setting in which the NPs are working, novices NPs alike report feelings of being unprepared and experiencing high levels of stress, anxiety, fear, and frustration. New research suggests that a comprehensive NP orientation and residency programs may provide a way to integrate the new NPs into their practice environment successfully.

Method: Kern’s Six Step Approach to Curriculum Development for Medical …

The Acute Care Pediatric Nurse Practitioner In Missouri: An Analysis Of Needs Assessment, Jessica L. Mann

Dissertations

Introduction: Due to an increasing number of acutely ill pediatric patients and changing healthcare demands, there is an even greater need for nurse practitioners (NPs) to work in the area of pediatric acute care (AC). There is a lack of alignment of education and certification with the scope of practice of the AC Pediatric Nurse Practitioner (PNP). The development and implementation of a graduate level AC PNP program in Missouri will support the alignment of education, clinical training, and certification with the scope of practice of the AC PNP and improve access to a quality program for nurses that currently …

Compassion Satisfaction And Compassion Fatigue Among Pediatric Nurses And The Impact On Patient Satisfaction, Maribeth Thornton

Nursing ETDs

Compassion fatigue and compassion satisfaction are two inter-related concepts. Individuals in helping professions may occasionally face compassion fatigue from giving so much of themselves to others. Compassion fatigue has been studied in a variety of settings: medical, social work, nursing, law enforcement, and fire departments, to name a few. While some researchers have studied nurses, little published work has focused exclusively on nurses who care for specialty pediatric populations. Additionally, there is scant research on whether compassion satisfaction and compassion fatigue are associated with patient satisfaction. The purpose of this study was to determine the level of compassion satisfaction and …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

An Online Educational Program Improves Pediatric Oncology Nurses’ Knowledge, Attitudes, And Spiritual Care Competence, Cheryl L. Petersen, Margaret Callahan, Donna O. Mccarthy, Ronda G. Hughes, Rosemary White-Traut, Naveen K. Bansal

Mathematics, Statistics and Computer Science Faculty Research and Publications

This study evaluated the potential impact of an online spiritual care educational program on pediatric nurses’ attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. It was hypothesized that the intervention would increase nurses’ positive attitudes toward and knowledge of spiritual care and increase nurses’ level of perceived spiritual care competence. A positive correlation was expected between change in nurses’ perceived attitudes toward and knowledge of spiritual care and change in nurses’ perceived spiritual care competence. A prospective, longitudinal design was employed, and analyses included one-way …

Social Ecological Factors Associated With Parental Vaccination Decisions And Perceptions Of Barriers To Childhood Immunizations, Catherine A. Ferris

Dissertations

The success of childhood immunizations has led to a decrease in the visibility of the morbidity and mortality of vaccine-preventable diseases. Parents are questioning the validity and safety of vaccines resulting in significantly increasing numbers of underimmunized and unvaccinated children throughout the country. The purpose of this dissertation was to explore the perceptions of barriers to immunizations in parents with children, birth to 12 months of age presenting for a well-child or vaccinations-only visit to one of two pediatric primary care clinics located in San Diego County. The social ecological model was used to guide this dissertation. A cross-sectional, descriptive …

A Quasi-Experimental Study Of A Health Patterning Modality About Childhood Vaginitis And Power In Haitian Primary Caregivers, Anne Marie Berthe Leveille-Tulce

Dissertations, Theses, and Capstone Projects

The purpose of the study was to appraise the power as knowing participation in change of primary caregivers of Haitian children aged 6 to 13 years old before and after participation in an education and resource health patterning modality related to risk factors and prevention of childhood vaginitis. The study was framed within the realm of Rogers’ Science of Unitary Human Beings and the conceptual framework of Barrett’s Power as Knowing Participation in Change. A pretest-posttest quasi- experimental study was conducted. Descriptive statistics were used to answer the first research question “What are the power profiles of Haitian caregivers before …

Business Plan For A Non-Profit Pediatric Iv Pole Wagon Distribution Program, Susan White Hester

Nursing Theses and Capstone Projects

Problem: Children have reported that pain and anxiety were the most difficult part of hospitalization, and under treatment of pain and anxiety can have short and long term effects on health outcomes. Most healthcare professionals recognize a link between emotional health and physical health, but this may be especially true for pediatric patients who may not be able to marshal adequate coping skills due to their developmental age. Providing age appropriate alternatives, such as distraction therapy, may result in less invasive treatments for pediatric patients. Distraction therapy is an effective nonpharmacological intervention that is often under-utilized in the acute care …

Text Message Follow-Up Reminders In The Pediatric Urgent Care, Kimberly R. Joo

Doctor of Nursing Practice Program Projects

Follow-up care by a primary care provider (PCP) immediately following a visit to the pediatric urgent care is recommended by the American Academy of Pediatrics. Unfortunately, studies indicate that between 26-56% of patients do not complete a recommended follow-up appointment with PCPs. Communication in the form of reminders to parents, guardians, and patients over the age of 18 may have the potential to increase rates of follow-up appointments after an urgent care visit. Short Message Service (SMS) text messages have been shown to be an effective means of communication between providers and patients in multiple types of healthcare settings. The …

Adult Qdts, Chinese, Marianne E. Weiss, Binghua Wang

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Influenza Vaccination In School-Aged Children, Isabella Jao, Chloe Mcfadin, Nica Nuguid, Dan Recinto, Kaitlin Van Ryn

Student Research Posters

Should schools in the United States require children between the ages of six months to 17 years to have flu vaccination shots? Influenza is a serious disease that can lead to hospitalization and sometimes even death. According to the Center of Disease Control (CDC), every flu season varies, and an influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year. Everyone is at risk for influenza, but the highest risk lies within children who are …

Exploring The Relationship Between Symptom Management And Distress In Pediatric Oncology Nurses, Amanda M. Schultz

Honors Undergraduate Theses

Pediatric oncology is known to be a stressful work environment due to the difficult aspects regarding patient care. This known stress related to work and caring for pediatric oncology patients can negatively impact nurses, patients, and families. The purpose of this study is to examine: relationships between patient symptom management and nurse distress; strategies used by nurses to manage symptoms in pediatric patients with cancer; nurse perceptions of the effectiveness of non-pharmacologic or nursing interventions; and nurse distress related to managing symptoms in pediatric patients with cancer. Registered nurses (N=13) at a local children’s hospital participated in an online survey. …

Reach Out And Read Program: Incorporating Early Literacy Promotion Into Practice, Melanie Miller

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Purpose: The purpose of this project was to increase the number of days per week parents read to their children ages six months to five years in order to increase literacy, brain and language development, and improve parent-child relationships and health outcomes.
Review of Literature: Between birth and age five, 90% of a child’s brain development occurs (Theriot et al., 2003). The Reach Out and Read© program is an evidence-based program incorporating books into well-child visits by primary care providers ages 6 months to 5 years (Reach Out and Read©, 2014). After being introduced to literacy programs, frequency of shared …

Use Of Personalized Patient Heart Diagrams At The Bedside To Improve Quality Of Care, Melissa D. Elliott

Posters

Title: Use of personalized patient heart diagrams at the bedside to improve quality of care

Background/Introduction: With congenital heart disease no two hearts are exactly the same. Even with the same lesion, the anatomy of the heart can be completely different. In response to a bedside nursing idea following a cardiac arrest, advanced practice nurses (APN) initiated a program to provide personalized cardiac anatomy diagrams at the bedside of every patient on the cardiology service.

Methods: When a cardiac patient is admitted to cardiology floor, the nurse will check the patients chart for an anatomy picture, then will place …

Pre-Implementation Of A Fontan Post-Operative Clinical Pathway: Summary Of 2016 Pdsa Cycles, Sarah M. Lagergren, Bryan Beaven, Suma Goudar, Megan Jensen

Posters

Background/Introduction: Post-operative hospitalization for the Fontan procedure tends to have an extended hospital length of stay (LOS). From 2013-2014, the average LOS at Children’s Mercy for the Fontan procedure is 14 days, whereas the U.S. national reported average is 11 days. Post-operative management of this patient population is often caregiver dependent. It has been theorized that developing a more standardized post-operative management regimen tailored specifically toward the unique physiology of Fontan patients may be able to improve outcomes and decrease LOS.

Methods: A review of literature was performed and revealed three pediatric institutions have published their post-operative Fontan care guidelines. …

Therapeutic Plasma Exchange (Tpe) Performed In Tandem With Crrt And/Or Ecmo: Experience Of One Pediatric Center, Lejla Music Aplenc, Cindy George, Kimberly Marriott

Posters

SUMMARY

The most common indications for starting tandem procedures were ASFA Category III indications, followed by un-categorized indications.

Similar to other reports in literature, hypocalcemia and hypotension were the most common complications. Transfusion reactions were rare, despite the use of large volumes of plasma.

Tandem procedures in critically ill pediatric patients require close monitoring and excellent communication between staff members.

An Expanded Role For Nurses In Laboratory Utilization, Marilyn S. Hamilton, Rangaraj Selvarangan, Michele Fix, Lynn E. Shriver

Posters

Introduction: The majority of laboratory testing errors occur in the pre-analytical stage, including specimen collection. Children provide special challenges including small blood volumes, small veins, and an inability to cooperate. We describe collaboration between laboratorians and nursing staff to improve specimen collection and the reliability of test results.

Methods: We identified three areas for improvement: 1) Volume of blood for culture, 2) Urine collection, and 3) Appropriate blood collection through a line. Base line data was established. Guidelines for specimen collection were updated. Nurse members of the Laboratory Utilization Committee developed educational tools.

Results: Nursing education was effective at improving …

Parent Perception Of Child’S Developmental And Coordination Skills Related To Participation In The Gymnastics Through Early Movement Program, Allison M. Theobald

DNP Projects

This study aims to evaluate the effectiveness of the Gymnastics through Early Movement program in increasing motor ability in children with motor developmental delay or coordination deficits through the perception of the parent. The Gymnastics through Early Movement program is a therapeutic gymnastics program developed by a pediatric nurse and professional member of United States of America Gymnastics. The program was designed specifically for pre-school aged children who experience motor challenges. Over the course of six weeks, each 45-minute lesson included activities and obstacles focusing on fundamental preschool gymnastics skills to develop strength, coordination, and flexibility. The American Academy of …