Pediatric Nursing Commons^™

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 …

Neonatal Hyperbilirubinemia And Phototherapy: The Implementation Of Seminal Clinical Practice Guidelines, Christina Coleman

Dissertations

Problem: On a postpartum care and pediatric unit from February 2022 to December 2023, the average monthly percentage of neonatal patients greater than 35 weeks gestation with hyperbilirubinemia who were treated with phototherapy before it was medically supported by the current guidelines was 42.855% (N=668). The department’s goal was to decrease this number to 10%. Initiation of phototherapy with a subthreshold bilirubin level exposes many infants to an unnecessary treatment modality which can prolong the infant’s length of stay in the hospital and can be associated with adverse effects, such as maternal-infant bonding and breastfeeding rates.

Methods: The …

Pediatric Streptococcal Pharyngitis Testing And Treatment Practices, Amanda Welch

Dissertations

Objective: The purpose of this pilot quality improvement study was to implement SmartPhrases and assess its impact on adherence to the Infectious Disease Society of America (IDSA) guideline for Group A Streptococcus (GAS) pharyngitis testing and treatment in pediatric patients ages 1-16 years old. The aim was to use SmartPhrases to improve adherence with the IDSA guideline by 30% for GAS pharyngitis swabbing and 10% for appropriate antibiotic prescribing in three months.

Methods: A retrospective data analysis approach was used, in reviewing SmartPhrases data from the electronic health records (EHR) in a metropolitan Urgent Care. This data were collected from …

Implementation Of Infant Driven Feeding™ In A Level Ii Nicu, Kelly Gardner

Graduate Theses, Dissertations, and Capstones

In the United States, currently, 1 in 10 babies are born premature. Due to the immaturity of their neurological, gastrointestinal, and cardio-respiratory functions, preterm infants can experience the inability to coordinate sucking, swallowing, and breathing that is essential to oral feed. Cue-based oral feeding methods are designed to give the caregiver the ability to recognize signs of readiness and respond appropriately to the infant cues to adjust the manner in which feeding intervention is performed to match the infant’s current state of physiologic tolerance. The Infant Driven Feeding™ program incorporates scales to assess readiness and quality of the oral feeding, …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

Nicu Experiences Of Adoptive Parents & Desired Preparation, Catherine J. Howe

Graduate Theses/Dissertations

Parents who have newborns admitted into the Neonatal Intensive Care Unit (NICU) have multiple experiences and emotions. Additional social and emotional layers are experienced by adoptive couples when the infant they wish to adopt needs specialized care. This research study was completed to find out what adoptive parents experience in the NICU and what preparation would have been helpful. The method included semi-structured, open-ended interviews with seven couples who adopted a newborn at a Midwestern adoption agency within the past three years and had a NICU experience. The results described adoptive couples’ experiences on the unit, bonding and attachment, fears …

Tiny Tusks Internship: Barriers To Breastfeeding, Cameron Watson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks Breastfeeding and Infant Support Internship allows students to gain insight on breastfeeding practices through volunteering at University of Arkansas sporting events. Therefore, I chose to review prevalent barriers to breastfeeding that mothers in the United States face. These mothers were at least one of these: Hispanic, Marshallese, African American, disabled, employed, a veteran, living in a rural area, or a woman of the general American population. This topic is relevant because of the many benefits that breastfeeding provides for both the baby and the mother.

An Altitude Adjustment: Implementing A Clinical Practice Guideline In The Newborn Nursery At Moderate Altitude, Leeann Blaskowsky

Student Scholarly Projects

Practice Problem: All infants undergo many changes at birth, but for some, the transition from intrauterine to extrauterine life presents more of a challenge, especially at altitude. Despite continuing research, neonatal prescribing guidelines for oxygen therapy remain ambiguous.

PICOT: For term and late preterm infants requiring oxygen beyond transition, does a clinical practice guideline compared to practice without a guideline, provide consistent, evidence-based care, support the mother-infant dyad, and impact nursing perceptions over a six-week pilot period?

Evidence: Birth at moderate altitude presents the newly born with less oxygen than those delivered at sea level. Several studies …

Accuracy Of Rn Visual Quantification Of Emesis Volumes In The Neonatal Intensive Care Unit, Stephen Stoever

Seton Hall University DNP Final Projects

An important component of nursing assessment of feeding tolerance in the neonatal intensive care unit (NICU) for both low-risk and high-risk babies, is the quantification of emesis volumes. While some nurses attempt to weigh the items saturated in emesis in order to quantify volume loss (QEV), there is no or limited consistency in this practice across nurses in this unit. Rather, volumes are “best-guessed” or estimated (EEV) and reported to the practitioner for decision-making. Often feed advances are paused or limited due to perceived feeding intolerance connected to emesis events in neonates.

For this project, 158 NICU nurses at a …

Tiny Tusks: Breastfeeding And Infant Support Internship Review, Blair Wilhelm

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks: Breastfeeding and Infant Support is a tent and lactation room at University of Arkansas athletic events such as men's basketball and football games that allows moms that are breastfeeding a comfortable and private area. Tiny Tusks aims to empower and educate moms about the benefits of breastfeeding and decrease the stigma behind it. The tent offers comfortable chairs, a changing table, arts and crafts for younger kids and educational pamphlets and brochures. Tiny Tusks is run by certified lactation consultants, BSN honors students and Eleanor Mann School of Nursing faculty. Participants were asked to fill out a survey …

Decreasing Hospitalization In Infants, William Hang

MSN Capstone Projects

Infants are the most vulnerable population at risk for serious diseases. Respiratory syncytial virus (RSV) is a disease that can be detrimental in infants because of their immature lungs and immune system. Palivizumab, a humanized monoclonal antibody medication, given every 28-30 days has been shown to reduces RSV symptoms and decrease rates of hospitalization by 15%. By reducing the rate of hospital stay, it will also reduce cost.

Implementation Of Early Mobility In The Pediatric Cardiac Intensive Care Unit, Kelly Lubbers

Doctoral Projects

Patients admitted to pediatric intensive care units and pediatric cardiac intensive care units often experience prolonged periods of immobility due to critical illnesses and surgical interventions. Many pediatric intensive care unit survivors develop physical and developmental disabilities that have long-lasting impacts into childhood and adulthood. Early mobility may be one aspect to mitigate the risks associated with pediatric intensive care unit admissions. Early mobility protocols have shown to be a safe and feasible intervention to encourage mobility in pediatric patients. This quality improvement project developed and implemented an infant holding tool to promote the mobilization of infant patients admitted to …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …