Pediatric Nursing Commons^™

Pediatric Delirium: Development Of A Standard Of Practice In A Cvicu And Picu Setting, Frances Gililand

DNP Projects

Pediatric delirium remains a significant cause of morbidity in pediatric critical care resulting in longer lengths of stay and increased healthcare costs that may extend beyond critical illness. Prevalence rates of pediatric delirium in pediatric intensive care settings are 20%. Not all children’s hospitals regularly assess for pediatric delirium. At the time of this project, the assessment of pediatric delirium was not a standard of practice at John Hopkins All Children’s Hospital (JHACH). Examining provider’s experience, knowledge and self-efficacy of pediatric delirium was the primary aim of this project. The secondary aim was to use information obtained through the first …

Impact Of Education On Provider Knowledge And Screening Practices Related To Childhood Obesity, Natalie B. Fulk

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of a provider education program on BMI screening practices and provider knowledge related to childhood obesity by implementing an educational intervention to advanced practice providers in a primary care clinic setting.

METHODS: A pretest/posttest design was used to examine changes in provider knowledge about BMI screening practices in children and adolescents, and lifestyle recommendations after a brief educational intervention was provided. A retrospective chart review was used to assess the screening and management practices for an elevated BMI percentile and provider documentation of lifestyle recommendations.

RESULTS: A total of …

Pilot Of An Educational Module For An Adolescent Congenital Heart Transition Program In The Pediatric Setting, Katie J. Dust

DNP Projects

Abstract

PURPOSE:The purpose of this project was to pilot an educational module on a new congenital heart transition program to be instituted at a large Midwest medical system.The transition program is meant to assist pediatric cardiology patients in transferring from pediatric to adult care. An educational module was developed for inpatient health disciplines who will be involved in the transition program. Before offering the program throughout the medical system, a pilot was conducted to determine if the education was at the appropriate level. The educational module was modeled after the Got Transition Six Core Elements designed by the National Health …

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Dyslipidemia Screening In Children Between The Ages Of 9 And 11 Years: An Evidence-Based Approach, Meredith Toms

DNP Projects

PURPOSE: The purpose of this study is to examine the outcome of healthcare provider education on the incidence of dyslipidemia screening in a pediatric primary care clinic.

METHODS: The design of this study was a descriptive pre and post design to evaluate if dyslipidemia screening rates, knowledge, and self-efficacy of healthcare providers changed following an education series at a general pediatric clinic in Lexington, KY. The rates of dyslipidemia screening were calculated prior to providing provider education as well as afterwards to see whether there was an improvement in screening rates. Provider’s knowledge and confidence before the education series was …

An Examination Of Primary Care Providers’ Assessment And Plan Of Care For Children And Adolescents Who Are Overweight Or Obese, Kevin Pinto

DNP Projects

Background: Childhood and adolescent obesity rates have more than tripled since the 1970s. Currently in the United States, one in five children is obese (6-19 years of age). It is important to identify children and adolescents who are overweight or obese because early intervention may help to reduce the long-term implications of obesity. The purpose of this project was to examine how often pediatric primary care providers diagnosed overweight or obesity and created a plan of care for children 6-17 years of age who were overweight or obese. Facilitators and barriers to diagnosing and creating a plan of care were …

Evaluation Of The Crafft Substance Use Screening Tool In Primary Care, Leanne Coleman

DNP Projects

PURPOSE: The purpose of this research study was to evaluate the use of the CRAFFT tool within a pediatric primary care setting. The specific objective was to assess the frequency of documentation of substance use screening, counseling, and/or intervention before and after the implementation of the CRAFFT tool.

METHOD: The practice site chose to implement an evidence based adolescent substance use screening tool (CRAFFT Tool) to improve practice. This practice improvement project utilized a descriptive design with a review of electronic medical records before and after a substance use screening tool was implemented. Two hundred medical records were reviewed, 100 …

Perceptions Of Pediatric Hospital Safety Culture In The U.S.: A Secondary Data Analysis Of The 2016 Hospital Survey On Patient Safety Culture, Pamela J. Gampetro

Dissertations

This study explored differences in conceptualizing safety cultures in pediatric hospitals and specialty units from an interprofessional perspective on a national level. Errors in the pediatric population can quickly cause harm and frequently lead to adverse events (AEs). Research has explored the problems of patient harm and identified strategies to prevent those harms; but sustainable improvements, particularly in pediatric settings, have not been achieved. This cross-sectional descriptive study used national data from the Hospital Survey on Patient Safety Culture's 2016 dataset developed by the Agency for Healthcare Research and Quality measuring 12 dimensions of safety culture. The extracted sample included …

Using Social Narratives To Improve The Healthcare Experiences Of Children Diagnosed With Autism Spectrum Disorder, Margaret Spindel

Senior Honors Projects, 2010-2019

Children with Autism Spectrum Disorder (ASD) often experience significant emotional stress when they visit a healthcare provider. The focus of this research project was to explore the use of social narratives to help reduce stress associated with this environment. Social narratives are short stories designed to walk a child through a potential situation that they will encounter, that they may not be familiar with, or that they are not currently handling properly. As part of an initial literature review, evidence for the need for additional intervention in the healthcare setting for children with ASD was established. Continuing literature review then …

Improving Nursing Adherence To Pediatric Pain Management Bundle Using The Pdsa Cycle, Stephen W. Lovern

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Given the current standards, pediatric post-operative pain management can be a distressing outcome to the patient and family. Adequate management of post-op pain in this population is a challenge despite the availability of evidence-based interventions combined to form care bundles. Tonsillectomies are common procedures in the pediatric population and often include moderate to severe pain with ineffective pain relief. Inadequate pain management leads to unplanned admissions, longer post anesthesia care unit (PACU) stays, slower oral intake, and longer recovery periods. In this project, two interventions were tested using the plan-do-study-act (PDSA) model for rapid cycle improvements. The first intervention was …

The Lived Experiences Of Parents With Chronic Sorrow Who Are Caring For Children With A Chronic Medical Condition, Lori L. Batchelor

Nursing Theses and Dissertations

Caring for the millions of children living with a chronic medical condition creates multiple parental burdens. Parents whose children have a diagnosis of a chronic medical condition may experience an ongoing, unresolved grief or sadness phenomenon known as chronic sorrow. This may impact parental ability to manage their child’s health care needs and may lead to negative health outcomes for the parent caregiver, affected child, and the family.

The aim of this interpretive phenomenological study was to understand the nature and meaning of the lived experiences of parents with chronic sorrow who are caring for a child with a chronic …

Improving Hpv Vaccination Series Initiation Rates And Compliance Among Indigent Women In South Texas, Ages 19-26, Through Provider Recommendation And Additional Clinic Funding: A Quality Improvement Project, Lacey Cudd

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase human papillomavirus vaccination series initiation rates among indigent women, ages 19-26, at a clinic in South Texas. The human papillomavirus is a sexually transmitted infection that has been associated with multiple types of cancers. Each year, approximately 6.2 million cases of the human papillomavirus infection are diagnosed; as many as 75% of all new infections occur among females 18-26 years of age. The human papillomavirus vaccination has a high efficacy in regards to cancer prevention, preventing as many as 76% of cancers with only one dose. The project included educating …

Implementation Of A Parental Notification System For The Improvement Of Well-Child Care Delivery, Frances Narvaiz

Doctor of Nursing Practice

This quality improvement project aimed to improve routine well-child exam rates in accordance with the American Academy of Pediatrics and Texas Health Steps recommendations through the implementation of a parental notification system. Missed well-child appointments impact health care by disturbing continuity of care and complicating preventive care services. Implementation of the parental notification system during June 2017 to August 2017 consisted of 100 patients from birth to 18 years of age for scheduled well-child visits in a pediatric clinic with a large Hispanic and Medicaid population. Interventions consisted of staff training, reminder phone calls 24 to 48 hours prior to …

Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson

Doctor of Nursing Practice

A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health …

The Relationship Between Bmi & Mandated Physical Education Requirements Of Elementary Schools, Kathryn Fairlamb

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The physical activity policies of elementary schools in Arkansas and correlations between physical activity requirements and body mass index have been studied. Examination of the policies at the individual school, district, or state level were noted. The statewide BMI database was consulted. Interviews with physical education teachers was conducted to assess policy implementation. Results may provide schools and policy makers with insight on future physical activity policies.

Openpediatrics: Integrating Technology Into Pediatric Healthcare Education, Marisa Albert

Senior Honors Projects

In contemporary times, the dissemination of knowledge across specialties has become convenient through the use of computer technology and the internet. Technology has been integrated into educational systems worldwide and has become invaluable in the advancement of healthcare. Nursing practice and education has utilized modern technology as a resource for continuing education such as through the use of online RN-BSN programs and sharing improvements in healthcare practice. A great part of a nursing student’s education is understanding the importance of a nurse’s professional commitment to lifelong learning by utilizing critical thinking skills to support evidence-based practice to improve standards of …

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …

Effects Of Chronic Illness On Self-Image In Adolescents, Krista Stillson

Grace Peterson Nursing Research Colloquium

EFFECTS OF CHRONIC ILLNESS ON SELF-IMAGE IN ADOLESCENTS:

AN INTEGRATIVE LITERATURE REVIEW

Krista Stillson

Abstract

Background: Chronic illness can pose more than just pathological effects on an individual. During the vulnerable developmental stage of adolescence, the psychological effects of disease can be equally as damaging. In adolescence, manifestations of chronic illness can cause a distorted self-image which may potentiate negative outcomes such as depression, anxiety and low self-esteem. For this reason, it is important for nurses to be aware of the broad impact that can accompany disease and use interventions to counteract such effects. Implementation of coping interventions can help …

Perceptions And Experiences Of Children Living With Type 1 Diabetes In A School Environment: An Integrative Literature Review, Michelle Gandhi

Grace Peterson Nursing Research Colloquium

Abstract

Background: Type 1 diabetes affects many children across the world. Many of these children spend majority of their time at school where they may not receive appropriate support from school staff and peers in order to better manage their condition. Examining school-aged children who are living with type 1 diabetes and their perceptions and experiences can help guide school staff in creating an appropriate environment to meet the children’s needs.

Objectives: The purpose of this literature review is to examine quantitative and qualitative studies that investigates common concepts that makes self-management of type 1 diabetes in children difficult while …

Effective Coping Methods For Pediatric Nurses Working With Terminally Ill Patients: A Literature Review, Jenna Gatziolis

Grace Peterson Nursing Research Colloquium

EFFECTIVE COPING MECHANISMS FOR PEDIATRIC NURSES WORKING WITH CRITICALLY AND TERMINALLY ILL PATIENTS: A LITERATURE REVIEW

Jenna Gatziolis

Faculty Sponsor: Dr. Kim Amer, PhD, RN

Background: One of the hardest aspects of pediatric nursing is dealing with the death of young and sick children. Because the death of a child is a traumatic event, special consideration must be taken into account as to how pediatric nurses are able to effectively cope with the death of a child. Oftentimes the emotional needs for nurses are overlooked and not discussed leading to poor personal and career related outcomes for the nurse.

Objectives: …

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Association Of Teen Mothers' And Grandmothers' Parenting Capacities With Child Development: A Study Protocol., Damali Wilson, Deborah Gross, Stacy Hodgkinson, Kirby Deater-Deckard

Pediatrics Faculty Publications

Children born to teen mothers may experience less responsive and supportive parenting and are at heightened risk for a range of social, developmental, and health issues. There is literature to support the positive impact of grandmothers on teen parents and their children. However, what if the teen's mother is also limited in her parenting capacities? How do parenting capacities across these two generations of mothers affect the developing child? In this ongoing study we are examining two important aspects of parenting capacities, attachment quality and executive functioning, in teen mothers (TM) and their biological, co- residing mothers or grandmothers (GM …

Impacting Women's And Children's Health Care Globally- A United State-Haiti Nursing Partnership., Melissa Motz, Mary Aungst, Karen Groves

Patient Care Services / Nursing

No abstract provided.

Mālama Nā Makua I Nā Keiki Me Ka Hānō: Native Hawaiian Parents Caring For Their Children With Asthma, May K. Kealoha, Merle Kataoka-Yahiro

Asian/Pacific Island Nursing Journal

Native Hawaiian children have the highest prevalence rate of asthma among all ethnicities in the State of Hawai‘i. Literature is limited regarding native Hawaiian parents’ perception and experience caring for their children with asthma. The purpose of this study is to explore contemporary native Hawaiian parents’ perspective and experience of caring for their children with asthma in the context of uncertainty. We applied a descriptive qualitative approach by means of directed content analysis using focus groups. Directed content analysis applied Mishel’s Uncertainty in Illness Theory to guide data collection, organization, and analysis. We found that parents’ personal stories about their …

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

The Use Of Simulation To Increase Critical Thinking Of Perinatal Nurses In The Care Of Preeclampsia Patients, Catherine Olubummo

Publications and Research

Objective: To increase critical thinking in perinatal nursescaring for patients with preeclampsia, with the support of key nursing, education, and medical leadership, an evidence-based practice.

Design: Quantitative, Descriptive study.

Setting: Metropolitan area of New York.

Participants: A total of six nurses were involved at a time: two from antepartum, two from labor and delivery, and two from postpartum.

Methods: This included 45 minutes for completion of the CCTST, a one-hour lecture supplemented with PowerPoint slides and two studies, two hours engaged in the simulation, 30 minutes for debriefing, and 15 minutes for a post-CCTST.

Results: The test results indicated that …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Implementing The Weefim System In Outpatient Pediatric Rehabilitation, Chelsea Ratilainen

Master's Projects and Capstones

Abstract

This project was designed to achieve an unmet criteria in the accreditation process for the outpatient pediatric rehabilitation program at a local, community hospital in the greater Bay Area. The clients range from 6 months old to 20 years old with functional disabilities. The Commission of Accreditation of Rehabilitation Facilities (CARF) requires that applicants demonstrate outcome measure data over a 6 month time period. During the self-evaluation process this was noted to be a deficiency in the department’s efforts. The WeeFIM system was chosen as the first tool to implement in the department. This is a functional improvement measurement …

The Availability & Efficacy Of Non-Pharmacological Interventions For Pain Management For Children With Sickle Cell Disease: A Systematic Review Of The Literature, Uchenna Onyema-Jones

Grace Peterson Nursing Research Colloquium

The Availability & Efficacy of Non-Pharmacological Interventions

For Pain Management for Children with Sickle Cell Disease:

A Systematic Review of the Literature

Uchenna N. Onyema-Jones

Faculty Sponsor: Tamara Poole, MS, APN, FNP-BC

Background: Pain is the leading cause of hospitalizations for many pediatric patients with sickle cell disease and unfortunately it is often sub-optimally managed by healthcare professionals with pharmacological interventions.

Objectives: The purpose of this systematic literature review was to examine the availability and efficacy of non-pharmacological interventions used to manage pain in pediatric patients with sickle cell disease.

Method: A systemic literature review was conducted using the databases …

Early Life Antibiotic Exposure And Its Association With Overweight/Obesity: An Integrative Review Of The Literature, Margaret Pfaff

Grace Peterson Nursing Research Colloquium

Early Life Antibiotic Exposure and its Association with Overweight/Obesity: An Integrative Review of the Literature

Margaret Pfaff

Faculty Sponsor: Dr. Shannon Simonovich

Background: Prevention of or treatment for obesity could improve quality of life for many people. Infancy may be a critical period during which efforts should be focused to mitigate modifiable factors that may influence the risk for developing obesity.

Objectives: This integrative literature identified factors associated with greater incidence or effects of antibiotic exposure during infancy and examined the connection between early life antibiotic exposure and later in life overweight/obesity.

Method: This analysis followed the Whittemore and Knafl …