Pediatric Nursing Commons^™

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guideline Update – Xi – Milk Supplement/Replacement Formulas For Infants And Toddlers With Cma – Systematic Review, Antonio Bognanni, Ramon Firmino, Stefania Arasi, Derek Chu, Alexandro Chu, Siw Waffenschmidt, Arnav Agarwal, Piotr Dziechciarz, Andrea Horvath, Rose Kamenwa

Paediatrics and Child Health, East Africa

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of …

Cease The Alarms - A Nurse-Led Bundled Approach To Alarm Management, Annie Tolliver

EBP Fellowship

No abstract provided.

Implementing The "Baby Drop Bundle", Natalie Aguirre

Master's Projects and Capstones

Problem: Falls are a preventable type of trauma that may lead to serious injury, prolonged hospital stays, and non-reimbursable costs to the organization. While there are established fall prevention policies for ambulatory patients, infants dropped by their caregivers are largely excluded.

Context: This quality improvement project aims to decrease newborn drops by implementing the “Baby Drop Bundle”. The bundle allows caregivers and bedside providers to partner in creating a safe environment for the patient.

Interventions: The Clinical Nurse Leader (CNL) will provide a brief in-service during the morning safety huddle to introduce the bundle to staff. The bundle includes educational …

Promoting Awareness In Nurses: Developing Culturally Competent Hair Care Education To Eliminate The Equity Gap For Bipoc Children In Inpatient Settings, Sharlene S. Lansiquot

Doctor of Nursing Practice Projects

Problem

A survey that was administered to staff members on nine units at a pediatric hospital assessing their awareness of hair care for Black, Indigenous, and people of color (BIPOC) indicated a lack of awareness. This impacts the fundamentals of nursing care, which encompasses cultural sensitivity and promoting health equity. In this survey, 12.18% (n=52) of the 427 patients on the nine participating units between December 12, 2023, and January 19, 2024, identified as BIPOC. Although this was the case, the survey sent out on December 12, 2023, to staff members on nine units which included 491 nurses, with 104 …

Feasibility Of Individualized Toolkits To Reduce Childhood Obesity In A Pediatric Primary Care Setting, Molly Sexe

DNP Projects

Background: Childhood obesity rates continue to rise, leading to comorbid conditions presenting in adolescence and adulthood (Durbin, 2018). Individualized toolkits focusing on various health habits have been identified as an effective intervention in pediatric primary care practices (Byrne et al., 2018; Henderson, 2021; Mead et al., 2017; Smith et al., 2021 & Wright et al., 2018). This project assessed barriers of the current obesity prevention program at a pediatric primary care clinic, Operation Get FIT. This project identified steps to revising Operation Get FIT to tailor it more to the needs and goals of the participating clinic, the providers, and …

Development And Implementation Of An Emergency Preparedness Policy And Procedure, Educational Intervention, And In-Situ Simulation In A Pediatric Primary Care Office: A Quality Improvement Project, Kaitlin Patel

Doctor of Nursing Practice Scholarly Projects

Background. Pediatric primary care offices are frequently unprepared to respond to clinical emergencies that may present to or occur at their site. The purpose of this project was to improve office emergency preparedness at a pediatric primary care office to align with the American Academy of Pediatrics policy statement for pediatric office emergency preparedness.

Methods. A PRISMA-guided literature review found support for both educational interventions and in-situ simulation to improve aspects of emergency preparedness. The aim of this project was to develop a practice-specific emergency preparedness policy and procedure and implement a training and in-situ simulation to increase medical and …

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 …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Implementation Of Chlorhexidine Gluconate Dressings And The Effect On Bloodstream Infections In Extracorporeal Membrane Oxygenation Patients At A Pediatric Hospital, Kaitlin Vernier

Dissertations

Extracorporeal membrane oxygenation (ECMO) is an advanced lifesaving therapy used for patients with significant cardiorespiratory failure not responding to conventional therapies. The most common and life-threatening complications associated with ECMO are blood stream infections (BSIs). In addition to increased mortality, BSI's increase patient length of stay and cost. Chlorhexidine Gluconate (CHG) is known to be a significant factor in BSI reduction. The purpose of this quality improvement project is to assess the utilization of CHG-impregnated dressings on the incidence of BSI rates in pediatric ECMO patients. The setting was a 40-bed pediatric intensive care unit (PICU) and a 30-bed cardiac …

Wiping Out Central Line Associated-Bloodstream Infections: Cleaning High Touch Surfaces In The Picu, Emily Heth

Dissertations

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant, preventable healthcare-related complication of hospital admission and medical management of critically ill and medically complex patients. CLABSIs result in significant adverse outcomes such as increased morbidity and mortality, prolonged length of stay (LOS) in the intensive care unit (ICU) and in the hospital, increased cost of treatment, and increased rates of readmission. Direct and indirect contact within the patient’s hospital environment are potential means of transmission for microorganisms, increasing the inherent risk of acquiring a CLABSI.

Method: For this quality improvement (QI) project, a pre-post design was utilized to evaluate the …

Implementation Of A Standardized Nursing Handoff In A Pediatric Intensive Care Unit, Tori Keeven

Dissertations

Handoff communication is critical in healthcare and is associated with patient safety outcomes. Various tools and interventions are available to improve handoff communication as inadequate communication contributes to medical errors, patient adverse events, and increased mortality. The implementation of a standardized handoff tool has been shown to be effective. Findings revealed a significant 60% reduction in reported patient harm events, despite the study's limited sample size and lack of statistical significance (p = .614). Challenges such as low utilization (18.62%) were attributed to concerns about tool organization, spatial constraints, and staff resistance to change. Recommendations include refining the tool to …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

A Guideline-Based Approach To Increase Early Mobilization In The Pediatric Patient Following Cardiothoracic Surgery, Kayla Keeven

Dissertations

A Guideline-Based Approach to Increase Early Mobilization in the Pediatric Patient Following Cardiothoracic Surgery

Problem: Prolonged bedrest during the post-operative period contributes to complications that lengthen hospital stay and increase mortality and medical costs. Early mobilization is recognized as safe and feasible in critically ill children. However, there is no standardized procedure nor method of identifying patients who are safe to mobilize in a pediatric cardiac intensive care unit (ICU).

Method: The quality improvement (QI) project employed a descriptive observational design utilizing a retrospective-prospective method to assess the effects of implementing an early mobilization guideline in a pediatric cardiac ICU. …

Neonatal Hyperbilirubinemia And Phototherapy: The Implementation Of Seminal Clinical Practice Guidelines, Christina Coleman

Dissertations

Problem: On a postpartum care and pediatric unit from February 2022 to December 2023, the average monthly percentage of neonatal patients greater than 35 weeks gestation with hyperbilirubinemia who were treated with phototherapy before it was medically supported by the current guidelines was 42.855% (N=668). The department’s goal was to decrease this number to 10%. Initiation of phototherapy with a subthreshold bilirubin level exposes many infants to an unnecessary treatment modality which can prolong the infant’s length of stay in the hospital and can be associated with adverse effects, such as maternal-infant bonding and breastfeeding rates.

Methods: The …

360 Degree Clinical Competence Evaluation For Pediatric Hospitalist Advance Practice Provders, Elizabeth A. Schickler

Dissertations

Problem: Advanced practice provider (APP) peer reviewed clinical competencies is an expected part of professional, organizational, and The Joint Commission (Joint Commission) requirements, however, is not well defined and subject to organizational application and interpretation. Providers favor peer review as a means to improve professional practice. There is a lack of data to support frequency of feedback and method of feedback to support readiness to change practice and comfort giving and receiving feedback.

Methods: The quality improvement project utilized an analytical experimental design.

The Cardin Hospitalist Advanced Practice Provider - Readiness Assessment (CHAPP-RA) tool was implemented to a convenience sample …

Improving Nurse Response To Seizure Events In A Pediatric Epilepsy Monitoring Unit With Use Of A Standardized Process, Stacey Obst Paule

Dissertations

Problem: Nurses responding to seizure events in the pediatric epilepsy monitoring unit (EMU) should initiate a neurological exam in addition to managing seizure activity. When nurses respond to these events, however, there can be significant variability, which can result in diagnostic inaccuracy and adverse patient outcomes. The purpose of this project is to implement a nursing response checklist and neurological assessment guide to standardize the process of response to seizure events in the pediatric EMU.

Methods: This quality improvement (QI) project utilized a cohort study design. Standardized tools were placed in an accessible area outside patient rooms. Education was provided …

Parental View On Hpv Vaccination, Rebecca Elaine Rhodes

Electronic Theses and Dissertations

The human papillomavirus (HPV) is a sexually transmitted infection widely seen in the United States. Millions of Americans are affected by it each year, especially those in their late teens and early 20s. Although most infections will resolve on their own, 1 in 10 will lead to health problems such as cancer. The HPV vaccine can prevent over 90% of associated precancers and cancers. However, uptake of the HPV vaccine and its completion among adolescents are significantly lower than other recommended adolescent immunizations, falling short of the Healthy People 2030 goal of 80% coverage. Understanding parental attitudes, beliefs, and perceptions …

A School-Based Asthma Initiative To Improve Student Self-Management Behaviors, Jenni R. Newland

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a Midwest public school system, students received robust academic education. Health education programs, specifically asthma management, were not offered. Over 400 elementary students with asthma lacked the knowledge and skills to effectively recognize and manage their asthma symptoms resulting in increased school clinic visits and absences, highlighting the urgent need for targeted intervention.

Aim of the Project: The aim of this project was to improve students’ asthma self-management skills by providing education based on the Open Airways for Schools (OAS) curriculum. Improving asthma self-management skills reduces student absences and time away from the classroom.

Review of Evidence: A …

Tight Squeeze!: The Implications Of Prolonged Tourniquet Time In The Pediatric Emergency Department, Kaitlyn Beresford, Kayla Bhakta, Jared Grace, Samantha Swift

2023

No abstract provided.

Head, Shoulders, Heels And Toes: Are Toes An Appropriate Option For Capillary Blood Sampling, Camille Chicoine, Nina De Leon, Ahley Diaz, Roe Ronia Eminikhah, Laisha Killian, Brianna Leal, Adalie Lepoire, Genesia Rivera, Genesis Rivera

2023

No abstract provided.