Pediatric Nursing Commons^™

Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

Only 50% of pediatric patients presenting with significant pain receive any form of analgesia while in the emergency department (ED). The American College of Emergency Physicians endorses the use of triage protocols to improve the speed and consistency of analgesia in the ED. However, given the unique needs of the pediatric population insufficient evidence exists, if any, to support the use of triage protocols for their treatment in the ED. After a review of the literature it is concluded that triage pain protocols are a safe and effective method for providing pediatric analgesia in the ED. However, the variability in …

Integrating The Patient And Caregiver Voice In The Context Of Pediatric, Adolescent, And Young Adult Care: A Family-Centered Approach, Sarah K. Featherston, Beatriz N. Rozo, Danielle A. Buzanga, Alexandra M. Garcia, Joanne Greene, Laura K. Salvador, Joan O'Hanlon-Curry

Patient Experience Journal

Family-centered care (FCC) is defined as an approach to care coordination founded in collaborative partnerships between healthcare providers, patients and their family caregivers. Amid the enthusiasm for FCC in the pediatric setting, opportunities have been identified to operationalize the engagement of pediatric, adolescent and young adult patients and their caregivers into decision making that translates not only to their healthcare, but also to the context in which care is provided, as well as the research informing their care. At a National Cancer Institute-designated comprehensive cancer center, the Children’s Cancer Hospital was instrumental in designing and implementing patient and family engagement …

Partnering With Pediatric Patients And Families In High Reliability To Identify And Reduce Preventable Safety Events, Julie Kirby, Courtney Cannon, Lynn Darrah, Yolanda Milliman-Richard

Patient Experience Journal

Frameworks for designing highly reliable behaviors and tools to reduce preventable harm are the result of the continued effort to improve patient safety in healthcare. Evidence shows that there has been limited research on engaging patients and families in the development of safety and reliability efforts to achieve zero harm. Our aim was to develop a tool that engages patients and families in an effort to reduce preventable harm in a pediatric academic medical center.

Caring Moments Within An Interprofessional Healthcare Team: Children And Adolescent Perspectives, Amélia Didier, David Gachoud, Gabriela Von Niederhäusern, Lazare Benaroyo, Maya Zumstein-Shaha

Patient Experience Journal

Patients are now recognized as key partners to improve healthcare outcomes. Some organisations such as the WHO or the Canadian Interprofessional Health Collaborative (CIHC) encourage considering patients as partners in the interprofessional healthcare team. However, limited knowledge exists on patients’ perspective of interprofessional collaboration (IPC) and of their role in the collaborative process, particularly in pediatric settings. The experiences and perspectives of patients regarding IPC have to be considered in order to fully understand the concept of IPC and integrate it into practice. This qualitative study aimed at gaining a better understanding of the perspective of children of IPC, how …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

Doctor of Nursing Practice Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Admission Criteria For The Pediatric Acute Care Unit To Reduce Length Of Stay In The Emergency Department, Peter G. Campbell

Master's Projects and Capstones

Abstract

The primary objective as outlined in this prospectus is to develop pediatric admission criteria to reduce length of stay (LOS) in the emergency department for patients being admitted to the pediatric acute care unit. The pediatric acute care unit is a 25-bed licensed bed at a tertiary hospital in San Francisco serving patients from 1 day to 21 years of age. Methods included both qualitative and quantitative data to determine relevance of quality improvement project related to LOS, patient safety, patient satisfaction, and nurse to physician communication. Data collected indicated that average LOS in the ED was significantly higher …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Barriers To Providing Quality Care For Pediatric Patients With Autism Spectrum Disorder As Identified By Baccalaureate Prepared Registered Nurses: A Basis To Enhance Professional Practice, Ugo Ndubaku

Doctoral Projects

The increased prevalence of autism spectrum disorder (ASD) foretells that this sector of the population will be accessing health care services in greater numbers; thus, it behooves healthcare providers to prepare for their impending needs. This qualitative study describes the experiences of baccalaureate prepared registered nurses caring for children and adolescents with ASD in order to identify challenges that hinder providing comprehensive and individualized care. A purposive sample of 10 baccalaureate degreed registered nurses (RNs) who have worked or work in the pediatric unit was used to gather rich descriptive experiences. The qualitative data analyses were based on an interpretive …

Attitudes Of Middle School Children Towards Mental Health Programs, Catherine Taylor

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Despite years of school mental health services, today’s youth remain in need of mental health resources. While schools provide a variety of services to help reduce mental health disparities, there is limited information concerning the success of services offered. The purpose of this study was to examine the attitudes of middle school children towards mental health programs offered at the selected study site. The design utilized was a cross sectional design using a convenience sample of middle school children in Northwest Arkansas. The results indicated that middle school children need a unique variety of programs offered to support their …

Causes Of Late Preterm Infant Hospital Readmission Rates In Relation To Feeding, Kaitlyn Reid

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background:

In the U.S., late preterm (LP) births, which occur at 34^0/7-36^6/7 weeks gestation, make up the largest and fastest-growing group of preterm births. Although there is a trend of increased rates of LP infant readmissions compared to term infant readmissions, the relationship between LP infant morbidities and method of feeding has not been extensively studied.

Objective:

The purposes of this study were to 1) identify the primary causes of LP infant hospital readmissions and, 2) correlate the primary causes of LP infant hospital readmissions with the method of feeding.

Methods:

The design of this nonexperimental …

Yoga And Its Influence On Children's Behavior, Paige Sellen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This study looked at the impact ten minutes of daily yoga had on the behavior of elementary school children. Yoga was led by classroom teachers once daily for ten minutes over a sixteen-week period. At weeks one, eight, and sixteen, classroom teachers evaluated student behavior in six categories: personal awareness, attention, rapport with friends, rapport with teacher, following rules and transition between activities. The teachers rated the behaviors on a never, sometimes, mostly or always scale. The data was then analyzed and interpreted. Results revealed a significant difference in the attention, ability to follow rules, transition between activities, and personal …

Elementary School Teachers' Student Health Concerns And Knowledge Of Resources, Aubrey Gahagan

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Teachers are with their students an average of seven to 10 hours a day, five days a week. The substantial amount of time teachers spend with their students allows them to provide helpful insight into health problems children face. The purpose of this study was to identify elementary school teachers’ concerns for student health and to assess their knowledge of resources that address those health concerns. A convenient sample of 86 teachers from three elementary schools in Northwest Arkansas was surveyed. Surveys were used to identify the three main concerns teachers have for their students. A cross-sectional design was used …

Perceptions Of Pediatric Nurses And Parents Of Hospitalized Children Engaged In Shared Decision Making., Lisa English Long

Electronic Theses and Dissertations

Achievement of optimal quality in today’s healthcare environment practices means that clinical practices must be based on evidence. Evidence-based practice (EBP) is the integration of research findings, clinician expertise, and patient-centeredness that includes a focus on preferences and values (Melnyk & Fineout-Overholt, 2015). An area within EBP needing increased attention is the aspect of patient preferences and values. The process of Shared Decision Making (SDM) incorporates assessment of preferences and values within a process in which where patients, families and healthcare professionals collaborate to make decisions regarding patient care. The purpose of this study was to describe perceptions of parents …

Health-Related Quality Of Life In Female Children With Congenital Adrenal Hyperplasia: A Mixed Methods Study, Lacretia Carroll

Theses and Dissertations (ETD)

Introduction. Health-related quality of life (HRQOL) has become a meaningful area in research, medical management, and in the evaluation of health outcomes. However, in children with congenital adrenal hyperplasia (CAH), HRQOL is a long-neglected subject. Previous research in individuals with CAH typically focused on medical treatment and outcomes, which suggested that HRQOL is influenced by personal factors such as genital ambiguity, impaired growth, higher incidence of obesity, metabolic syndrome, hypertension, acute adrenal crisis, as well as losses in psychosexual milestones and psychological functioning. Social contexts, such as family, were identified as factors that contribute to an individual’s perceived HRQOL. Today, …

Perceptions Of Caring In The Pediatric Medically Complex Population, Ivette Becerra-Ortiz

Doctoral Projects

In a hospital system that transitioned from a non-caring science model to a professional practice model based on the Theory of Human Caring/Caring Science, it is important to measure the outcomes of the care delivery transition. In a non-experimental, cross-sectional, correlational, quantitative study the aim was to compare a pre/post-Caring Science model implementation at a pediatric and obstetric medical center, by assessing perceptions of caring in the medically complex pediatric population and in the nurses that care for them.

This study used a convenience sample of 102 pediatric families enrolled in a complex care program, and 23 nurses providing care …

Assessment Of Nurse Behaviors That Influence Care And Maintenance Of Pediatric Oncology Central Venous Catheters, Susan Elizabeth Mckenna

Doctoral Projects

Central venous catheters (CVC) are devices necessary to medically treat pediatric patients diagnosed with conditions such as cancer. Central line associated bloodstream infection (CLABSI) is a complication associated with utilizing a central line. Nurses are responsible for maintaining and complying with strict prevention protocols. The aims of this quality improvement project are to: (a) gain an understanding of perceptions of CLABSI prevention, (b) observe adherence to the CLABSI prevention bundle, (c) measure adherence to the current CLASBI prevention bundle (post-training), (d) identify ways to improve adherence to the CLASBI bundle, and (e) ascertain potential strategies for further compliance efforts. Three …