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The Psychometric Properties of the Pediatric Early Warning Score System in the Pediatric Medical Surgical Units
SPN 2011 ELECTRONIC POSTER ABSTRACT WINNERS
Sleep in Hospitalized Pediatric Patients and Their Parents Katherine Davis PhD, CPNP, Lisa J. Meltzer PhD, Jodi A. Mindell PhD The Children's Hospital of Philadelphia, Philadelphia, PA
Objectives: • Describe how sleep during hospitalization differs from sleep at home for pediatric inpatients and their parents. • Examine potential sleep disruptors in the hospital setting, especially those amenable to nursing intervention. Background: Although sleep complaints during hospitalization are common, few studies have examined different aspects of sleep (quantity, quality, disruptions) in a single study. Furthermore, how hospitalization can affect parent sleep has been understudied. This study examines multiple aspects of sleep for non-intensive care pediatric inpatients and their rooming-in parents in a children's hospital. Purpose: To determine whether sleep during hospitalization differs from sleep at home for patients and parents and examine potential sleep disruptors. Methods: Seventy-two pediatric inpatients (8–21 years) and 58 rooming-in parents completed the Sleep in a Children's Hospital questionnaire, a self-report survey providing information about sleep patterns at home (bedtime, sleep onset latency, night waking frequency, wake time, total sleep time), the previous night's sleep while hospitalized, and sleep disruptors in hospital (e.g., pain, noise, procedures). Results: Younger children reported later bedtimes and wake times, more night wakings, and shorter total sleep time while hospitalized. Adolescents had later wake times, more night wakings, and longer total sleep time during hospitalization. In addition, parents reported later bedtimes and wake times, and more night wakings when rooming-in at the hospital. Sleep disruptions due to noise, worries, pain, and vital sign checks were related to longer time to fall asleep, increased number of night wakings, and earlier morning wake times. Conclusion: Sleep is significantly disrupted during hospitalization, especially for younger children and parents. Interventions that reduce noise, manage pain, decrease vital sign checks, and address cognitive worries are needed to improve both child and parent sleep in hospital. doi:10.1016/j.pedn.2011.01.235 0882-5963/$ – see front matter
The Psychometric Properties of the Pediatric Early Warning Score System in the Pediatric Medical Surgical Units Nicole Ryan BSN, RN, CPN Children's Hospital Orange County, Orange, CA
Objectives: • To describe our institution's Pediatric Early Warning Score (PEWS) tool. • To discuss the preliminary results of the research project including reliability, validity, specificity, and sensitivity. Background Information/Introduction: Identifying and treating clinical deterioration in a pediatric patient is crucial to improving outcomes. Response teams in the pediatric setting has proven effective, but the use of an early warning scoring tool to improve recognition has mostly been studied in the adult population. In 2008, 60% of our patients displayed signs of deterioration 8 hours prior to the rapid response team (RRT) call. Many pediatric hospitals across the nation have begun to institute a scoring tool to begin to recognize deterioration earlier. Purpose: The purpose of this study is to determine if the PEWS at our institution is a reliable, valid, specific, and sensitive measure of deterioration in medical–surgical patients. A retrospective study will be conducted to examine the PEWS of patients who had an event (RRT, pediatric intensive care unit transfer, and/or code white) and those that did not have an event. PEWS captures the patient's current respiratory, cardiovascular, and neurobehavioral status into one single score that is displayed in the Cerner system and on the electronic patient assignment board on the units. We anticipate 114 patients will have an event and 114 control patients. We project a high interrater reliability correlation, a significant difference in PEWS for the sample and control groups, and an increase in the patient's PEWS number as the patient's status deteriorates. Conclusion: The use of the PEWS empowers the nurse to present the patient to the health care team in a shared terminology that is clear, intuitive, and easy to visualize. doi:10.1016/j.pedn.2011.01.236 Look Before You LEAPP: An Evidence Based Approach to Pediatric Procedural Management Pamela Haines MS, RN, Michelle Jeski MSN, RNC Upstate Golisano Children's Hospital, Syracuse, NY
Sleep in Hospitalized Pediatric Patients and Their Parents Katherine Davis PhD, CPNP, Lisa J. Meltzer PhD, Jodi A. Mindell PhD The Children's Hospital of Philadelphia, Philadelphia, PA
Objectives: • Describe how sleep during hospitalization differs from sleep at home for pediatric inpatients and their parents. • Examine potential sleep disruptors in the hospital setting, especially those amenable to nursing intervention. Background: Although sleep complaints during hospitalization are common, few studies have examined different aspects of sleep (quantity, quality, disruptions) in a single study. Furthermore, how hospitalization can affect parent sleep has been understudied. This study examines multiple aspects of sleep for non-intensive care pediatric inpatients and their rooming-in parents in a children's hospital. Purpose: To determine whether sleep during hospitalization differs from sleep at home for patients and parents and examine potential sleep disruptors. Methods: Seventy-two pediatric inpatients (8–21 years) and 58 rooming-in parents completed the Sleep in a Children's Hospital questionnaire, a self-report survey providing information about sleep patterns at home (bedtime, sleep onset latency, night waking frequency, wake time, total sleep time), the previous night's sleep while hospitalized, and sleep disruptors in hospital (e.g., pain, noise, procedures). Results: Younger children reported later bedtimes and wake times, more night wakings, and shorter total sleep time while hospitalized. Adolescents had later wake times, more night wakings, and longer total sleep time during hospitalization. In addition, parents reported later bedtimes and wake times, and more night wakings when rooming-in at the hospital. Sleep disruptions due to noise, worries, pain, and vital sign checks were related to longer time to fall asleep, increased number of night wakings, and earlier morning wake times. Conclusion: Sleep is significantly disrupted during hospitalization, especially for younger children and parents. Interventions that reduce noise, manage pain, decrease vital sign checks, and address cognitive worries are needed to improve both child and parent sleep in hospital. doi:10.1016/j.pedn.2011.01.235 0882-5963/$ – see front matter
The Psychometric Properties of the Pediatric Early Warning Score System in the Pediatric Medical Surgical Units Nicole Ryan BSN, RN, CPN Children's Hospital Orange County, Orange, CA
Objectives: • To describe our institution's Pediatric Early Warning Score (PEWS) tool. • To discuss the preliminary results of the research project including reliability, validity, specificity, and sensitivity. Background Information/Introduction: Identifying and treating clinical deterioration in a pediatric patient is crucial to improving outcomes. Response teams in the pediatric setting has proven effective, but the use of an early warning scoring tool to improve recognition has mostly been studied in the adult population. In 2008, 60% of our patients displayed signs of deterioration 8 hours prior to the rapid response team (RRT) call. Many pediatric hospitals across the nation have begun to institute a scoring tool to begin to recognize deterioration earlier. Purpose: The purpose of this study is to determine if the PEWS at our institution is a reliable, valid, specific, and sensitive measure of deterioration in medical–surgical patients. A retrospective study will be conducted to examine the PEWS of patients who had an event (RRT, pediatric intensive care unit transfer, and/or code white) and those that did not have an event. PEWS captures the patient's current respiratory, cardiovascular, and neurobehavioral status into one single score that is displayed in the Cerner system and on the electronic patient assignment board on the units. We anticipate 114 patients will have an event and 114 control patients. We project a high interrater reliability correlation, a significant difference in PEWS for the sample and control groups, and an increase in the patient's PEWS number as the patient's status deteriorates. Conclusion: The use of the PEWS empowers the nurse to present the patient to the health care team in a shared terminology that is clear, intuitive, and easy to visualize. doi:10.1016/j.pedn.2011.01.236 Look Before You LEAPP: An Evidence Based Approach to Pediatric Procedural Management Pamela Haines MS, RN, Michelle Jeski MSN, RNC Upstate Golisano Children's Hospital, Syracuse, NY