A highlight of SPN’s yearly conference are the posters presented by members. This sharing of scholarship advances the science of pediatric nursing in its dimensions of Clinical Practice, Education, Clinical Inquiry via Evidence-based practice, Quality Improvement, and Research, and leadership/management initiatives. Upon submission the abstracts are reviewed by members of the Clinical Practice and Research Committee according to their areas of knowledge and expertise. Each abstract is scored using the objective judging criteria developed for that category. Criteria are general, such as relevance to pediatric practice, background information, gap in knowledge and literature, implications for practice, well organized, correct grammar, current references and adherence to published guidelines. More significantly criteria are specific to the category being used for submission. Specific criteria are well delineated and conform with that generally accepted and expected for each category. A personal aim for each poster submission should be to use it and the feedback received at conference as a ‘stepping-stone’ to publishing it as an article The committee members also consider whether the abstract is congruent with the current strategic goals for the organization. Strategic goals for 2019-2022 are as follows: Goal 1: SPN will increase its scope of influence in pediatric health care delivery through advocacy, research and partnerships. Goal 2: SPN will develop resources aimed at nurses from varied practice settings. Goal 3: SPN will increase number of new members and retain existing members through enhanced marketing and understanding of member needs. Goal 4: SPN will cultivate a culture of diversity and inclusion through both internal and external actions. Once all the abstracts are evaluated, committee members meet, make the final decision for each abstract and notify the person who submitted the abstract whether it was accepted for a poster presentation. The final task is to choose the best abstract in each category, which is announced at conference. Simulation and Telemedicine in Caregiver Training for Medically Complex Pediatric Patients presented by Jennifer Wirth, RNC-NIC, MSN and Catherine Barz, BSN, RN, CCRN-K The number of children with complex health conditions is growing (Graham et al., 2019). Hospitals must prepare the patient and caregivers for a safe transition home. A phased discharge process must be implemented, emphasizing caregiver training with simulation and telemedicine. The American Thoracic Society recommends a pediatric patient discharged home with ventilation should be prepared using standardized criteria (Sterni et al., 2016). Pediatric Intensive Care Unit (PICU) care managers developed a new discharge process for medically complex pediatric patients (MCPP). MCPPs include those with medical technology including tracheostomy tube, mechanical ventilation, enteral feeding and medication administration. Early identification of a MCPP is crucial for a safe, timely discharge. The discharge process includes a patient specific education plan, cardiopulmonary resuscitation training, emergency simulation scenarios, hands-on rooming in, and telemedicine follow up. Simulation meets the needs of adult learners and provides real time feedback. Shay et al. (2018) identified that 34.3% of MCPPs present for a healthcare visit or are readmitted within the first 48 hours after discharge, which telemedicine follow up can eliminate or decrease. With the use of simulation and telemedicine, the PICU has successfully discharged MCPPs home safely without complications or readmission. MCPPs had a 30-day zero readmission rate after discharge home. Family satisfaction for respondents was 5/5 regarding the process of telemedicine follow-up. This discharge process can reduce risk and ensure quality care at home, improving overall health outcomes for MCPPs. Further studies need to be conducted to demonstrate clinical significance of this multimodal discharge process and create a new standard of care including simulation and telemedicine for MCPPs. Time spent in a hospital can exacerbate health and developmental disparities in MCPPs (Sobotka et al., 2017). A comprehensive discharge process for MCPPs can improve outcomes. Graham, R. J., Amar-Dolan, L. R., Roussin, C. J., & Weinstock, P. H. (2019). Bridging the stressful gap between ICU and home: Medical simulation for pediatric patients and their families. Pediatric Critical Care Medicine, 20(4), e221-e224. https://doi.org/10.1097/pcc.0000000000001869 Shay, S., Shapiro, N. L., & Bhattacharyya, N. (2018). Revisits after pediatric tracheotomy: Airway concerns result in returns. International Journal of Pediatric Otorhinolaryngology, 104, 5-9. https://doi.org/10.1016/j.ijporl.2017.10.021 Sobotka, S. A., Agrawal, R. K., & Msall, M. E. (2017). Prolonged hospital discharge for children with technology dependency: A source of health care disparities. Pediatric Annals, 46(10), 365-370. https://doi.org/10.3928/19382359-20170919-01 Sterni, L. M., Collaco, J. M., Baker, C. D., Carroll, J. L., Sharma, G. D., Brozek, J. L., Finder, J.D., Ackerman, V. L., Arens, R., Boroughs, D. S., Carter, J., Daigle, K. L., Dougherty, J., Gozal, D., Kevill, K., Kravitz, R. M., Kriseman, T., MacLusky, I., Rivera-Spoljaric, K., … Halbower, A. C. (2016). An official American thoracic society clinical practice guideline: Pediatric chronic home invasive ventilation. American Journal of Respiratory and Critical Care Medicine, 193(8), 16-35. https://doi.org/10.1164/rccm.201602-0276ST Piloting a Unit-Based Nursing Journal Club presented by Michelle High, MSN, RN, CNL, CPN Evidence-based nursing practice can lead to improved health outcomes, reliability and quality of care, improved patient experience, and reduction of health care costs. Nursing journal clubs are a strategy for teaching EBP and commonly cited benefits include skill development in reading research and critical appraisal, facilitation of EBP learning and practice, nurse empowerment, and professional development. Since 88% of the unit’s nurses (n=26) reported no previous participation in a nursing journal club, this educational strategy for teaching EBP was piloted. The target audience was unit-based pediatric staff nurses in a freestanding children’s hospital. Planning for a unit-based nursing journal club began in April 2019 with a literature review of strategies for effective implementation. A research proposal to measure change in nurses’ EBP beliefs and implementation was approved by the hospital’s Institutional Review Board. A variety of strategies were incorporated to engage learners including involving the unit’s nurses in finding relevant topics, offering continuing education credit, and providing paid off-unit education time. During the pilot period from August 2019 to January 2020, 27 nurses attended at least one of six journal club meetings. Fifty-one hours of continuing education were awarded. At pilot completion, survey results showed 92.9% of nurses (n = 14) strongly agreed or agreed that journal club is a useful tool to promote evidence-based practice in nursing and that it provides opportunities to connect relevant research evidence to clinical practice. Over 85% of nurses (n=15) strongly agreed or agreed that journal club helps develop skills in reading and appraising research. After pilot completion, 75% of nurses reported (n=16) that a primary reason for attending was interest in the activity. However, barriers to participation included journal club timing, work schedules, and distance. Overall, pilot results indicate that a unit-based nursing journal club may be a useful tool for teaching EBP. Teach-Back to Keep Them from Coming Back: Evidence-Based Practice Project to Reduce Readmissions presented by Maggie McClelen, BSN, RN, CPN and Kaitlin Smith, BSN, RN, CPN Teach-back is an extremely important way to verify patient understanding and education adherence. When teach-back is not used effectively, medical errors, readmission rates, and cost of care increase. Based on increased readmissions, nurse managers of a medical unit within a large pediatric medical center requested an evidence-based practice (EBP) project to re-implement teach-back. PICO question: For inpatient staff nurses on a pediatric medical unit, would using video education of standardized teach-back increase nursing knowledge, confidence, and use of teach-back? Eleven publications reviewed were: 2 systematic reviews, 1 randomized-control trial, 3 quasi-experimental studies, 4 non-experimental research, and 1 expert opinion. Agency for Healthcare Research and Quality (AHRQ) provided teach-back definition. Literature synthesis revealed: (1) teach-back leads to increased compliance, information retention, and prevention of medical errors post-discharge; (2) improved patient/family engagement in discharge planning; (3) videos as effective teaching tools; and (4) ‘motivation to learn’ increases ‘need to know.’ Iowa Model-Revised (Hanrahan et al., 2019; Titler et al., 2001) was used: (1) literature and AHRQ website reviewed; (2) data on current 7-day readmission rates collected; (3) team-building: nurse managers, educator, Quality director, and Director of Nursing Research; (4) development of 4-item pre- and post-intervention survey for nurses; (5) selection of 4 videos demonstrating teach-back; (6) creation of banners with teach-back phrases; (7) emails to nurses with readmission data, teach-back explanation, pre-survey, and 4 videos; and (8) post-survey 30 days post-intervention. Pre-survey results (n=28): (1) On a 1-10 scale (10 being very knowledgeable or very confident), teach-back knowledge between 7 and 10 and confidence between 5 and 10; and (2) 74% “sometimes” use teach-back. Post-survey results (n=8): (1) On a 1-10 scale (10 being very knowledgeable or very confident), teach-back knowledge and confidence between 8 and 10; and (2) 75% stated they “will use teach-back every time.” Ongoing evaluation of project’s impact on unit readmission rates continues. Hanrahan, K., Fowler, C. and McCarthy A.M., Iowa model revised: Research and evidence-based practice application, Journal of Pediatric Nursing, https://doi.org/10.1016/j.pedn.2019.04.023 Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., Buckwalter, C., Tripp-Reimer, T., Goode, C. J. (2001). The Iowa model of evidence-based practice to promote quality care. Critical Care Nursing Clinics of North America, 13(4), 497–509. Reducing Hospitalized Pediatric Falls by Increasing Nursing Adherence to Fall Prevention Protocol presented by Jinger Roy, DNP, APRN, FNP-C Hospitalized fall rates were steadily increasing past the national average at a pediatric hospital in the Gulf South, especially on the pediatric neurorehabilitation floor. The project leader discovered that this floor had the lowest rates of proper fall prevention protocol implementation in the hospital. The increase in falls and low rate of protocol implementation necessitated a quality improvement (QI) project to help increase nursing compliance and accountability for fall prevention. Two different interventions were used. First, fall prevention posters, tailored to each patient's fall risk, were placed in each patient's room. The poster served as an impetus for fall prevention education and a reminder for all staff and caregivers about the proper bundle elements to be used, based on the hospital's fall prevention policy. Second, two nursing unit champions were elected to help provide enthusiasm and educate patients, parents, and nurses about fall prevention. Direct in-room audits and chart checks, in Plan-Do-Study-Act (PDSA) cycles, were conducted to determine if these interventions helped to increase implementation of the fall prevention protocol above the hospital's goal of 90%. These interventions resulted in an increase in overall proper protocol implementation from 43% to 67%, a 56% improvement from baseline measurements. The use of small-scale iterative changes during PDSA cycles helped tailor the interventions to the specific needs of the neurorehabilitation floor but limited the expansion of the project to other acute care floors. A logic model evaluation performed afterwards revealed that nursing perceptions of barriers to fall prevention may have influenced the project not reaching its goal, and the nursing feedback received identified further avenues for research and QI projects relating to patient safety in the pediatric environment. Impact of an Immersive, Virtual Reality (VR) Experience on Healthcare Provider Burnout and Stress presented by Jennifer Hayakawa DNP, CNS, CCRN, CNRN Burnout and stress are experienced by healthcare professionals in their caregiving roles and may result in emotional exhaustion, diminished performance, higher absenteeism and turnover rates, and greater conflict with others. Beyond personal consequences for clinicians, burnout has been linked to poorer-quality patient care, including increased medical errors and lower patient/family satisfaction. To examine the utility of an immersive classical music virtual reality (VR) experience to reduce healthcare provider burnout and stress at a freestanding children's hospital. There is evidence that classical music has a physiological impact on the brain that may reduce stress and anxiety. Maestro Games SPC is a mission driven social purpose corporation focused on creating a powerful digital health platform combining the resiliency building power of music, virtual reality and gamification. Their fully immersive, orchestral conducting VR experience entitled The Last MaestroTM is a VR-based immersive experience that aims to create a safe space to heal through the power of classical music. Pre/posttest study design - A total of 127 individuals participated in this interventional study, yielding 71 participants with usable data. The self-reported professional quality of life survey was used. Fifty-nine registered nurses (83%) provided data. There was a statistically significant decrease in self-reported burnout (<0.0001) and secondary traumatic stress (<0.0001). Among the study participants, 87% reported that they would recommend this intervention for other staff. COVID-19 has highlighted the importance of mental resilience and wellness during a period of anxiety and fear. We recognize the need to explore and advance effective modalities of mental health care for our healthcare workers. This study has provided preliminary evidence that The Last MaestroTM may be a useful tool to reduce burnout and post-traumatic stress in healthcare workers. Future studies are needed to evaluate the impact of this intervention on healthcare professionals with high levels of burnout and stress as well as its utility in patients and families. Converging Towards Excellence: Outcomes from a Nursing Professional Development Program presented by Angela York, BSN, RN, CPN and Jamie Bankston, MS, RN Low numbers of registered nurses participated in a task-focused clinical excellence program at an urban pediatric hospital, even though maintaining a pay increase with continued achievement was used as an incentive. Nurses did not participate because the program did not enhance professional growth. The purpose of transitioning to a professional development program (PDP) was to promote quality care, encourage/recognize excellence, reward professional development, and exemplify the practice model and values. The literature describes PDP benefits to include alignment with Magnet concepts of structural empowerment, transformational leadership, new knowledge, innovation, improvements, and exemplary professional practice. PDPs incentivize nurse development and may enhance job satisfaction. An implementation committee (Chief Nursing Officer, directors, managers, staff nurses, educators) reviewed literature, other professional programs, and developed a 2-year achievement structure. They met with Human Resources and Finance, advocated for nursing professional development, potential impact on patient outcomes, and gained approval. Nurses earn points for tenure/experience, formal/continuing education, and professional development. Four levels are possible with a bachelor’s degree required for level 3 and master’s degree for level 4. Presentations at forums and staff meetings led to immediate engagement. A review committee received letters of intent to participate and served as mentors. Two-year evaluation revealed that 53 nurses presented portfolios, earned bonuses, certificates, and Nurses’ Week recognition. After only 4 years, participation quadrupled. Significant outcomes include increases in research, evidence-based practice and quality projects, participation in councils, volunteerism, continuing education, and conference presentations. Nurses became super-users for change initiatives. Several obtained advanced degrees and promotions. Other disciplines developed similar programs. PDP aim to empower nurses to seek improvement, growth, and education with the goal of improving job satisfaction and retention. Organizations that invest in the careers of their staff are recognized for their commitment and rewarded by staff contributions to the organization. The next two awards were given for work done exemplifying goals of SPN’s Strategic Plan The Design and Implementation of a Child Physical Abuse Dashboard: Nurses at the Forefront presented by Celia Pulver, RN, BSISM; Tracy Pasek RN, DNP, CCNS, CCRN, CIM; Lisa Meyer, RN-BC, BSN, CPN; and Gabriella Butler, RN, MSN Maltreatment is a leading cause of death and disability in children. More than 3 million reports to Child Protective Services are made yearly in the US. Last year, 1 in 7 children experienced child abuse and neglect and nearly 1,770 children died in 2018 due to maltreatment. Results reported in the midpoint follow-up of the 2012 Delphi study by the Society of Pediatric Nurses (SPN) demonstrated a gap in care. The pre- and post-Delphi research priorities revealed that child abuse was not addressed (pre) and only marginally 5 years later (post). Emergency department (ED) nurses use of a validated screening instrument become key in identifying child abuse in less acute forms. The ability to capture, transform, and visualize data from our Child Abuse Clinical Decision Support System (CA-CDSS) was the impetus for creation of a dynamic user-friendly dashboard. Nurses with extensive knowledge of frontline clinician processes, technical nuances of the electronic health record (EHR) and data analytics led the project. EHR data (including nurses’ documentation and validated screening tool) are organized into 28 triggers suggestive of child abuse (e.g., <1-year-old with chief complaint of bruising/petechiae). When a trigger is activated, clinical decision support alerts potential abuse and sends link to the provider with a physical abuse order set. Extracted CA-CDSS data, inclusive of demographic information, are represented on the dashboard making trending by end-users possible. Approximately 800 children over 6 months (~30 per week) trigger the CA-CDSS. The dashboard enables providers to interpret patients’ screening results and intervene appropriately. A dashboard demonstration showcases a bias-free, comprehensive CA-CDSS that supports measurement of screening timeliness and completion of intervention. We predict enhanced screening quality will improve sensitivity and specificity of diagnostic imaging. Social isolation and socioeconomic challenges are risk factors for child abuse. Real-time detection of triggers suggestive of abuse will enable providers to intervene more promptly and decrease child morbidity and mortality. The Pediatric Specialty Hospital at The Children’s Home & Lemieux Family Center, a 30-bed, independent hospital in Pittsburgh, PA submitted their Ready. Set. Home! initiative to the 2021 Annual Conference for consideration in response to SPN’s inaugural call for innovative nursing care projects. The Pediatric Specialty Hospital serves medically fragile infants and children from birth to age 21. Marlee Gallagher and Carrie Wall The Pediatric Specialty Hospital at The Children’s Home & Lemieux Family Center is unique in that the child’s medical care is provided without cost to the family. Families participate in formulating the daily care plan, which is tailored to fit the specific needs of their child. Family members stay on-site at their child’s bedside or in fully equipped family living areas that offer a comfortable, home-like environment. Most notably, the Pediatric Specialty Hospital’s clinical staff works to provide the highest level of care to patients while at the same time and with the same equipment used at home, teach parents and guardians how to provide the care. This process instills confidence and supports family caregivers to successfully prepare for discharge. Based on the premise that teaching while providing care builds caregiver confidence, reduces home emergencies and decreases return visits to the hospital, this practice is part of the hospital’s onboarding process for registered nurses and nurse practitioners. Each nursing staff member is taught how to care for complex, medically fragile children and to teach families how to be independent caregivers. Two years ago, The Children’s Home began looking for opportunities to build on their program’s success, enhance clinical education and improve strategies for educating families. Forging an innovative partnership with the Highmark Foundation resulted in Ready. Set. Home! a nine-part educational video series for family caregivers. Ready. Set. Home! covers a range of complex and everyday tasks to ensure each family has the knowledge and tools they need to keep their child healthy at home. The video series covers the following topics:•Caring for a Central Line•Changing a Tracheostomy Tube•Go Bag•G-tube Care•Nesting with Your Child•Packing Your Kid Kart•Trach Care•Traveling with Medical Equipment•Troubleshooting Tracheostomy Emergencies In collaboration with Anthem Video, The Children’s Home will launch the Ready. Set. Home! streaming channel so families can access any video from either the Pediatric Specialty Hospital or from home. A companion medical discharge binder is in production to complement the videos and provide another resource for clinical staff and families. The potential for this project to advance the science, promote patient-family-centered care, provide high quality care to children and families and serve as a model for similar projects is endless. Congratulations for receiving the Society of Pediatric Nurses (SPN) 2021 Innovation Award.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Lisa Houlihan, RN, BSN Manager of Nursing Services The Children’s Home & Lemieux Family Center [email protected] (412) 441-4884 Marlee Gallagher, BA Foundation & Community Relations Manager The Children’s Home & Lemieux Family Center [email protected] (412) 441-4884 Carrie Wall, CVA SPN staff