Pediatric Nursing Commons^™

Enteral Nutrition Protocol For Pediatric Burn Patients: A Quality Improvement Initiative, Margaret Tepe

Doctoral Projects

Objective: This quality improvement project was conducted to determine the efficacy of an enteral feeding protocol to improve nutrition supplementation in pediatric burn patients.

Methods: Non-ICU patients with >10% total burn surface area requiring enteral nutrition supplementation were fed within 12 hours of admission or with the first sedated dressing change, whichever took place first. Pre (n = 3) and post (n = 5) implementation of the enteral feeding protocol data were obtained. Data were collected via chart audit and survey.

Results: Patients and nurses had similar characteristics; and nurses had similar nutrition practices. Total intake of calories (93.8%) and …

Utilizing Educational Materials To Change Vaccine Compliance In Children Under 24 Months Of Age, Kelsey M. Arnold

Doctoral Projects

Background: Childhood vaccinations are critical to preventative care for the pediatric population. The goal for the clinic’s combination 10 insurance quality measure, which reflects the number of fully vaccinated children by 24 months of age, is to be greater than 68%.

Purpose: This quality improvement project sought to implement evidence-based interventions to improve childhood vaccine compliance by increasing the parent/caregiver’s knowledge about vaccines and increasing the communication with their healthcare provider.

Methods: A parent friendly vaccine schedule, information pamphlet, interactive video, and survey were given to parents/caregivers during well-child visits. A total of 117 parent/caregiver surveys were collected. Vaccine compliance …

Tracheostomy Education For Pediatric Patients And Parents, Jonathon Batts, Kendall Baker

Scholars Week

To begin this project, we found that this specific facility did not have proper education given to parents about pediatric tracheostomies. Pediatric patients with tracheostomies are a very delicate population that requires extensive, round the clock care. We were able to establish a theoretical framework with Orem’s Self-Care theory that matched very well with our topic, and finally we were able to find research articles that looked at this patient population specifically. The need for a tracheostomy in pediatric patients can lead to extreme anxiety in patients and parents. Our recommendations for this facility would be to implement the “Trach …

Joining Forces: A Response To Limited Clinical Sites During The Covid-19 Pandemic, Katherine Dixon, Leah Hawsey, Jan Shows, Candace Gandy

Journal of Interprofessional Practice and Collaboration

Students who are unable to attend Pediatric clinical during the COVID-19 Pandemic needed an alternative method to meet the clinical objectives of the nursing curriculum. Utilizing semester-five management students to implement a simulation activity with the semester three pediatric students allowed the opportunity to simulate clinical experiences and develop interpersonal, clinical, and professional skills. Allowing the semester five students to pre-brief, implement, debrief, educate and mentor the semester-three pediatric students allowed the students to meet their course objectives and develop skills in patient-centered care, safety, informatics, documentation, delegation, education, and mentoring.

Preventing Insulin Storage And Administration Errors, Makena Reddick

Scholars Week

■The research problem was discovered when nurses were observed storing and administering insulin improperly. The objectives of this project were to find the correct policies for these procedures, obtain research that backed these policies, and present this information to nurses to create a safer habit. In researching, it was found that reducing the physical distance between a person completing work and the materials required to do so increased compliance (Gibbs & McLernon, 2017). In a second study, the delivery of safe, effective and high-quality care for patients with diabetes in the community is dependent upon (district) nurses having appropriate knowledge …

Evidence-Based Practice: Delaying Infant Bathing, Gabrielle Wadle, Grace Frankland

Scholars Week

A hospital's policy regarding infant bathing is currently not congruent with best nursing practice. The hospital’s current policy is to bathe an infant once they are stable and their rectal temperature is at or above 98.6 °F. Although the infant may become stable within the first 24-hours of birth, the World Health Organization recommends that, “Bathing should be delayed until 24 hours after birth.” (2013, p. 4). Research has been completed to support delaying infant bathing until 24 hours post-delivery, suggesting potential modifications to current policy.

Pediatric Wound Care: Establishing A Consensus Group To Develop Clinical Practice Guidelines, Ryan Krasnosky, Geran Barton, Linda Highfield, Sheila Martinez, Stephen Linder, Edward Buchanan, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. Wound care practices for neonatal and pediatric patients have created a lack of standardized evidence-based guidelines for treatments in clinical practices. Unfortunately, published clinical guidelines for the evaluation and management of wounds in pediatric populations is limited. Consensus groups are used to develop clinical guidelines which define key aspects of the quality of health care, particularly appropriate indications for interventions. The aim of this initiative was to conduct the first two steps of the guideline development process, and to report on the findings from the expert consensus group for pediatric wound care.

Methods. The goal was to recruit a …

Exploring Parent Perception Of Adverse Childhood Experiences Screening In Pediatric Primary Care: A Clinical Inquiry Project, Kathryn Stevens

The Eleanor Mann School of Nursing DNP Capstone Projects

This manuscript explores the incidence and implications of Adverse Childhood Experiences (ACEs) and outlines a project assessing parental perception of their own ACEs screening during their child’s wellness visit. ACEs are adversarial events occurring during childhood, which may be chronic or singular. Abuse, neglect, and household dysfunction result in negative outcomes, including compromised neurological development and cognitive behaviors, developmental delays, poor lifestyle choices, and reduced mental and physical health. Additionally, a growing body of literature supports the impaired parenting skills in those with a history of ACEs. This can perpetuate intergenerational trauma, deprived opportunities, and poor familial health. Despite the …

Program Evaluation Of Parent Engagement Activities In The Pediatric Cardiac Intensive Care Unit, Cheryl A. Bos

Doctoral Projects

Introduction: Leaders of a six-bed pediatric cardiac critical care unit identified the need to evaluate family engagement in patient care activities prior to implementing quality improvement initiatives. This program evaluation identified staff and family perception of barriers and facilitators to parent engagement in the Pediatric Cardiac Intensive Care Unit.

Methods: Data were collected through quantitative and qualitative methods. Surveys collected staff baseline and parent pre-/post-hospital perception of the role of family engagement in caring for the child.

Results: The Questionnaire of Factors That Influence Family Engagement survey of 58 registered nurses indicated the nurse workflow (τb = .579, p = …

Connected Care: The Relationship Between Infant-Caregiver Interaction & Preterm Infant Development, Amelia G. Williams

University Honors Theses

This thesis encompasses how families and healthcare workers alike can uplift preterm infants’ development in the Neonatal Intensive Care Unit. The use of positive facial expressions, skin-to-skin contact, verbalizing with the infant, quality time, and focused attention are explored to promote the preterm infant’s positive development. Additionally, this thesis includes research on optimizing the transition from hospital to home for both parents and infants.

This thesis aims to gather information that caregivers can easily reference and put into action with preterm infants. At the end of each body paragraph, the reader can promptly locate summarizing bullet points of how caregivers …

A Practice Innovation To Improve Staff Vaccination Knowledge And Skills, Ijeoma Ugochukwu

Nursing Posters

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and …

Nursing Student’S Expectancy-Value Regarding Sudden Infant Death Syndrome Knowledge Retention, Raquel Suba

Nursing | Student Research Posters

Sudden Infant Death Syndrome (SIDS) is a sudden and unexpected death within the first year of life, which is attributable to unexplained causes after autopsies and full case investigations are unable to resolve the reason for death. Annually in the United States, approximately 3,600 infants die unexpectedly and suddenly of Sudden Unexpected Infant Death (SUID) and in 2018, there were 1,300 infant deaths due to SIDS (CDC, 2018). Despite American Academy of Pediatrics (AAP) recommendations promoting the endorsement and modelling of SIDS risk-recommendations from birth, studies reveal that both nursing students and registered nurses have deficient knowledge in adequate SIDS …

Picu Team Member Innovative Support Planintentional Caring Practices To Mitigate Moral Distress, Secondary Trauma, Andburnout In The Intensive Care Unit., Ginny Leinweber, Kendel Richards, Jessica Roumillat

2021

Situation:

PICU staff frequently verbalize feelings of moral distress, anxiety, and exhaustion related to repeated exposure to complicated, ethically challenging situations and the intense nature of work in the PICU. Stressors associated with complex long term patient cases, deaths, medical errors, and adverse events are compounded by factors like the pandemic, high patient acuity, and instability of staffing. Collectively, these situations increase the risk of burnout and decreased job satisfaction.

Background:

Research shows that cultivating resiliency practices can improve overall well-being of the individual and lessen burnout and turnover. Though the hospital offers a program (RISE) that promotes resilience, integrated …

Perceived Neighborhood Characteristics And Parental Role In Physical Activity Of African American Youth, Kashica Webber-Ritchey, Elizabeth A. Moxley, Sungsoon Hwang, Desale Habtzghi, Sai Yalla

Faculty Articles, Papers, and Other Scholarship

Introduction: Lack of physical activity (PA) serves as one of the contributing factors to pediatric obesity in African American (AA) youth.

Objective: Further examination of the Social Ecological Model [SEM] influences on PA in AA youth is vital. The purpose of this pilot study is to explore environmental factors, built environment (BE) and parental role, in PA promotion.

Methods: Using mixed method data collection, a convenience sample of 28 AA parents/caregivers of school-aged children (6-12 years) enrolled in Chicago Youth Programs (CYP) completed an online survey. Parents/caregivers along with their child participated in focus group sessions (n=18 parent/child dyads). …

Improving Catheter Associated Urinary Tract Infection Rates Of Pediatric Patients Through Standardization Of Catheter Care, Shelby Beyers, Jenna Buys, Hayden Dutton

2021

Background/Significance: Pediatric patients with urinary catheters are at an increased risk for developing Catheter Associated Urinary Tract Infections (CAUTI). Standardization of urinary catheter care improves CAUTI rates. At Children’s Health, the CAUTI rate increased from 2 infections to 10 infections from 2018 to 2019. Review of organizational policy revealed that urinary catheter care practices were not standardized. Bedside staff performed catheter care with soap and water but utilized different methods and supplies, leading to variability in practice.

Purpose/EBP Question: The purpose of this Evidence Based Practice (EBP) project was to standardize catheter care throughout Children’s Health. Nurse resident sought …

Ir Unplanned Line Removals, Toni Haynes

2021

Problem
In 2020, the Hematology/Oncology unit noticed an increased trend in Intravascular Access Devices (IVADs) needing to be removed due to infection or dehiscence of the incision.

Key EBP Practices
A Clinical Nurse Specialist, Central Line Nurse, Bone Marrow Transplant Doctor, and four Interventional Radiologist Surgeons came together to discuss potential causes of the increase in line removals. Team decided to track unplanned line removals. Unplanned line removal criteria are met when a central line is removed within 30 days of placement from an infection or dehiscence. Evidence shows studies looked at 30-day periods for line removals, and line removals …

Optimizing A Pediatric Dka Protocol In A Tertiary Care Hospital System In Northern West Virginia, Jennifer L. Burky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body compensates for insufficient insulin, producing dangerously high levels of ketones. Without proper treatment, DKA can be fatal. For that reason, staff in the pediatric intensive care unit (PICU) at a tertiary care hospital in northern West Virginia expressed concerns about the complexity of and lack of adherence to a poorly referenced and dated DKA treatment protocol.

Objective: The purpose of this project was to assess the feasibility and sustainability of optimizing the DKA protocol in the PICU. The primary objective was to implement an updated, …

The Associations Among Parental Emotional States, Adolescent Emotional States, And A1c In Adolescents With Type 1 Diabetes, Jennifer L. Yenke

DNP Projects

Background: This study examined depression and diabetes distress (DD) in adolescents with type 1 diabetes (T1D) and in their parents. Depressive symptoms and DD are associated with poor glycemic control.

Objectives: To describe the prevalence of parental and adolescent depressive symptoms and DD in the sample and to evaluate correlations among depressive symptoms, DD, and A1c in parent-adolescent dyads in which the adolescents have T1D.

Methods: Thirty-two parent-adolescent dyads completed measures assessing depressive symptoms (Patient Health Questionnaire-9) and DD (Problem Areas in Diabetes- Parent of Teen and Teen versions), self-reported socio-demographic and clinical variables, and responded to questions about living …

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …