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Responding to Verbal Abuse: Exploring Successful Nursing
e18 Little literature is available regarding best practice for family education and ongoing documentation of the education. Methods: A standardized nursing education tool and parent video were developed to ensure that accurate and consistent information is taught to families and caregivers of patients with bronchiolitis. Nurses will be educated on the use of the standardized education tool and video by in-services and completion of an online training course. This standardized nursing education tool will be used to direct and document family education. Results: Data will be generated through completion of satisfaction questionnaires by families and nurses caring for the patients. Length of stay and readmission rates will be compared for winter 2007– 2008 when no standardized education tool was used and 2008– 2009 when the standardized education tool and video was in place. Descriptive statistics will be used to analyze the data. Full data analysis is pending completion of the study. Graphs show improved compliance using the pathway and the orders therein. Some of the preliminary data are based on questionnaires received from 16 admissions and are included in a table. Conclusions: Based on the preliminary data, it is obvious that while many methodologies help to enhance overall learning, all the parents who responded to the questionnaire believed that they learned the most when receiving information and demonstrations from a nurse or therapist in person. The importance of having nurses and therapists who are knowledgeable and able to educate may be the most important factor for education and increased satisfaction of parents. doi:10.1016/j.pedn.2009.12.055 Adult and Child Weight Perception in Wendover, UT Karen Lundberg MS, RN, CNE, James E. Kohl CAPT, NC, USN(Ret), MS, RN Brigham Young University, Provo, UT
Significance: Childhood obesity is a prevalent and significant problem in the United States demonstrated across all age groups, ethnicities, and educations levels. Childhood obesity puts children at greater risk for associated comorbidites such as heart disease, hypertension, diabetes, and cancer (Towns & D'Auria, 2009). Management of childhood obesity continues to be problematic and challenging for both parents and health care providers. Selfperception of correct BMI should be considered when developing obesity treatment programs. Purpose: The purpose of this pilot study was to assess the participants' perception of obesity related to their actual body mass index (BMI). Hypothesis/Research Question(s): What is the correlation between perception of the child's or adult's weight and actual BMI? Sample: A convenience sample of community participants attending a health fair at Anne Smith Elementary School on May 15, 2008, in Wendover, UT, was used for this study. Inclusion criteria included all health fair participants 5–99 years of age with a signed consent form (n = 88). Methodology: This study has a correlational descriptive design. After consent/assent was obtained, study participants filled out the paper-and-pencil “Health Survey Tool” in either English or Spanish to establish the relationship between perceived child or adult weight
SPN 2010 Convention Poster Abstracts and actual BMI. Quantitative health data were collected by Brigham Young University nursing students under the direct supervision of nursing faculty. Height and weight were assessed using commercial stadiometer and digital scales. Descriptive correlational statistical analysis was utilized on the data collected. Methods include rates, frequencies, averages, means and correlations between age, gender, and BMI. Data obtained from children were matched with data from parents when possible. Results: Statistical analysis was significant for participants' perception of their own obesity. We found that the adults' perception was correct meaning that those adults who said they were overweight were overweight. The children, however, had misconceptions regarding their perceived weight. More children perceived their weight as healthy but were really overweight. Children's Perception BMI 85% Total Perceived health weight Perceived overweight
22 1
17 12
39 13
3 1
4 22
7 23
Adult's Perception BMI 25 total Perceived health weight Perceived overweight
Implications: We have concluded that children in this particular population do not have a realistic self-perception of healthy weight. Nursing implications for working with Hispanic children in Wendover should include teaching the definition of healthy vs. non healthy weight. Reference Towns, N., & D'Auria, J. (2009). Parental perceptions of their child's overweight: An integrative review of the literature. Journal of Pediatric Nursng, 24, 115–130.
doi:10.1016/j.pedn.2009.12.056 Responding to Verbal Abuse: Exploring Successful Nursing Huong Mai BSN, RN, CPN, Mary Dominiak PhD, MBA, RN, Candace Hale BSN, RN Children's Memorial Hospital, Chicago, IL
Significance: Verbal abuse (VA) is the most common form of workplace violence that nurses experience (Cameron) and can result in psychological trauma, decreased morale, and decreased job satisfaction in nurses; can affect staff retention; and can negatively impact quality patient care. Research findings suggest that VA is a problem for nurses in all areas, including the pediatric setting (Pejic). No studies have been found that describe successful nurse interventions and strategies to prevent or reduce VA. Problem and Purpose: In a study of pediatric nurses, 94.3% experienced VA at least once in a 3-month period (Pejic). Nurses indicated that VA creates a negative, unsupportive environment, which is cause for special concern at a time of nursing shortages. The purpose of this study is to identify nurse interventions and
SPN 2010 Convention Poster Abstracts strategies that may minimize workplace VA and reduce its impact on staff and patient care. Sample: Study participants are staff nurses employed at a large Midwestern children's hospital. Design: A focus group design and a semistructured interview method to elicit nurse perceptions and descriptions of incidents of VA and methods used to counter these incidents provides the data for analysis. Data will be analyzed for patterns and themes that describe nurse interventions that successfully decrease VA. Results: Study is in progress and findings will be available for presentation. Implications: Findings from this study can be used to develop effective intervention strategies and education programs focused on avoiding or reducing the impact of VA, thereby decreasing its negative effects on nursing staff and patient care. doi:10.1016/j.pedn.2009.12.057 Incremental Research for Developing a Questionnaire on Child Autonomy Toward Minor Surgery—By Way of the Parent and the 3- to 6-Year-Old Child Undergoing Minor Surgery for Inguinal Hernia Satomi Ono DNSc, RN, PHN, Yukiki Manabe MS, RN St Luke's College of Nursing, Tokyo, Japan
The objective of this research is to inquire into the intrinsic appropriateness of questions as part of an incremental process developing a questionnaire regarding child autonomy toward minor surgery. Preparing a child to undergo surgery is important pediatric care. The Questionnaire of Child's Autonomy Toward the Minor Surgery was developed to have an index for evaluating such care. The questionnaire, a 5-point Likert scale comprising 18 items posed to the person(s) raising the child, was based on semistructured interviews, carried out in a previous study, of parents with children undergoing day surgery. In an incremental verification of the validity of the questionnaire, a survey (n = 50) was conducted of the parents of 3- to 6-year-old children undergoing minor surgery for inguinal hernia, and a factor analysis was undertaken to inquire into its internal validity. From the results, the four factors were deduced. The first factor indicated “health issues and treatment.” The second was the “process in which the child himself defines and orients himself toward the treatment.” The third was “requests by the child for support in orienting himself.” The fourth indicated an “affirmative expression of intent in regard to the surgery.” Because these factors enable the mode of the child's autonomy toward minor surgery to be interpreted, they were considered appropriate as categories for the question items. In the future, studies will examine these issues to conduct further sampling, verify the reliability and validity of the questionnaire, and apply it to clinical nursing practice as an evidence-based index for evaluating preparation. doi:10.1016/j.pedn.2009.12.058 At Camp and Caring for Special Needs Children: The Lived Experience of Student Nurses Brenda Pavill PhD, RN, FNP, Roberta Allred MS, RN, LCCE, FACCE, CD, Nancy Jackson MSN, RN, CPNP University of North Carolina, Wilmington, Wilmington, NC
e19 Significance to Pediatric Clinical Practice: The study uses a phenomenological qualitative approach to better understand the experiences of student nurses in a pediatric rotation attending an overnight camp respite program to care for special needs children of military families. The findings can have an impact on pediatric clinical practice in several ways. First, depending on the responses of the students attending the experience, faculty may choose to include or not include similar pediatric experiences in their curricula. If nursing faculty includes such experiences in clinical rotations the frequency that respite care can be offered to parents of special needs children increases. Additionally, the feedback obtained from student responses can be used to make modifications and improvements for future students attending similar programs. Also, utilizing similar community pediatric experiences may provide another avenue for faculty and students trying to find clinical placement in communities where inpatient pediatric census is low. Lastly, if students perceive their lived experience as a constructive one, they would be more likely to consider working with this population in the future; an outcome that can positively impact care of special needs children and their families. Problem and Purpose: The reason for conducting this study related to the fact that nursing faculty and several Military Exceptional Family Member Program (EFMP) Specialists believed that involving student nurses in caring for special needs children of military families would provide a positive pediatric clinical experience. Sometimes when students actually attend some clinical programs their perceptions of the experience may not be the same as faculty originally perceived. Therefore, the purpose of this study is to describe the meaning of the lived experience of a group of nursing students when caring for special needs children of military families in a camp-like setting. Sample: Senior level baccalaureate nursing students during their pediatric rotation enrolled in a southern university school of nursing program. Methodology: The phenomenological method was used in which the researchers asked students to write responses to four questions related to their lived experience caring for special needs children attending an overnight camp program. Data analysis includes thorough readings and identification of common themes and central meanings from each respondent's written answers. Three different researchers will separately review all participants' responses completing the same process of identifying themes and supporting passages. The researchers will then compare findings and develop a comprehensive list of similar themes and descriptions based on the words of the student participants. Results: Researchers are in the process of beginning individual reviews of participants' written responses. No preliminary results are available. Implications: This study leads into additional questions that other researchers may wish to explore. Would other nursing student populations have similar perceptions of caring for special needs children in community settings such as the camp-like program? Would the experience be similar with special needs children of nonmilitary families? What are lived experiences of the children matched with the student nurses? Do the student nurses make a positive impact on the children? What are the parents' perceptions? Do parents of the special needs children feel better leaving their children at camps knowing student nurses are caring for their
Significance: Childhood obesity is a prevalent and significant problem in the United States demonstrated across all age groups, ethnicities, and educations levels. Childhood obesity puts children at greater risk for associated comorbidites such as heart disease, hypertension, diabetes, and cancer (Towns & D'Auria, 2009). Management of childhood obesity continues to be problematic and challenging for both parents and health care providers. Selfperception of correct BMI should be considered when developing obesity treatment programs. Purpose: The purpose of this pilot study was to assess the participants' perception of obesity related to their actual body mass index (BMI). Hypothesis/Research Question(s): What is the correlation between perception of the child's or adult's weight and actual BMI? Sample: A convenience sample of community participants attending a health fair at Anne Smith Elementary School on May 15, 2008, in Wendover, UT, was used for this study. Inclusion criteria included all health fair participants 5–99 years of age with a signed consent form (n = 88). Methodology: This study has a correlational descriptive design. After consent/assent was obtained, study participants filled out the paper-and-pencil “Health Survey Tool” in either English or Spanish to establish the relationship between perceived child or adult weight
SPN 2010 Convention Poster Abstracts and actual BMI. Quantitative health data were collected by Brigham Young University nursing students under the direct supervision of nursing faculty. Height and weight were assessed using commercial stadiometer and digital scales. Descriptive correlational statistical analysis was utilized on the data collected. Methods include rates, frequencies, averages, means and correlations between age, gender, and BMI. Data obtained from children were matched with data from parents when possible. Results: Statistical analysis was significant for participants' perception of their own obesity. We found that the adults' perception was correct meaning that those adults who said they were overweight were overweight. The children, however, had misconceptions regarding their perceived weight. More children perceived their weight as healthy but were really overweight. Children's Perception BMI 85% Total Perceived health weight Perceived overweight
22 1
17 12
39 13
3 1
4 22
7 23
Adult's Perception BMI 25 total Perceived health weight Perceived overweight
Implications: We have concluded that children in this particular population do not have a realistic self-perception of healthy weight. Nursing implications for working with Hispanic children in Wendover should include teaching the definition of healthy vs. non healthy weight. Reference Towns, N., & D'Auria, J. (2009). Parental perceptions of their child's overweight: An integrative review of the literature. Journal of Pediatric Nursng, 24, 115–130.
doi:10.1016/j.pedn.2009.12.056 Responding to Verbal Abuse: Exploring Successful Nursing Huong Mai BSN, RN, CPN, Mary Dominiak PhD, MBA, RN, Candace Hale BSN, RN Children's Memorial Hospital, Chicago, IL
Significance: Verbal abuse (VA) is the most common form of workplace violence that nurses experience (Cameron) and can result in psychological trauma, decreased morale, and decreased job satisfaction in nurses; can affect staff retention; and can negatively impact quality patient care. Research findings suggest that VA is a problem for nurses in all areas, including the pediatric setting (Pejic). No studies have been found that describe successful nurse interventions and strategies to prevent or reduce VA. Problem and Purpose: In a study of pediatric nurses, 94.3% experienced VA at least once in a 3-month period (Pejic). Nurses indicated that VA creates a negative, unsupportive environment, which is cause for special concern at a time of nursing shortages. The purpose of this study is to identify nurse interventions and
SPN 2010 Convention Poster Abstracts strategies that may minimize workplace VA and reduce its impact on staff and patient care. Sample: Study participants are staff nurses employed at a large Midwestern children's hospital. Design: A focus group design and a semistructured interview method to elicit nurse perceptions and descriptions of incidents of VA and methods used to counter these incidents provides the data for analysis. Data will be analyzed for patterns and themes that describe nurse interventions that successfully decrease VA. Results: Study is in progress and findings will be available for presentation. Implications: Findings from this study can be used to develop effective intervention strategies and education programs focused on avoiding or reducing the impact of VA, thereby decreasing its negative effects on nursing staff and patient care. doi:10.1016/j.pedn.2009.12.057 Incremental Research for Developing a Questionnaire on Child Autonomy Toward Minor Surgery—By Way of the Parent and the 3- to 6-Year-Old Child Undergoing Minor Surgery for Inguinal Hernia Satomi Ono DNSc, RN, PHN, Yukiki Manabe MS, RN St Luke's College of Nursing, Tokyo, Japan
The objective of this research is to inquire into the intrinsic appropriateness of questions as part of an incremental process developing a questionnaire regarding child autonomy toward minor surgery. Preparing a child to undergo surgery is important pediatric care. The Questionnaire of Child's Autonomy Toward the Minor Surgery was developed to have an index for evaluating such care. The questionnaire, a 5-point Likert scale comprising 18 items posed to the person(s) raising the child, was based on semistructured interviews, carried out in a previous study, of parents with children undergoing day surgery. In an incremental verification of the validity of the questionnaire, a survey (n = 50) was conducted of the parents of 3- to 6-year-old children undergoing minor surgery for inguinal hernia, and a factor analysis was undertaken to inquire into its internal validity. From the results, the four factors were deduced. The first factor indicated “health issues and treatment.” The second was the “process in which the child himself defines and orients himself toward the treatment.” The third was “requests by the child for support in orienting himself.” The fourth indicated an “affirmative expression of intent in regard to the surgery.” Because these factors enable the mode of the child's autonomy toward minor surgery to be interpreted, they were considered appropriate as categories for the question items. In the future, studies will examine these issues to conduct further sampling, verify the reliability and validity of the questionnaire, and apply it to clinical nursing practice as an evidence-based index for evaluating preparation. doi:10.1016/j.pedn.2009.12.058 At Camp and Caring for Special Needs Children: The Lived Experience of Student Nurses Brenda Pavill PhD, RN, FNP, Roberta Allred MS, RN, LCCE, FACCE, CD, Nancy Jackson MSN, RN, CPNP University of North Carolina, Wilmington, Wilmington, NC
e19 Significance to Pediatric Clinical Practice: The study uses a phenomenological qualitative approach to better understand the experiences of student nurses in a pediatric rotation attending an overnight camp respite program to care for special needs children of military families. The findings can have an impact on pediatric clinical practice in several ways. First, depending on the responses of the students attending the experience, faculty may choose to include or not include similar pediatric experiences in their curricula. If nursing faculty includes such experiences in clinical rotations the frequency that respite care can be offered to parents of special needs children increases. Additionally, the feedback obtained from student responses can be used to make modifications and improvements for future students attending similar programs. Also, utilizing similar community pediatric experiences may provide another avenue for faculty and students trying to find clinical placement in communities where inpatient pediatric census is low. Lastly, if students perceive their lived experience as a constructive one, they would be more likely to consider working with this population in the future; an outcome that can positively impact care of special needs children and their families. Problem and Purpose: The reason for conducting this study related to the fact that nursing faculty and several Military Exceptional Family Member Program (EFMP) Specialists believed that involving student nurses in caring for special needs children of military families would provide a positive pediatric clinical experience. Sometimes when students actually attend some clinical programs their perceptions of the experience may not be the same as faculty originally perceived. Therefore, the purpose of this study is to describe the meaning of the lived experience of a group of nursing students when caring for special needs children of military families in a camp-like setting. Sample: Senior level baccalaureate nursing students during their pediatric rotation enrolled in a southern university school of nursing program. Methodology: The phenomenological method was used in which the researchers asked students to write responses to four questions related to their lived experience caring for special needs children attending an overnight camp program. Data analysis includes thorough readings and identification of common themes and central meanings from each respondent's written answers. Three different researchers will separately review all participants' responses completing the same process of identifying themes and supporting passages. The researchers will then compare findings and develop a comprehensive list of similar themes and descriptions based on the words of the student participants. Results: Researchers are in the process of beginning individual reviews of participants' written responses. No preliminary results are available. Implications: This study leads into additional questions that other researchers may wish to explore. Would other nursing student populations have similar perceptions of caring for special needs children in community settings such as the camp-like program? Would the experience be similar with special needs children of nonmilitary families? What are lived experiences of the children matched with the student nurses? Do the student nurses make a positive impact on the children? What are the parents' perceptions? Do parents of the special needs children feel better leaving their children at camps knowing student nurses are caring for their