Referring Provider Opinions of Pediatric Cardiology Evaluations Performed by Nurse Practitioners.

In the setting of physician shortages, nurse practitioner (NP) roles have evolved, with increasing independence across most healthcare settings. We sought to characterize referring clinician perceptions of NP-performed outpatient pediatric cardiology consultations. We electronically distributed to pediatric and family medicine physicians and NPs in Arkansas our 11-item survey assessing the acceptability of pediatric cardiology consultations being completed by an NP under varying circumstances.

Heart Transplantation in Children With Down Syndrome.

Background Children with Down syndrome (DS) have a high risk of cardiac disease that may prompt consideration for heart transplantation (HTx). However, transplantation in patients with DS is rarely reported. This project aimed to collect and describe waitlist and post- HTx outcomes in children with DS.

Methodological Challenges Encountered in a Study of the Impact of Animal-assisted Intervention in Pediatric Heart Transplant Patients.

Purpose: The purpose of this pilot study was to examine the impact of animal-assisted intervention (AAI) on ambulation, physiologic stability, patient satisfaction, and perceived benefit in hospitalized pediatric heart transplant patients.

Design And Methods: This pilot study used a two-period, two-sequence cross-over design. Using a convenience sample of heart transplant patients between the ages six and nineteen, each subject participated in one AAI and one non-AAI study session over one week.

Catheter-Associated Blood Stream Infections in Intracardiac Lines.

 Right atrial (RA) or intracardiac lines are commonly used for hemodynamic monitoring in children undergoing cardiac surgery. In some institutions, these lines are used as the preferred long-term access line due to concerns for catheter-associated blood stream infections (CABSI) and catheter-related venous thrombosis with central lines in other locations. However, the rates and risk factors for CABSI and other complications are not known for RA lines.

Improved Survival While Waiting and Risk Factors for Death in Pediatric Patients Listed for Cardiac Transplantation.

Our aim is to determine (a) the effect of changes in pre-transplant management and era of listing on survival of children listed for HTx and (b) risk factors for death while waiting. This retrospective study included all children listed between 1/1993 and 12/2009 at our center. Survival was determined using survival analysis and competing outcomes modeling.

Online Focus Groups with Parents And Adolescents with Heart Transplants: Challenges and Opportunities.

Pediatric heart transplant recipients are scarce and widely dispersed. Previous studies of adolescents in this population were limited to small homogenous samples. Although online focus groups are an emerging data collection method, its use in pediatric populations has not been fully realized.

Heart Transplantation in the Short Term After Chemotherapy.

Anthracycline antibiotics are an effective therapy for a variety of neoplastic diseases. Dilated cardiomyopathy is a known risk of their use. Because of the risk of new or recurrent neoplasm with immunosuppression transplantation is often delayed.

Transition to self-management after pediatric heart transplant.

Context: Little is known about adolescent transition to self-management after heart transplant. This gap in knowledge is critically important because the consequences of poor self-management are costly and life-threatening, often resulting in nonadherence, rejection, repeated hospitalizations, and poor quality of life.

Objective: To explore how adolescents and parents perceive their roles in self-management, and how adolescents integrate self-management into their daily lives and navigate the transition from parent-dominated to self-management.

Quantification, identification, and relevance of anti-human leukocyte antigen antibodies formed in association with the berlin heart ventricular assist device in children.

Background: Ventricular assist devices (VADs) are increasingly being used in pediatric patients to provide long-term cardiac support. One potential complication of VAD therapy is the development of antibodies directed against human leukocyte antigens (HLA). This phenomenon has not been well described with the Berlin Heart EXCOR VAD, the most commonly used VAD in pediatric patients.

Rapid reduction in donor-specific anti-human leukocyte antigen antibodies and reversal of antibody-mediated rejection with bortezomib in pediatric heart transplant patients.

Background: High titer donor-specific antibodies (DSA) and positive crossmatch in cardiac transplant recipients is associated with increased mortality from antibody-mediated rejection (AMR). Although treatment to reduce anti-human leukocyte antigen antibodies using plasmapheresis, intravenous immunoglobulin, and rituximab has been reported to be beneficial, in practice these are often ineffective. Moreover, these interventions do not affect the mature antibody producing plasma cell.

Effectiveness of a simulation-based educational program in a pediatric cardiac intensive care unit.

Optimal staff performance of resuscitation skills is best achieved through regular effective training. However, providing this teaching in a busy high-acuity pediatric cardiac intensive care unit (ICU) had become a challenge due to time and logistical constraints. A program to effectively and efficiently teach ICU nurses the skills necessary in patient resuscitation was developed using simulation training to better meet staff learning needs.

Professional development for an advanced practice nursing team.

Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members.

Parent education after newborn congenital heart surgery.

The moment an infant is diagnosed with a congenital heart defect, parents experience a mixture of shock, disbelief, fear, anger, and often a profound sense of sadness. In the midst of these emotions they must learn to provide for the special needs of their infant. Providing parents with the knowledge and skills to care for their infant during this stressful time requires the concerted effort of a multidisciplinary team who can provide clear, concise, and consistent communication.

The physiologic basis for and nursing considerations in the use of subatmospheric concentrations of oxygen in HLHS.

Subatmospheric concentrations of oxygen are used in the preoperative and postoperative care of infants with hypoplastic left heart syndrome (HLHS). This technique increases the pulmonary vascular resistance (PVR) and thereby improves systemic blood flow. There have been no controlled studies of this therapy in humans.