-
Squashing Superbugs: Using Procalcitonin Levels to Identify Bacterial Infections to Direct Antibiotic Therapy
Janna Berg, Tera Holland, and Krista Westbrook
The current standard in diagnosing and treating pediatric infections is obtaining cultures, interpreting complete blood count results, and following the trends of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Infection triggers an inflammatory response; if untreated or mistreated, this microbe invasion can lead to sepsis. The purpose of this submission is to address the promising use of procalcitonin levels (PCT) as a superior marker in the early detection of bacterial infection via a scholarly literature review. Studies involving PCT are more readily found in the evaluation of the neonatal population and in adults with respiratory illnesses. Pediatric studies are limited, therefore more research and an increased number of subjects are needed to validate PCT as being the best marker for early bacterial detection. PCT levels in a healthy individual are almost undetectable and will rise sharply when the inflammatory response is triggered by invading bacteria. PCT levels normalize faster than CRP levels in response to appropriate therapy; antibiotic therapy can be individualized to match this recovery. ESR and CRP do not differentiate bacterial infections from other invaders thus a predetermined antibiotic course is indiscriminately prescribed. The literature explains that PCT levels could encourage prompt diagnosis, early treatment and antibiotic stewardship. A scholarly search of more than 30 journal articles was reviewed and critiqued by the presenters. Research shows that in adults and neonates, PCT is the standard for diagnosing and treating bacterial infections. Elevated PCT levels in neonates determine the need for antibiotic treatment in bacterial infection or supportive treatment in its absence (viral infection). Determining the nature of increased inflammation is crucial to treatment; it can help isolate infections in adults presenting with pre-existing respiratory diseases, like COPD. Studies on the pediatric population show promise that PCT will be just as crucial in bacterial infections.
-
Improving Catheter Associated Urinary Tract Infection Rates of Pediatric Patients Through Standardization of Catheter Care
Shelby Beyers, Jenna Buys, and Hayden Dutton
-
Improving Pediatric Healthcare Workers Personal Safety Through the Implementation of a Behavioral Rapid Response Team
Jennifer Brown and Diana Montoya
From 2017 to 2018, a metropolitan pediatric hospital noted a 62.6% increase in calls to security for uncooperative patients related to physical aggression and acute behavioral decompensation. Even with annual de-escalation and restraint training, a 2019 survey conducted by clinical educators discovered only 27% of staff felt safe when handling an aggressive patient. This drove a collaborative initiative to formulate a multidisciplinary Behavioral Emergency Response Team (BERT) to standardize care, emergently respond in behavioral situations, and act as a resource to staff. Nurse professional development (NPD) specialists were used to create and develop a multifaceted education approach including instructor-led training, simulation, a computer-based training program and a six-month post-implementation face-to-face content refresher and simulation. One-year post implementation, and over 100 BERT responses, a follow up survey revealed staffs’ perception of personal safety more than doubled to 55%. This illustrates the BERT is a valuable staff resource and supports a safer work environment. Continuous tracking of BERT activations, responses, and staff perceptions of personal safety will help fine tune the current process and allow for development of future programs to promote workplace safety. The success in development, training and implementation of the BERT on our main campus, has led to its adoption at other satellite hospitals.
-
Promoting Patient Safety using Virtual Safety Huddles
Rachael Burris-Alcala, Julie Baker, and Ann Gosdin
-
Exploring Child Anxiety and Family Satisfaction in the Pre Anesthesia Clinic
Ann Johnson, Bonita Conley, and Brenda Fields
-
How a Crew of Experts Can Pave the Road to Quality Improvement in Preventing Central Line-Associated Bloodstream Infections
Ginny Leinweber, Angie Morris, and Kendra Shotts-Fraser
-
PICU Team Member Innovative Support Plan Intentional caring practices to mitigate moral distress, secondary trauma, and burnout in the Intensive Care Unit.
Ginny Leinweber, Kendel Richards, and Jessica Roumillat
-
Nurse: Are you in Pain? Patient: (No answer)
Katie McLaurin
Many infants and children admitted to the pediatric intensive care unit (PICU) have difficulty self-reporting pain requiring nurses to score pain utilizing the FLACC scale. However, when surveyed, PICU nurses at Children’s Health expressed dissatisfaction with the FLACC scale because it did not accurately assess pain in the PICU population (mean=4.1). An extensive literature review was conducted to determine the best behavioral pain scale to use for nonverbal patients in the PICU. Based on the literature, the COMFORT-B scale was selected. The COMFORT-B scale is a behavioral pain scale validated in the PICU in children 0 to 10 years and in Down Syndrome 0 to 3 years. The goal of the project was to trial the COMFORT-B Scale to measure the PICU nurses’ perceptions of the COMFORT-B scale’s accuracy for non-verbal patients’ pain compared to the FLACC scale and determine feasibility of adopting the COMFORT-B scale at Children’s Health. Seven PICU nurses participated in the trial. Following education of the COMFORT-B scale, nurses scored their patients with the tool over two weeks on 80 patients. Participants completed a pre and post survey questions. The results from the post survey showed at participants thought the COMFORT-B scale was easier to use (mean= 8.1) and was more accurate (mean= 7.9) than FLACC. Even though the COMFORT-B scale is more thorough and takes more time to score than FLACC, participants thought the COMFORT-B Scale could be adapted into the workflow of a nurse’s daily tasks (mean=7.6).
-
INITIAL RESULTS OF THE ASQ (ASK SUICIDE QUESTIONS)PATIENT QUESTIONNAIRE INPLEMENTED AT CHILDREN’S HEALTH
Jane Miles, Karla Hutcherson, and Jennifer Brown
-
Exploring Nurse Beliefs and Perceived Readiness for System-Wide Integration of Evidence-Based Practice in a Large Pediatric Health Care System
Lindsey Patton, Mayra Garcia, Virginia Young, and Jerithea Tidwell
-
Improving Patient Safety by Predicting Early Deterioration in the Pediatric Pulmonary Population
Christina Smith, Lindsey Patton, and Peng Chen
-
Decreasing the Risk: Early Discontinuation of Urinary Catheters Through Nurse Led Removal Program
Valerie Tidwell, Victoria Washington, and Ginger Young
Printing is not supported at the primary Gallery Thumbnail page. Please first navigate to a specific Image before printing.