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Nursing Research and Evidence-Based Practice (EBP)

Nurse smiling at young girl patient

Nurses are the heart of the organization and have the greatest opportunity to make a difference in direct patient care. CHOC nurses are dedicated to enhancing pediatric acute, critical, and ambulatory care through the creation of new knowledge and the implementation of evidence-based practice (EBP). At CHOC, nurses at all levels of the organization are encouraged and supported to engage in:

Research
Evidence-based practice
Innovation
Quality improvement
FY17 and FY18 CHOC Nursing Research, EBP, and QI Project

Research

Research is the creation of new knowledge and/or the validation of existing knowledge through the use of systematic and rigorous methods (qualitative, quantitative/mixed). Nurses are ideally positioned to design, develop, and conduct research on patient and caregiver interventions, protocols and processes.

Nursing Research and Innovation Council (NRIC)
The purpose of this shared governance council is to promote the integration of evidence-based practice, research, and innovation into practice, and facilitate nurse involvement in related activities across the organization. Our mission is to engage nurses in these activities and sustain a culture of inquiry that improves patient outcomes at CHOC.

Nursing Research Fellowship (NRF) Program
The Nursing Research Fellowship program was first introduced in our organization in 2005 and over the past 12 years, we have successfully graduated 25 Research Fellows. This program resulted in multiple national presentations as well as peer-reviewed publications and has been instrumental in developing internal expertise. This program has been generously supported by the Walden and Jean Young Shaw Foundation.

Nursing Research Associate (NRA) Training Program
The NRA training program provides a meaningful and relatable approach to empower nurses, at all levels, to participate in multidisciplinary research. This innovative, new program increases participation, re-engages nurses, and generates excitement and awareness. Nurses today enter the workforce with different levels of knowledge and exposure to research activities. The NRA offers a gradation of participation opportunities- meeting learners where they are at. Participants attend didactic classes on research design and concepts; ethical conduct and vulnerable populations; organization specific processes and policies; as well as hands-on training with a clinical research coordinator. NRAs complete a minimum of 20 hours per year of research-related activities such as consenting, or data collection/entry. This program is currently supported by the Walden and Jean Young Shaw Foundation.

Nurse Scientist
CHOC employs a full-time doctoral-prepared nurse scientist who functions to develop and maintain a supportive infrastructure; acquire necessary resources, and mentor nurses on project formation, execution, and outcome dissemination. This position is funded, in part, by a grant from West Coast University.

Spotlight on CHOC Nursing Research
Erica Crawford, BSN, RN, CPHON; Eileen Fry-Bowers, PhD, JD, RN, CPNP; Kathleen Adlard, MN, RN, CPON recently presented a poster at the Association of Pediatric -Hematology/Oncology Nurses Conference, August 17-19, 2017 in Palm Springs, CA. Aromatherapy as a Home Tool for Symptom Management in the Pediatric Oncology Patient. This poster won the People’s Choice Award!
Karen DeAnda, BSN, RN, CPHON; Eileen Fry-Bowers, PhD, JD, RN, CPNP; Kathleen Adlard, MN, RN, CPON poster abstract was accepted for presentation at the Center to Advance Palliative Care (CAPC) national seminar, November 9–11, 2017 in Phoenix, AZ. Pediatric Nurses’ Knowledge, Beliefs, Practices and Perceived Barriers to Pediatric Palliative Care across Institutional Settings.

Evidence-Based Practice

Best Evidence and Recommendation (BEaR) Statements from CHOC EBP Scholars

Evidence-based practice (EBP) is a dynamic process of integrating research, credible sources of knowledge, clinical expertise, and patient & family preferences and values to achieve optimal patient outcomes, enhance practice, and manage health care costs.

The CHOC nursing EBP scholars program is a formal 6-month program that consists of monthly meetings with expert academic faculty. Scholars receive education about the EBP process and guidance in completing a literature review and analysis. The ultimate goal of the program is to translate research (and other sources of evidence) into practice to enhance patient outcomes. By the completion of the program, scholars develop a Best Evidence and Recommendation (BEaR) statement to disseminate their findings and share practice recommendations based on the best available evidence.

Browse by topic or specialty/discipline.

Innovation

Young female nurse Innovation is simply solving problems with creativity and execution.

“We keep moving forward, opening new doors, and doing new things, because we’re curious and curiosity keeps leading us down new paths.” –Walt Disney

Medical Intelligence and Innovation Institute (MI3)
CHOC has embraced innovation in the past two years with the formation of the Sharon Disney Lund Medical Intelligence and Innovation Institute (MI3) with its monthly meetings and summer internship program. In addition, with the support for a chief intelligence and innovation officer, CHOC is investing in its future in both data analytics/ artificial intelligence as well as innovation in pediatric medicine. Nurses are encouraged to attend monthly meetings at CHOC to learn about the latest advances in data intelligence and medical innovations, and provide a forum to network and exchange ideas with fellow innovators. These meetings often include invited speakers and are open to everyone at CHOC and to the outside community. Please join us every second Monday of the month, 4-6 p.m. at CHOC Hospital in Orange. Email MI3@choc.org for more information.

Innovation Beach (iBeach)
Innovation Beach is a 4-hour CHOC training program to educate participants on the 7-steps of innovation and to motivate clinicians to think outside of the box and create new ways of improving care. Nurses are encouraged to attend and learn more about their role as innovators. The next Innovation Beach is scheduled for October 18th, 2017 from 8:30 a.m. – 12:30 p.m. at the Innovation Lab in Newport Beach.

Innovation Lab
Building upon the progress of MI3, CHOC joined the Innovation Lab, a consortium of member health care systems and industry partners focused on transforming healthcare through innovative new products, services and ideas. Innovation Lab is a “technology” incubator that works with CHOC innovators to develop medical products and IT solutions that improve patient care and reduce costs. The Lab is a safe place for CHOC nurses (as well as all associates and physicians) to bring unmet medical needs and ideas for proposed solutions. The Innovation Lab will cover all costs associated with the development and protection of the idea, and will return 40 percent of any revenue generated from commercializing the idea to the innovator. The remaining revenue is distributed to CHOC (20 percent) and invested back into the Innovation Lab (40 percent) to fund the development of other innovations.

Innovation Portal
The Innovation Lab has made the process for submitting ideas as easy as possible via a secure online portal: www.choc.org/innovation

The site is also a source for participating in innovation challenges and brainstorming sessions with your colleagues.

In addition, CHOC has a dedicated innovation leader—Suzy Engwall—from the Innovation Lab to guide you throughout the process. Suzy can be reached at suzy.engwall@ii4change.com or at 714-234-6349.

Quality Improvement

CHOC Nursing Quality Improvement is defined as the cyclic evaluation of current work processes of practice (critical knowledge and skill), safety, patients, organizational support (critical tools and environment) and barriers, and practice benchmarks against established indicators, providing a method to continually evaluate and improve current practices. As nursing research identifies what is best practice and EBP questions whether we are doing the best, Quality Improvement (QI) assesses if we are doing the best thing right every time. Hallmarks of success are posted in the departments throughout the hospital.

The Nursing Quality and Safety Council’s purpose it to promote the best possible patient outcomes through the presentation and discussion of clinical practice and practice related information, evidence-based quality improvements, and safety initiatives – all in an effort to strengthen and improve the quality and safety of the patient care we provide.

FY17 and FY18 CHOC Nursing Research, EBP, and QI Project Presentations

Juleah Walsh, MSN, PCNS-BC, CPAN & Jennifer Hayakawa, DNP, PCNS-BC, CCRN, CNRN presented a podium presentation at the ASPAN conference in Anaheim, CA, May 1, 2018. The Impact of a Behavioral Intervention on Patient and Family Experience Scores in the Pediatric Outpatient Surgical Setting.

Lauren Kanamori, MSN, CPNP presented a poster presentation at the APSNA conference in Palm Desert, CA, April 30-May 3, 2018. Are Routine Chest X-Rays Necessary After Chest Tube Removal?

Cyndie Sapikowski, BSN, RN, CCRN & Juleah Walsh, MSN, PCNS-BC, CPAN presented a poster presentation at the ASPAN conference in Anaheim, CA, April 29-May 3, 2018. Pre-Admission Anesthesia Risk Screening of Pediatric Patients.

Holly Birkinshaw, MSN, RN, CPN, CLE, PCNS-BC & Elyse McClean, MSN-RN-BC, CPN, CNS presented a poster presentation at SPN in Denver, CO, April 5-8, 2018. Pediatric Clinical Nurse Specialist Succession Plan.

Jennifer Hayakawa, DNP, PCNS-BC, CCRN, CNRN presented a poster presentation at the APU-STTI Nursing Research Symposium in Azusa, CA, March 22, 2018. Innovations in Leading and Advancing a Culture of Inquiry.

Erica Crawford, BSN, RN, CPHON presented a poster presentation at the the APU-STTI Nursing Research Symposium in Azusa, CA, March 22, 2018. Aromatherapy as a Home Tool for Symptom Management in the Pediatric Oncology Patient.

Jennifer Hayakawa, DNP, PCNS-BC, CCRN, CNRN; Jennifer Bray, BSN, RN, CCRN; Melanie Go, BSN, RN, CCRN presented a poster presentation at the AANN conference in San Diego, CA, March 17-20, 2018. The Use of Automated Pupillometry in Children.

Nancy Kraus, MSN, RN presented a poster presentation at the ACNL conference in Monterey, CA, February 5-7, 2018. The Charge Nurse Academy.

Alisa Brown, BSN, RN, CCRN & Robin Franzen, BSN, RN, CCRN presented a poster presentation at the ACNL conference in Monterey, CA, February 5-7, 2018. The Consultants Have Left the Building. Now What? Improving Associate Engagement Scores After a Leadership Redesign.

Jennifer Hayakawa, DNP, PCNS-BC, CCRN, CNRN presented a poster presentation at the ACNL conference in Monterey, CA, February 5-7, 2018. Innovations in Leading and Advancing a Culture of Inquiry.

Susan See, BSN, RN, CPHON; Susan Feidner BSN, RN; Laura Luciani, MSN, RN, CPN, CPNP presented a poster presentation at the ACNL conference in Monterey, CA, February 5-7, 2018. Preventing Medical Device-Related Pressure Injury Using Silicone Contact Layer Under EEG Leads in the Pediatric Population.

Brittney Anderson, DNP, CPNP presented a podium presentation at the Pediatric Trauma Society Conference in South Carolina, November 3, 2017. Discharge Follow Up Phone Call Screening for Concussive and PTSD Symptoms in Pediatric Trauma Patients.

Pernilla Fridolfsson, BSN, RNC-NIC, VA-BC presented a poster presentation at the AVA Conference in Phoenix, AZ, September 16-19, 2017. Development of Evidence Based Guidelines to Standardize PICC Line Placement & Maintenance in the Pediatric & Neonatal Population

Pernilla Fridolfsson, BSN, RNC-NIC, VA-BC presented a podium presentation at the AVA Conference in Phoenix, AZ, September 16-19, 2017. Development of Evidence Based Guidelines to Standardize PICC Line Placement & Maintenance in the Pediatric & Neonatal Population

Sharon Bergeron, BSN, RN, CPON presented a podium presentation at the Annual Nursing Research Conference in Loma Linda CA, September 28, 2017. Oncaspar (Peg-Asparaginase) in the First-Line Treatment of Pediatric ALL.

Kathleen Adlard, MN, RN, CPON; presented a podium presentation at the APHON National Conference in Palm Springs, CA, August 17, 2017. Playing to our strengths: Developing interprofessional teams in pediatric hematology/oncology

Kathleen Adlard, MN, RN, CPON; presented a podium presentation at the APHON National Conference in Palm Springs, CA, August 17, 2017. Acute promyelocytic leukemia: Current COG treatment for a unique AML subtype.

Erica Crawford, BSN, RN, CPHON; Eileen Fry-Bowers, PhD, JD, RN, CPNP; Kathleen Adlard, MN, RN, CPON; presented a poster presentation at the APHON National Conference in Palm Springs, CA, August 17, 2017. Aromatherapy as a Home Tool for Symptom Management in the Pediatric Oncology Patient, winner People’s Choice Award

Christine Yun, MSN, PNP, CPON presented a podium presentation at the APHON National Conference in Palm Springs, CA, August 17, 2017. Acute Lymphoblastic Leukemia: Current COG Trials for T Cell, Ph+, and PH-Like ALL

Christine Yun, MSN, PNP, CPON presented a podium presentation at the APHON National Conference in Palm Springs, CA, August 19, 2017. ALL Treatment and Considerations around Asparaginase Hypersensitivity

Jennifer Hayakawa DNP, PCNS-BC, CNRN, CCRN; Juleah Walsh presented a podium presentation at the Stanford Children’s Nursing Research Symposium in Palo Alto, CA, June 2, 2017. Parent and Child Perception of Pediatric Postoperative Pain

Jennifer Hayakawa DNP, PCNS-BC, CNRN, CCRN; Juleah Walsh presented a poster presentation at the Stanford Children’s Nursing Research Symposium in Palo Alto, CA, June 2, 2017. Optimizing Healing through Behavioral Intervention to Reduce Pediatric Postoperative Pain

Kara Bame MSN, RN, CCRN; Dyana Mejia BSN, RN, CCRN; Alisa Brown BSN, RN, CCRN; Jennifer Hayakawa DNP, PCNS-BC, CNRN, CCRN presented a poster presentation at NTI in Houston, TX, May 22-25, 2017. Keepin’ Beacon: Sustaining and Exceeding the “Gold Standard”

Sharon Bergeron BSN, RN, CPON presented a poster at the SCAPHON National Conference, May 1, 2017. The Impact of an Adolescent and Young Adult Activity Specialist on AYA Patients

Sharon Bergeron BSN, RN, CPON; Jaclyn Hill Bassee, BSN, RN, CPON presented a poster at the SCAPHON National Conference, May 1, 2017. Implementation of Safety Infusion Procedure for IV PEG – Asparaginase

Sharon Bergeron BSN, RN, CPON presented a poster at the SCAPHON National Conference, May 1, 2017. “Rock the Halls””: A Unique Fitness Program for Adolescent and Young Adults.

Beverly Walti MSN, CPNP, CNS, RNC-NIC presented a podium presentation at the Synova NICU Leadership Forum, Arizona, April 25-29, 2017. Harlequin Ichthyosis: A Case Study

Tammy Yoon, BSN, RNC-NIC presented a podium presentation at the WestEd Center for Prevention and Early Intervention ESPS- Early Start Partners Symposium, April 12, 2017 in Anaheim, CA. Beyond the NICU: Planning Early Intervention for Premature Infants and their Families.

Laura Luciani MSN, RN, CPN, CPNP; Susan Feidner BSN, RN; Susan See RN,CPHON (in collaboration with multidisciplinary partners Kim Clemens, Angela M. Villa, Jeanette Garcia) presented a poster at the Symposium on Advanced Wound Care Spring/Wound Healing Society, in CA, April 10, 2017. Preventing Medical Device Related Pressure Injury using Silicon Contact Layer under EEG leads in the Pediatric Population.

Jennifer Pugh MSN, RN, CPNP; Jennifer Clark BSN, RN, CPN presented a poster presentation at the Society of Pediatric Nurses Conference in FL, April 9, 2017. Creating a New culture: Improving Relationships between Physicians and Nurses

Shannon Overpeck, BSN, RN, CCRN, CLEC presented a poster presentation at NeoHeart Conference in San Diego, CA, March 22-25, 2017. Colostrum Swabbing in the CVICU

Melissa Terah BSN, RN, CCRN; Lisa Penna BSN, RN, CCRN presented a poster presentation at ACNL, Anaheim, CA, February 5-8, 2017. Professional Development of the Charge Nurse Role through a Shared Governance Structure

Cheryl Deters MSN, RN, CPNP presented at the National Association of Pediatric Nurse Practitioner- Southwest Regional Conference in Palm Springs, CA, November 11-13, 2016. Pain Management in Primary Care

Robyn Robinson, CNP, MSN presented a podium presentation at the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition conference, November 4, 2016. Creating an Effective Advanced Practice Provider/Physician Partnership, with Emphasis on the Small to Medium Size Peds GI Practice

Nancy Kraus, MSN, RN; Donna Bigani, MSN, RN, CPN presented a podium presentation at the ANCC National Magnet conference in Orlando, FL, October 1, 2016. Maintaining a Magnet Culture during Organizational Restructure

Samantha Hayward BSN, RN; Kathleen Adlard, MN, RN, CPON; presented at the APHON National Conference in Indianapolis, September 29, 2016. Changing CVC Flushing Frequency: A Pilot Study Comparing Two Regimens

Samantha Hayward BSN, RN; Sharon Bergeron BSN, RN, CPON presented at the APHON National Conference in Indianapolis, September 29, 2016. Targeted Immunotherapy: Launching an Effective Education and Administration Strategy for the Bedside Pediatric Oncology Nurse

Peggy Scoggin, MSN, CDE presented a poster at the National AADE Conference, August 12-15, 2016 in San Diego, CA. Innovative Techniques for Teaching New Onset Diabetes Patients and Families

Michele Kincaid BSN, RN; Juleah Walsh MSN, PCNS-BC, RN, CPAN presented a podium presentation at the American Society of PeriAnesthesia Nurses Conference in Philadelphia, PA, April 12, 2016. The Perianesthesia Pathway for Patients with Autism Spectrum Disorders: A successful process improvement project to individualize care and increase patient satisfaction scores.

Recent Publications

Adlard, K., & Kuntz, N. (2016). Development of an Evidence-Based Approach to Nutritional Support for Children Undergoing Stem Cell Transplantation. Biology of Blood and Marrow Transplantation, 22(3), S286.

Bartholomew, J., Washington, T., Bergeron, S., Nielson, D., Saggio, J., & Quirk, L. (2017). Dinutuximab: A Novel Immunotherapy in the Treatment of Pediatric Patients with High-Risk Neuroblastoma. Journal of Pediatric Oncology Nursing, 34(1), 5-12.

Bigani, D. K., & Correia, A. M. (2018). On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report. Journal of pediatric nursing.

Lebet, R., Hayakawa, J., Chamblee, T. B., Tala, J. A., Singh, N., Wypij, D., & Curley, M. A. (2017). Maintaining Interrater Agreement of Core Assessment Instruments in a Multisite Randomized Controlled Clinical Trial: The Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Trial. Nursing Research, 66(4), 323-329.

Morris, M., Cleary, J. P., & Soliman, A. (2015). Small baby unit improves quality and outcomes in extremely low birth weight infants. Pediatrics, 136(4), e1007-e1015.
Peterson, J., Adlard, K., Walti, B. I., Hayakawa, J., McClean, E., & Feidner, S. C. (2015). Clinical nurse specialist collaboration to recognize, prevent, and treat pediatric pressure ulcers. Clinical Nurse Specialist, 29(5), 276-282.

Rodrigues Nunes, M. D., Jacob, E., Adlard, K., Secola, R., & Nascimento, L. C. (2015, September). Fatigue and Sleep Experiences at Home in Children and Adolescents With Cancer. In Oncology nursing forum (Vol. 42, No. 5).

Thu, V. H., & Bergeron, S. (2017). Asparaginase Toxicities: Identification and Management in Patients With Acute Lymphoblastic Leukemia. Clinical journal of oncology nursing, 21(5), E248-E259.

Zadeh, S., Wiener, L., Sender, L., Adlard, K., Begino, C., Fasciano, K., & Souza, P. (2016). Adolescents and Young Adults (aya) at the End of Life: Using Voicing My Choices to Enhance Communication and Guide Planning. Pscyho-oncology, 25, 5-6.