Andrea Tilford - Academia.edu (original) (raw)

Papers by Andrea Tilford

Research paper thumbnail of Evolution of Pediatric Critical Care Nursing

Critical Care Nursing Clinics of North America, Sep 1, 2023

Research paper thumbnail of Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner, 1e

Research paper thumbnail of Nursing in the Pediatric Intensive Care Unit

Journal of Pediatric Intensive Care, 2015

Research paper thumbnail of Impact of Obesity during Pediatric Acute and Critical Illness

Journal of Pediatric Intensive Care, 2015

There are several pulmonary mechanics affected by increased BMI. Pulmonary indices including expi... more There are several pulmonary mechanics affected by increased BMI. Pulmonary indices including expiratory reserve volume, forced expiratory volume in 1 sec, diffusing capacity, and maximal voluntary ventilation have been noted to be less than that predicted for gender, height, and body surface area in obese children. 14 While some studies have suggested an association between asthma and obesity, the etiology of the Keywords ► pediatric ► obesity ► critical illness ► overweight

Research paper thumbnail of Pediatric Nurse Practitioners as Hospitalists

Journal of Pediatric Health Care, 2010

Research paper thumbnail of NAPNAP Position Statement on the Role of Pediatric Nurse Practitioners in Quality Improvement

Journal of Pediatric Health Care, 2013

Research paper thumbnail of Supporting the family left behind – Loss of a child to congenital heart disease

Progress in Pediatric Cardiology, 2018

Abstract Congenital heart disease is a significant cause of childhood morbidity and mortality. Ad... more Abstract Congenital heart disease is a significant cause of childhood morbidity and mortality. Advances in medical and surgical therapies for children with congenital heart disease have both prolonged and enhanced the lives of children and their families affected by congenital and acquired heart disease. While many of these children will ultimately lead happy and productive lives, a significant proportion of this patient population will succumb to their disease. This paper will briefly highlight the incidence and outcomes of congenital heart disease as well as provide an in-depth review of techniques, such as hospital-based bereavement programs, for supporting the families of those children who do not survive.

Research paper thumbnail of Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery Patients

Pediatric Critical Care Medicine

OBJECTIVES The objective of this study was to determine the prevalence of ICU delirium in childre... more OBJECTIVES The objective of this study was to determine the prevalence of ICU delirium in children less than 18 years old that underwent cardiac surgery within the last 30 days. The secondary aim of the study was to identify risk factors associated with ICU delirium in postoperative pediatric cardiac surgical patients. DESIGN A 1-day, multicenter point-prevalence study of delirium in pediatric postoperative cardiac surgery patients. SETTING Twenty-seven pediatric cardiac and general critical care units caring for postoperative pediatric cardiac surgery patients in North America. PATIENTS All children less than 18 years old hospitalized in the cardiac critical care units at 06:00 on a randomly selected, study day. INTERVENTIONS Eligible children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the study team in collaboration with the bedside nurse. MEASUREMENT AND MAIN RESULTS Overall, 181 patients were enrolled and 40% (n = 73) screened positive for delirium. There were no statistically significant differences in patient demographic information, severity of defect or surgical procedure, past medical history, or postoperative day between patients screening positive or negative for delirium. Our bivariate analysis found those patients screening positive had a longer duration of mechanical ventilation (12.8 vs 5.1 d; p = 0.02); required more vasoactive support (55% vs 26%; p = 0.0009); and had a higher number of invasive catheters (4 vs 3 catheters; p = 0.001). Delirium-positive patients received more total opioid exposure (1.80 vs 0.36 mg/kg/d of morphine equivalents; p < 0.001), did not have an ambulation or physical therapy schedule (p = 0.02), had not been out of bed in the previous 24 hours (p < 0.0002), and parents were not at the bedside at time of data collection (p = 0.008). In the mixed-effects logistic regression analysis of modifiable risk factors, the following variables were associated with a positive delirium screen: 1) pain score, per point increase (odds ratio, 1.3; 1.06-1.60); 2) total opioid exposure, per mg/kg/d increase (odds ratio, 1.35; 1.06-1.73); 3) SBS less than 0 (odds ratio, 4.01; 1.21-13.27); 4) pain medication or sedative administered in the previous 4 hours (odds ratio, 3.49; 1.32-9.28); 5) no progressive physical therapy or ambulation schedule in their medical record (odds ratio, 4.40; 1.41-13.68); and 6) parents not at bedside at time of data collection (odds ratio, 2.31; 1.01-5.31). CONCLUSIONS We found delirium to be a common problem after cardiac surgery with several important modifiable risk factors.

Research paper thumbnail of A Description of Nurse Practitioner Practice: Results of a NAPNAP Membership Survey

Journal of Pediatric Health …, 2012

... Dolores Jones, Director of Practice, Education, and Research, National Association of Pediatr... more ... Dolores Jones, Director of Practice, Education, and Research, National Association of Pediatric Nurse Practitioners, Cherry Hill, NJ. ... components for productivity will allow NPs to continue to be esteemed in the health care environ-ment (Rhoads, Ferguson, & Langford, 2006). ...

Research paper thumbnail of Recommendations for Matching Pediatric Nurse Practitioner Education and Certification to Pediatric Acute Care Populations

Journal of Pediatric Health Care, 2013

Conflicts of interest: Drs. Bolick, Reuter-Rice, Haut, and Verger and Ms. Kline-Tilford are assoc... more Conflicts of interest: Drs. Bolick, Reuter-Rice, Haut, and Verger and Ms. Kline-Tilford are associated with pediatric nurse practitioner (PNP) academic programs. Drs. Reuter-Rice and Bolick co-edited the textbook Pediatric Acute Care: A Guide for Interprofessional Practice. Drs. Bolick and Reuter-Rice and Ms. Bevacqua are item writers for the AC PNP certification examination. Dr. McComiskey and Mr. Cavender are PNP employers. Ms. Bevacqua is a practicing PNP.

Research paper thumbnail of A Limited Study on Which to Base National Guidelines: The National Survey of the Primary and Acute Care Pediatric Nurse Practitioner Educational Preparation

Journal of Pediatric Health Care, 2011

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2011 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution.

Research paper thumbnail of Evolution of Pediatric Critical Care Nursing

Critical Care Nursing Clinics of North America, Sep 1, 2023

Research paper thumbnail of Lippincott Certification Review: Pediatric Acute Care Nurse Practitioner, 1e

Research paper thumbnail of Nursing in the Pediatric Intensive Care Unit

Journal of Pediatric Intensive Care, 2015

Research paper thumbnail of Impact of Obesity during Pediatric Acute and Critical Illness

Journal of Pediatric Intensive Care, 2015

There are several pulmonary mechanics affected by increased BMI. Pulmonary indices including expi... more There are several pulmonary mechanics affected by increased BMI. Pulmonary indices including expiratory reserve volume, forced expiratory volume in 1 sec, diffusing capacity, and maximal voluntary ventilation have been noted to be less than that predicted for gender, height, and body surface area in obese children. 14 While some studies have suggested an association between asthma and obesity, the etiology of the Keywords ► pediatric ► obesity ► critical illness ► overweight

Research paper thumbnail of Pediatric Nurse Practitioners as Hospitalists

Journal of Pediatric Health Care, 2010

Research paper thumbnail of NAPNAP Position Statement on the Role of Pediatric Nurse Practitioners in Quality Improvement

Journal of Pediatric Health Care, 2013

Research paper thumbnail of Supporting the family left behind – Loss of a child to congenital heart disease

Progress in Pediatric Cardiology, 2018

Abstract Congenital heart disease is a significant cause of childhood morbidity and mortality. Ad... more Abstract Congenital heart disease is a significant cause of childhood morbidity and mortality. Advances in medical and surgical therapies for children with congenital heart disease have both prolonged and enhanced the lives of children and their families affected by congenital and acquired heart disease. While many of these children will ultimately lead happy and productive lives, a significant proportion of this patient population will succumb to their disease. This paper will briefly highlight the incidence and outcomes of congenital heart disease as well as provide an in-depth review of techniques, such as hospital-based bereavement programs, for supporting the families of those children who do not survive.

Research paper thumbnail of Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery Patients

Pediatric Critical Care Medicine

OBJECTIVES The objective of this study was to determine the prevalence of ICU delirium in childre... more OBJECTIVES The objective of this study was to determine the prevalence of ICU delirium in children less than 18 years old that underwent cardiac surgery within the last 30 days. The secondary aim of the study was to identify risk factors associated with ICU delirium in postoperative pediatric cardiac surgical patients. DESIGN A 1-day, multicenter point-prevalence study of delirium in pediatric postoperative cardiac surgery patients. SETTING Twenty-seven pediatric cardiac and general critical care units caring for postoperative pediatric cardiac surgery patients in North America. PATIENTS All children less than 18 years old hospitalized in the cardiac critical care units at 06:00 on a randomly selected, study day. INTERVENTIONS Eligible children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the study team in collaboration with the bedside nurse. MEASUREMENT AND MAIN RESULTS Overall, 181 patients were enrolled and 40% (n = 73) screened positive for delirium. There were no statistically significant differences in patient demographic information, severity of defect or surgical procedure, past medical history, or postoperative day between patients screening positive or negative for delirium. Our bivariate analysis found those patients screening positive had a longer duration of mechanical ventilation (12.8 vs 5.1 d; p = 0.02); required more vasoactive support (55% vs 26%; p = 0.0009); and had a higher number of invasive catheters (4 vs 3 catheters; p = 0.001). Delirium-positive patients received more total opioid exposure (1.80 vs 0.36 mg/kg/d of morphine equivalents; p < 0.001), did not have an ambulation or physical therapy schedule (p = 0.02), had not been out of bed in the previous 24 hours (p < 0.0002), and parents were not at the bedside at time of data collection (p = 0.008). In the mixed-effects logistic regression analysis of modifiable risk factors, the following variables were associated with a positive delirium screen: 1) pain score, per point increase (odds ratio, 1.3; 1.06-1.60); 2) total opioid exposure, per mg/kg/d increase (odds ratio, 1.35; 1.06-1.73); 3) SBS less than 0 (odds ratio, 4.01; 1.21-13.27); 4) pain medication or sedative administered in the previous 4 hours (odds ratio, 3.49; 1.32-9.28); 5) no progressive physical therapy or ambulation schedule in their medical record (odds ratio, 4.40; 1.41-13.68); and 6) parents not at bedside at time of data collection (odds ratio, 2.31; 1.01-5.31). CONCLUSIONS We found delirium to be a common problem after cardiac surgery with several important modifiable risk factors.

Research paper thumbnail of A Description of Nurse Practitioner Practice: Results of a NAPNAP Membership Survey

Journal of Pediatric Health …, 2012

... Dolores Jones, Director of Practice, Education, and Research, National Association of Pediatr... more ... Dolores Jones, Director of Practice, Education, and Research, National Association of Pediatric Nurse Practitioners, Cherry Hill, NJ. ... components for productivity will allow NPs to continue to be esteemed in the health care environ-ment (Rhoads, Ferguson, & Langford, 2006). ...

Research paper thumbnail of Recommendations for Matching Pediatric Nurse Practitioner Education and Certification to Pediatric Acute Care Populations

Journal of Pediatric Health Care, 2013

Conflicts of interest: Drs. Bolick, Reuter-Rice, Haut, and Verger and Ms. Kline-Tilford are assoc... more Conflicts of interest: Drs. Bolick, Reuter-Rice, Haut, and Verger and Ms. Kline-Tilford are associated with pediatric nurse practitioner (PNP) academic programs. Drs. Reuter-Rice and Bolick co-edited the textbook Pediatric Acute Care: A Guide for Interprofessional Practice. Drs. Bolick and Reuter-Rice and Ms. Bevacqua are item writers for the AC PNP certification examination. Dr. McComiskey and Mr. Cavender are PNP employers. Ms. Bevacqua is a practicing PNP.

Research paper thumbnail of A Limited Study on Which to Base National Guidelines: The National Survey of the Primary and Acute Care Pediatric Nurse Practitioner Educational Preparation

Journal of Pediatric Health Care, 2011

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2011 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution.