Pediatric Nursing Commons^™

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Implementation Of A Code Lobby Surge And The Impact On Left Without Being Seen Rates, Nicole Plouffe

Student Scholarly Projects

Practice Problem: Crowding of emergency departments contribute to higher-than-average left without being seen (LWBS) rates. LWBS patients pose risks to the hospital as well as to one’s own health.

PICOT: The PICOT question that guided this project was in a pediatric emergency department (P), does implementation of a “Code Lobby Surge” (I), compared to standard care (C), decrease left without being seen rates (O) within eight weeks (T)?

Evidence: Surge interventions and decreasing the visual of crowding have shown to decrease LWBS rates.

Intervention: “Code Lobby Surge” was implemented to decrease LWBS rates and improve throughput within the …

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

Virtual Reality Pain Intervention For Pediatric Burn Patients, Tanya Ann Hinrichs

Theses and Graduate Projects

Burns can be devasting trauma in the pediatric population, leading to lifelong physical and psychological pain and anxiety. Burn pain management is complicated and undertreated traditionally. The purpose of this scholarly project is to examine the use of virtual reality (VR) for distraction in pediatric patients who have experienced a burn to determine if VR improves pain management during painful procedures. A literature review revealed a gap in pain management in pediatric burn survivors with just traditional pharmacologic analgesia during painful procedures. Leininger’s Culture Care Theory provides a theoretical framework for this project’s purpose to determine if implementing a virtual …

Using Family Focused-Care Solutions To Improve Child’S Quality Of Life, Joshua M. Del Sol

Nursing | Senior Theses

Chronic illness in children impacts not only themselves but their families too. Everyone in the family supports each other and provides each other with pretty much all our physiological needs including our emotional needs. Parents/caregivers are the role models for their young children and really shape the person they become because basic values and their early relationships are formed. A family provides that consistent balance in our life that is the center of our life at a young age. When children are diagnosed with a chronic illness, parents may feel responsible, ashamed, guilty, or angry. Families may turn on each …

Assessing And Improving Pediatric Nurses' Documentation Of Childhood Immunization Status Using The Electronic Health Record, Katherine Engalichev

Master's Theses and Capstones

BACKGROUND: Adherence to the standardized childhood immunization schedule put forth by the American Academy of Pediatrics is the gold standard for decreasing vaccine-preventable disease morbidity. The first step to improving adherence with the recommended immunization schedule is identifying children who are under-immunized. The inpatient setting offers an opportunity to screen pediatric patients for immunization status. A survey was administered to nurses working on an inpatient pediatric unit to gauge nurse self-report of Cerner™ Electronic Health Record (EHR) use for immunization documentation, their perceptions regarding EHR ease of use for documenting pediatric immunization status, attitudes towards documenting immunization status, and perceived …

Evaluation Of Universal Depression Screening In A Pediatric Diabetes Outpatient Clinic With The Integration Of A Depression Screening Tool Into An Electronic Health Record, Jenna Westberry

DNP Projects

Background: Depression is a significant problem for adolescents with chronic health conditions. Prevalence rates are two to three times higher in adolescents with diabetes compared to adolescents without diabetes (Badescu et al., 2016). Routine depression screening is not transpiring at rates and frequency recommended by the American Diabetes Association for this population. Implementing use of the Patient Health Questionnaire for all adolescents over the age of twelve years with Type 1 & Type 2 Diabetes Mellitus during routine health visits may improve early identification and diagnosis of depression and improve long-term health outcomes.

Purpose: The goal of this project was …

Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton

DNP Projects

Abstract

Background/Purpose

Conversations between care providers and patients are integral to medicine and are the most performed “procedure” (Luff et al., 2016). In Pediatric Intensive Care Units (PICUs) and Pediatric Cardiac Intensive Care Units (PCICUs), children of all ages with diverse diagnoses and needs are treated for critical illnesses and traumatic events. Therefore, providers frequently have difficult conversations with patients and their families. Pediatric critical care nurses are often invited to participate in these discussions. However, their role during, and after, these conversations is not always clear. The goal of this project was to evaluate the impact of an educational …

Evaluation Of Pharmaceutically Compounded Oral Caffeine On The Impact Of Medication Adherence And Risk Of Readmission Among Preterm Neonates: A Single-Center Quasi-Experimental Study, Gul Ambreen, Manoj Kumar, Amin Ali, Syed Akbar Ali Shah, Syed Muzaffar Saleem, Ayesha Tahir, Muhammad Sohail Salat, Muhammad Shahzad Aslam, Kashif Hussain

Department of Biological & Biomedical Sciences

Background: Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates.
Methods: We conducted a single-center quasi-experimental study for this quality …

Children’S Experiences Of Hospitalization Over Time: An Evaluation Of Using Poetry And Creative Writing By Children To Assess Their Experiences Of Hospitalization, David Wood

Patient Experience Journal

This article explores children’s experiences of hospital admissions through their poetry and creative writing and assesses the validity of this medium compared to other methods of evaluation. Pediatric patient experiences of hospital and their effects on children have been studied in various ways and there have been stepwise changes throughout the past century, matching the overall changes of medical care from paternalistic to patient centered. 17 poems were analyzed from children aged 6-13 years old (median 10) for recurrent themes whilst admitted to a large tertiary hospital in the north of England. Children frequently wrote about attacks on their senses, …

Screening For Social Determinants Of Health In A Comprehensive Pediatric Sickle Cell Disease Clinic, Marie Turner

Dissertations

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.

Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized …

Alleviation Of Atopic Dermatitis Symptoms By Implementation Of Standard And Alternative Treatments, Nika Sayvongsa

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Atopic Dermatitis (AD) is a chronic dermatological disease caused by a combination of hereditary and environmental factors. This is a common condition that is primarily diagnosed among children, but can persist throughout adulthood. Twenty peer-reviewed articles are analyzed in this expanded literature review. Various methods were implemented throughout these studies, including randomized, double-blind, placebo-controlled, and single-blind studies; all of the studies shared the objective of evaluating AD alleviation with the use of either standard treatment modalities or alternative/ complementary therapies.

Implementation Of An Adhd Electronic Portal In Pediatric Primary Care, Heather Cathey

Epsilon Sigma at-Large Research Conference

Clinical practice guidelines (CPGs) for Attention Deficit Hyperactivity Disorder (ADHD) recommend documentation of symptom scales and comorbidity screenings at the time of diagnosis and routinely throughout care. Rates of documentation for these tools in pediatric primary care are consistently low, creating a gap in care that impairs diagnosis, management, and patient outcomes. The purpose of this quality improvement project was to implement an online ADHD portal that emails, collects and scores these tools. The aims of the project are to improve utilization of CPGs by increasing documentation rates of symptom scales and comorbidity screenings for pediatric patients with ADHD. One …

Pediatric Depression, Emily Farkas

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background

Many people in the pediatric population are be brushed off and misdiagnosed when it comes to depression. I decided to research into pediatric depression and how the effects of their peers, parents, and exposure to violence correspond with depression and how it effects their daily life.

Purpose Statement

The purpose of this literature review is to systematically and critically appraise current literature to examine the associations between pediatric depression and sleep issues, exposure to violence, peer relationships, and parental criticism.

Literature Review

For this literature review I gathered a total of 5 articles which are included …

Best Practices For The Prevention And Treatment Of Microcytic Hypochromic Anemia In Infancy, Janelle Paredes

Nursing | Senior Theses

Background: Microcytic hypochromic anemia is the most common nutritional deficiency in the world. This type of anemia is commonly found during infancy due to the lack of iron-fortified foods after six months of age. The effects linked to this deficiency can cause developmental delays and behavioral disturbances in infants if not treated immediately. Therefore, it is important for nurses to find the best practices to prevent microcytic hypochromic anemia to decrease its prevalence in infancy.

Objective: To find the best nursing practices for the prevention and treatment of microcytic hypochromic anemia in infancy.

Methods: This research will utilize …

Experience Of Parents Caring For A Child With An Acquired Disability, Brad E. Phillips

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Parents caring for a child with an acquired disability often report a negative impact on physical, psychological, emotional, and spiritual health associated with caregiver burden related to their child’s complex health needs. This is further complicated by additional challenges related to the loss of a previously healthy child. Traditional patterns of loss follow linear, time-bound stages that have been observed to be unrelated to the experiences of these specific parents and their families. Therefore, the concept transforming loss has been developed to better understand how these parents navigate loss and find meaning in spite of their suffering.

Purpose: The …

Evaluating The Feasibility Of A Collaborative Care Clinical Pathway For The Treatment Of Adolescent Depression And Anxiety In Rural Pediatric Primary Care, Kayla R. Watson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Evaluating the Feasibility of a Collaborative Care Clinical Pathway for the Treatment of Adolescent Depression and Anxiety in Rural Pediatric Primary Care

Kayla Watson

Background: Due to a national shortage of Child and Adolescent Psychiatrists (CAP), Primary Care Providers (PCP) are often required to manage patients with mental health disorders despite a lack of focused training and lower self-efficacy or confidence in the management of these disorders. Referral to CAPs for management following the diagnosis of adolescent depression and anxiety is a common practice. The integration of mental health services within the primary care setting can overcome many of these …

Employee Engagement And Increasing Patient Satisfaction In The Pediatric Outpatient Setting, Carol Liang

Master's Projects and Capstones

Problem: An ambulatory pediatric surgical center in the San Francisco Bay Area has an organizational goal of reaching the 85th percentile in NRC patient satisfaction scores. The annual compliance report states the current score is at 80.7 as of September 2021. These NRC findings indicate several areas for improvement including: (1) trust providers with care, (2) care providers listened, (3) was told when could leave, (4) got help as soon as wanted, (5) care provider explain things, (6) NPS: facility would recommend, and (7) procedure began on time.

Context: Priorities include implementing strategies to increase employee engagement and patient satisfaction. …

The Influence Of Gender Bias On Male Nurses And Nursing Students In The Obstetric, Maternal, And Pediatric Nursing Profession., Julian Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review analyzes if gender bias influences the disproportionate number of male nurses and male nursing students in the pediatric, maternal, and obstetric nursing fields as compared to nursing as a whole. PubMed and CINAHL databases were utilized to find 15 research articles focused on the experiences of male nurses and male nursing students. These articles were compared amongst each other to find common themes of the male experience in the nursing fields of pediatrics, maternity, and obstetrics. The three common themes found were 1) Men tend to encounter situations where their professionalism will be monitored more closely when …

Leadership Rounding To Improve Patient Satisfaction In Pediatric Ambulatory Care, Tara J. Haskell

Student Scholarly Projects

Practice Problem: Low patient satisfaction has been linked to poor treatment compliance, patients leaving the practice, staff decreased job satisfaction, and high staff turnover (Haskard Zolnierek & DiMatteo, 2009; Prakash, 2010). Magnet reporting has identified wide discrepancies in ambulatory clinics, with some clinics reporting below benchmark patient satisfaction ratings.

PICOT: In pediatric ambulatory and primary care services, how will the implementation of leader-led customer service rounding, compared to current practice, increase family and/or patient satisfaction over 4 weeks?

Evidence: Key findings are that the rounding needs to be population-specific, intentional, and swiftly followed up when problems are identified. The body …

A Safety Net: Early Assessment Of Multiple Social Determinants Of Health Risk Factors In The Pediatric Inpatient Population, Emily Caroline Brister

Doctoral Projects

A lack of protocol for screening of social determinants of health (SDH), specifically for pediatric patients, despite national endorsement, is setting a basis for increased rates of negative health outcomes that can follow individuals into adulthood. The PRAPARE tool, or the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences, is a guided national effort to assist healthcare centers in the collection of the necessary social data required to care for patients and act upon their social determinants of health (The National Association of Community Health Centers [NACHC], 2019). This project acted to identify if the early assessment …

Evaluation Of A Dirfloortime® Program For Autism Spectrum Disorder, Jennifer L. Pipitone

Dissertations

Problem. Parents with children who have neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) experience high levels of parenting stress. The prevalence of ASD is on the rise in the United States. As a result, there has been an increase in the use of treatment modalities, in effort to better understand which modalities have the most positive impact on children and their parents. DIRFloortime® is a developmental treatment modality used to help strengthen the parent-child bond and used to decrease parental-child stress. The Autism Parenting Stress Index (APSI) measures the impact of an intervention …

Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel

Doctor of Nursing Practice Final Manuscripts

Abstract

Background

Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.

Methods:

Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …

Optimizing Mri Experience For Children Living With Autism Spectrum Disorder, Lyn Tran

Master's Theses

Magnetic Resonance Imaging (MRI) in pediatric patients living with Autism Spectrum Disorder (ASD) is often complicated by challenges. The child perceives the MRI environment as abnormal and uncertain of the implications of the procedure. The child may exhibit distress becoming anxious and frightened, reluctant to enter the scanner, and unable to remain still throughout the duration of the procedure. The issue lies within the child’s mental and behavioral challenges to understand and follow the task demands to ensure safety and accurate acquisition of image artifacts. After reviewing literature, observing MRI protocol for pediatric patients, and conducting multiple nursing staff surveys …

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

A Practice Innovation To Improve Staff Vaccination Knowledge And Skills, Ijeoma Ugochukwu

Nursing Posters

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and …

Pediatric Emergency Department Nurse’S Knowledge And Attitudes Of Pediatric Fluid Resuscitation, Tannah Kimberly O'Brien, Kerry Nolte Phd, Fnp-C, Denise Downey Msn, Rn-Bc, Cpen, Debra Lajoie Jd, Phd, Msn, Rn, Esq., Allison Ivers Msn, Rn, Cnl, Kathleen Sultan Bsn, Rn, Cpen

Honors Theses and Capstones

Background: Rapid fluid resuscitation is essential to the management of pediatric shock, but there are many barriers to published guideline adherence. Limited evidence describing emergency department (ED) nurse’s knowledge and attitudes of fluid resuscitation exists. This study described pediatric ED nurse’s knowledge and attitudes of fluid resuscitation.

Methods: This single-site descriptive study used survey methodology. A 23-question survey was distributed to nurses in the ED at Boston Children’s Hospital. The survey measured nurse’s knowledge, attitudes, and perceived barriers to fluid resuscitation.

Results: Findings suggested gaps found between actual and perceived knowledge consistent with prior evidence. There was a 50.9% response …

Childhood Anxiety, Cognitive Behavioral Therapy And/Or Pharmacological Treatment, Jennifer S. Mccarthy

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: Evaluate best practice in managing anxiety in the pediatric population, including both school age children and adolescents. This literature review compared pharmacological treatment and cognitive behavioral therapy (CBT)’s effectiveness on the management of anxiety within the pediatric population.

Background: Up to 25% of children in the United States are affected by a mental health disorder, anxiety being the most prevalent. Childhood anxiety can have a distressing impact on social, family, and academic functioning. If persisting into adulthood it increases the risk of developing other co-occurring mental health conditions, substance abuse issues, and contributes to impaired employment retention and socioeconomic …

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. …