Pediatric Nursing Commons^™

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

2021

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

Ir Unplanned Line Removals, Toni Haynes

2021

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

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

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

2021

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

The Associations Among Parental Emotional States, Adolescent Emotional States, And A1c In Adolescents With Type 1 Diabetes, Jennifer L. Yenke

DNP Projects

Background: This study examined depression and diabetes distress (DD) in adolescents with type 1 diabetes (T1D) and in their parents. Depressive symptoms and DD are associated with poor glycemic control.

Objectives: To describe the prevalence of parental and adolescent depressive symptoms and DD in the sample and to evaluate correlations among depressive symptoms, DD, and A1c in parent-adolescent dyads in which the adolescents have T1D.

Methods: Thirty-two parent-adolescent dyads completed measures assessing depressive symptoms (Patient Health Questionnaire-9) and DD (Problem Areas in Diabetes- Parent of Teen and Teen versions), self-reported socio-demographic and clinical variables, and responded to questions about living …

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …

Optimizing A Pediatric Dka Protocol In A Tertiary Care Hospital System In Northern West Virginia, Jennifer L. Burky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body compensates for insufficient insulin, producing dangerously high levels of ketones. Without proper treatment, DKA can be fatal. For that reason, staff in the pediatric intensive care unit (PICU) at a tertiary care hospital in northern West Virginia expressed concerns about the complexity of and lack of adherence to a poorly referenced and dated DKA treatment protocol.

Objective: The purpose of this project was to assess the feasibility and sustainability of optimizing the DKA protocol in the PICU. The primary objective was to implement an updated, …

Perceived Neighborhood Characteristics And Parental Role In Physical Activity Of African American Youth, Kashica Webber-Ritchey, Elizabeth A. Moxley, Sungsoon Hwang, Desale Habtzghi, Sai Yalla

Faculty Articles, Papers, and Other Scholarship

Introduction: Lack of physical activity (PA) serves as one of the contributing factors to pediatric obesity in African American (AA) youth.

Objective: Further examination of the Social Ecological Model [SEM] influences on PA in AA youth is vital. The purpose of this pilot study is to explore environmental factors, built environment (BE) and parental role, in PA promotion.

Methods: Using mixed method data collection, a convenience sample of 28 AA parents/caregivers of school-aged children (6-12 years) enrolled in Chicago Youth Programs (CYP) completed an online survey. Parents/caregivers along with their child participated in focus group sessions (n=18 parent/child dyads). …

Perceptions Of Paediatric Surgeons On The Selection & Admission Processes In Master Of Paediatric Surgery : A Qualitative Study, Anand Sanmugam

Student Works (2020-2029)

The selection and intake criteria for the paediatric training surgery training program (Master of Paediatric Surgery) has undergone changes. Changes were instituted to ensure a more robust selection system to ensure that the best candidates were selected into the program. However, there has not been any data to show that these changes have resulted in selection of candidates that could graduate on time and possess the attributes that predicted the development of competencies required. The aim of this study aim was to explore the perspectives of senior paediatric surgeons on the Master of Paediatric Surgery selection and intake process. The …