SPN 2010 Convention Poster Abstracts
by the nurses in the focus groups were consistent with
Associations Among Distinct Behaviors of Children With Autism,
Community Support for the Family, and Family Adaptation
Heather Hall PhD, NNP, RNC
University of South Alabama College of Nursing, Mobile, AL
Purpose: This study examined the distinct behaviors of children
with autism, community support for the family, and family
adaptation and the relationships among these variables.
Background: Children with an autistic disorder present more
socially unacceptable behaviors than other children their age
including children with intellectual disabilities. Parents of children
with autism have reported how they search for encouragement from
friends, seek advice from other families with children diagnosed
with autism, pursue support from agencies and programs, and place
little emphasis on spiritual support.
Methods: A descriptive, correlational, cross-sectional study was
conducted with a purposive sample of parents/primary caregivers of
children with autism. Pearson product–moment correlation will be
used to identify relationships. Multiple regression analysis will
identify which variable better predicts family adaptation.
Results and Implications for Practice: These results will present
thoughts and suggestions about how to care for children with autism
and their families.
doi:10.1016/j.pedn.2009.12.052
Magnet From the Frontline: Using Focus Groups to Realize
the Possibilities
Amy Huett BSN, RN, Pamela Trevino BSN, RN
Arkansas Children's Hospital, Little Rock, AR
Background: The ANCC Magnet Recognition Program recognizes
nursing excellence. Early in the journey toward Magnet recogni-
tion, a freestanding children's hospital developed a staff advisory
council to advise the senior nursing leadership team. The council
suggested focus groups to learn from nurses with work experience
in a Magnet organization.
Sample: Nurses with experience in Magnet hospitals were
invited to participate in focus groups. Ten nurses participated,
eight of whom were less than 40 years of age. Eight of the
participants held baccalaureates and two held master's degrees in
nursing. Each of the nurses had worked in different Magnet
designated facilities.
Methods: Four focus groups were conducted by two member teams
from the staff advisory council. The teams used open-ended
questions to elicit detailed information on the nurses' experiences in
Magnet hospitals. Comments were recorded verbatim on flip charts,
which were later transcribed as a Word document. Content analysis
was used to identify major themes.
Results: Participants were very positive about their experiences in
Magnet hospitals. Key themes included the impact of shared
decision making on staff satisfaction and care and the importance of
visible and accessible nursing leaders, interdisciplinary relation-
ships, and nursing autonomy.
Implications: The participants provided insight into their experi-
ences at Magnet hospitals, which will help provide guidance to the
staff advisory council and senior leadership team as we move
forward on our Magnet journey. The positive attributes identified
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characteristics of Magnet hospitals described in the literature.
doi:10.1016/j.pedn.2009.12.053
Risk Factors and Interventions for Ventilator Associated Pneumonia
Among Ventilated Pediatric Intensive Care Unit Patients
Jacalyn Iacoboni BSN, RN, CPN
MetroHealth Medical Center, Cleveland, OH
Significance: Ventilator-associated pneumonia (VAP) is a leading
nosocomial infection in pediatric intensive care units, affecting
patient outcomes and hospital costs. Implementation of all or
nothing evidence-based interventions (VAP bundle) has reduced
VAP among ventilated adult patients. However, little research has
investigated these VAP bundles in pediatric patients. Baseline data
on the presence of VAP risk factors and current practices among
ventilated pediatric patients is needed.
Purpose: The aims of this study are to (a) identify risk factors
associated with VAP among ventilated pediatric patients and (b)
describe current VAP prevention practices.
Sample: Patients admitted to the PICU requiring mechanical
ventilation. Exclusion criteria included immunological disorders,
known underlying lung infection, ventilated less than 48 hours.
Methods:
Design: Retrospective cohort study.
Data Analysis: Descriptive statistics, chi-square analyses.
Results: N = 38. Most common risk factor for VAP: DVT
prophylaxis (80% of patients did not have sequential compression
devices). Second risk factor: continuous IV sedation (45% receiving
2 continuous medications). Additional risk factors: GI feeds (54.8%
received no GI feeds, 26.4% lacked GI ulcer prophylaxis). Review
of VAP prevention practices revealed better documentation is
needed of: oral care, suctioning method, ventilator circuit changes,
and HOB elevation (not documented over 90% of the time). There
were no significant differences between groups with regard to
risk factors.
Implications: Findings provide information to guide implementa-
tion of VAP bundles in the PICU. Specifically bundles should
include SCD and GI prophylaxis. Implementation should focus on
adequate documentation of VAP prevention efforts by all health
care team members. Documentation of efforts are crucial to
demonstrate compliance with VAP bundles.
doi:10.1016/j.pedn.2009.12.054
Standardized Bronchiolitis Education
Joanne Kaye RN, CPN, Emma Elizabeth Scotter BSN, RN, CPN
Arkansas Children's Hospital, Little Rock, AR
Background: Bronchiolitis is the leading cause of hospitalization of
infants and toddlers up to age 15 months. The American Academy
of Pediatrics has well-defined evidence-based recommendations for
providing optimum care for this patient population, which is
reflected in a care pathway developed and used at our hospital.
Treatment for bronchiolitis is most often supportive care only. The
bulk of care for bronchiolitis is done by parents after discharge as
symptoms can continue for 3 to 4 weeks after hospitalization.
Parents must feel confident in caring for their children at home.
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Little literature is available regarding best practice for family
education and ongoing documentation of the education.
Methods: A standardized nursing education tool and parent video
were developed to ensure that accurate and consistent information is
taught to families and caregivers of patients with bronchiolitis.
Nurses will be educated on the use of the standardized education
tool and video by in-services and completion of an online training
course. This standardized nursing education tool will be used to
direct and document family education.
Results: Data will be generated through completion of satisfaction
questionnaires by families and nurses caring for the patients. Length
of stay and readmission rates will be compared for winter 2007–
2008 when no standardized education tool was used and 2008–
2009 when the standardized education tool and video was in place.
Descriptive statistics will be used to analyze the data. Full data
analysis is pending completion of the study. Graphs show improved
compliance using the pathway and the orders therein. Some of the
preliminary data are based on questionnaires received from 16
admissions and are included in a table.
Conclusions: Based on the preliminary data, it is obvious that while
many methodologies help to enhance overall learning, all the
parents who responded to the questionnaire believed that they
learned the most when receiving information and demonstrations
from a nurse or therapist in person. The importance of having nurses
and therapists who are knowledgeable and able to educate may be
the most important factor for education and increased satisfaction
of parents.
doi:10.1016/j.pedn.2009.12.055
Adult and Child Weight Perception in Wendover, UT
Karen Lundberg MS, RN, CNE,
James E. Kohl CAPT, NC, USN(Ret), MS, RN
Brigham Young University, Provo, UT
Significance: Childhood obesity is a prevalent and significant
problem in the United States demonstrated across all age groups,
ethnicities, and educations levels. Childhood obesity puts children
at greater risk for associated comorbidites such as heart disease,
hypertension, diabetes, and cancer (Towns & D'Auria, 2009).
Management of childhood obesity continues to be problematic and
challenging for both parents and health care providers. Self-
perception of correct BMI should be considered when developing
obesity treatment programs.
Purpose: The purpose of this pilot study was to assess the
participants' perception of obesity related to their actual body mass
index (BMI).
Hypothesis/Research Question(s): What is the correlation between
perception of the child's or adult's weight and actual BMI?
Sample: A convenience sample of community participants
attending a health fair at Anne Smith Elementary School on May
15, 2008, in Wendover, UT, was used for this study. Inclusion
criteria included all health fair participants 5–99 years of age with a
signed consent form (n = 88).
Methodology: This study has a correlational descriptive design.
After consent/assent was obtained, study participants filled out the
paper-and-pencil “Health Survey Tool” in either English or Spanish
to establish the relationship between perceived child or adult weight
SPN 2010 Convention Poster Abstracts
and actual BMI. Quantitative health data were collected by Brigham
Young University nursing students under the direct supervision of
nursing faculty. Height and weight were assessed using commercial
stadiometer and digital scales.
Descriptive correlational statistical analysis was utilized on the data
collected. Methods include rates, frequencies, averages, means and
correlations between age, gender, and BMI. Data obtained from
children were matched with data from parents when possible.
Results: Statistical analysis was significant for participants'
perception of their own obesity. We found that the adults'
perception was correct meaning that those adults who said they
were overweight were overweight. The children, however, had
misconceptions regarding their perceived weight. More children
perceived their weight as healthy but were really overweight.
Children's Perception
BMI 85% Total
Perceived health weight 22 17 39
Perceived overweight 1 12 13
Adult's Perception
BMI 25 total
Perceived health weight 3 4 7
Perceived overweight 1 22 23
Implications: We have concluded that children in this particular
population do not have a realistic self-perception of healthy weight.
Nursing implications for working with Hispanic children in
Wendover should include teaching the definition of healthy vs.
non healthy weight.
Reference
Towns, N., & D'Auria, J. (2009). Parental perceptions of their child's
overweight: An integrative review of the literature. Journal of Pediatric
Nursng, 24, 115–130.
doi:10.1016/j.pedn.2009.12.056
Responding to Verbal Abuse: Exploring Successful Nursing
Huong Mai BSN, RN, CPN, Mary Dominiak PhD, MBA, RN,
Candace Hale BSN, RN
Children's Memorial Hospital, Chicago, IL
Significance: Verbal abuse (VA) is the most common form of
workplace violence that nurses experience (Cameron) and can result
in psychological trauma, decreased morale, and decreased job
satisfaction in nurses; can affect staff retention; and can negatively
impact quality patient care. Research findings suggest that VA is a
problem for nurses in all areas, including the pediatric setting
(Pejic). No studies have been found that describe successful nurse
interventions and strategies to prevent or reduce VA.
Problem and Purpose: In a study of pediatric nurses, 94.3%
experienced VA at least once in a 3-month period (Pejic). Nurses
indicated that VA creates a negative, unsupportive environment,
which is cause for special concern at a time of nursing shortages.
The purpose of this study is to identify nurse interventions and