Pediatric Nursing Commons^™

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Evaluation Of A Nicotine Prevention Program In A Third Grade Classroom, Jennifer A. Pile

DNP Projects

Purpose: The purpose of this project was to increase knowledge of nicotine products and promote negative perceptions of nicotine use among third-grade students through early prevention education.

Background: Prevention is key and to prevent nicotine use, there must be an educational program with that aim in a much younger population. Third grade encompasses 8-, 9-, and 10-year-olds. This group is in the middle childhood stage and begin more complex thinking and problem-solving skills. There is physical and emotional development among this group.

Methods: This is a quasi-experimental study among third grade students in Breckinridge County Kentucky with pretest and …

Prevention Of Burnout Among Critical Care Nurses, Jenelle Balaoing, Junela Bautista

Nursing | Student Research Posters

Background: Nursing burnout is a state of mental and physical exhaustion caused by excessive stress among nurses. Critical care nurses face challenges with direct patient care that contribute to emotional and psychological strain that are greatly influenced by workplace adversity and emotional management. Purpose: This research examines the prevalence of burnout among pediatric and adult intensive care unit (ICU) nurses, highlighting particularly high rates of burnout among those with extended years of service. Method: ICU nurses will participate in a qualitative interview that involves open ended questions relevant among burnout and resilience during shifts. Aspects specifically years of critical experience …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

The Impact Of Hourly Safety Rounding On Pediatric Fall Rates, Natalie Doskal-Poe

Dissertations

The Impact of Hourly Safety Rounding on Pediatric Fall Rates

Abstract

Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Senior Theses

Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child within …

Pediatric Obesity In Primary Care, Lynne C. Liggins

Electronic Theses and Dissertations

The purpose of this evidence-based quantitative quasi-experimental research was to compare if providing the parents with information on the health risk associated with childhood obesity would cause the parents to make healthier food choices and encourage their children to be involved in a full hour of physical activity a day. Participants included parents and pediatric and adolescent children 5 to 18 years of age at a solo practice primary care office in a large city in Southern, California, which specializes in treating pediatric and adolescent patients. A pre- and postquantitative intervention design were used and analyzed using the paired t …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Reducing Catheter-Associated Urinary Tract Infections In The Pediatric Intensive Care Unit, Maria Smith

Dissertations

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC).

Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything …

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 …

Prevention Of Abusive Head Trauma Using An Educational Program For Parents/Caregivers, Camile Williams

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The National Center on Shaken Baby Syndrome reports that 1,300 abusive head trauma (AHT) cases occur in the USA each year, a quarter of which are fatal. Injuries are caused by impact, shaking, or both and result in intracranial and spinal damage, retinal hemorrhages, fractures of the ribs and other bones. AHT case rates in the community involved in this project had a 22% increase of AHT from 2018 to 2019.

Context: A practice improvement project involved the implementation of an AHT educational program targeted at parents/caregiversreceiving care services at a children’s hospital pediatric well-child clinic located in …

Determining The Knowledge And Practices Of Obstetrics Healthcare Professionals Regarding Maternal Intrapartum Pertussis Vaccination Administration, Kristie Mattix

Doctor of Nursing Practice Scholarly Project

Pertussis is a contagious respiratory disease that can occur in all age groups. Signs and symptoms of pertussis, however, are worse in infants and young children; likewise, the rates of severe cases, hospitalizations, and deaths are higher in this group as well. Vaccination against pertussis is the most effective way to combat this illness. In the last 15 years, there have been a number of changes in the recommendations regarding vaccination against pertussis. In order for these recommendations to be followed, healthcare professionals must be aware of the guidelines as well as be knowledgeable about the condition they are trying …

Managing Childhood Obesity In A Primary Care Clinic, Linda Nnajiofor

Doctor of Nursing Practice

Background: Childhood obesity and overweight have increased health burdens on health care systems, and contribute to chronic diseases such as diabetes, heart disease, asthma, and cancer. Childhood obesity is very complex for healthcare providers to manage in primary care settings.

Purpose: To improve childhood overweight and obesity approach and management in a selected primary care practice (Clinic A) in a large east Texas urban community.

Objectives: 1. Increase the percentage of children and adolescents ages 2 to 19 years seen in Clinic A, who received adequate weight management and obesity counseling, to 75%. 2. Increase the number of referrals to …

Evidence-Based Skin Champion Program Reduces Pressure Injuries In A Pediatric Hospital, Alexandra Luton Mn, Rn, Ncns-Bc, Mary D. Gordon Phd, Rn, Cns-Bc, Megnon Stewart Msn, Rn, Ellena Steward-Scott Msn, Rn, Joellan Mullen Msn, Rn, Ccrn-K, Angela Jones Mn, Rn, Ne-Bc, Joseph Hagan Scd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Prevention of pressure injuries (PIs) in pediatric patients is an important nurse-sensitive quality goal. The PI rate at a large urban pediatric hospital triggered a call to action by the Chief Nursing Officer to establish a Hospital Acquired PI (HAPI) Task Force which identified the Skin Champion program as a key improvement strategy. The goals of the Skin Champion program are to lower the rate of HAPIs, empower front line care providers to implement evidence-based care bundles, achieve consistency of practice, and provide resource availability at the point of care. The implementation of the Skin Champion quality improvement program achieved …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

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 …

Coping Mechanisms Of Children With Atopic Dermatitis, Whitney A. St. Mary

Honors Theses

This was a qualitative study that explored the lived experience of parents who had children with atopic dermatitis, otherwise known as eczema. The study had seven volunteer participants and the objective of this study was to determine any coping mechanisms used to overcome the negative aspects of atopic dermatitis. Volunteers were obtained from the Oak Grove Family Clinic. Phone interviews were then conducted and the participants were asked a series of eight questions. After the interviews concluded the researcher then transcribed the interviews and determined common themes from parents’ responses. All of the parents discussed how using unscented lotion, preventing …

Outpatient Medication Error Improvement, Savannah M. Klinginsmith

Master's Projects and Capstones

Patient Safety Initiative -Improving Medication Administration (Outpatient Care)

SPECIFIC AIM: We aim to Improve the medication administration process and involve all staff within 6 months

In the microsystem consisting of 14 family practice and urgent care clinics, there is not a standard process based on evidence based practices for medication administration. With and estimated of 400-600 medications (immunizations included) being administered per day, without a standard of care protocol, the risk for medication errors is evident.

Objectives and changes anticipated based on implementation of the project is to engage staff in support for improving medication administration standard of care based …

Prevention, Recognition, And Treatment Of Pediatric Obesity In The Ambulatory Care Setting, Susan Farrus-Brown

Doctor of Nursing Practice Scholarly Projects

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a “global epidemic.” The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases.

The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) …

Implementation Of A Prone Position Pressure Injury Prevention Bundle In The Picu, Lauren Hacker

Dissertations

Pronation is a low cost, high value intervention used in treating children and adults with Acute respiratory distress syndrome (ARDS). Hospital-acquired pressure injury is the most common complication of pronation. While the presence of PI bundles and protocols have been shown to reduce incidence of PI in the prone position there is no standard bundle or protocol found in the literature, and no bundle or protocol specific to pediatric patients. The purpose of this quality improvement project is to create and implement a prone position pressure injury prevention bundle, called “Prone Pack”. This QI project setting was a 40 bed …