Measuring the Validity and Reliability of the Vascular Access Complication Staging and Treatment Instrument in a Pediatric Population.

A multiphase study designed with Delphi and observational components was conducted to establish the preliminary validity and reliability of the 2018 Vascular Access Complication Staging and Treatment Instrument in pediatric and neonatal populations from a single, free-standing academic children's hospital. The instrument uses objective measurement criterion to determine the severity of swelling and tissue damage to inform treatment decisions. The results of the study provided preliminary empirical evidence to support a pediatric and neonatal intravenous complication staging instrument to assess degree of swelling and severity of tissue injury. The study also offered preliminary evidence that the instrument was perceived by the nurses who participated in the study to be efficient and easy to use.

Changing the Culture of Pediatric Palliative Care at the Bedside.

The benefits of palliative care services have been widely documented; however, many organizations are unable to financially support the number of professionals needed to meet the growing demand. Nurses receive minimal training in palliative care, and the resulting knowledge gap can lead to a lack of confidence when providing the essential aspects of palliative care. Recognizing the needs of patients and staff, one organization created a Palliative Care Champions Program to support and educate bedside staff. The Champions received initial and ongoing education, allowing them to function as liaisons to the Palliative Care Team while providing education and mentorship to staff. A program evaluation tool measuring Champion comfort and confidence in the provision of palliative care has shown positive results. Champions reported an increase in confidence in their ability to identify appropriate consults and mentor staff, as well as an increase in comfort in being considered an expert in palliative care. Consults to the Palliative Care service increased by 28% within the first 12 months of program implementation. The Palliative Care Champions Program framework can be easily adapted to fit the needs of other organizations.

Communication Under Pressure: A Quasi-Experimental Study to Assess the Impact of a Structured Curriculum on Skilled Communication to Promote a Healthy Work Environment.

Effective communication in health care is a mainstay of patient safety and staff perception of a healthy work environment. A quasi-experimental study was conducted to assess the impact of a course on staff perceptions of communication. A Wilcoxon signed-ranks test indicated a statistically significant difference between pre and post scores for the self-assessment component of the Heathy Work Environment Instrument (p = .0005); coworker assessments revealed borderline statistical significance (p = .056).

Targeted Education and Trends in Pediatric Nurses Perceptions of Barriers, Facilitators, Confidence, and Attitudes Toward Research and Evidence-Based Practice Over Time.

The purpose of this repeated cross-sectional study was to periodically assess perceptions of pediatric nurses' confidence, attitudes, barriers, and facilitators to research utilization and evidence-based practice as changes to the nursing research environment and a targeted curriculum were implemented. The study results were used by the nursing professional development specialist to further customize the nursing research curriculum to better meet the self-reported education and mentorship needs of the nurses.

Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses.

The purpose of this descriptive study was to identify the perceived barriers and facilitators to research utilization and evidence-based practice among nurses employed in a tertiary care children's hospital. Results revealed seven facilitator and six barrier themes that contribute to the understanding of the problem. The themes can be utilized by nursing professional development specialists to customize organizational infrastructure and educational programs.

Clinician perceptions of a changing hospital environment.

OBJECTIVE: The purposes of this study were to describe how a move into a new hospital influenced the work environment, how long it takes clinicians to adjust to such a significant change, and how much a new hospital work environment helps the practice shift toward patient- and family-centered care (PFCC). BACKGROUND: Creating a healthy work environment to keep patients safe and staff engaged in the mission of the organization is perhaps one of the most important roles of hospital administrators and nursing leaders. METHODS: A descriptive and comparative design was used to investigate how clinicians perceive, evaluate, and adjust to a new hospital environment, and how much a healthy work environment helps the practice shift toward patient- and family-centered care. RESULTS: Perceived stress was significantly higher than baseline 15 months after the move into the new hospital (p < 0.0000), and employees with 3 or more years of service had significantly higher stress than others (p < 0.000). Nurses had the second lowest mean stress score (x = 12.5). The PFCC score increased significantly (p < 0.007). CONCLUSIONS: The single-patient room model increased the workload of many clinicians, and their stress increased after 15 months. There were additional burdens not measured that also may have added to the stress of the participants. The new hospital enabled a significant practice shift toward PFCC. KEYWORDS: Healing environments, organizational transformation, patient-centered care, pediatric, satisfaction.