A Pilot Study of Family Support After Pediatric Traumatic Brain Injury

e4 prior to admission result in a faster, less-invasive, and more satisfactory cleanout. PICO Question: In children admitted for bowel preparation procedures, does initiating a clear liquid diet 24 hours prior to admission, versus no preadmission dietary restriction, result in decreased time necessary for bowel preparations, fewer invasive procedures during the preparation, and increased patient and family satisfaction? Summary of Literature: Few bowel preparation studies manipulate diet as an independent variable. Many alter cleansing agents between groups. No articles directly compare a regular diet to clear liquids. Outcomes measured typically do not include length of cleanout or invasiveness. Researchers often measure tolerability and adverse events, but not satisfaction. EBP Model: ACE Star model of Knowledge Transformation (Stevens, 2004). Outcomes: There is insufficient evidence and lack of consensus to make a recommendation on the use of a clear liquid diet prior to admission for pediatric patients admitted for bowel preparations. We recommend that research be done on this topic. Our team is currently developing a protocol to test whether a preadmission dietary restriction will result in decreased nausea and emesis, fewer episodes of nasogastric tube dislodgement, and decreased anxiety for pediatric patients admitted for bowel preparations. Implications: A consistent evidence base is essential for nurses to guide families concerning bowel preparations. A well-designed study will help identify the appropriate balance between the discomfort of dietary restriction and the discomfort of a lengthy and invasive preparation. doi:10.1016/j.pedn.2010.12.024

Reference Stevens, K. R. (2004). ACE Star Model of EBP: Knowledge transformation. Academic Center for Evidence-based Practice. The University of Texas Health Science Center at San Antonio from www.acestar.uthscsa.edu. A Pilot Study of Family Support After Pediatric Traumatic Brain Injury Amy Huett BSN, RNa, Mary Aitken MD, MPHa,b, Angela Green PhD, APNa,b a Arkansas Children's Hospital, Little Rock, AR b University of Arkansas for Medical Sciences, Little Rock, AR

Purpose: The purpose of this pilot project was to increase family knowledge and support after pediatric traumatic brain injury (TBI). A multidisciplinary team was assembled to develop a notebook designed to provide families with a resource for education about TBI in children during and after hospitalization. Families of a child experiencing a TBI not only face a lengthy hospital course but also often extended rehabilitation after discharge. This time can be frightening and confusing for families as they receive large volumes of information with complicated medical terminology pertaining to the child's condition. The ultimate goal for this project is to provide better patient and family support and education about TBI and in turn improve their overall outcomes. The purpose of this poster presentation is to describe the development of the TBI family

Abstract support notebook, its implementation, and the subsequent evaluation of the project. Methods: Upon admission to the pediatric intensive care unit (PICU) with a primary diagnosis of TBI, the child's family was given the patient and family support notebook by either the social worker or child life specialist, both members of the TBI task force. Once the family was transferred to the inpatient rehabilitation unit, the research nurse contacted the family for participation in a brief, informal survey to assess the efficacy and usefulness of the resources provided. Outcomes evaluated include usefulness of TBI resources, appropriate timing of the resources, and improved family understanding of TBI. The family's responses to survey questions were documented and reported back to the team. Findings: Early preliminary data suggest that the notebooks are perceived as helpful and useful to parents. Parents specifically noted illustrations of the brain included in the notebook as particularly helpful. Conclusions: Additional plans for expansion of this project to include children with TBI who were admitted to units other than the PICU and development of support notebooks to encompass other diagnoses are in place. doi:10.1016/j.pedn.2010.12.025 What is the Evidence: Decreasing Stress in Parents of Children Hospitalized in the Cardiac Intensive Care Unit Jackie Whyte RN, CPN, Azizi Jones RN, CPN, Angelica Arias RN, Margerry Yuhico RN, Gloria Tellez RN, Alice Latorre RN, Mary Ernst ARNP, MSN, NE-BC Miami Children's Hospital, Miami, FL

Practice Problem and Purpose: An effective way to reduce the stress of parents of hospitalized critically ill children has long been a concern of the pediatric nursing community. Although there is abundant information in the literature, it is unclear what is considered “best practices.” PICO Question: What are the best nursing interventions to reduce stress in parents of hospitalized critically ill children in the cardiac intensive care unit? Summary of the Literature: Although some studies examined conditions in the intensive care unit, which contributed to parental stress (Brown, 2001; Miles et al., 1989), and others suggested interventions (Riddle et al., 1989; Tsuruta et al., 2005), the strongest degree of evidence was demonstrated in two studies testing the efficacy of the Creating Opportunities for Parent Empowerment Intervention Program (Melnyk et al., 1997; Melnyk et al., 2004). Evidence-Based Practice Model/Process: The Johns Hopkins Nursing Evidence-Based Practice Model was used as the framework for this project. The three-phased process of evidencebased practice conceptualizes asking a practice question, finding evidence, and translating the evidence into practice (PET). Outcomes: As a result of this ongoing project, it is anticipated that parents will have a standardized orientation as to what behaviors to expect in their children and how best to intervene. Clear expectations may lead to greater well-being in the parent and healthier interactions with their child. Conclusions and Implications: Many children that undergo cardiac surgery often require repeated admissions. Standardized implementation of an intervention that addresses parental stress