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| 1 | Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination显示文摘AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is 'just part of the process' [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children. | Jennifer Verrill Schurman Amanda D Deacy Rebecca J Johnson Jolynn Parker Kristi Williams Dustin Wallace Mark Connelly Lynn Anson Kevin Mroczka | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 3 |
| 2 | In-fiber reflection mode interferometer based on a long-period grating for external refrac- tive-index measurement显示文摘 | Kim D W Zhang Y Kristie L | 2005 | Applied Optics2005，44，26： | 1 |
| 3 | Prevention and Intervention Srategies to Alleviate Preoperative Anxiety in Children A Critial Review显示文摘 | Kristi D Wright Sherry H Stewart G | 2007 | Behavior Modification2007，31，1： | 1 |
| 4 | Renal cell carcinoma bone metastasis-elucid-ing the molecular targets显示文摘 | Kristy W Michele D | 2007 | Cancer Metastasis Rev2007，26，： | 1 |
| 5 | The influence of photoperiod and temperature on the kinetics of stem elongation in Dendranthema grandiflorum显示文摘 | Tutty J R Hicklenton P R Kristie D N | 1994 | Journal of the American Society for Horticultural Science1994，119，2： | 1 |
| 6 | Bacteria from the gut microbiota regulate host serotonin biosynthesis显示文摘 | Yano J M Kristie Yu Gregory P D | 2015 | Cell2015，，161： | 1 |
| 7 | A medical disaster response to reduce immediate mortality after an earthquake 显示文摘 | Carl H S M D Kristi L K | 1996 | The New England Journal of Medicine1996，334，7： | 1 |
| 8 | Psychosocial factors inpeople with chronic kidney disease prior to renal replacementtherapy显示文摘 | Charlotte M Kristy S Matthew D | 2013 | Nephrology (Carlton)2013，18，9： | 1 |
| 9 | Cost-Effectiveness of treatment strategies for cervical infection among women at high risk in Madagascar显示文摘 | Kristi M Frieda B Kathleen V D | 2007 | Sexually Transmitted Disease2007，34，3： | 1 |
| 10 | Social cognitive theory and cancer patients' quality of life:a meta analysis of psychosocial intervention components显示文摘 | KRISTI D G | 2003 | Health Psychol2003，22，2： | 1 |
| 11 | Simultaneous determination of total polychlorinated biphenyl and dichlorodiphenyltrichloroethane (DDT) by dechlorination with Fe/Pd and Mg/Pd bimetallic particles and flame ionization detection gas chromatography显示文摘 | Engelmann M D Hutcheson R Kristy Henschied | 2003 | Microchemical Journal2003，74，： | 1 |
| 12 | Glycolipid and ganglioside metabolism imbalances in Huntington' s disease 显示文摘 | PAULA A D CHRISTINE A D KRISTI E K | 2007 | Neur of Disease2007，27，： | 1 |
| 13 | Temperature and develop- mental stage influence diurnal rhythms of stem elongation in snap- dragon and zinnia显示文摘 | Neily W G Hicklenton P R Kristie D N | 1997 | JASHS1997，122，6： | 1 |
| 14 | Dual-use chromophores for photorefractive and irreversible photochromic applications显示文摘 | Kristi D H Rajani A Shane J S | | 0，，17： | 1 |
| 15 | Impact of postharvest treatments, chlorine and ozone, coupled with low-temperature frozen storage on the antimicrobial quality of lowbush blueberries (Vaccinium angustifolium) 显示文摘 | Kristi M C A1 B Kathy D D | 2012 | Food Science andTechnology2012，47，1： | 1 |
| 16 | A Medical Disaster Response to Reduce Immediate Mortality after an Earthquake 显示文摘 | Carl H S M D Kristi L K 1996 | 1996 | The New England Journal of Medicine1996，334，7： | 1 |
| 17 | Simultaneous determination of total polychlorinated biphenyl and dichlorodiphenyltrichloroethane (DDT) by dechlorination with Fe/Pd and Mg/Pd bimetallic particles and flame ionization detection gas chromatography显示文摘 | Engelmann M D Hutcheson R Kristy Henschied | 2003 | Microchemical Journal2003，74，： | 1 |
| 18 | The interferon-inducible gene Viperin restricts West Nile virus pathogenesis显示文摘 | Kristy J Szretter James D Brien Larissa B Thackray Herbert W Virgin Peter Cresswell Michael S Diamond | 2011 | J Virol2011，85，11： | 1 |
| 19 | Favourable effects of fenofibrate on lipids and cardiovascular disease in women with type 2 diabetes: results from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study显示文摘 | Michael C. d’Emden Alicia J. Jenkins Liping Li Diana Zannino Kristy P. Mann James D. Best Bronwyn G. A. Stuckey Kris Park Juha Saltevo Anthony C. Keech | 2014 | Diabetologia2014，，11： | 1 |
| 20 | Gelation of covalently cross-linked PEG-heparin hydrogels 显示文摘 | Kelly M S Aaron D B Kristi L K | 2009 | Macromolecules2009，42，14： | 1 |
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