Journal of Pediatric Surgical Nursing

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Editorial
Restricted accessEditorialFirst published July, 2017pp. 51-51
Collaborative Writing to Increase Nursing Publications
Kimberly McIltrot
Letter
Restricted accessLetterFirst published July, 2017pp. 52-52
President's Message
Barbara Bratton
Research article
Restricted accessResearch articleFirst published July, 2017pp. 53-55
Probiotics,Prebiotics,and Synbiotics
Lauri Jacobs
Research article
Restricted accessResearch articleFirst published July, 2017pp. 56-57
Exploration of Right Knee Pain
Mayra G. Garcia
Research article
Restricted accessResearch articleFirst published July, 2017pp. 58-67
Patient Characteristics and Prevalence of Unplanned Postoperative Pediatric Intensive Care Unit Admissions
Amy McHenryMichael ForbesMira Brown
Abstract
Objectives:
The aim of this study was to identify the prevalence of unplanned postoperative pediatric intensive care unit (PICU) admissions (UPPAs) and associated patient characteristics.
Design:
A retrospective, descriptive study at a single institution was conducted from January 1, 2011, to December 31, 2014. Trauma, medical, and weekend admissions were excluded. In addition, cardiac, orthopedic, and urology surgical admissions were excluded. A derived disability level was calculated using the baseline Pediatric Overall and Cognitive Performance Criteria. Mortality risk and acuity scores were compared between UPPAs and planned PICU admissions (PPAs). Outcomes as a function of patient origin (operating room [OR], postanesthesia care unit [PACU], and acute care floor [ACF]) and surgical services were compared.
Setting:
This study was conducted in a free-standing, tertiary care children's hospital.
Patients:
Patients admitted to the PICU within 24 hours following an operative procedure.
Measurements and Main Results:
There were 158 (34%) UPPAs. Compared with postoperative PPAs, UPPAs had higher acuity and mortality scores (p < .05). UPPAs were highest from the OR (58%), followed by those from the PACU (PACU-UPPA, 27%) and ACF (13%). There was no difference in the odds of UPPAs from the OR among surgical services. There was increased odds of PACU-UPPA after otolaryngology (odds ratio = 1.15, p < .0001) and pediatric surgery (odds ratio = 2.19, p < .0001) and the presence of disability (odds ratio = 3.67, p = .011). None of the variables were associated with UPPAs from the ACF.
Conclusions:
This study identified surgical services and moderate disability as independent risk factors for UPPA. PACU-UPPA may represent an improvement opportunity. It is feasible to derive a risk stratification model for UPPA.
Research article
Restricted accessResearch articleFirst published July, 2017pp. 68-69
Patient Characteristics and Prevalence of Unplanned Postoperative Pediatric Intensive Care Unit Admissions
Research article
Restricted accessResearch articleFirst published July, 2017pp. 70-77
Caregiver Appraisals of Anxiety,Pain,and Behavioral Changes Among Children After Ambulatory Surgery
Erin HennesseyRonald L. HickmanValerie Boebel Toly
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Abstract
Background:
Preoperative anxiety is very common across the age continuum; however, for children who experience anxiety, it can be especially challenging. On the basis of the report of caregivers, this anxiety can sometimes lead to negative behaviors postoperatively.
Purpose:
The purpose of this study was to examine the relationship between pediatric trait anxiety and postoperative outcomes in pediatric patients who undergo ambulatory surgery.
Methods:
A quantitative cross-sectional descriptive research design study of 64 caregivers was conducted. Inclusion criteria consisted of caregivers of children aged 1–8 years who underwent ambulatory surgery and provided informed consent. Measures administered included the Post Hospitalization Behavioral Questionnaire to evaluate postoperative behavior of patients after discharge from the hospital, Parents' Postoperative Pain Measure-Short Form to evaluate pain of a child after surgery, and Screen for Child Anxiety Related Emotional Disorders to evaluate children's anxiety. Data were analyzed using measures of central tendencies and bivariate correlational analysis.
Results:
Caregivers' appraisals of trait anxiety in children undergoing ambulatory surgery were low, whereas negative postoperative behaviors and pain levels were high. The only statistically significant relationship was a negative correlation between trait anxiety and postoperative pain of children who underwent ambulatory surgery.
Conclusions:
Central to this finding is the importance of developing adaptive skills of children to improve postoperative outcomes such as pain management. However, this study showed that trait anxiety is not related to postoperative negative behaviors.
Research article
Restricted accessResearch articleFirst published July, 2017pp. 78-78
Syncopal Workup in Pediatric Trauma Patients
Laurie Sands
Abstract
Evaluation and treatment of patients experiencing a syncopal episode after an unwitnessed trauma can be a challenging dilemma for the pediatric surgery/trauma team. The workup may include consultation to many specialists including neurology, neurosurgery, and cardiology. Testing can be extensive and confusing to patients and their families. The goal of this poster presentation is to provide nurses and advanced practice providers with a sequence of steps to assist in the workup of pediatric trauma patients after a syncopal episode.
Research article
Restricted accessResearch articleFirst published July, 2017pp. 79-80
Hirschsprung’s Disease: How to Prevent Enterocolitis With Rectal Irrigations
Lauren YegerlehnerTrina Blunk
Abstract
Hirschsprung’s disease is a condition where intestinal motility is compromised because of the absence of ganglion cells in the submucosal and myenteric plexus. A suction rectal biopsy is the definitive way to diagnose Hirschsprung’s disease. Enterocolitis is an inflammation of the small intestines and colon, which can be caused by bacterial overgrowth. Rectal irrigations are performed to help evacuate stool and gas from the small intestines and colon. It is important to perform adequate rectal irrigations on patients to prevent enterocolitis. Because of the importance of preventing enterocolitis, appropriate education is needed on Hirschsprung’s disease and enterocolitis and how to perform rectal irrigations effectively. A pilot study of 210 Neonatal Intensive Care Unit registered nurses was conducted to give education via poster presentation to deliver information on Hirschsprung’s disease and how to prevent enterocolitis with rectal irrigations. A pretest was administered before viewing the educational material. The test contained three questions on the topic. The poster was reviewed, and the questions were repeated utilizing a posttest to evaluate retention. Of the 210 Neonatal Intensive Care Unit registered nurses evaluated, there was an overall improvement on the three areas measured. The rates varied with each question. There was a 4.8% increase with Question 1, a 1.4% increase with Question 2, and a 10% increase with Question 3. These results showed an overall retention of the education provided. This was an effective way to educate a large group of nurses who provide bedside care to neonates with Hirschsprung’s disease. With this education, the nurses are better equipped to perform successful irrigations, thereby preventing enterocolitis.
Research article
Restricted accessResearch articleFirst published July, 2017pp. 81-81
Pediatric Strokes: The Who,What,When,and Beyond...
Gina ThompsonTonya Stafford
Abstract
The prevalence of pediatric strokes, incidence of delay in treatment, and misdiagnosis has become an epidemic in healthcare. The purpose of this poster presentation is to provide education to healthcare professionals related to the extensive care required for pediatric stroke patients, from diagnosis until adulthood. As healthcare professionals, we must be educated and aware that pediatric strokes (one of the top 10 causes of death in children aged 1–19 years) occur and their recovery includes a multidisciplinary approach. We have developed an educational booklet for patients and parents that includes diagnoses through all stages of childhood. Topics discussed are risk factors, types of strokes, signs and symptoms, treatment options, therapies such as physical therapy, occupational therapy, and speech therapy, local and national resources, and common terms. Information is presented in road maps for each age group.

Volume 6, Issue 3, July 2017