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Journal of Pediatric Health Care

Anna Evans, Kellie Loera, Deborah Harris, Susan Carson, Leticia Boutros, Carol Okuhara
This article describes the development and implementation of a nurse practitioner professional ladder (NPPL) at a large freestanding urban pediatric hospital. The NPPL was created to recognize advanced practice registered nurses and differentiate levels of clinical expertise, role development, leadership, and professional contributions into a three-tiered approach, designated as NP I, NP II, and NP III. The results of a nurse practitioner satisfaction survey at Year 2 and Year 4 after the development of the NPPL are summarized...
September 15, 2018: Journal of Pediatric Health Care
Jennifer Sonney, Morgan Duffy, Xiao Hoogerheyde, Erika Langhauser, Danielle Teska
This study aimed to design and test an asthma essentials kit to support parent-child shared asthma management. Fourteen children (age range = 7-11 years) with asthma and their parents participated in this study. Development of the asthma essentials kit involved a generative phase, focused on understanding and designing to meet user needs, and an evaluative phase, which entailed narrowing, evaluating, and refining the asthma essentials kit. As is typical in human-centered design, analysis was iterative throughout the design process such that findings informed each subsequent phase...
September 15, 2018: Journal of Pediatric Health Care
Anna Jo Bodurtha Smith, Anita Gupta Hurwitz, Tara Singh, Kathleen F Harney
INTRODUCTION: Pediatric primary care providers prescribe the majority of contraception to adolescents, but they often lack training in long-acting reversible contraception (LARC). Our objective was to assess whether a provider education initiative was associated with a change in LARC use for adolescents. METHOD: Using electronic medical records, we examined LARC use for 7,331 women ages 15 to 21years with an established primary care provider before and after a provider education initiative on LARC...
September 15, 2018: Journal of Pediatric Health Care
Danielle Karasko
INTRODUCTION: Bariatric surgery is a treatment option for the obese adolescent. There are three primary surgical procedures: the bypass, sleeve gastrectomy, and lap band. The most recent literature was reviewed to examine changes in weight, comorbidities, and complications after bariatric surgery in the adolescent. METHOD: A systematic search was performed to identify original research articles published in the United States between the years of 2000 and 2017 with patients between the ages of 11 and 21years that provided greater than 30 days of results...
September 14, 2018: Journal of Pediatric Health Care
Mary M Ramos, Rachel A Sebastian, Emilie Sebesta, Adrienne E McConnell, Courtney R McKinney
INTRODUCTION: Outpatient pediatric providers play a crucial role in the promotion of breastfeeding. We conducted a mixed methods study to measure provider knowledge, attitudes, and current practices around breastfeeding counseling. METHOD: In New Mexico in 2016 and 2017, we conducted a knowledge, attitudes, and practice survey of outpatient pediatric providers (i.e., nurse practitioners, physicians, and physician assistants) and conducted focus groups with outpatient pediatric providers...
September 11, 2018: Journal of Pediatric Health Care
Lisa B E Shields, Dennis S Peppas, Eran Rosenberg
Floating-Harbor syndrome is a rare condition marked by short stature and delayed bone age, characteristic facial features, and speech impairment. Floating-Harbor syndrome commonly results from a sporadic genetic mutation. Renal abnormalities have rarely been encountered. We report the first patient with Floating-Harbor syndrome who spontaneously passed a renal calculus consisting of calcium oxalate monohydrate and calcium oxalate dihydrate. A renal ultrasound showed echotexture within the renal pyramids, hydronephrosis, and a cyst...
September 8, 2018: Journal of Pediatric Health Care
Abigail Kleinschmidt
Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. Health care providers are mandated reporters of suspected abuse but may misdiagnose potentially abusive injuries because of lack of knowledge in recognizing maltreatment. Premobile infants rarely have bruising or intraoral injuries without a reported accident or underlying systemic disease and should raise concern for abuse...
September 3, 2018: Journal of Pediatric Health Care
Elizabeth B Mason, Kimberly Burkhart, Rina Lazebnik
INTRODUCTION: The American Academy of Pediatrics recommends that adolescents be screened for mental health concerns and receive anticipatory guidance on stress management strategies. METHODS: Eighty-six participants (50 participants in the intervention group; 36 participants in the control group) participated in the study. Intervention group participants received training in diaphragmatic breathing, progressive muscle relaxation, and use of no-cost/low-cost exercise options...
September 3, 2018: Journal of Pediatric Health Care
Lauren Davis, Lisa M Kreashko, Virginia Allison
INTRODUCTION: A quality improvement project was commenced to determine if personalized, patient-specific education can increase parent/guardian knowledge and reduce subsequent emergency department (ED) visits and inpatient admissions secondary to asthma. METHOD: Pre- and post-education survey scores were analyzed for a change in knowledge. A retrospective electronic health record (EHR) chart review was performed one year following the education to determine if the patients had additional ED visits or inpatient admissions...
September 1, 2018: Journal of Pediatric Health Care
Christina M Sharkey, Megan N Perez, Dana M Bakula, DeMond M Grant, Larry L Mullins
OBJECTIVE: To identify a developmentally relevant factor structure of the Mishel Uncertainty in Illness Scale-Community form (MUIS-C) among adolescents and young adults with chronic medical conditions. METHODS: Data on college students with a self-reported chronic medical condition (N = 238) were collected between November 2013 and May 2015. Participants completed the MUIS-C as part of a larger questionnaire battery. An exploratory factor analysis and a confirmatory factor analysis were conducted...
August 31, 2018: Journal of Pediatric Health Care
Nadine L Camp, Rebecca C Robert, Candice S Dawes, Katherine Patterson Kelly
INTRODUCTION: Childhood overweight and obesity remains prevalent. We sought to identify characteristics associated with correct coding of obese and overweight children ages 2-9 years by pediatric primary care providers (PCPs) in an urban, minority clinic. METHOD: Samples included electronic health records pre- (n = 262) and post- (n = 244) provider training to implement an intervention aiming to improve consistency in obesity prevention and management guidelines from 15 providers...
August 29, 2018: Journal of Pediatric Health Care
Sheila L Mason, Katherine E Chike-Harris, Bettina M Gyr, Emily Johnson
INTRODUCTION: Because health care reimbursement is being linked to discharge quality and patient satisfaction, this quality improvement initiative reviewed the outcomes of embedding a pediatric nurse practitioner within the resident team at an academic medical facility. METHODS: The project was completed at a pediatric orthopedic unit at a large Southeastern U.S. academic medical facility. During the intervention, the pediatric nurse practitioner student completed daily rounds, communicated with the resident team, assessed readiness for discharge, provided patient education, and ensured that comprehensive discharge materials were completed...
August 25, 2018: Journal of Pediatric Health Care
Shao-Yu Tsai, Wang-Tso Lee, Suh-Fang Jeng, Chien-Chang Lee, Wen-Chin Weng
We designed a cross-sectional study to examine the association between sleep and behavior problems in toddlers and preschool-age children with epilepsy. We found that 71 (78.9%) children slept less than 10 hours in a 24-hour period according to the actigraphy, with 75 (83.3%) children waking for more than an hour during nocturnal sleep. Twenty-five (27.8%) children usually or sometimes had an inconsistent bedtime, and 24 (26.7%) did not sleep the same amount each day. Twenty-nine (32.2%) and 18 (20.0%) children had an internalizing and externalizing problem in clinical range, respectively...
August 24, 2018: Journal of Pediatric Health Care
Kathleen F Gaffney, Deborah A Kermer, Panagiota Kitsantas, Albert V Brito, Katya M Ramos, Graciela Pereddo, Luisa Villatoro
INTRODUCTION: This study examined postpartum depression, food insecurity, and underestimation of infant size as potential early life factors for overweight risk at 12 months among infants of Hispanic immigrant mothers. METHOD: Weight-for-length (WFL) measurements and face-to-face interviews were completed during well child visits. Regression models estimated the impact of early life factors (0-6 months) on overweight risk at 1 year. RESULTS: WFL ≥ 85th percentile was found among 2...
August 23, 2018: Journal of Pediatric Health Care
Rayna B Hirst, Amie L Haas, Anna M Teague, L Taighlor Whittington, Eric Taylor
INTRODUCTION: Sports-related concussion is a significant pediatric health risk, given the number of children involved in sports and the vulnerability of developing brains. Although most research has focused on high school/college athletes, these findings may not be applicable to younger athletes. METHOD: A mixed-methods analysis examined concussion incidence and sequelae in a cohort of 8- to 13-year-old males (N = 31) playing youth football and their parents...
August 23, 2018: Journal of Pediatric Health Care
Naomi N Duke
INTRODUCTION: Research suggests that diverse examples of adverse childhood experiences (ACEs) may link to health. This study examines relationships between conventional (abuse, neglect, household dysfunction) and expanded examples (bullying, safety perceptions) of ACEs and adolescent mental health among youth participating in a statewide school-based survey. METHODS: Logistic regression was used to determine whether 10 types of conventional ACEs and 11 types of additional ACEs were associated with the odds of youth meeting cutoff scores for a positive Patient Health Questionnaire-2 (PHQ-2) after adjustment for demographic covariates and known mental health problems...
August 23, 2018: Journal of Pediatric Health Care
La Monica L Hunter, Stephanie Blake, Catherine Simmons, Julie Thompson, Anne Derouin
BACKGROUND: Parents of preterm hospitalized infants, whose lengths of stay can range from a few days to several months, often experience emotional liability. Because the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) is a stressful and intimidating environment, prompt attention should be given to reducing parental stress and increasing parental confidence in preparation to care for their child post-discharge. METHODS: A quality improvement pilot project was designed to evaluate the parent education and support program, titled HUG Your Baby, in a Level II SCN for its ability to decrease stress and increase confidence for postpartum mothers of preterm infants born at less than 35 weeks gestation during the infant's hospitalization...
August 23, 2018: Journal of Pediatric Health Care
Ainat Koren, Linda Kahn-D'angelo, Susan M Reece, Rebecca Gore
INTRODUCTION: This exploratory study investigated the infant time spent in tummy time (TT) in relation to body mass index z score (BMI-z), weight gain, and motor development in infants from birth to 4 months. METHOD: Mothers and their infants were telephone surveyed at 2 and 4 months. Mother demographics; TT; feeding practices; and infant length, and height, and development were collected each time. RESULTS: Results from Cochran-Mantel-Haenszel and single logistic regression showed a significant association between development, level of BMI-z, and time spent in TT at 2 months of age (p < ...
August 18, 2018: Journal of Pediatric Health Care
Abbey J Horner, Donna G Nativio
Childhood cancer survivors are at high risk for a myriad of complications secondary to oncologic treatment regimens. Caries is one of the major sequela of oncologic treatment that place the childhood cancer survivor at risk for complications in adulthood. Dental caries can be prevented with optimum dental care, early identification, and patient education. A barrier to their prevention is the lack of routine dental care received by this population. Health care providers are in a prime position to remedy this problem through their frequent contact with the childhood cancer survivor during sick and well-child office visits...
August 17, 2018: Journal of Pediatric Health Care
Nancy Cantey Banasiak
BACKGROUND: Asthma is one of the major chronic diseases in the pediatric population, affecting 9.5% of children. The National Heart, Lung, and Blood Institute recommends the use of the Asthma Control Test (ACT) for periodic assessment of asthma control. The purpose of this evidence-based project was to implement the Asthma Control Test screening tool into the primary care practice to improve management of patients with asthma by more accurately addressing asthma control. METHODS: The project was a pre- and post-implementation study comparing two different groups of patients with asthma seen at the clinic over 5-week periods...
August 10, 2018: Journal of Pediatric Health Care
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