These slides have been presented at a meetings in Children's Mercy and around the world. They represent research that was done at the time they were created, and may not represent medical knowledge or practice as it exists at the time viewers access these slide presentations.>
-
Implementation of a Guideline-based Non-tuberculous Mycobacteria Management Algorithm
Christopher M. Oermann
NTM in CF. NTM are ubiquitous environmental organisms that can cause chronic pulmonary infection. Prevalence among CF patients is increasing. 1-3% in the earliest study reported in 1984. CF Registry with average of 12% but significant range (0-28%). 32.7% reported among patients less than or equal to 40 years in Colorado. Generally categorized as “slow growers” and “rapid growers”.
-
ABCs of Safe Sleep
Alyson Hill RN, Jennifer Markey RN, Bailey Ritter RN, Ashley Smith RN, and Aaron Smithson RN
PICO Question
Does education and teaching to parents and family regarding safe sleep practices increase the compliance of safe sleep for infants 0-12 months on 4 Sutherland compared to the current practice?
Aim Statement
The objective of the evidence based practice project is to increase Safe Sleep compliance by improving education given to parents and family from 20% to 90% by February 2018
-
Baby Got BAC
Tina Histand BSN, RN; Heidi Mustapich BSN, RN; Brittany Parks RN; Mallory Potter BSN, RN; and Melanie Traynham RN
PICO Statement
• Population: 6 Henson patients who qualify for Safe Sleep Practices according to the Safe Sleep Policy.
• Intervention: Signs will placed in high patient care areas to provide awareness and reminders to 6 Henson patient caregivers of correct safe sleep practices.
• Comparison: Current standard of care
• Outcomes: Increased compliance with safe to sleep practicesAim Statement
The objective of this evidence based practice project is to increase Safe Sleep compliance on the 6 Henson unit by 10% by March of 2018
-
Chasing Never: Unplanned Extubation
LeeAnna Gaspers BSN,RN; Brittney Gerber BSN,RN; Madison Hersma BSN,RN; Erin Keith-Chancy BSN,CCRN; Audrey Knodell BSN,RN; Jordan Miller BSN,RN; Liz Morrow BSN,RN; Tara Otterson BSN,RNC; Chantal Rogers BSN,RN; and Abby Slaven BSN,RN
PICO Question
• P:In the Intubated neonate
• I: can the bundling of potentially best practice recommendations (tube location documentation, 2-person handling, and management of positioning and secretions) and standardized hourly assessment with documentation of compliance
• C: current standard of practice
• O: decreased unplanned extubationsAim Statement
Decrease the rate of unplanned extubations in the ICN from 1.38/100 ventilator days in 2016 to 1 event/100 ventilator days in 2017.
-
ED Staff Morale
Madison Wilkins RN, Tonya Cross RN, Brittany Schmalzbach RN, Noah Olla RN, Fred Richards RN, and Emily Pendleton RN
PICO Question
PICO Question & Aim Statement
• (Population, Intervention, Comparison, Outcomes Measures)
• P: ED Nurses and Support Staff
• I: Huddle Recognition and prizes
• C: No recognition
• O: Improved nursing morale
To increase the median morale of nursing and support staff from 74% to 80% as measured by Daily Pulse by March of 2018
-
ICN Flu Vaccine Cocooning
Allison Bauer BSN, RN; Brittany Wolter BSN, RN; Jonathan Rind BSN, RN; Maggie Butaud BSN, RN; Sarah Dumovich BSN,RN; Tori Weishaar BSN, RN; and Karli Wittenbach BSN, RN
PICO Question
P (Population): Registered nurses in the CMH Intensive Care Nursery providing patient care.
I (Intervention): Electronic documentation of parent flu vaccine status. Include vaccine status reminder in pod huddle.
C (Comparison): Current practice
O (Outcome): Increase the percentage of families receiving the flu-vac
Aim Statement
The objective of this evidence based practice project is to increase the percentage of families receiving the flu vaccine from 83% to 85% by March of 2018
-
PICU Patient Satisfaction
Kaitlyn Enochs BSN, RN; Jonathan Foley BSN, RN; Tara Goodman BSN, RN; Abby Haupt BSN, RN; Chelsea Koerkenmeier BSN, RN; Allison Mills BSN, RN; Kara Mishler BSN, RN; Madison Myers BSN, RN; Michelle Noykhovich BSN, RN; Sophia Poplin BSN,RN; Austin Reyes BSN, RN; Kylie Stottlemyre BSN, RN; Sarah Swift BSN, RN; Danielle Warner BSN, RN; Emily Zimmerman BSN, RN; Brooke English MSN, RN, CCRN; and Katherine Hoffman BSN, RN
PICO
PICU secretaries and parents will be able to increase the number of completed parent satisfaction surveys compared to current actions and supports.
Aim Statement
- To increase rate of completed parent survey by 5%, as measured by the number of surveys submitted each quarter by January 2018
- To have 10% response rate to surveys for patients that have been in the PICU for 30 days or greater.
-
Safe Baby
Hannah Burger BSN, RN; Samantha Cockrell BSN, RN; Shauni Lawrence BSN, RN; Shae McGinnis BSN, RN; Christina Montgomery RN; and Elizabeth Taylor RN
PICO Question
P: 4 Henson and 5 Sutherland patients who qualify for Safe Sleep Practices according to the Safe Sleep Policy.
I: Creating a useable checklist to be completed with each infant and each shift change
C: Current standard of care
O: Increased compliance with safe to sleep practicesAim Statement
The objective of this evidence based practice project is to increase Safe Sleep compliance from 50% to 65% on 4 Henson and 5 Sutherland by February 1, 2018.
-
Same Day Discharge for Non-Perforated Appendicitis in Children: An Updated Institutional Protocol
Tolulope A. Oyetunji MD MPH
-
Evaluating the Consistency and Quality of Search Strategies and Methodology in Cochrane Urology Group Systematic Reviews
Jennifer A. Lyon, Carrie Price, Jamie Saragossi, and Clara Y. Tran
OBJECTIVES
The Cochrane Urology Working Group has undergone multiple administrative and personnel changes over its history. Presently, there are nearly a dozen Information Specialists volunteering from several institutions and two countries. To identify areas for quality and consistency improvement, we evaluated the search methodologies in 64 Urology Group Reviews/Protocols.
METHODS
64 published Urology Group Cochrane Systematic Reviews (CSR) and Protocols (CSP) were downloaded from the Cochrane Library on September 15, 2016. A data form was created using Qualtrics consisting of several sections including expanded PRESS (Peer-Review of Electronic Search Strategies) elements, database selection, search methodology reporting, & consistency. Four librarians, including two Cochrane Urology Assistant Information Specialists, evaluated 20 CSR/Ps each, allowing overlap to verify data extraction reliability.
RESULTS
Librarian reviewers noted high variability in CSR/P search methods including selection of databases searched, full search strategies reporting, and use of publication filters, clinical trial registries, conference proceedings, and journal TOCs. Within search strategies, common errors included wrong line numbers, misspellings, inappropriate syntax, and duplicated lines.
CONCLUSIONS
Cochrane Reviews are frequently viewed as the "gold standard" of systematic reviews, therefore the CSR/Ps should have high quality search methodology. This retrospective analysis represents a historical overview of search method reporting in CSR/Ps from the Cochrane Urology Group. Our results demonstrate a need for improved standardization including complete documentation of all strategies, more consistent database selection, less variation in strategy construction, increased use of peer-review and inclusion of the PRISMA Flow Diagram, and tighter adherence to the Cochrane Handbook/MECIR Standards.
-
Congenital Abnormalities of the Lower Airways and Lungs
Christopher M. Oermann
Goals and Objectives. Participants will be able to: Describe the 5 stages of fetal lung development. Summarize the prenatal identification and management of congenital abnormalities of the lower airway and lung (CALAL). Explain the classification of CALAL. Compare the clinical characteristics, pathology and management of common CALAL. Discuss the long term prognosis of CALAL.
-
High Acuity Readmission Risk Pediatric Screen Tool (HARRPS)
Sarah Bradshaw and Anita Powell
Podium Presentation on Quality Improvement Project: Implementing Use of HARRPS Tool
Objectives:
- Describe the development of an evidence-based pediatric risk screen tool for inpatient admissions
- Articulate how formal Continuous Quality Process Improvement (CQPI) methods were utilized during implementation
- Discuss lessons learned and next steps
-
Pulmonary Complications of Cystic Fibrosis
Christopher M. Oermann
Goals and Objectives. Participants will be able to: Explain the pathophysiology leading to the pulmonary complications of cystic fibrosis. Recognize the clinical presentation of the pulmonary complications of cystic fibrosis. Formulate a treatment plan for the pulmonary complications of cystic fibrosis.