Improving Mobility Practices of Critically Ill Children.

Introduction: This quality improvement project aimed to improve mobility practices in a pediatric intensive care unit.

Method: Three interventions were implemented: a staff-developed mobility progression guideline (including patient mobility phase identification using animal images), physical therapy (PT), and occupational therapy (OT) referrals for all patients with expected hospitalizations of more than 3 days, and the use of activity goal posters. The frequency of mobility activities performed, the number of PT and OT referrals and nurses' confidence in mobilizing patients were compared before and after project implementation.

Improving Pediatric Delirium Assessment Documentation and Implementation of a Nonpharmacologic Delirium Management Bundle in the Cardiovascular Intensive Care Unit.

Background: Pediatric delirium is common, associated with negative patient outcomes, and infrequently assessed in the ICU. Locally, pediatric delirium assessments in the cardiac PICU were infrequently documented resulting in an initiative to increase assessment documentation and implement a nurse-driven management protocol, the Bundle to Eliminate Delirium (BED).

Methods: This was a nurse-driven, quality improvement project in an eleven-bed cardiac PICU at a large academic health care facility.

Overcoming Barriers to Delirium Screening in the Pediatric Intensive Care Unit.

Background: Delirium is associated with poor outcomes in adults but is less extensively studied in children.

Objectives: To describe a quality improvement initiative to implement delirium assessment in a pediatric intensive care unit and to identify barriers to delirium screening completion.

Methods: A survey identified perceived barriers to delirium assessment.

Introducing Essential Oils into Pediatric and Other Practices at an Academic Medical Center.

Aromatherapy is an integrative intervention that uses essential oils to address symptom management, potentially as a first-line intervention or as a complement to other medical treatments. Aromatherapy is gaining widespread acceptance and increased scientific evidence of efficacy. Integrative and holistic nursing care uses integrative therapies such as aromatherapy and the principle of moving from a less invasive intervention to a more invasive intervention according to patient needs, symptoms, and preferences.

Comparison of staff and family perceptions of causes of noise pollution in the Pediatric Intensive Care Unit and suggested intervention strategies.

Noise and excessive, unwanted sound in the Pediatric Intensive Care Unit (PICU) is common and has a major impact on patients' sleep and recovery. Previous research has focused mostly on absolute noise levels or included only staff as respondents to acknowledge the causes of noise and to plan for its reduction. Thus far, the suggested interventions have not ameliorated noise, and it continues to serve as a barrier to recovery.

Identifying hospitalized pediatric patients for early discharge planning: a feasibility study.

A screening tool utilized by nurses at a critical point in the discharge planning process has the potential to improve caregiver decisions and enhance communication. The Early Screen for Discharge Planning-Child version (ESDP-C) identifies pediatric patients early in their hospital stay who will benefit from early engagement of a discharge planner. This study used a quasi-experimental, non-equivalent comparison group design to evaluate the impact of the ESDP-C on important outcomes related to discharge planning.

Implementation of patient-centered bedside rounds in the pediatric intensive care unit.

Implementation of effective family-centered rounds in an intensive care unit environment is fraught with challenges. We describe the application of PDSA (Plan, Do, Study, Act) cycles in a quality improvement project to improve the process of rounds and increase family participation and provider satisfaction. We conducted pre-/postintervention surveys and used 5 process measures for a total of 1296 daily patient rounds over 7 months.

Developing and testing a discharge planning decision support tool for hospitalized pediatric patients.

Purpose: To develop and test a decision support tool that identifies patients who would benefit from early consult with discharge planners.

Design And Methods: A predictive, correlational design was used with parents/guardians of children (1 month to 18 years; N = 197). Data were collected by interviews and record reviews.