Matching Items (13)
Description
Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated, triage-based CS administration and determine the effect on overall length of stay (LOS). Methods: For this quality improvement initiative, ED nurses at a large, freestanding, children’s emergency department in the southwestern United States were given education on inclusion and exclusion criteria for nurse-initiated CS in ED triage. Time to CS administration, LOS, and whether the ED nurse or provider ordered the CS were evaluated through chart reviews of patients presenting with a chief complaint of difficulty breathing. These metrics were compared to charts from the previous year during the same timeframe to evaluate for improved timeliness of CS delivery. Results: Time to CS administration decreased from a mean of 98.6 minutes to 57.6 minutes. LOS decreased from an average of 259.3 minutes to 169.6 minutes. The effect of timely CS on LOS was significant for December p =.003, January p =.002, and February p = <.001. Conclusion: A streamlined process for CS delivery to pediatric patients experiencing an asthma exacerbation can enable providers to achieve efficient and effective care in the ED and decrease a patient’s overall LOS.
ContributorsBain, Ilyssa D. (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
Description
Extracorporeal membrane oxygenation (ECMO) is a high-risk, but highly successful intervention for the survival of critically ill neonatal and pediatric patients. Patients supported by ECMO require continuous infusions of anticoagulant medications to prevent clotting of the ECMO circuit, thrombotic events in the patient, and other bleeding complications. Close monitoring, care, and management of the ECMO circuit and its components, with specific focus on systemic anticoagulation, is vital as many factors may influence the efficacy of the anticoagulant and ultimately the patient condition. Globally accepted guidelines exist for the correct management of anticoagulation while supported on ECMO; however, health care centers frequently deviate from these recommendations. This project report synthesizes the most current literature on anticoagulation management in the pediatric ECMO supported population, discusses the limitations in current research, and demonstrates the necessity to use standardized anticoagulation protocols for the safest and most successful outcomes. To implement these findings, this project report suggests the need for an evidence-based project that focuses on the quality improvement of current ECMO anticoagulation guidelines.
ContributorsHolmes, Lauren Michelle (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
Description
Introduction: The purpose of this project was to evaluate a tablet-based documentation application for massive transfusion protocols (MTPs).
Methods: 13 trauma nurses at a level-one pediatric trauma center were randomly assigned to use paper documentation (n=5) or the tablet-based application (n=8) during simulated MTPs. Documentation completeness was compared using an independent t-test. Tablet users completed a system usability survey (SUS).
Results: Documentation of blood product volumes and times significantly improved with the tablet (p=<0.001 and p=0.001 respectively). The tablet received a mean SUS score of 89%.
Discussion: A tablet-based application has potential to improve real-time documentation of MTPs.
ContributorsShoop, Morganne (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Nursing burnout is a predominant issue for the modern nurse and must be more fully addressed for the health and success of the field and the individuals who make it up. Mindfulness exhibits efficacy in multiple studies as an intervention for burnout and should thus be considered as an option for treatment and prevention of this issue. The creation of the included mindfulness workbook allows nurses to assess and address their specific level of burnout in a cost-effective manner.
ContributorsAlexander, Taylor (Author) / Sebbens, Danielle (Thesis director) / Towers, Laura (Committee member) / Barrett, The Honors College (Contributor) / School of Social Transformation (Contributor) / Edson College of Nursing and Health Innovation (Contributor)
Created2022-05
Description
Cases of sudden unexpected infant deaths (SUID) have taken thousands of lives of infants from families each year. The dangers of accidental suffocation, sudden infant death syndrome (SIDs), and even unknown causes have been prevalent throughout history. There are several behavioral risk factors that are associated with SUIDS and SIDS, which threaten the life of infants less than one year of age because they are in their vulnerable state of being. Being cautious of the crib environment, sleeping position, and co-sleeping can all help in reducing the risk of developing SIDS. The goal of this project is to continue to spread awareness regarding preventable measures to protect infants from unintentional deaths. These risks are modifiable and can help reduce the decline of health and help first-time parent(s) and caregivers protect their young
ContributorsDine, Hadaad (Author) / Chang, Jasmine (Co-author) / Hagler, Debra (Thesis director) / Sebbens, Danielle (Committee member) / Barrett, The Honors College (Contributor) / Edson College of Nursing and Health Innovation (Contributor)
Created2024-05
Description
Cases of sudden unexpected infant deaths (SUID) have taken thousands of lives of infants from families each year. The dangers of accidental suffocation, sudden infant death syndrome (SIDs), and even unknown causes have been prevalent throughout history. There are several behavioral risk factors that are associated with SUIDS and SIDS, which threaten the life of infants less than one year of age because they are in their vulnerable state of being. Being cautious of the crib environment, sleeping position, and co-sleeping can all help in reducing the risk of developing SIDS. The goal of this project is to continue to spread awareness regarding preventable measures to protect infants from unintentional deaths. These risks are modifiable and can help reduce the decline of health and help first-time parent(s) and caregivers protect their young.
ContributorsChang, Jasmine (Author) / Dine, Hadaad (Co-author) / Hagler, Debra (Thesis director) / Sebbens, Danielle (Committee member) / Barrett, The Honors College (Contributor) / Edson College of Nursing and Health Innovation (Contributor)
Created2024-05
Description
Background: Traumatic brain injury (TBI) is a leading cause of death and long-term disability among children. The Brain Trauma Foundation (BTF) guidelines integrate initiation of early enteral nutrition which is essential for achieving best clinical outcomes. Gaps in knowledge, consistency, and collaboration when managing these patients hinder adherence to the guidelines and puts the patient at risk.
Objective: This project purpose was to review the updated BTF guidelines and implement a rounding checklist to increase the early initiation of enteral feeding following a TBI.
Methods: This quality improvement project was conducted in the pediatric intensive care unit (PICU) at a level one pediatric trauma center and included all patients admitted with severe TBI. A pre- and post-test accompanied education regarding the guidelines and instructions for checklist completion. The checklists included all BTF guidelines, with a primary focus on early initiation of feeds. Checklist data was presented by the bedside nurse during rounds.
Results: Using descriptive statistics, the average pre-test score was 69% and average post-test score was 93%. Prior to the education, 82% of registered nurses believed a bedside checklist would help manage patients with severe TBI and increased to 95% after education. The checklist was used on 7 (100%) patients and 43% had feeds initiated within 72 hr post-injury (n = 3).
Conclusions: Early initiation of feeding in critically ill patients impacts patient outcomes. A rounding checklist can improve interprofessional communication and healthcare quality by delivering standardized pediatric TBI care. Research regarding enteral nutrition is needed to ensure nutrition is provided in a safe, timely manner.
ContributorsMichael, Holly N. (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
All-terrain vehicles (ATVs) are a leading cause of pediatric trauma. Children may experience a range of injuries from concussion and fractures to severe traumatic brain injury and even death. ATV safety is a priority. Research emphasizes the importance of helmet use while riding an ATV and adhering to manufacturing guidelines for ATVs. These findings have led to the initiation of an evidence-based project to identify behavioral changes within the pediatric population, specifically children 12-18 years of age who are on the Trauma Service of Phoenix Children’s Hospital. Each patient was given a pre-test survey to assess their knowledge regarding ATV safety. After the pre-test survey was completed, an educational component was implemented, the participant used teach-back to the project personnel to demonstrate understanding, and a post-test survey immediately followed. The posttest had several open-ended questions that identified the patient’s intention to follow the safety recommendations when riding their ATV in the future.
ContributorsO'Donnell, Elly (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Skin and soft tissue infections (SSTI’s) are a significant health concern with serious potential implications. Evidence suggests the importance of implementing a severity stratification tool to improve early identification of SSTI’s. The aim of this evidence based project is to examine if educating healthcare staff on the use of a severity stratification tool would increase staff knowledge of SSTI's. The sample consisted of 18 participants, 12 healthcare providers and 6 healthcare staff at a correctional facility in the Southwestern United States. A pre-and posttest design, including an educational session was implemented.
A 14-item multiple choice self-developed questionnaire was used to evaluate participants’ knowledge of identifying and ranking SSTI’s using the CREST tool. A one tail paired t-test was performed to compare the pre-and post-test case study scores for the healthcare provider group. A significant increase from pre-test to post-test case study scores was found (t(13)= -6.19, p < 0.00). Of the healthcare providers, 57% found the tool “moderately helpful.” Of the non-provider sample, 50% found the tool “extremely helpful” and plan to use the tool “all of the time.” The findings of this study suggest that implementing an educational session on a wound severity stratification tool improves staff knowledge and increases the likelihood of the tool being used in practice. Recommendations for future research include larger sample sizes across a variety of regional correctional facilities to further explore the use and knowledge of the tool in practice.
ContributorsCason, Chelsea (Author) / Baker, Laurie (Thesis advisor)
Created2018-04-30
Description
Introduction: Palliative care can significantly benefit children managing a life-limiting illness; unfortunately, services are generally reserved for end of life. The aim of this project was to demonstrate how established guidelines coupled with provider education could impact referrals.
Methods: Educational sessions developed using information processing theory and outlining referral recommendations were offered to providers in the NICU, PICU, and Center for Cancer and Blood Disorders at a tertiary care facility. Presurveys and postsurveys were administered at the time of the intervention and referral numbers for the organization were collected for two months prior and two months following.
Results: Descriptive statistics and paired t-tests were used to compare survey data and referral rates.
Discussion: Palliative care is imperative for meeting patient goals and optimizing quality of life. Provider knowledge of referral criteria ensures that patients receive this service early in their disease trajectory and can benefit from its inclusion within their care team.
Methods: Educational sessions developed using information processing theory and outlining referral recommendations were offered to providers in the NICU, PICU, and Center for Cancer and Blood Disorders at a tertiary care facility. Presurveys and postsurveys were administered at the time of the intervention and referral numbers for the organization were collected for two months prior and two months following.
Results: Descriptive statistics and paired t-tests were used to compare survey data and referral rates.
Discussion: Palliative care is imperative for meeting patient goals and optimizing quality of life. Provider knowledge of referral criteria ensures that patients receive this service early in their disease trajectory and can benefit from its inclusion within their care team.
ContributorsNewton, Katelyn A. (Author) / Sebbens, Danielle (Thesis advisor)
Created2018-04-27