Pediatric Nursing Commons^™

Advocating For Health Equity: A Quality Improvement Project Surrounding Social Determinants Of Health Screening, Rose Anne Dela Cruz, Amanda Marquez, Madison Lemmons

2025

INNOVATION & LEADERSHIP

Background: Social Determinants of Health (SDOH) can gravely impact patient recovery. Health organizations should prioritize identifying high-risk SDOH patients to improve patient outcomes. Current research suggests SDOH screening should be standard practice in preventative care. With this awareness, healthcare team members must identify patients with complex social determinants of health needs to ensure essential resources are offered to enhance their healing process during hospitalization and sustain it post-discharge. The most straightforward approach to identifying patients from diverse backgrounds with SDOH requirements is via SDOH screening. The collaborating health system, serving a diverse pediatric population in the …

Circling Together To Support Transitioning Nurses With Mentorship, Martha Shaw, Jill Hesler, Sarah Ritchie

2025

QUALITY IMPROVEMENT

Background: Nurses orientating to new environments can experience transition shock as they navigate new professional experiences, challenges, and identities. While much attention is given to supporting new graduate nurses, experienced nurses changing specialties frequently receive less structured support, despite facing unique challenges. Experienced nurses enter their new roles with a level of competence and expertise from a previous specialty, only to find themselves functioning as beginners in a new practice setting. Mentoring practices have been shown to increase confidence, decrease anxiety, and improve rates of retention and growth behaviors over the course of a career leading to …

Epilogue: Postoperative 30-Day Follow-Up, Tess Davis, Karisa Price, Courtney Russ

2025

INNOVATION & LEADERSHIP

Background: The NSQIP-P Surgical Clinical Reviewers (SCR) of Children’s Health of Texas initiated a quality project with the goal of maintaining an 80% postoperative follow-up rate. To remain relevant in the ever-changing landscape of healthcare, we recognize the need for thoughtful and individualized approaches to follow-up. Unprecedented growth in the healthcare sector creates a demand for innovative solutions to address the ever-changing needs of the pediatric surgical population. Patient expectations have driven the desire for organizational transparency and robust approaches to ensure optimal, holistic outcomes. This has been accomplished using tailored follow-up strategies to meet organizational …

Impact Of An Escape Room Educational Intervention For Telephone Triage Nurses, Susan Webber, Kathleen Ellis

2025

RESEARCH

Purpose: This study examines the impact of an escape room educational intervention on the knowledge, preparedness, and confidence of nurses who work in pediatric telephone triage, as well as examining the effect of the intervention on perceptions of teamwork.

Methods: This study used a quantitative pre-post study. Six Likert-scale questions focused on pre- and post- intervention comparisons, while four questions addressed participant satisfaction.

Results: The sample had a long tenure in nursing, with 81.57% having 15 years or more of nursing experience. Length of time working in telephone triage was fairly equally divided between groups who …

Reducing Unexpected Nasogastric Tube Reinsertions Through Interdisciplinary Education: A Pediatric Ambulatory Initiative, Jordon Delatorre, Nadia Gose, Leslie Moore, Aren Parker, Shivani Patel, Iman Rahim-Tejani

2025

INNOVATION & LEADERSHIP

Background: In late 2024, pediatric GI clinic RNs noted a rise in unexpected visits for nasogastric tube (NGT) reinsertion, continuing into early 2025. These visits disrupted clinical flow and strained limited RN resources. Caregivers were often unable or unwilling to perform reinsertion at home. RNs escalated the issue to leadership, prompting collaboration with the ambulatory clinical program director. Weekly planning meetings began in April 2025 to develop a safe, efficient workflow aimed at reducing unplanned NGT-related visits and improving care delivery.

Implementation: An interdisciplinary team, including GI clinic RNs, inpatient GI and NICU nurses, educators, …

I Don’T Want To Be Alone: The Impact Of Cohorting Neonates On One Unit, Deb Lathrop, Rose Dela Cruz

2025

INNOVATION & LEADERSHIP

Background: The hospital has been caring for neonates since it opened in 2005. To comply with state regulations, a state designation for neonatal care is required. The facility hired a program manager to address specific needs and to apply for the state designation. A designation of Level 1 neonatal care was obtained at the end of 2023. The facility does not possess a Neonatal Intensive Care Unit. The program manager started collecting historical data on thermoregulation who are located on every unit of the facility in October 2023. It became evident that neonates in the hospital …

Nursing Care For The Sexual Assault Patient Using Trauma-Informed Care: Development Of Simulation Curriculum, Lauren Orr

2025

INNOVATION & LEADERSHIP

Background: In 1999, the American Association of Colleges of Nursing (AACN) called for nursing programs to include nursing care of patients who have experienced violence, including sexual violence. The care of these vulnerable patients requires specialized care, but also the use of specialized language through using trauma-informed care (TIC) to prevent revictimization and to further support healing. A simulation curriculum was developed that can both introduce the nursing care needed for a sexual assault patient and allow students to practice using TIC that is used when students practice independently as licensed nurses. Multiple studies have supported …

Improving Sdoh Screening Compliance In Pediatric Settings: Addressing Health Literacy In East Texas, Katie Bien

2025

QUALITY IMPROVEMENT

Background: Low parental health literacy is an under-screened social determinant of health (SDOH) that drives inequities in rural communities such as East Texas, where over 105,000 children lack access to a pediatrician, and families travel 80+ miles for care. Pediatric mortality in this region is 2.5 times the national average (UT Tyler SOM, 2023). National data indicate that one in three parents has limited health literacy (Tran et al., 2008), further exacerbating risks of missed appointments, medication errors, and poor outcomes.

Methodology: The initiative was conducted in a rural outpatient pediatric cardiology clinic within Children’s Health …

Ask Me 3® In Action: Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

2025

EBP

Literature Review: Parents and caregivers’ understanding of how to provide safe and effective care at home is vital. However, elevated levels of stress and limited health literacy face significant challenges in understanding discharge instructions. Patients who understand heath instructions make fewer mistakes when they take their medicine, follow treatment plans, and prepare for medical appointments. Patients have reported higher satisfaction and found that the use of Ask Me 3 was helpful in learning more about their medical condition.

PICO: For parents of pediatric patients seen in an acute perioperative setting, how will the use of the Ask Me 3 …

Implementation Of No Wake Times, Chloe Martin, Drew Mullinax

Scholars Week

Hospitalized patients frequently experience poor sleep quality due to clinical activities that occur during typical sleeping hours such as vital sign checks and medication administration. These nighttime disruptions negatively impact patient recovery times and decrease patient satisfaction. This evidence-based practice evaluated if restructuring nighttime clinical activities would minimize sleep disturbances and improve sleep quality in hospitalized patients. Patient surveys were used to assess the frequency of nighttime awakenings as well as the different sources of these awakenings. Interventions included moving nighttime clinical activities (blood pressure checks and medication administrations) to not be done during the hours of 10pm to 5am …

Compassion Fatigue And Burnout In Community-Based Psychiatric Staff, Faith Carini-Graves

Advances in Clinical Medical Research and Healthcare Delivery

Community-based psychiatric staff, such as the Youth ACT teams that are being initiated across New York State, are at risk for compassion fatigue due to their proximity to the trauma of their patients. This literature review explores current evidence that is available on the topic and grapples with what can be done to support psychiatric staff who work in the community with patients who experience trauma.

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Increasing Clinical Internal Mobility Through A Student Nurse Technician Program, Radiance G. Bean

EBP Fellowship

Practice Problem: Currently 67% of internal applicants are hired into our nurse residency program. Feedback from nursing leadership suggests internal candidates often fall short in areas like interviewing skills and professionalism, making external candidates stronger. Given the higher education resources provided to team members and our organization’s commitment to internal mobility, identifying ways to support employees and retaining top nursing talent is a priority. Our EBP question is: Will participation in a Student Nurse Technician (SNT) program increase the percentage of Patient Care Technicians (PCTs) in good standing that are accepted into the nurse residency compared to the current …

Elevating Nursing Leadership: How Nurse Managers Empower Unit Practice Councils, Katie Fields

EBP Fellowship

Problem: Unit Practice Councils (UPCs) are foundational to Nursing Professional Governance (NPG), a structure that is designed to foster autonomy, accountability and authority for nurses. These councils are vital for empowering nurses to engage in decision-making and implementing practice changes. At one large pediatric hospital, UPC effectiveness varied across units, largely due to differences in nurse manager engagement and support. This variation highlighted a critical gap in how nurse managers were supporting UPCs within their unit. To close this gap, it was important to identify leadership best practices and behaviors that lead to successful UPCs. The following PICOT question …

The Efficacy Of Emdr Therapy Compared To Tf-Cbt In Adopted Children To Manage Post-Traumatic Stress: An Integrative Review, Grace Ann Steiner

Senior Honors Theses

This integrative review examines the efficacy of eye movement desensitization and reprocessing (EMDR) therapy compared to trauma-focused cognitive behavioral therapy (TF-CBT) in managing post-traumatic stress disorder (PTSD) in adopted children. Children adopted from foster care tend to experience more adverse childhood experiences (ACEs) and maladjustment issues when compared to the general population, which necessitates effective therapeutic interventions to reduce PTSD symptoms and emotional dysregulation. Through analysis and comparison of the data, it was determined that both EMDR and TF-CBT effectively alleviated trauma-related symptoms, although one technique is not necessarily always more effective or efficient than the other. Along with reviewing …

Ask Me 3® In Action Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

EBP Fellowship

Background: Parents and caregivers’ understanding of how to provide safe and effective care at home is vital. However, elevated levels of stress and limited health literacy face significant challenges in understanding discharge instructions.

For parents of pediatric patients seen in an acute perioperative setting, how will the use of the Ask Me 3® health literacy tool impact understanding of medical information and communication with healthcare providers?

Literature Evidence: Patients who understand heath instructions make fewer mistakes when they take their medicine, follow treatment plans, and prepare for medical appointments (Six-Means, Amy, et al, May 2012). Patients have reported …

Empowering Nurses: A Training Initiative On Essential Oils For Pediatric Neurosurgery Patients, Sheri Sacks

EBP Fellowship

PICO Question: In pediatric neurosurgical bedside nurses, does education on lavender essential oil, compared to no education, improve knowledge, confidence and intent to integrateit as a complementary therapy for TBI patients?

Literature Review: Pediatric neurosurgery patients often face increased anxiety and agitation. Nurses may lack knowledge of non-pharmacological interventions to reduce agitation and anxiety in their patients. Literature review used MeSH Headings and keywords to find recent English articles. Evidence shows EO reduces anxiety. Lavender inhalation lowers anxiety, pain, and vital signs in pediatric dental patients. In adults, aromatherapy decreases anxiety, pain, blood pressure, and improves sleep, also …

Fierce And Focused - Virtual Reality Support For Pediatric Oncology Patients, Javarius Barber-Esparza

EBP Fellowship

Practice Problem: Pediatric oncology patients often experience anxiety during needle procedures. Even with anesthetic pain management in place, visually encountering the needle can be more distressing than the procedure itself. Virtual Reality (VR) has emerged as a nonpharmacological tool that provides immersive distraction, effectively lowering pain perception and anxiety. Studies show VR reduces anxiety during medical procedures, including accessing Implanted venous access devices (IVAD). Yet, its adoption in pediatric oncology settings remains limited.

Literature/Evidence: Search strategy in the CINAHL (EBSCOhost) database used MeSH headings and keywords, including English articles published within the last five years. Studies show that …

Improving Confidence And Competence In Treating Pediatric Peripheral Intravenous Extravasation, Ann Gosdin

EBP Fellowship

Practice Problem: Peripheral Intravenous Infiltrations and Extravasation (PIVIE) can cause severe skin and tissue damage. Prompt intervention helps prevent moderate or severe skin tissue damage. In the U.S. PIVIE complications can cost $10,895 versus $7,009 per patient without PIVIE. An Australian ED estimated the annual cost of PIV occlusion/infiltration and dislodgement of $14.01 million Australian dollars.

Quality event reviews demonstrated a staff knowledge deficit of treating extravasations per guidelines. Treatment could be delayed if the Vascular Access Team (VAT) was not available. Education on treatment of IV extravasation was needed to address this practice gap.

PICO(T) Question: In …

Seeing Clearly: The Impact Of Standardized Skin Assessments In Pediatrics, Hadley Brewer, Kristalyn Brown, Citlali Delgado, Sarah Irion, Riley Rice, Breyana Smith

2024

No abstract provided.

Safe Steps: Protecting Pediatric Patients From Falls, Sydney Richter, Generra Okello, Adaeze Ndulue, Megan Bauman, Robert Riegler

2024

No abstract provided.

Need A Buddy? A Mentorship Program For New Graduate Nurses, Makenzie Smith, Clarissa Leal, Danae Jones, Tram Anh Tran, Serenity Helaire

2024

No abstract provided.

It’S Yappy Hour! Standardized Rounding That Keeps Patient Families In The Loop, Brittany Culp, Audrey Hinchey, Bronwen Seidel, Michelle Aboagye, Dileen Bilbas, Cheyanne Dias

2024

No abstract provided.

Bridging The Gap: Strategies To Minimize Medication Delays And Enhance Interdisciplinary Collaboration In Hospital Settings, James Greenalch, Hector Murillo, Nantz Shelby Olson, Emma Putnam, Heidi Rodriguez, Jenna Stehly

2024

No abstract provided.

Bridging The Gap: A Cross-Unit Approach To Thermoregulation In A Large Pediatric Hospital, Isabelle Hernandez, Hernandez Velasco, Samuel Casu, Angel Castillo, Loree Sword, Noe Garcia

2024

No abstract provided.

Symptom Clusters And Their Association With Health-Related Quality Of Life In Pediatric Cancer Survivors After Treatment Completion, Krishtee Napit

Theses & Dissertations

A critical area of cancer research, symptom management, has evolved from focusing on individual symptoms to recognizing the complexity of co-occurring symptoms, commonly referred to as symptom clusters. However, most studies on pediatric cancer symptom clusters have focused primarily on the treatment phase or long-term survivorship, overlooking the early post-treatment period. This dissertation examines the prevalence of multiple symptoms and symptom clusters in pediatric cancer survivors post-treatment; factors associated with the total number of symptoms and symptom clusters; and the association of the total number of symptoms and symptom clusters with health-related quality of life (HRQoL). We developed and tested …

Kid Power: Mastering Asthma Management To Keep Hospitals Away!, Kriste L. Moret

Master's Projects and Capstones

Problem: Pediatric asthma remains a leading cause of preventable hospitalizations, particularly in California’s Central Valley, where environmental and health disparities worsen symptoms. Many children are discharged without understanding their Asthma Action Plan (AAP) or feeling confident in symptom management.

Context: On a unit in a community hospital in this high-risk region, asthma-related admissions persisted. Gaps in discharge education highlighted the need for a structured intervention. The Institute for Healthcare Improvement (IHI) Model for Improvement (MFI) guided this effort.

Intervention: A nurse-led, developmentally appropriate asthma education bundle was implemented. Teaching began on admission and was reinforced using teach-back, color-coded AAPs, culturally …

Take 3 For Me: Coping With Occupational Stress In Pediatric Oncology Nursing: Quality Improvement., Alexys Nadeau

Doctor of Nursing Practice Papers

Background: High acuity oncology patients increase RN emotional demands, worsening RN compassion fatigue. RNs are more prone to occupational stress/burnout. Maximizing coping self-efficacy can help nurses deal with occupational stress and burnout.

Environment: Implemented at a hospital caring for a pediatrics in a medium-sized Southeastern US city on the hematology/oncology unit, which serves bi-state counties.

Purpose: This QI project uses a Plan-Do-Study-Act framework to assess the levels of stress experienced, implement a stress management program, reassess the stress levels, and evaluate the program’s effectiveness in improving coping self-efficacy.

Procedures: Nurses received education flyers and emails regarding Take3forMe. Then asked to …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

The Impact Of Mindfulness Therapy To Reduce Disruptive Behavior In High School, Wendy Peters

Electronic Theses and Dissertations

The aim of this project was to determine the impact and effectiveness of Gina Biegel’s mindfulness techniques for stressed teens method on adolescent anxiety and the disruptive symptoms that lead to high school adolescents being assigned to detention. This project described a quantitative correlational design research project that investigated a small adolescent sample size, with a goal of decreasing the number of local high school adolescent students who are repeat detention offenders, by implementing Gina Biegel’s mindfulness techniques for stressed teens method on those high school adolescents who were assigned to detention. This was achieved by collecting demographic data from …