Pediatric Nursing Commons^™

Exploring The Use Of A Mindfulness Based Yoga Intervention For Children With Severe Asthma, Sharon Lack

Theses and Dissertations

Introduction: A diagnosis of severe asthma greatly impacts the physical and psychological health of children. Often experiencing increased stress, decreased physical activity, and increased exacerbations, children with severe asthma frequently exhibit poor health outcomes. Mindful yoga is a complementary health approach that may improve the physical and psychological well-being of children with severe asthma. The aims of this research were to evaluate the tolerability, feasibility, acceptability, and preliminary effects of a mindful yoga intervention in children with severe asthma. A novel theoretical framework encompassing concepts from three vulnerability nursing theories guided the research.

Methods: A mixed methods pilot …

Increasing Medication Compliance In Pediatric Asthma Patients By Implementing A Home Medication Dosing Chart, Lindsey K. Shader

DNP Projects

Background: There are 6.2 million children under the age of 18 years who have an asthma diagnosis (Center for Disease Control and Prevention, 2017). Only 60% of children ages 7-17 years with persistent asthma maintain their prescribed inhaled corticosteroid (ICS) controller medication regimen (Arnold, Bixenstine, Cheng, & Tschudy, 2018). The purpose of this paper is to discuss a practice inquiry project that incorporated the implementation of an asthma medication dosing chart to increase compliance in pediatric asthma patients.

Method: The quasi-experimental pretest-posttest design evaluated the daily use of a medication dosing chart, which was to serve as a physical reminder …

Effectiveness Of A School-Based Asthma Education Program For 8-10-Year-Old Children, Laura Hunt

DNP Projects

Background: Asthma is the most common chronic condition to affect children in the United States Five million children throughout the United States and approximately 112, 000 children in Kentucky are living with the diagnosis of asthma (CDC, 2017; CHFS, 2017). Based on current rates 1 out of 10 elementary school-age students will likely have asthma (CDC, 2019). Educating elementary-age students about asthma and symptoms of an asthma exacerbation is very important and could save a life.

Methods: A school-based asthma education program targeting children in third and fourth grades was implemented at two elementary schools in Central Kentucky. The asthma …

Improving First Dose Administration Of The Hpv Vaccine For Adolescents In A Pediatric Primary Care Clinic, Scarlett Mikesell-Pierce

DNP Projects

BACKGROUND: Nationwide more than 90% of cervical cancer cases are caused by the human papilloma virus (HPV). Cervical cancer can be largely prevented by administration of the HPV vaccine for children before becoming sexually active. However, vaccination rates in the United States, remain low at 60%, and only 39.7% through series of completion, despite the strong evidence to support the effectiveness of the HPV vaccine. Research indicates a clinician’s recommendation, providing information and opportunity for discussion about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity. This study addresses the barriers to parent/caregiver intent to …

The Effect Of A Virtual Child Passenger Safety Educational Intervention On Uk Pediatric Residents' Self-Reported Knowledge, Confidence, And Anticipatory Guidance Beliefs, Brooklyn Johnson

DNP Projects

Background: Motor vehicle crashes are the leading cause of death in children. Car safety seats (CSS), when used properly, have been proven to reduce injuries and deaths in children during motor vehicle accidents. The leading cause of car seat misuse is parental lack of knowledge about proper car seat use and best practice recommendations. Studies have shown that pediatric primary care providers have variable knowledge of the most updated car safety seat recommendations and are not consistently educating parents about child passenger safety during well child checks.

Objective: To evaluate UK pediatric residents' self-reported knowledge, confidence, and anticipatory guidance beliefs …

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 …

The Effect Of The Program Promoting Infection Prevention Behaviors In Family Caregivers Of Pre-School Age Children With Acute Lymphoblastic Leukemia: The Application Of Self-Care Deficit Nursing Theory, Su-Ari Lamtrakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

This quasi-experimental, pretest-posttest design aimed to compare infection prevention behaviors (medication administration, infection control, and infection surveillance) between the family caregivers of preschool-age children with acute lymphoblastic leukemia (ALL) in the experimental group and the control group. This nursing program is based on the Self-Care Deficit theory, to enable dependent care agencies regarding infection prevention behaviors of family caregivers. The dependent care agency consisted of the ability to acquired knowledge, ability to make a decision, and ability to perform infection prevention behaviors. The sample was 45 family caregivers of preschool age children with ALL, 23 were an experimental group and …

Implementation Of A Mentor Program To Support Nurse Retention: A Pilot Project, Lucy Camarena

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Primary factors affecting nurses’ decisions to stay at an organization include nurse self-concept, job satisfaction, and professional growth. A high turnover rate of nurses poses a risk to patients’ safety and healthcare outcomes. The implementation of mentor programs in institutions that employ new nurses has been shown to reduce turnover rates, increase the quality of patient care, and empower nurses in professional development. The existing literature supports the use of mentor programs and encourages their implementation in healthcare institutions.

Interventions: The DNP project’s goal was to identify effective methods of promoting positive nurse self-concept and increasing job satisfaction …

Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Julie Barragan, Macy Andrada, Mercedes Greenberg, Tatiana Grib, Samantha Gerber, Amanda Dailor

Master's Projects and Capstones

At a large, community-based pediatric hospital in Southern California, a quality improvement project commenced with a goal to improve patient outcomes by decreasing length of stay and pain levels, while increasing toleration of feeds. Implementing a standardized guideline would ensure safe practice across the continuum and allow providers to use a systematic tool for postoperative care, including nursing care interventions and medications. The Root-Cause-Analysis tool was used to assess the microsystem and determine the contributing factors to the identified problem. A SWOT analysis was then performed, followed by a plan to collect data from all pediatric cleft palate procedures performed …

Standardization Of Postoperative Care Guidelines For Pediatric Cleft Palate Patients, Amanda Dailor, Macy Therese G. Andrada, Julie C. Barragan, Samantha T. Gerber, Mercedes S. Greenberg, Tatyana Grib

Master's Projects and Capstones

At a large, community-based pediatric hospital in Southern California, a quality improvement project commenced with a goal to improve patient outcomes by decreasing length of stay and pain levels, while increasing toleration of feeds. Implementing a standardized guideline would ensure safe practice across the continuum and allow providers to use a systematic tool for postoperative care, including nursing care interventions and medications. The Root-Cause-Analysis tool was used to assess the microsystem and determine the contributing factors to the identified problem. A SWOT analysis was then performed, followed by a plan to collect data from all pediatric cleft palate procedures performed …

Assessing Knowledge And Perspectives Of Pediatric Nurse Practitioners Students After Receiving Trauma Informed Care Training, Laura Roettger, Phd, Crnp, Jane Tobias, Dnp, Crnp

College of Nursing Posters

PNP students showed improved understanding and comfort level in caring and managing children exposed to adverse childhood experiences following two TIC learning sessions.

Future Implications

• TIC education should be integrated into curriculum.
• Interprofessional collaboration among students improves knowledge base and understanding of TIC

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 …

Exploring Perceptions And Attitudes Of Health In Marshallese Adolescents Who Are Overweight In Northwest Arkansas, Lauren Love

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Purpose

Childhood obesity is a growing public health problem in the United States. An increasing number of children are becoming overweight or obese and facing the negative health issues from this diagnosis. They might also suffer socially due to their weight because they are more likely to be bullied or picked on. This project explored the perceptions and attitudes of health in Marshallese adolescents that are overweight in Northwest Arkansas. The goal of our project was to investigate themes for commonality amongst adolescents that are overweight about how they perceive their weight and their beliefs towards health and body image. …

Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings

Dissertations

Author: Lisa Cummings PhD RN

Fathers’ Experiences with Their Premature Infants or Unhealthy Neonates

Purpose and Background/Significance: Fifteen million babies worldwide are born prematurely each year, impacting a multitude of fathers. The importance of an early close father-infant relationship has been identified as central for the development of the child. Fathers influence on a child’s emotional and cognitive development and their physical well-being and health. Many times, the Neonatal Intensive Care Unit (NICU) is the initial contact environment between a father and his premature infant. Studies have shown that the NICU can be a stressful environment for parents, producing emotional …

Picture Perfect: Pediatric Ct Utilization In Trauma, Laura Strickland, Christa Zino Md

Pediatrics

No abstract provided.

Safe To Sleep In The Icn, Megan Kelly, Alexandra (Lexi) Van Noy, Molly Kruse, Megan English, Hannah Culbertson, Brianne Truitt, Ziryan Salihparkhy, Jenny Mckee, Brecklyn Findley

Posters

The CDC states that 1,545 infants passed away from SIDS in 2014. Safe sleep includes supine, in a crib, head of bed flat, firm sleep surface, tightly fitted sheet, no loose blankets, no toys or supplies in crib with infant. It is important for nurses to model safe sleep practices in the hospital setting. Current compliance with safe sleep in the Intensive Care Nursery is 50%.

AIM Statement:

By August 1, 2019 we want to increase the compliance of modeling safe sleep behaviors for patients who qualify for safe sleep from 50% to 90% in the Intensive Care Nursery.

Implementing Treat To Target Approach In The Care Of Children With Juvenile Idiopathic Arthritis, Julia G. Harris, Jamie Holland, Emily Fox, Leslie Favier, Ashley M. Cooper

Posters

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory disease seen in pediatric rheumatology. Despite advances in biologic therapy, many children with JIA will experience morbidity. Treat to Target is a treatment paradigm that involves setting a target of disease activity, using shared decision making, and incorporating clinical decision support. Our clinic aimed to set a treatment target on 50% of eligible JIA patients by December 31, 2019.

Improving Care Of The Small Baby, Beckie Palmer, Abdebayo Oshodi, Brandy Huitt, Kaylee Hurt, Pamela Kliethermes, Trudy Koons, Patricia Lanzer, Ashley Mirabile, Allyson Owen, Christian Anthony Schneider, Betsi Anderson, Steven Olsen

Posters

Hierarchy of Aims:

• Global Aim: Create a Small Baby Unit for infants admitted to our NICU that arebirth, in which 90% of our patients are admitted to F pod on day of admission, by March 2019
• Interim Aim: Staff 80% of our micropremie patients with a Small Baby Team nurse from admission until >32 weeks by May 2019.
• Sub Aim: Increase rates of developmentally appropriate care (2 person cares, kangaroo care compliance) by 50% by August 2019.

6 Hall Team Norms: It's Our Patient, Mallory Rittel, Markeyta Brown, Ron Chenoweth, Marcy Page, Chelsi Peterzalek, Amanda Woldruff

Posters

Aim Statement

6 Hall will increase NDNQI RN-RN interaction scores from 5.06 to 5.45 to meet the 2019 National Magnet Facilities benchmark b August 1, 2019.

6 Hall Team Norms

• We strive for excellence: our work is complex, mistakes will happen.
• We provide timely (<1 >week) feedback, which includes positive, learning and interpersonal feedback.
• We celebrate as a team and our environment feels like every individual matters.
• When trust is broken, we ask ourselves: how did I contribute? What can I do to make it better? We are careful in not making assumptions.
• Our behaviors are supportive and display respect. …

Increasing Kangaroo Care In A New Small Baby Unit, Dianne Wilderson, Barb Haney, Ashley Mirabile, Beckie Palmer, Jenny Heltzer, Erin Keith-Chancy Bsn,Ccrn, Brooke Smith, Christian Anthony Schneider, Abdebayo Oshodi

Posters

Project Aim: Increase the percent of eligible patients receiving kangaroo care from 19% to 30% by September 2019.

Results:

113 staff completed education

OT consults completed on all SBU patients

20 kangaroo wraps purchased

Kangaroo care rate in NICU increased from 19% (prior to SBU) to 36% (Post SBU opening).

Conclusion: Due to increased multidisciplinary awareness of importance of kangaroo care in the SBU more parents are completing kangaroo care.

Modifications For An Overnight Camp For Children With Chronic Illnesses, Victoria Walker

Mahurin Honors College Capstone Experience/Thesis Projects

An overnight camp is something that almost every child looks forward to attending. Unfortunately, children with chronic illnesses are often not able to attend these types of camps. However, medical camps that institute modifications can make overnight camp stays a reality for children with chronic illnesses. The purpose of this study was to explore modifications made for children with chronic illnesses at a medical camp. The two research questions for this study were: 1) what modifications do overnight camps make for children with chronic illnesses to keep them safe and promote fun, and 2) how can these modifications be applied …

Making The Management Of Acute Otitis Media A Snap, Cassandra Newell, Donna Wyly, Tanis Stewart, Alaina N. Burns, Brian R. Lee, Rana El Feghaly

Posters

AIM:

To improve Watchful Waiting or Safety Net Antibiotic Prescription (WW/SNAP) in children >6 months old diagnosed with acute otitis media by Advanced Practice Nurses in the Emergency Department by May 2020.

Safe Sleep In The Nicu, Ashley Mirabile, Barb Haney, Dianne Wilderson, Beckie Palmer, Ashley Domsch, Eugenia K. Pallotto

Posters

Goal: To evaluate a staff education program on approach to improve in the rate of eligible NICU infants in safe sleep in a busy 84-bed level IV NICU.

Outcome Measures; Improve safe sleep compliance for eligible patients to 90% or greater by December 2019.

Process Measures: Audits from bedside RNs showing compliance with safe sleep.

Planned Intervention: In December of 2018 a multidisciplinary work group brainstormed and implemented best practice safe sleep education for staff and parents. September 2019 a Safe Sleep Educational Toolkit was made available for staff.

Results: Safe Sleep compliance has gone from 53% to 90% in …

Increasing Rates Of Breastmilk Use At Time Of Neonatal Intensive Care Unit (Nicu) Discharge: An Improvement Project In A Midwest Level Iv Nicu, Kathleen Hortenstine, Teresa Fulk, Stephanie Callis, Kyla Galate, Beckie Palmer

Posters

• Breast milk is the preferred food for all infants.
• The rate of breast milk use at time of discharge was below the goal of the institution.
• A gap was identified in bedside nursing education, limiting their ability to provide resources and education to mothers. Nursing involvement ensures skilled, comprehensive, and accessible breastfeeding support.
• The aim of this project is to increase breast milk rates at time of NICU discharge to 95% of eligible patients by December of 2019.

Lighting The Way To Ensure Safe Transition Home, Barb Haney, Ashley Mirabile, Dianne Wilderson, Beckie Palmer, Ashley Lewis, Cris Mills, Eugenia K. Pallotto

Posters

All aspects of discharge (education, screenings, appointments, plans and home services" must be completed and appropriately communicated prior to discharge to ensure safe transition to home.

Goal: Standardize all aspects of discharge in a large, busy 84-bed Level IV NICU with >1000 admissions/year and >300 nurses, >60 NNPs, and >25 neonatologists.

• 95% of patients with lengths of stay >3 days have all discharge planning completed prior to discharge/Parent Care Unit overnight stay

Improving Bedside Nurse Engagement In Quality Improvement (Qi) Projects, Beckie Palmer, Sarah Carboneau, Ashley Domsch, Barb Haney, Brandy Huitt, Ashley Lewis, Ashley Mirabile, Allison Ronco, Dianne Wilderson

Posters

Project Aims:

• Improve nursing engagement in QI as evidenced by increasing nurse involvement to 40% of overall staff by December 2018, with a continual increase to >50% by June 2019.
• Decrease the % of nurses who express "my opinion doesn't matter" as a reason they do not participate in QI by 30% by June 2019.

Clabsi Prevention Through Prevention Huddles And Clabsi Risk Assessment And Prevention Form In Electronic Medical Record, Tara Benton, Barb Haney, Lacey Bergerhofer, Yolanda Ballam, Kaitlyn Hoch

Posters

Our aim is to increase the awareness of high risks for central line associated bloodstream infection (CLABSI) and decrease the CLABSI rate with the implementation of CLABSI prevention huddles and an electronic medical record (EMR) "CLABSI Risk Assessment and Prevention" form.

A Multifaceted Approach To Improve Quarterly Visit Rates At A Pediatric Cystic Fibrosis Care Center, Paula Capel, Jessica Banks, Micaela Mckenna, Ashley Andrews, Christopher M. Oermann

Posters

Standard quality improvement methodology was used to improve quarterly visit rates among cystic fibrosis patients at Children's Mercy Kansas City Cystic Fibrosis Center.

• A family-centered, team-based approach was adopted
• A change in culture led to sustained improvement

Improved quarterly visit rates should drive improvement in outcomes including pulmonary function and nutritional status.

Trauma Informed Care: Improving Staff Morale On 6 Henson, Kara Humphreys, Katherine Karstens, Kortney Neiderhauser, Briana Pina, Payton Tallent, Stephanie Assad, Madison Dexter

Posters

Six Henson staff reported feeings of burnout and compassion fatigue.

Aim Statements:

Decrease percentage of 6 Henson staff feeling sometimes or often "worn out because of [their] work as a helper" from 86% to 50% by August 1, 2019.

Increase the number of KUDOS cards submitted by 6 Henson staff from 2-3 per week to 10 per week by August 3, 2019.

Both aim statements were met and exceeded.

Decreasing Length Of Stay In Pediatric Urgent Care With Electronic Discharge Instructions, Jennifer Wooster, Aimy Patel, Brian R. Lee, Amanda Nedved

Posters

Time spent waiting in the urgent care clinic is dissatisfying for patient and staff. This "wasted time" accounted for more than 52% of the urgent care visit at our urgent care.

The aim of our project is to decrease length of stay by 10 minutes by April 30, 2019 for all patients discharged from Blue Valley Urgent Care by offering patients a paperless depart process. To be eligible for discharge without paper families must be enrolled in the online patient portal.

Electronic discharge instructions significantly decrease length of stay and is associated with improved patient experience scores. Patients who received …