An Accelerated Evidence-Based Nursing Orientation: The Hybrid Instructor Preceptor Model.

The Hybrid Instructor Preceptor Model is a novel, accelerated, evidence-based nursing orientation model. The Hybrid Instructor Preceptor Model uses instructor and preceptor phases, which standardize foundational content, approach skills acquisition, and increase clinical experiences for a new hire. A pediatric acute cardiac care unit successfully onboarded 30 nurses in 10 months using the Hybrid model.

Measuring the Interprofessional Health of the Pediatric Cardiovascular Operating Room Work Environment.

Introduction: Pediatric cardiac surgery is complex and has significant risk, requiring interprofessional teamwork for optimal outcomes. Unhealthy work environments have been linked to poor patient outcomes, staff dissatisfaction, and intention to leave. We describe the interprofessional health of pediatric cardiovascular operating room (CVOR) work environments in the United States and the establishment of a healthy work environment (HWE) benchmark score.

The Voice of Travel Nurses: Facilitating Effective Staffing During Pandemic and Expansion-Related Demands in a Children's Hospital.

Objective: The aim of this study was to explore the experience and perceived value of travel nurses in a children's hospital.

Background: Children's hospitals face unique challenges related to highly specialized care requirements and workforce expansion limitations. Travel nurses can augment nurse staffing capacity during times of intense demand and may offer insights as organizations seek to strengthen work environments.

Perceptions of Interprofessional Practitioners Regarding Pediatric Palliative Transports.

Background: Pediatric palliative transport (PPT) is the practice of offering critically and terminally ill children requiring life-sustaining measures the opportunity to be discharged from the hospital to home or a hospice facility for end-of-life care. Although studies have shown PPT to favorably affect both children and their families, limited research exists on the perspectives of health care practitioners.

Objectives: To understand the experience of interprofessional practitioners who have cared for a critically or terminally ill child during a PPT and their perception of PPT as a care option.

Failure to tolerate continuous subcutaneous treprostinil in pediatric pulmonary hypertension patients.

Continuous subcutaneous (SubQ) treprostinil is an effective therapy for pediatric patients diagnosed with pulmonary hypertension (PH). To date, the clinical characteristics and factors associated with failure to tolerate this therapy have not been described. The purpose was to describe patient-reported factors contributing to SubQ treprostinil intolerance in pediatric patients with PH.

Moving from Vaccine Hesitancy to Acceptance: Engaging Underrepresented Employees in a Pediatric Academic Medical Center.

Unlabelled: Underrepresented populations historically underserved by the healthcare system and/or marginalized by systematic policies regionally and nationally were particularly vulnerable during the COVID-19 pandemic. While vaccine hesitancy has been described among hospital employees, the employees' experiences from an underrepresented population cohort have not been reported. We, therefore, sought to understand employees' vaccine experiences, hesitancy, and ways to enhance ongoing COVID-19 vaccine education and communication to build a hospital-wide culture of vaccine acceptance.

Validation of the withdrawal assessment tool-1 (WAT-1) in pediatric cardiovascular patients on an inpatient unit.

Purpose: Sedation and analgesia are administered to critically ill patients, which may result in physical dependence and subsequent iatrogenic withdrawal. The Withdrawal Assessment Tool-1 (WAT-1) was developed and validated as an objective measurement of pediatric iatrogenic withdrawal in intensive care units (ICUs), with a WAT-1 score ≥ 3 indicative of withdrawal. This study's objectives were to test interrater reliability and validity of the WAT-1 in pediatric cardiovascular patients in a non-ICU setting.

Steroid Use for Management of Vasoactive Resistant Shock in Pediatric Cardiac Intensive Care Patients: Experience of the Consortium of Congenital Cardiac Care-Measurement of Nursing Practice.

Background: Although a variety of doses and duration of hydrocortisone have been reported as a treatment modality for congenital heart surgery patients with refractory hypotension, there remains a lack of understanding of the clinical use in pediatric cardiac programs.

Objectives: The aim of this study was to describe the current practice of steroid use for refractory hypotension in postoperative congenital heart surgery patients.

Method: Survey participants were recruited from the Consortium of Congenital Cardiac Care-Measurement of Nursing Practice.

Refinement of the Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes III Acuity Tool.

Background: The Intensive Care Unit (ICU) Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) acuity tool quantifies patient acuity in terms of nursing cognitive workload complexity.

Objectives: The aim of this study was to refine the ICU CAMEO II acuity tool. An expert panel of nursing staff from 4 pediatric ICUs convened to refine the CAMEO II across a large, freestanding children's hospital in the United States.

Nurses' perceptions and use of near infrared spectroscopy in paediatric cardiac intensive care.

Background: Near-infrared spectroscopy (NIRS) is a non-invasive technology that estimates regional oxygen saturation. Literature demonstrates that NIRS can provide valuable data for clinical staff. However, little research has addressed the nursing care and management of NIRS in the critical care environment.

Effects of COVID-19 on paediatric cardiac centres in low-income and middle-income countries: a mixed-methods study.

Objectives: The aim of this study was to understand the effects of the COVID-19 pandemic on paediatric cardiac services in critical access centres in low-income and middle-income countries.

Design: A mixed-methods approach was used.

Setting: Critical access sites that participate in the International Quality Improvement Collaborative (IQIC) for congenital heart disease (CHD) were identified.

Use of Music for Newborns After Cardiac Surgery: A Pilot Study.

Background: Music can benefit the neurodevelopmental and clinical care of newborns in the neonatal intensive care unit. Newborns in the cardiac intensive care unit experience similar stressors to those in the neonatal intensive care unit, but music therapy has not been widely studied in the cardiac intensive care unit population.

Objective: To explore the feasibility of implementing nurse-led music therapy in a cohort of newborns recovering from cardiac surgery in the cardiac intensive care unit.

Measuring Acuity and Pediatric Critical Care Nursing Workload by Using ICU CAMEO III.

Background: The Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes (ICU CAMEO III) acuity tool measures patient acuity in terms of the complexity of nursing cognitive workload.

Objective: To validate the ICU CAMEO III acuity tool in US children's hospitals.

Methods: Using a convenience sample, 9 sites enrolled children admitted to pediatric intensive care units (ICUs).

#Healthcare: Patient and Family Uses and Perceptions of Health Care Social Media.

Background/introduction: Although social media is becoming a primary resource for information and support in all aspects of life, including health care, limited information is available describing social media use in parents whose child undergoes surgical care.

Objectives/aims: The aims of this study were to describe how patients/families use social media to address health care needs and understand their perceptions of social media privacy and reliability.

Methods: A descriptive survey of 39 questions, both fixed choice and open ended, was distributed to a convenience sample of parents during their child's preoperative visit.

Individualized Family-Centered Developmental Care for Infants With Congenital Heart Disease in the Intensive Care Unit.

Background: Individualized family-centered developmental care (IFDC) is considered the standard of care for premature/medically fragile newborns and their families in intensive care units (ICUs). Such care for infants with congenital heart disease (CHD) varies.

Objective: The Consortium for Congenital Cardiac Care- Measurement of Nursing Practice (C4-MNP) was surveyed to determine the state of IFDC for infants younger than 6 months with CHD in ICUs.

Parent Perception of Their Role in the Pediatric Cardiac Intensive Care Unit.

Background/introduction: One way the goal of establishing a partnership with families is accomplished, specific to the pediatric intensive care units, is 24-hour visitation and presence/participation during medical rounds and procedures. Despite the breadth of literature on the positive effect of parent presence, as well as the nearly nationwide adoption of 24-hour pediatric intensive care unit visitation, there is little to no research about how these changes have affected parents' perception of their role in the pediatric cardiac intensive care unit (PCICU).

Objectives/aims: The purpose of this study was to explore and better understand the experience of parents in the PCICU within a patient/family-centered care model.

Factors Associated With Increased Laboratory Use in the Pediatric Cardiac Intensive Care Unit.

Background: Laboratory testing is frequently used to guide postoperative management and contributes to hospital resource utilization; however, there is little evidence identifying patient or clinical factors to inform the appropriate frequency of laboratory testing in the pediatric cardiac intensive care unit.

Objectives: To examine the factors associated with increased laboratory utilization following pediatric congenital heart surgery.

Methods: For each patient, the total number of tests and types of laboratory tests were recorded.

Development and Implementation of an Inpatient CAMEO© Staffing Algorithm to Inform Nurse- Patient Assignments in a Pediatric Cardiac Inpatient Unit.

Background: Nursing workload measurement systems are vital to determine nurse staffing for safe care. The Inpatient Complexity and Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO©) acuity tool provides a standardized language to communicate the acuity and complexity of nursing care in the pediatric inpatient setting.

Design And Methods: A process improvement project was implemented on a pediatric cardiac inpatient unit to utilize the Inpatient CAMEO© tool to inform nurse-patient assignments.

Expanding Hospital Capacity during the COVID-19 Pandemic: The Family Voice Matters.

Unlabelled: During the initial COVID-19 response, this children's hospital reduced its inpatient capacity by 52 beds with double rooms' conversion to single patient occupancy, causing significant capacity constraints. To solve this challenge, the family perspective was engaged to safely redouble patient rooms and expand capacity as clinical activity increased during the COVID-19 response.

Methods: The team conducted qualitative descriptive interviews with parents of children undergoing congenital heart surgery admitted to the inpatient cardiac unit in a 404-bed free-standing children's hospital.

Nurse-Sensitive Quality Metrics to Benchmark in Pediatric Cardiovascular Care.

Background: Associations between the quality of nursing care and patient outcomes have been demonstrated globally. However, translation and application of this evidence to robust measurement in pediatric specialty nursing care has been limited.

Objectives: To test the feasibility and performance of nurse-sensitive measures in pediatric cardiovascular programs.

Clinical descriptors of pneumothorax following chest tube removal in paediatric cardiac surgery.

Background: There is limited data describing the characteristics of paediatric post-operative cardiac surgery patients who develop pneumothoraces after chest tube removal. Patient management after chest tube removal is not standardised across paediatric cardiac surgery programmes. The purposes of this study were to describe the frequency of pneumothorax after chest tube removal in paediatric post-operative cardiac surgical patients and to describe the patient and clinical characteristics of those patients who developed a clinically significant pneumothorax requiring intervention.

Nursing science fellowship at Boston Children's Hospital.

Introduction: Clinical inquiry is vital to safeguard nursing practice and ensure optimal outcomes for our patients and families. The innovative Nursing Science Fellowship (NSF) was developed to provide structured mentorship for pediatric nurses by nurse scientists to design and conduct clinical inquiry generated from their practice.

Methods: Each fellow is paired with a nurse scientist mentor to receive support for timely project completion.

The acuity of pediatric neuroscience nursing using the Inpatient Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO ) tool.

Purpose: The neuroscience nurse must possess advanced knowledge and skills to care for a wide range of unique congenital and acquired neurological diagnoses. For each of these clinical scenarios, the measurement of complexity and acuity of patient care is key to informing staffing models and patient assignments. The Inpatient Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO ) acuity tool measures patient acuity in terms of nursing cognitive workload complexity.

Iatrogenic withdrawal syndrome in specialty pediatric critical care.

Aim: To describe the occurrence of opioid and benzodiazepine withdrawal symptoms in a cohort of pediatric intensive care unit (PICU) patients, the characteristics of this group, and patterns of withdrawal scoring observed during medication weaning.

Background: Patients in the PICU are a complex and vulnerable population. Opioids and benzodiazepines are routinely administered in this setting.

The Measurement of Pediatric Inpatient Nursing Using the Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO©) Tool.

Purpose: Physiologic measurement of patient acuity has been used to predict patient outcomes, length of stay, and resource utilization. To date, these tools are not sufficiently comprehensive to inform nurse staffing assignments and have limited practical application. The Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO©) acuity tool was initially developed and validated to quantify patient acuity in terms of complexity of nursing cognitive workload in pediatric intensive care units (ICU).