Pediatric Nursing Commons^™

Human Trafficking And Today's Youth, Rachel Whitfield

Presentations

This presentation is designed to help health care providers

• Dispel myths around US domestic trafficking
• Define the different types of human trafficking
• Understand the contributing factors for trafficking
• Understand the effect of pornography on the developing brain
• Recognize risk factors and signs and symptoms of trafficking
• Know how to report human trafficking and where to find local resources

Adolescent Obesity In The Past Decade: A Systematic Review Of Genetics And Determinants Of Food Choice, Eleanor T. Campbell, Alexis T. Franks, Paule V. Joseph

Publications and Research

Background and purpose: As the incidence of global obesity increases, concerns about adverse health outcomes in adolescents continues to rise. The complexity and expense of this problem require early recognition and specific preventive treatments. Knowledge of genetics and determinants of food choices contributing to adolescent obesity warrants further examination. The primary goal was to appraise the literature from the past decade (2007–2017) on the current state of food choice and genetic determinants of adolescent overweight/obesity in the United States. The secondary goal was to determine trends in the literature and areas for future research.

Methods: A systematic review of research …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Use Of Best Practice Alerts To Improve Adherence To Evidence-Based Screening In Pediatric Diabetes Care, Daniel Desalvo, Sara K. Bartz, Blair Mockler, Rona Y. Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Youth with type 1 diabetes (T1D) are at increased risk for comorbid autoimmune conditions and long-term complications. To help with early identification of these complications, the American Diabetes Association (ADA) has published evidence-based screening guidelines. The aim of our quality improvement intervention was to improve and sustain adherence to the ADA recommended screening guidelines to >90% for youth with T1D in the Texas Children’s Hospital (TCH) Diabetes Center by utilizing best practice alerts (BPA) within the electronic medical record (EMR).

Methods: In accordance with the ADA Standards of Care screening guidelines for youth with T1D, we analyzed the database …

Spreading The News About Peanuts: Implementing An Infant Allergy Risk Assessment, Kelly E. Kotula

Doctor of Nursing Practice Final Manuscripts

Peanut allergies are the leading cause of death from food anaphylaxis. In 2017, the National Association of Allergy and Infectious Disease (NIAID) issued a guideline for use by primary care providers to identify infants who would benefit from early peanut consumption. Many providers have not yet implemented these guidelines in clinical practice. The purpose of this project was to implement a practice change to improve assessment of risk factors for peanut allergies utilizing the NIAID guideline in infants at their six-month well-child examination at a pediatric primary care practice. Risk factors assessed included: a history of eczema and/or egg allergy …

Peripheral Intravenous Infiltrates: Engaging Staff To Increase Reporting, Emily Weber, Kimberly Castrillon, Joyce Ramsey-Coleman

Journal of Nursing & Interprofessional Leadership in Quality & Safety

A large free standing children’s academic hospital aimed to improve patient safety and outcomes by decreasing the overall severity of peripheral intravenous infiltration and extravasations (PIVIEs). A care bundle was developed by creating a PIVIE measurement tool within the electronic medical record (EMR) and integrating the tool into standardized daily practice for nurses. The care bundle included creating a team of clinical leaders consisting of empowered bedside nurses acting as mobilized resources embedded into each unit. The initiative resulted in a large scale increase in reported PIVIEs system-wide within 1 month of education dissemination to bedside RN staff. The QI …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

The Usability And Acceptability Of An Electronic Clinical Decision Support Tool For Antibiotic Selection For Common Pediatric Infections In Outpatient Rural Healthcare Clinics, Samantha Simpson

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to determine the potential role, usability and acceptability of an electronic clinical decision support tool (ECDST) for optimizing antibiotic prescribing practices for pediatric patients in outpatient rural healthcare clinics. Providers working with pediatric patients at Community Health Center of Southeast Kansas were asked to use the ECDST to complete two case studies. Following completion of the case studies, participants completed two standardized surveys regarding usability and mental workload of the ECDST. The ECDST used in this project was found to require a low mental demand, have a high usability value, and was accepted as …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Effects Of Learning Mindfulness Based Stress Reduction On Psychosocial Variables And Hba1c In Adolescents With Type 1 Diabetes, Denise Van Sant - Smith

Electronic Theses and Dissertations

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to …

The Impact Of Bedside Reporting On Patient Safety Events, Patient Satisfaction, And Nurse Accountability In A Pediatric Unit, Ginger Mcearl

Theses and Dissertations from 2019

One of the fundamental elements of nursing practice is the transfer of patient information from one provider to another known as a bedside report. However, an unstructured bedside report that occurs away from the bedside, places patient safety, quality of patient care, and patient satisfaction in jeopardy. The purpose of this quality improvement (QI) project is to determine if the implementation of bedside reporting in an acute care pediatric unit will: decrease preventable errors reported through an event reporting system known as Safety Tracker, increase patient satisfaction in provider communication, and improve nurse accountability. The study included a convenience sample …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Anna Vaughn School of Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

The Impact Of A School-Based Program On Diabetes And Cardiovascular Risk Factors, Lindsey Thielman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obesity is an increasing health issue both in the United States and worldwide. Furthermore, childhood obesity is increasing in prevalence. Childhood obesity is associated with an increased risk of comorbidities in adulthood. Obesity in childhood and adolescence makes one more likely to become obese during adulthood. This study sought to determine the effect of a school-based obesity prevention program on diabetes and cardiovascular risk factors such as body mass index (BMI), blood pressure, waist circumference, and acanthosis nigricans. Measurements were taken before education in the fall semester, and again after two education sessions in the spring semester. Student and faculty …

Who Codes In The Nicu: An Analysis Of Demographics And Factors That Place Neonates At Higher/Lower Risk Of A Serious Code Event And Prognosis Post-Code, Danielle N. Gonzales, Ashley K. Sherman, Jennifer Dremann, Staci Elliott, Amelia Gute, Amber Bellinghausen, Jessica Brunkhorst, Danielle Reed

Posters

This study analyzed resuscitation events in a level IV neonatal intensive care unit from 2012-2017 to determine whether there are identifiable differences between those who have a rapid response event and those with a short or long code and determine factors post-event that may impact survival to discharge.

Nurses’ Perception Of Discharging The Medically Complex Pediatric Patient, Stacie Camille Licon

Doctoral Projects

The purpose of this study is to query the nurses for their perceptions of the barriers and facilitators of discharging medically complex pediatric patients from a freestanding children’s hospital in central California. Using a mixed methods research design via an online survey, 90 nurses identified 3 distinct themes that act as barriers. Those barriers include: 1) knowing the plan of care, 2) time, and 3) disposition of the family. Several implications for improving the discharge process for medically complex patients and overcoming the identified barriers include strategies to improve multidisciplinary communication, implementation of a Family Learning Center, use of video …

Caring For The Pediatric Neurofibromatosis Type-1 Patient: Improving Nursing Knowledge Through An Innovative Educational Tool, Samantha Ingerick

Doctoral Projects

Standardized nursing education can help equip nurses with appropriate skills needed to care for certain patient populations. Pediatric neurofibromatosis type-1 (NF1) patients have unique health needs, and often seek care at institutions where no NF1 training has been provided. The purpose of this project was to explore existing nursing NF1 knowledge and knowledge perception in a pediatric oncology infusion center within a large bay area children’s hospital, a location where nurses have varied NF1 education and have recently been asked to care for this population. Malcolm Knowles’ adult learning theory was used to design an NF1 educational tool for nurses. …

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

Living As A Dying Child: A Gadamerian Analysis Of The Poetry Of Mattie J. T. Stepanek, Corinne Ann Settecase-Wu

Dissertations, Theses, and Capstone Projects

Yearly, approximately 500,000 children live with life-limiting conditions in the United States; 50,000 die. Yet, details regarding children’s days of living as dying are unknown. The aim of this qualitative hermeneutic study is to gain understanding of the phenomenon of living as a dying child. A Gadamerian-inspired approach was implemented to underpin the study, and to analyze poetic text to address the research question: What is it to be living as a dying child? The text sample included 499 poems written by Mattie J. T. Stepanek, a dying child. The Settecase-Wu Conceptual Guide was developed and implemented to ensure accuracy …

Decreasing Unplanned Extubations By Taping Technique & Creating A Culture Of Safety, Karishma Rao, Beckie Palmer, Christopher R. Nitkin, Christian Anthony Schneider, Brandy Huitt, Molly Terhune, Ashley Orwick, Dianne Wilderson, Sarah Carboneau, Jenny Mckee, Kerrie A. Meinert, Eugenia K. Pallotto

Presentations

Describes strategies used to decrease the unplanned extubation rate in the Level IV neonatal intensive care unit to less than 1.0 event per 100 ventilator days by December 2018.

Human Papillomavirus Vaccine Program, Magdalena Ruiz

Doctoral Projects

Pediatric primary care focuses on maintaining patients’ health, preventing diseases, and assessing children’s developmental milestones. Vaccine administration and disease prevention are key components of a well-child exam for pediatric patients; however, vaccine refusal is an important complication of pediatric patient care. Of particular interest to this researcher is the HPV vaccine which was approved by the Federal Drug Administration and is currently recommended by the Centers for Disease Control and Prevention (2016) for both males and females, beginning at 11 or 12 years of age through age 26 years. The HPV vaccine protects against diseases and cancers caused by the …

Pilot Study: Program Evaluation Of Peanut Oral Immunotherapy In A Private Clinic, Kinga Olson

Doctoral Projects

The privilege of providing a therapy perceived by patients and families as “life changing” has seasoned physicians describing food oral immunotherapy (OIT) as one of “the most impactful and rewarding thing that they have done in medicine” (Wasserman, Jones, & Windom, 2018). OIT is a medical treatment that allows the immune system to become desensitized to a food to which it may otherwise be allergic. This is not a cure for food allergies but a way to decrease the incidence of anaphylaxis due to accidental ingestion. Living with food allergies can be distressing due to the daily fear of exposures. …

Toward Expert Consensus On Guidelines For The Use Of Yoga In The Treatment Of Anxiety In Children And Adolescents., Laura J. Abels

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Despite clinical evidence to support the use of yoga as a treatment option for children and adolescents with anxiety, clinical practice guidelines do not exist. Purpose: This project used the modified Delphi technique to determine if consensus exists on the need for clinical practice guidelines among experts in the fields of child and adolescent psychiatry, psychology, and yoga. Additionally, this project aimed to determine if consensus exists on what should be included in clinical practice guidelines for the use of yoga as a therapeutic intervention for anxiety in children and adolescents. Methods: Three rounds of questionnaires were used …

Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase selfefficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Changing Healthcare Provider And Parent Behaviors In The Pediatric Post‐Anesthesia‐Care‐Unit To Reduce Child Pain: Nurse And Parent Training In Postoperative Stress (Np‐Tips), Brooke N. Jenkins, Michelle Fortier, Robert S. Stevenson, Mai Makhlouf, Paulina Lim, Remy Converse, Zeev N. Kain

Psychology Faculty Articles and Research

Background

Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain.

Methods

In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents …

Identifying Structural Factors Associated With Central Line-Associated Bloodstream Infections (Clabsi) Risk In A Single-Center Pediatric Academic Hospital, Elizabeth Monsees, Paul N. Bauer, Yolanda Ballam, Brian R. Lee

Posters

Objective: compare unit structure and process-related factors against unit-specific CLABSI rate.

Conclusion: CLABSI mitigation requires more than individual competence with task-related practices; the unique work ecology of each clinical area may broadly influence CLABSI as an outcome; extending analyses to consider organizational structure can inform resource allocation and recalibrate traditional prevention strategies.

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

The Long And Winding Road: A Case Study Of A Child With Niemann-Pick Disease, Michele M. Dzomic

Patient Care Services / Nursing

No abstract provided.

Shelby Powell's Portfolio, Shelby Powell

Honors College Portfolios

The field of pediatric nursing is one that has captured my heart since I was 16. When I thought about what I wanted to be when I grew up, the only aspiration in my clearly uncertain plan was that I wanted to work with children. Soon after, I came to see the huge gratification that being a peds nurse could bring me. Through the work I have completed in my honors independent study, I have had the opportunity to focus on and learn more about this exceptional and rewarding field.

I began with comprising an educational blog focused on the …

Usability And Acceptability Of An Electronic Clinical Decision Support Tool For Antibiotic Selection For Common Pediatric Infections In Outpatient Rural Healthcare Clinics, Sammi Simpson, Karen Johnson, Amy Hite, Kristi Frisbee, Anuradha Ghosh

Posters

The purpose of this project was to determine the potential role of an electronic clinical decision support tool (ECDST) for optimizing antibiotic prescribing practices in rural clinical practice. The specific aim was to evalu­ate the usability and acceptability of an ECDST for antibiotic prescribing in pediatric patients in outpatient ru­ral health clinics. The data was collected from providers working with pediatric patients at Community Health Center of Southeast Kansas. The ECDST used in this project was found to have a high usability value and was accepted as a potential tool for clinical practice by the majority of the providers who …