Pediatric Nursing Commons^™

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 …

Pediatric Hospital Environments: Do They Make A Difference?, Rhyan Elliott, Barbara Mcclaskey

Posters

The environment can have an extreme impact on a child’s well-being, growth and health. This should be taken into consideration especially for those children that are surrounded by a hospital environment. The healthcare system can come across as extremely intimidating and frightening to young patients. The purpose of his research study is to change this mind-set by creating a more welcoming atmosphere through child-friendly interventions such as magic, colorful art, and nature. By conducting interviews with the children of these hospitals and using visual and exploratory techniques, the essence of what keeps a child’s spirit alive can be captured to …

Autism Screening Knowledge And Practice In Southeast Kansas, Briana Laforge, Ashleigh Heter, Janis Schiefelbein, Ananda Jayawardhana

Posters

Autism spectrum disorder (ASD) is classified as a neurodevelopmental disorder characterized by delays in social communication and interaction as well as restricted repetitive behaviors, interest, and activities. According to the most recent reports from the CDC, it is estimated that 1 in 68 children are diagnosed with some form of ASD in the United States. Research has shown that early identification and intervention can significantly improve out­comes in those individuals diagnosed. As a result of this research, the American Academy of Pediatrics (AAP) has recommended routine screening on all children for ASD at the age of 18 months and again …

Pediatric Patients With Diabetes Transition To Adult Care, Sara Jennings

Doctoral Projects

The purpose of this study was to identify the optimal age to target transition to adult care education for adolescent and young adults (AYA) with Type 1 and Type 2 Diabetes Mellitus (DM) as they transition from pediatric endocrinology providers to adult DM providers. A secondary purpose of this study was to identify if there was a relationship between attendance rate, age, gender, years diagnosed with DM, ethnicity, insurance type, Type of DM, and current county of residence with control of diabetes, measured by glycosylated hemoglobin (HgbA1c). A quantitative study through chart audits was conducted at Valley Children’s Healthcare, VCH, …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

Evaluation Of Patient Throughput In An Outpatient Pediatric Hematology, Oncology, And Bone Marrow Transplant Clinic, Samantha Depadova Msn, Rn, Anp-C, Ocn

Doctor of Nursing Practice Projects

Background: Outpatient oncology clinics are complex environments. The multi-step, sequential nature of oncology treatment contributes to delays. Prolonged wait time impacts patient compliance, satisfaction, and staff satisfaction.

Objectives: To assess throughput in the outpatient pediatric oncology clinic and explore staff’s assessment of throughput and their opinions of what might be improved.

Methods: Our descriptive-comparative study used retrospective reviews to measure four time intervals for 312 visits at our mid-Atlantic outpatient clinic. Patient and appointment factors were explored. Mean interval times were calculated and differences impacting throughput were analyzed using ANOVA. Prospective survey data were obtained from 22 clinic staff …

Improving Communication Of Asthma Related Care Between Pediatric Primary Care Providers And Schools, Jessica N. Heichel

Doctoral Projects

Introduction: Asthma is a life-altering chronic disease that affects many children throughout the state of Michigan. Evidence-based guidelines recommend a written asthma action plan (AAP) be given to all caregivers of children with asthma. This would include schools, but the plans are not making it there. This project focused on collecting school asthma data and designing a process change at a local clinic to send the plans directly to the schools.

Objectives: The goal of this project was to improve communication between healthcare providers and schools for children with asthma. The objectives were to increase the percentage of children with …

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

Final Defense: Sepsis Screening Tool Assessment At A Freestanding Children’S Hospital In The Midwest, Cassandra Cummings

Doctoral Projects

Pediatric sepsis is a major contributor to childhood morbidity and mortality. Tools for predicting sepsis in pediatric patients have had poor predictive ability nor been validated. Risk assessment screening tools are effective at earlier detection of sepsis. The implementation of an evidence-based pediatric sepsis screening tool could reduce time to detect and diagnose severe sepsis so that patient treatment could occur earlier. This was a quality improvement project that evaluated a sepsis screening tool predictive validity at a children’s hospital.

Implementation Of The Vaccines For Children Program In A Midwest, Urban Clinic Dedicated To The Underserved Population, Akmal Saydazamov

Doctoral Projects

Background: Low immunization rates weaken herd immunity and endanger children. The Safety Net Health Clinic (SNHC) study site serves an underprivileged and refugee population with significantly lower than ideal coverage. Series completion disparities persisted after control for demographic, access-to-care, poverty and language effects (Varan et al, 2016).

Objectives: SNHC implemented the Vaccines for Children (VFC) program in order to increase the vaccination rates among the underserved population.

Methods: As an efficacy study, the project focused on three major areas in the VFC implementation – cost, staff preparedness and patient need. Cost was determined by utilizing electronic medical records (EMR) and …

Halting Hyperbilirubinemia: Creating A Pathway To Success, Nicole C. Dalessio Bsn, Rn, Cpn, Ashley M. Divincenzo Bsn, Rn, Cpn, Kendra J. Savage Bsn, Rn, Cpn, Samantha Steich Bsn, Rn, Cpn

Patient Care Services / Nursing

No abstract provided.

In Situ Pediatric Mock Codes: The First Five Minutes, Josephine N. Ruiz

Doctoral Projects

The purpose of this quality improvement project was to use in situ simulation-based mock codes to evaluate the effectiveness of participants’ actions and perceived confidence, and to potentially reinforce and improve knowledge retention, skill acquisition, and confidence levels of nursing staff with regards to pediatric emergencies. Simulated drills were evaluated with a tool focused on high-performance teams and team dynamics as outlined by American Heart Association Pediatric Advanced Life Support 2016. Twenty-four simulated drills were conducted from January to February 2019. Each hour-long session was composed of pre-briefing, simulated drill or scenario, and debriefing and took place in empty patient …

Using The Qsat To Generate Multi-Source Feedback On An In-Situ Pediatric Simulation Case, Michael C. Nguyen Md, Nicole Elliott Do, Michael R. Jong Md, Msc, Suzanne S. Puentes Bsn, Ccrn, Rn, Diane Begany Md, Matthew D. Cook Do, Louis Morolla Do, Zachary Matuzsan Do, Jennifer E. Macfarlan Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Risk Factors For Vte In Orthopedic Surgery, Kellie Musick

Nurse Presentations

Describes a project to halt the rising incidence of venous thromboembolism in pediatric surgery patients and the underuse of sequential compression devices in the operating room.

Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, Mckenna Scharlau, Jacob Schneider

Nurse Presentations

Describes a project to improve use of the Sepsis Tool in the Emergency Department and to improve documentation of blood pressure measurements in high risk sepsis patients under three years of age.

Vte Risk Factors: Scd Education And Compliance, Kaly Hayden, Shari Gardner, Baleigh Haag, Alex Wofford

Nurse Presentations

Describes a project to increase the use of sequential compression devices in post-operative patients to prevent venous thromboembolism.

Minimizing Unplanned Extubations In The Intensive Care Nursery, Lindsay Barrosse, Blaire Collins, Cassidy Horton, Jodie Seitzer, Brittney Hunter, Jenny Mckee

Nurse Presentations

Describes a project to ensure compliance with a standardized process for endotracheal tube management in the intensive care nursery in order to reduce the number of unplanned extubations and their consequent adverse effects.

In The Pocket With Kangaroo Education, Brett Butler, Carly Creekmore, Skylar Suppes

Nurse Presentations

Describes a quality improvement project to deliver timely kangaroo care education that empowers parents.

Timely Interventions In Patients Developing Sepsis Within The Picu, Lindsey Bloom, Ashley Bramel, Kelsey Cumpton, Christopher Damrat, Emily Lingo, Grace Sexton, Breton Struble

Nurse Presentations

Describes a project to increase the number of sepsis interventions completed within one hour in the pediatric intensive care unit, and to improve the documentation (COW Cards) of rapid interventions.

Sepsis: Identification & Recognition, Shelbi Ethington, Lakisha Irwin, Jodi Cramer, Victoria Roell, Mindy Von Elling

Nurse Presentations

Describes educational interventions to increase confidence of pediatric nurses on a medical/surgical unit in their recognition and treatment of sepsis.

Breathe In Breathe Out...Now What? Improved Pediatric Asthma Outcomes Through Improved Inhaler Technique, Gina M. Nickels-Nelson

DNP Final Reports

Asthma is a chronic disease affecting families in the United States; especially pediatric patients aged 5-18. In Pittsfield, Massachusetts the local prevalence of asthma is 14.4% versus 12.1% statewide and 8.4% nationally. These patients miss school days thus causing parental workday loss. In 2016, 14.4 million missed school days occurred due to asthma (Alexander et al., 2016). Unexpected clinic visits, as well as emergency room visits due to asthma, can contribute to rising healthcare costs both locally and nationally. Unexpected asthma visits are a leading reason for visits to this author’s clinic.

Asthma is treated with inhaled medications through a …

Adolescent Substance Abuse Patients Within The Therapeutic Alliance: An Integrative Literature Review, Emily Decker

Grace Peterson Nursing Research Colloquium

Background: Adolescent patients with substance use disorders (SUD) struggle with seeking treatment, staying motivated during treatment, and are at a higher risk of relapse following treatment compared with other SUD patients. A positive therapeutic alliance between provider and patient has been shown to positively affect treatment outcomes. Therefore, describing interpersonal patient traits which influence this alliance is integral to keeping patients in treatment and preventing relapse post-treatment.

Objectives: The purpose of this integrative review was to identify interpersonal characteristics of adolescent patients with a substance use disorder which can significantly influence their therapeutic alliance with the provider, ultimately leading to …

The Association Between Electronic Cigarettes And Traditional Cigarettes In The Youth: An Integrative Literature Review, Anam Hussain

Grace Peterson Nursing Research Colloquium

Abstract

Background: Electronic cigarettes or e-cigarettes are seen as a “healthy” alternative in comparison to traditional cigarettes. However, the increased use of e-cigarettes as a new trend among the youth, may serve as a gateway to traditional cigarette use.

Objective: The integrative literature review aimed to provide a comprehensive review of current research on the association of e-cigarettes with the use of traditional cigarettes in the youth.

Method: An integrative literature review was used to examine and summarize previous research on the correlation between the use of electronic cigarettes and traditional cigarette in the youth population.

Findings/Results: The analysis revealed …

The Role Of Nurses In The Care Of Children & Adolescents With Type One Diabetes, Lauren Francis

Grace Peterson Nursing Research Colloquium

Abstract

Background: Type one diabetes is a leading chronic illness among children within the United States. The risk of complications is high, and with adequate care, these can be prevented. Current research indicates that the support, education and care that nurses give are vital to these patients’ outcomes and their families. By gaining a comprehensive look into the care that nurses provide, the art of nursing science can gain a new dimension in how to better care for these patients.

Objectives: The aim of this literature review is to analyze current research in order to better understand the various roles …