The Arcus Experience: Bridging the Data Science Gap for Nurse Researchers.

Background: For years, nurse researchers have been called upon to engage with "big data" in the electronic health record (EHR) by leading studies focusing on nurse-centric patient outcomes and providing clinical analysis of potential outcome indicators. However, the current gap in nurses' data science education and training poses a significant barrier.

Objectives: We aimed to evaluate the viability of conducting nurse-led, big-data research projects within a custom-designed computational laboratory and examine the support required by a team of researchers with little to no big-data experience.

Multisystem Inflammatory Syndrome in Children in the Critical Care Setting.

Background: Multisystem inflammatory syndrome in children is a new syndrome that has been hypothesized to be connected with the COVID-19 pandemic. Children are presenting-likely after SARS-CoV-2 infection or exposure-with vague symptoms including fever, gastrointestinal distress, and/or rash.

Objective: To review what is currently known about multisystem inflammatory syndrome in children, including physiology, signs and symptoms, laboratory and imaging findings, treatment options, and nursing considerations in critical care settings.

Behavioral Crisis Management: A Quality Improvement Pilot for Improving Teamwork in a Primary Care Pediatric Setting.

Introduction: Children with behavioral escalations in the primary care office may pose safety risks to themselves and others. Interprofessional teams utilizing crisis resource management (CRM) skills more successfully manage behavioral crises. The purpose of this quality improvement (QI) pilot project was to improve team performance during a behavioral crisis in pediatric primary care, as well as evaluate learner satisfaction with the curriculum.

CE: Multisystem Inflammatory Syndrome in Children: A Review.

The coronavirus disease 2019 (COVID-19) pandemic has impacted the health of children worldwide. Although overall mortality from COVID-19 in children remains low, an associated multisystem inflammatory disorder has emerged. The disorder has been recognized and named multisystem inflammatory syndrome in children (MIS-C) by the World Health Organization and the Centers for Disease Control and Prevention.

Nurses' Perceptions of Workload Burden in Pediatric Critical Care.

Background: Quantifying nurses' perceptions of workload burden when managing critically ill patients is essential for designing interventions to ease nurses' workday.

Objectives: To explore pediatric intensive care unit (PICU) nurses' perceptions of their workload when caring for critically ill patients and managing protocolized therapies.

Methods: This study was embedded in a multicenter randomized clinical trial where participants were assigned to receive either lower-target or higher-target glucose control.

Evidence in Hand: Optimizing the Unique Skill Set of a Hospital-Based Center for Nursing Research and Evidence-Based Practice.

This paper describes how, as the COVID-19 pandemic emerged, one hospital-based center for nursing research and evidence-based practice capitalized on its unique skill mix to quickly pivot to provide hospital administrators and staff with timely, relevant evidence regarding the care of patients and families, as well as the protection of direct care providers and all support staff. The products produced by this center, both proactive and in direct response, contributed to clinical operations decision-making and thus, tangibly impacted practice. The positive outcomes described speak not only to the clinical environment, but also to the presence and specialized contributions of a multiprofessional center for nursing research and evidence-based practice in such a way that was not possible prior to COVID-19.

Developing Leadership Competencies in Midlevel Nurse Leaders: An Innovative Approach.

A pediatric teaching hospital developed a comprehensive leadership training program for midlevel nurse leaders with varying levels of management knowledge and experience. Content was based on American Organization for Nursing Leadership nurse manager competencies and data from a comprehensive needs assessment. Learners identified differentiating between leadership and management, influencing behavior, managing change, and communication as areas of increased confidence.

Outcome-Focused Critical Care Orientation Program: From Unit Based to Centralized.

Background: An effective orientation ensures that new nurses are prepared to deliver competent care to patients. In organizations with several critical care units, opportunities exist to achieve standardization of core content applicable to all critical care areas.

Purpose: This quality improvement project, conducted in a large children's hospital with multiple critical care units, was designed to centralize critical care orientation and standardize its content, as well as to measure learning outcomes of the revised program.

CE: Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency.

Advances in genetic and genomic research, combined with the rapid development of new technologies, have reshaped our understanding of health and disease processes, generating what have collectively become known as "omics" sciences. These sciences are now an integral part of health care delivery, with nurses and nurse scientists at the forefront, implementing and adapting genomic technologies in the clinical setting while advancing knowledge in these areas. With the increasing focus on precision medicine and health care, integrating genetic and genomic knowledge has become an essential competency in nursing care, research, and education, as it enables nurses to collaborate effectively with patients in improving their health and well-being.

Face and content validity of variables associated with the difficult-to-sedate child in the paediatric intensive care unit: A survey of paediatric critical care clinicians.

Background: Clinicians recognise that some critically ill children are difficult-to-sedate. It may be possible to identify this clinical phenotype for sedation response using statistical modelling techniques adopted from machine learning. This requires identification of a finite number of variables to include in the statistical model.

Maintaining Interrater Agreement of Core Assessment Instruments in a Multisite Randomized Controlled Clinical Trial: The Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Trial.

Background: RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) was a cluster randomized clinical trial evaluating a sedation strategy in children 2 weeks to <18 years of age with acute respiratory failure supported on mechanical ventilation. A total of 31 U.S.

Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial.

Objective: To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial.

Study Design: We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation. Multivariable logistic regression modeling estimated associations between patient race and ethnicity and parental refusal of study consent.

Comparison of arm and calf automatic noninvasive blood pressures in pediatric intensive care patients.

The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences.