BackgroundThe incidence of venous thromboembolism in children has increased dramatically, with most cases occurring in children with cancer, surgery, trauma, congenital heart disease, and systemic lupus erythematosus. Early assessment of risk factors present in children would minimize morbidity and mortality from these events. Objectives To evaluate the reliability and validity of a tool for assessing risk for venous thromboembolism in children. Methods The tool was developed after a review of the literature with assessment of content validity by a multidisciplinary team of experts. Patients' charts were reviewed retrospectively to establish reliability and validity of the tool. A P value less than .05 was considered statistically significant. Results Thirty-five charts were assessed for tool validity and were found to be statistically significant for all 3 risk score assessment categories. Logistic regression was used to assess 1001 patients' charts for internal consistency, which was found to be high (χ 2 5 [n = 1001] = 100.6, P < .001). Results indicated that most patients at risk for venous thromboembolism were between the ages of 13 and 17 years, with females having more than 7 times greater risk than males. Conclusions Descriptive statistics show that the assessment tool displays strong reliability and validity. Results validated a significant relationship between the risk score and the incidence of venous thromboembolism. Findings suggest that use of the assessment tool could significantly reduce adverse outcomes associated with venous thromboembolism in children. Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Identify factors associated with increased risk for development of venous thromboembolism (VTE) in pediatric patients. 2. Describe study findings regarding the relationship between the total score on the risk assessment tool and the incidence of VTE in pediatric patients. 3. Discuss opportunities for future research related to VTE in pediatric patients.

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Injectable medications have been found to be associated with a higher incidence of errors than with other medication preparations. Carpuject syringe systems have been implemented to protect patients and improve safety; however, an overall lack of knowledge of the device was discovered. The purpose of this study, using a pre/postsurvey design, was to investigate nursing knowledge of and practices with the prefilled Carpuject syringe system and narcotic dilution practices before and after multidisciplinary interventions. Statistically significant differences were found before and after interventions.

All rights reserved.iv DEDICATION This dissertation is dedicated to those hospitalized children who were willing to share their stories with me. This work was possible because of them. To Ryan, Evan, Anna, and Valerie -thank you for listening, encouraging, and understanding when work came before play. I would also like to dedicate this work to my good friend and colleague, Eve Butler. Thank you for paving the way and providing such encouragement and support.To my mom, thank you for driving me home, listening to my stories, and centering me. You have always been my biggest cheerleader and fan. Thank you for believing in me, sometimes more than I believed in myself. We do not need to scratch the 2014 date off the mugs! I love you so much. Aims: The purpose of this qualitative study was to investigate school age children's and adolescents' perceptions of PICU while in the PICU; changes in perceptions after transfer to the General Care Unit (GCU); differences in perceptions of school age children/adolescents and those with more invasive procedures.Methods: Interviews were conducted in PICU within 24-48 hours of admission and 24-48 hours after transfer to GCU. Data on demographics, clinical care and number/types of procedures were obtained.Results: Participants were 7 school age children, 13 adolescents; 10 Hispanic; 13 males.