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015–Heart Sounds of Parents: Careful Listening.
ABSTRACTS OF THE SOCIETY OF PEDIATRIC NURSES' ANNUAL CONVENTION
015–Heart Sounds of Parents: Careful Listening. Jerilyn Ray, BSN, RN, CPN, J. Sandquist, K. Jarrett, L. McGrath, J. Mackey, L. Fox, M. Brown, J. Shannon, Children's Center at Mercy, Des Moines, IA Purpose: This initiative focused on improving education of future parents/families of pediatric cardiac patients. Utilizing “careful listening,” input was obtained from previous patients and families that had gone through the open-heart surgery process. Description: Within our organization, approximately 100 to 120 pediatric open-heart cases are performed annually; yet, involving parents/families beyond the physical care of their child, namely in designing an educational tool, was absent. Processes were put into place for focused parent/family discussions to gain insights for educational tools and useful information. Careful listening was integrated as a guiding principle by caregivers. Using the expertise of the Heart-toHeart Support Group Nurse Liaison as lead, a multidisciplinary team was created with representatives from nursing, social services, child life, education, and parents/families. An educational tool was created that focused on sequential processes from admission through discharge; however, it was the parents' expertise that offered meaningful contributions such as colored photographs of what to expect (e.g., iv lines, chest tubes, endotracheal tube, and ventilator) and the title of the reference booklet, “Healing Hearts: A Parent's Guide.” Final approval of the proposed draft was received from a parent whose daughter had undergone multiple cardiac surgeries. Evaluation: Voices of parents have been heard by careful listening of caregivers with proven success and as evidenced by the creation of “Healing Hearts: A Parent's Guide.” It has also promoted a unit-based cultural change for continued involvement of parents/families as a vital resource for future initiatives.
016–Congruency Between Parents' Actual and Desired Participation in the Care of Their Hospitalized Child. Daria Romaniuk, MN, RN, PhD, McMaster University, Faculty of Health Sciences (Nursing), Hamilton, Ontario, Canada; Ryerson University, Faculty of Community Services, School of Nursing, Toronto, Ontario, Canada Purpose: Parents' participation in the care of their hospitalized child is an integral part of pediatric nursing practice and is considered to be beneficial for children and parents. However, parents rarely discuss their participation with nurses and often base their activities on their perceptions of nurses' assumptions and expectations regarding parents' participation in care. Nurses may assume a gatekeeping role regarding parents' participation, deciding what parents will do and then monitoring these activities. Thus, parents' actual participation in care may be more or less than their desired level of participation. To date, no attempt has been made to measure the difference between parents' actual and desired participation in care. Research Question: The question to be addressed in this study is: “What is the congruency between parents' desired and actual levels of participation in their child's care?” Methods: A cross-sectional, descriptive design will be used to measure parents' actual level of participation in care and their desired level of participation in care, and to describe the congruency between them. A sample of 200 parents of children admitted to medical-surgical units in a tertiary care children's hospital will be recruited.
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Analysis: Data will be described using frequency, mean and standard deviation, and a paired t test will be used to determine the extent of congruency between parents' actual and desired levels of participation. Implications for Practice: Discrepancies between actual and desired levels of participation may negatively affect parents' and children's hospitalization experience. A better understanding of this phenomenon can contribute to improving care of children and parents.
017–Safer Patient Handoff: The Shift-to-Shift Report. Rebecca Schaedig, MS, RN, CPN, Mary Bloom, BSN, RN, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI Target Audience: Staff nurses on inpatient units. Background: There are multiple handoffs of communication that occur in a hospital on a daily basis. One of the most important of those is between nurses during shift-to-shift report. National Patient Safety Goal 2E of the Joint Commission on Accreditation of Healthcare Organizations suggests to improve effectiveness of communication among caregivers hospitals should “implement a standardized approach to hand off communications including an opportunity to ask and respond to questions” (2007). Problem: Despite a routine method of shift-to-shift report, using a tape recorder and verbal updates, our unit continued to have patient safety reports filed that suggested room for improvement. The timeframe of this intervention was in sync with the initiation of a computerized order entry system. Method: Implementing a face-to-face handoff at change of shift, the use of a computerized clinical summary that replaced the paper Kardex, and implementing a two-nurse patient safety check including documentation on a bedside checksheet. Results: Data to be measured will include number and types of patient safety reports filed, analysis of bedside check sheets to determine “near misses,” patient comfort level at discharge and overall patient satisfaction. Implications for Practice: By communicating face-to-face at the bedside and completing a safety check between nurses at shift change, we hope to decrease the number of patient safety incidents on an acute care medical surgical unit. Reference: Joint Commission of Accreditation of Healthcare Organizations. (2007). 2008 National Patient Safety Goals, hospital program. Retrieved June 2007, from http://www. jointcommission.org/PatientSafety/NationalPatientSafetyGoals/ 08_hap_npsgs.htm.
018–The CRH/Pediatric Unit: An Effective Combination. Kathleen M. Sibre, MSN, RN, Judilyn Ondik, MSN, RN, CPN, Thomas Jefferson University Hospital, Philadelphia, PA The CRH/Pediatric Unit is a unique 13-bed acute pediatric and rehabilitation unit located within Thomas Jefferson University Hospital. This unit provides specialized care required by children with acute and chronic respiratory disorders including ventilator-dependent infants, diabetes, failure to thrive, surgery, trauma, neurological disorders, and sepsis requiring long-term antibiotic therapy, infant transition, and drug withdrawal. To provide optimal care of our patient population, we combined
015–Heart Sounds of Parents: Careful Listening. Jerilyn Ray, BSN, RN, CPN, J. Sandquist, K. Jarrett, L. McGrath, J. Mackey, L. Fox, M. Brown, J. Shannon, Children's Center at Mercy, Des Moines, IA Purpose: This initiative focused on improving education of future parents/families of pediatric cardiac patients. Utilizing “careful listening,” input was obtained from previous patients and families that had gone through the open-heart surgery process. Description: Within our organization, approximately 100 to 120 pediatric open-heart cases are performed annually; yet, involving parents/families beyond the physical care of their child, namely in designing an educational tool, was absent. Processes were put into place for focused parent/family discussions to gain insights for educational tools and useful information. Careful listening was integrated as a guiding principle by caregivers. Using the expertise of the Heart-toHeart Support Group Nurse Liaison as lead, a multidisciplinary team was created with representatives from nursing, social services, child life, education, and parents/families. An educational tool was created that focused on sequential processes from admission through discharge; however, it was the parents' expertise that offered meaningful contributions such as colored photographs of what to expect (e.g., iv lines, chest tubes, endotracheal tube, and ventilator) and the title of the reference booklet, “Healing Hearts: A Parent's Guide.” Final approval of the proposed draft was received from a parent whose daughter had undergone multiple cardiac surgeries. Evaluation: Voices of parents have been heard by careful listening of caregivers with proven success and as evidenced by the creation of “Healing Hearts: A Parent's Guide.” It has also promoted a unit-based cultural change for continued involvement of parents/families as a vital resource for future initiatives.
016–Congruency Between Parents' Actual and Desired Participation in the Care of Their Hospitalized Child. Daria Romaniuk, MN, RN, PhD, McMaster University, Faculty of Health Sciences (Nursing), Hamilton, Ontario, Canada; Ryerson University, Faculty of Community Services, School of Nursing, Toronto, Ontario, Canada Purpose: Parents' participation in the care of their hospitalized child is an integral part of pediatric nursing practice and is considered to be beneficial for children and parents. However, parents rarely discuss their participation with nurses and often base their activities on their perceptions of nurses' assumptions and expectations regarding parents' participation in care. Nurses may assume a gatekeeping role regarding parents' participation, deciding what parents will do and then monitoring these activities. Thus, parents' actual participation in care may be more or less than their desired level of participation. To date, no attempt has been made to measure the difference between parents' actual and desired participation in care. Research Question: The question to be addressed in this study is: “What is the congruency between parents' desired and actual levels of participation in their child's care?” Methods: A cross-sectional, descriptive design will be used to measure parents' actual level of participation in care and their desired level of participation in care, and to describe the congruency between them. A sample of 200 parents of children admitted to medical-surgical units in a tertiary care children's hospital will be recruited.
e5
Analysis: Data will be described using frequency, mean and standard deviation, and a paired t test will be used to determine the extent of congruency between parents' actual and desired levels of participation. Implications for Practice: Discrepancies between actual and desired levels of participation may negatively affect parents' and children's hospitalization experience. A better understanding of this phenomenon can contribute to improving care of children and parents.
017–Safer Patient Handoff: The Shift-to-Shift Report. Rebecca Schaedig, MS, RN, CPN, Mary Bloom, BSN, RN, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI Target Audience: Staff nurses on inpatient units. Background: There are multiple handoffs of communication that occur in a hospital on a daily basis. One of the most important of those is between nurses during shift-to-shift report. National Patient Safety Goal 2E of the Joint Commission on Accreditation of Healthcare Organizations suggests to improve effectiveness of communication among caregivers hospitals should “implement a standardized approach to hand off communications including an opportunity to ask and respond to questions” (2007). Problem: Despite a routine method of shift-to-shift report, using a tape recorder and verbal updates, our unit continued to have patient safety reports filed that suggested room for improvement. The timeframe of this intervention was in sync with the initiation of a computerized order entry system. Method: Implementing a face-to-face handoff at change of shift, the use of a computerized clinical summary that replaced the paper Kardex, and implementing a two-nurse patient safety check including documentation on a bedside checksheet. Results: Data to be measured will include number and types of patient safety reports filed, analysis of bedside check sheets to determine “near misses,” patient comfort level at discharge and overall patient satisfaction. Implications for Practice: By communicating face-to-face at the bedside and completing a safety check between nurses at shift change, we hope to decrease the number of patient safety incidents on an acute care medical surgical unit. Reference: Joint Commission of Accreditation of Healthcare Organizations. (2007). 2008 National Patient Safety Goals, hospital program. Retrieved June 2007, from http://www. jointcommission.org/PatientSafety/NationalPatientSafetyGoals/ 08_hap_npsgs.htm.
018–The CRH/Pediatric Unit: An Effective Combination. Kathleen M. Sibre, MSN, RN, Judilyn Ondik, MSN, RN, CPN, Thomas Jefferson University Hospital, Philadelphia, PA The CRH/Pediatric Unit is a unique 13-bed acute pediatric and rehabilitation unit located within Thomas Jefferson University Hospital. This unit provides specialized care required by children with acute and chronic respiratory disorders including ventilator-dependent infants, diabetes, failure to thrive, surgery, trauma, neurological disorders, and sepsis requiring long-term antibiotic therapy, infant transition, and drug withdrawal. To provide optimal care of our patient population, we combined