- Tulsa, Oklahoma, United States
Ivy Razmus
University of Detroit Mercy, College of Health Professions, Faculty Member
Research Interests:
Research Interests:
Research Interests:
Research Interests:
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks,... more
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks, Oklahoma. ...
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...
Research Interests:
Research Interests:
Research Interests: Nursing, Risk assessment, Medicine, Prospective studies, Humans, and 15 moreChild, Female, Male, Infant, Risk factors, Newborn Infant, Risk Factors, Risk Assessment, Pressure Ulcer, Receiver Operating Characteristic, Predictive value of tests, Cohort Studies, Acute Disease, Child preschool, and cutoff
Research Interests:
Research Interests:
ABSTRACT Abstract This study investigated the usefulness of a Modified Comfort Scale to evaluate adequacy of sedation for muscle relaxed children. The Comfort Scale was modified to address the muscle relaxed child. Parameters of the... more
ABSTRACT Abstract This study investigated the usefulness of a Modified Comfort Scale to evaluate adequacy of sedation for muscle relaxed children. The Comfort Scale was modified to address the muscle relaxed child. Parameters of the Comfort Scale that could not be valid in a paralyzed child were replaced with objective measurements of skin perfusion, pupillary size and response and cardiovascular response to auditory and tactile stimulation. Parameters of agitation, alertness, physical movement, respiratory response and muscle movement were removed. The scale was altered from an eight-parameter scale to a six-parameter scale. The Modified Comfort Scale was evaluated with a technique similar to the one described in the original Comfort Scale study. The child was evaluated simultaneously by four raters, two using the Modified Comfort Scale and two using a Likert type Adequacy of Sedation Scale (previously known as Physician Adequacy of Sedation Scale). A comparison was made between the two scales.
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for... more
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for hospitalized children. Adult instruments were the only valid tools for fall risk assessment, and they were being used in populations where the validity had not been established. A prospective cohort study was conducted to analyze the sensitivity and specificity of the CHAMPS pediatric fall risk assessment tool. Analysis was conducted to further establish validity. The CHAMPS instrument had a sensitivity of 0.75 and a specificity of 0.79, with a relative risk of 3.5, excess risk of 200%, and an odds ratio of 10.8. This instrument can be categorized as moderate to strong in prediction of pediatric falls, while specificity was found to be slightly stronger than sensitivity.
Research Interests:
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart... more
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart review coded the presence or absence of risk factors and completed both the Morse Fall Scale and Hendrich II Fall Risk Model. Overall, a significant difference was detected between pediatric fallers and non-fallers on the Morse Fall Scale. The Morse Fall Scale's sensitivity, specificity and false positive rate suggested that the scale does little better than chance at detecting true fallers and may inaccurately identify non-fallers as high risk. Episodes of disorientation and fall history were the best predictors of pediatric falls for this sample.
Research Interests: Nursing, Risk assessment, Pediatric nursing, Medicine, Humans, and 14 moreChild, Female, Male, Risk factors, Analysis of Variance, Retrospective Studies, Chi Square Distribution, Risk Factors, Risk Assessment, Inpatients, Sensitivity and Specificity, Logistic Models, Accidental falls, and Paediatrics and reproductive medicine
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of... more
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of 45 at diagnosis. Nurses are an integral part of educating patients and families with a history of colon and uterine cancer.
Research Interests:
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks,... more
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks, Oklahoma. ...
Research Interests:
E vidence-based practice (EBP) is a process by which nurses make clinical decisions using the best available research evidence, their clinical expertise, and patient preferences.1 Information technology is an essential tool for obtaining... more
E vidence-based practice (EBP) is a process by which nurses make clinical decisions using the best available research evidence, their clinical expertise, and patient preferences.1 Information technology is an essential tool for obtaining relevant literature at each step of this process and it’s also instrumental in the implementation of practice changes through the electronic health record. Nursing documentation can also link to EBP rationale for nursing interventions to support patient and family education and nursing decision making.1 EBP is an important tool for hospitals that seek Magnet designation because it can help improve quality and safety. It also
Research Interests:
PURPOSE To identify risk factors in hospitalized children using two validated adult fall risk scales. METHODS For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The... more
PURPOSE To identify risk factors in hospitalized children using two validated adult fall risk scales. METHODS For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart review coded the presence or absence of risk factors and completed both the Morse Fall Scale and Hendrich II Fall Risk Model. FINDINGS Overall, a significant difference was detected between pediatric fallers and non-fallers on the Morse Fall Scale. The Morse Fall Scale's sensitivity, specificity and false positive rate suggested that the scale does little better than chance at detecting true fallers and may inaccurately identify non-fallers as high risk. CONCLUSIONS Episodes of disorientation and fall history were the best predictors of pediatric falls for this sample.
Research Interests: Nursing, Risk assessment, Pediatric nursing, Medicine, Humans, and 14 moreChild, Female, Male, Risk factors, Analysis of Variance, Retrospective Studies, Chi Square Distribution, Risk Factors, Risk Assessment, Inpatients, Sensitivity and Specificity, Logistic Models, Accidental falls, and Paediatrics and reproductive medicine
Research Interests:
Circumcision is the surgical removal of the foreskin of the glans penis. Newborns undergoing circumcision demonstrate objective, measurable evidence of pain, yet the procedure is often performed without analgesia. Newborn circumcision is... more
Circumcision is the surgical removal of the foreskin of the glans penis. Newborns undergoing circumcision demonstrate objective, measurable evidence of pain, yet the procedure is often performed without analgesia. Newborn circumcision is reported to be the most common ...
Research Interests: Nursing, Pain, Male Circumcision, Pediatric nursing, Medicine, and 15 moreHumans, Male, Analgesia, Sucrose, Newborn Infant, Analysis of Variance, Lidocaine, Nerve Block, Nursing Assessment, Pain Measurement, Clinical Nursing Research, Prilocaine, Combined Modality Therapy, Severity of Illness Index, and Paediatrics and reproductive medicine
Research Interests:
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital... more
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status. Extracted data on pressure ulcer prevention included skin assessment, pressure-redistribution surface use, routine repositioning, nutritional support, and moisture management. These data were organized by unit type and merged with data on hospital characteristics for the analysi...
Research Interests:
MATERNAL ADJUSTMENT TO PREMATURE BIRTH: UTILIZING THE ROY ADAPTATION MODEL AS A THEORETICAL FRAMEWORK By Ivy Razmus The purpose of this study was to ascertain whether the adjustment for primiparous mothers of preterm infants was less... more
MATERNAL ADJUSTMENT TO PREMATURE BIRTH: UTILIZING THE ROY ADAPTATION MODEL AS A THEORETICAL FRAMEWORK By Ivy Razmus The purpose of this study was to ascertain whether the adjustment for primiparous mothers of preterm infants was less positive than for primiparous mothers of term infants utilizing the Roy Adaptation Model as a conceptual framework. This secondary analysis utilized data from a larger longitudinal study. The data was collected at three months post birth in the homes of the mothers. The sample consisted of 55 preterm and 46 full term mothers. The Affects Balance Scale (Derogatis, 1983) was used to measure adjustment. A significant difference was found between preterm and full term mothers on the Positive Affects Scale and the subscales: joy, contentment and vigor. No significant differences were found between preterm and fullterm mothers on the Negative Affects Scale.
Research Interests:
Evaluation of pain and sedation in the PICU patient population is challenging. This article provides an overview of sedation and analgesia assessment tools developed for the critical pediatric patient who is mechanically ventilated and... more
Evaluation of pain and sedation in the PICU patient population is challenging. This article provides an overview of sedation and analgesia assessment tools developed for the critical pediatric patient who is mechanically ventilated and pharmacologically paralyzed. Studies reviewed include adult critical care, pediatric, and neonatal patients. No single tool has emerged that can adequately address pain management in the mechanically ventilated pharmacologically paralyzed pediatric patient. Nurses, as an integral part of the health care of critical pediatric patients, should endeavor to develop evidence-based methods for the evaluation of simple yet accurate scales to monitor sedation and pain in the pharmacologically paralyzed pediatric patient.
Research Interests:
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of... more
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of 45 at diagnosis. Nurses are an integral part of educating patients and families with a history of colon and uterine cancer.
Research Interests:
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for... more
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for hospitalized children. Adult instruments were the only valid tools for fall risk assessment, and they were being used in populations where the validity had not been established. A prospective cohort study was conducted to analyze the sensitivity and specificity of the CHAMPS pediatric fall risk assessment tool. Analysis was conducted to further establish validity. The CHAMPS instrument had a sensitivity of 0.75 and a specificity of 0.79, with a relative risk of 3.5, excess risk of 200%, and an odds ratio of 10.8. This instrument can be categorized as moderate to strong in prediction of pediatric falls, while specificity was found to be slightly stronger than sensitivity.
Research Interests:
Mercy is a valued nursing attribute. It often identifies faith-based educational institutions, clinics, and hospitals and has been a quality valued and taught by the Catholic Sisters of Mercy through nursing's history. This... more
Mercy is a valued nursing attribute. It often identifies faith-based educational institutions, clinics, and hospitals and has been a quality valued and taught by the Catholic Sisters of Mercy through nursing's history. This qualitative study explored the meaning of mercy as expressed by undergraduate nursing students attending a faith-based nursing school. This article presents the findings of a question posed to students: What does mercy mean to me? Nursing practice and education implications are also presented.
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While there are valid and reliable pressure ulcer risk assessment tools available for adult patients, none exist for infants and children. To remedy this, the Braden Scale was adapted for use in pediatrics, calling it the Braden Q Scale.... more
While there are valid and reliable pressure ulcer risk assessment tools available for adult patients, none exist for infants and children. To remedy this, the Braden Scale was adapted for use in pediatrics, calling it the Braden Q Scale. The purpose of this study was to: (a) establish the predictive validity of the Braden Q Scale in an acutely ill pediatric population; (b) determine the critical cutoff point for classifying patient risk; and (c) determine the best time to assess patient risk. A multisite prospective cohort descriptive study with a convenience sample of 322 patients on bedrest for at least 24 hours without pre-existing pressure ulcers or congenital heart disease were enrolled from three pediatric intensive care units (PICU). The Braden Q score and skin assessment were independently rated and data collectors were blind to the other measures. Patients were observed up to 3 times per week for 2 weeks and then once a week until PICU discharge for a median of 2 observations reflecting 887 skin assessments. Eighty-six patients (27%) developed 199 pressure ulcers; 139 (70%) were Stage I pressure ulcers, 54 (27%) were Stage II pressure ulcers, and 6 (3%) were Stage III pressure ulcers. Most pressure ulcers (57%) were present at the first observation. Using Stage II+ pressure ulcer data obtained during the first observation, a Receiver Operator Characteristic (ROC) curve for each possible score of the Braden Q Scale was constructed. The area under the curve (AUC) was 0.83. At a cutoff score of 16, the sensitivity was 0.88 and the specificity was 0.58. The Braden Q Scale was then modified to eliminate 4 subscales with an AUC <0.7. With 3 subscales (mobility, sensory perception, tissue perfusion/oxygenation) the AUC of this Modified Braden Q Scale was maintained at 0.84. At a cutoff score of 7, the sensitivity was 0.92 and the specificity was 0.59. The performance of the Braden Q Scale in a pediatric population is similar to that consistently reported for the Braden Scale in adult patients. The Modified Braden Q Scale, with 3 subscales, provides a shorter yet comparable tool.
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...
Research Interests:
Research Interests:
Venous thromboembolism (VTE) is a cause of significant morbidity and mortality in hospitalized patients in the United States. Quality improvement (QI) strategies to increase the rates of prophylaxis in patients at-risk for VTE have been... more
Venous thromboembolism (VTE) is a cause of significant morbidity and mortality in hospitalized patients in the United States. Quality improvement (QI) strategies to increase the rates of prophylaxis in patients at-risk for VTE have been shown to be successful. The development of a formal, active strategy addressing the prevention of VTE, as a written, institutionwide VTE prophylaxis policy, presents a challenge for hospitals In 2007 a multidisciplinary VTE committee was initiated to develop and implement a hospitalwide QI program to standardize VTE risk assessment and prophylaxis prescribing practices at Saint Francis Hospital (Tulsa, Oklahoma). The QI program included clinician education, VTE order set and electronic trigger implementation, and changes in mechanical prophylaxis usage. The VTE prophylaxis order set was successfully piloted and implemented hospitalwide within three months of the project's initiation. Standardization of VTE prophylaxis practices across surgical and medical specialties was the key aim of this QI program. As a result, patient-related outcomes were also improved. The number of hospital-acquired VTE events decreased from 123 (0.39%) in 2008 to 99 (0.32%) in 2009 and 87 (0.27%) in 2010, and a reduction in the VTE rate between 2008 and 2010 of 31.6%. There was a significant decrease between 2008 and 2010 in the number of hospital-acquired VTE events (p = .035). Keys to the success of this QI program included leveraging multidisciplinary VTE committee members, physician champions, multiple approaches to communication and education, and providing evidence to support the changes. Sharing the hospital's QI process may provide a model for other hospitals challenged with developing and sustaining positive outcomes in patients at risk for VTE.
Research Interests:
The purpose of this study was to identify associations among pediatric patient characteristics (age and gender), hospital characteristics, inpatient unit characteristics (unit type, pressure injury prevention practices, and nurse staffing... more
The purpose of this study was to identify associations among pediatric patient characteristics (age and gender), hospital characteristics, inpatient unit characteristics (unit type, pressure injury prevention practices, and nurse staffing measures), and hospital-acquired pressure injuries (HAPIs) in a group of pediatric patients and in those determined to be at risk for pressure injury. A descriptive, correlational analysis of data from a large dataset. The sample comprised 39,984 children aged 1 day to 18 years of age from 678 pediatric units in 271 participating hospitals across the United States. Data related to pressure injuries and prevention among pediatric patients from the National Database of Nursing Quality Indicators (NDNQI) were analyzed. All data were collected during the year 2012. Descriptive statistics were used to summarize the study sample. Hierarchical logistic regression analysis was used to analyze patient age and gender, unit type, pressure injury risk, prevent...
Research Interests:
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital... more
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status. Extracted data on pressure ulcer prevention included skin assessment, pressure-redistribution surface use, routine repositioning, nutritional support, and moisture management. These data were organized by unit type and merged with data on hospital characteristics for the analysi...
Research Interests:
The purpose of this study was to describe the prevalence and rate of hospital-acquired pressure injuries (HAPIs) in pediatric patients. Descriptive, secondary analysis of 2012 data on pressure injuries among pediatric patients from the... more
The purpose of this study was to describe the prevalence and rate of hospital-acquired pressure injuries (HAPIs) in pediatric patients. Descriptive, secondary analysis of 2012 data on pressure injuries among pediatric patients from the National Database for Nursing Quality Indicators (NDNQI). The sample included 39,984 patients 1 day to 18 years old from 678 pediatric acute care units (general pediatrics, pediatric critical care, neonatal intensive care, pediatric step-down, and pediatric rehabilitation units) in 271 US hospitals that submitted pressure injury data to the NDNQI for at least 3 quarters during 2012. The pressure injury prevalence was 1.4% and the prevalence of HAPI was 1.1%. The rate of HAPI among males was 1.06%, and the rate among females was 1.14%. HAPI rates were highest among children ages 9 to 18 years (1.6%) and 5 to 8 years (1.4%) and lowest among patients 1 to 30 days of age (0.72%). By unit type, HAPIs were highest among patients in pediatric critical care units (3.7%) and pediatric rehabilitation units (4.6%) and lowest in general pediatrics units (0.57%). Most of the HAPIs were Stage 1 and Stage 2 (65.6%); 14.3% were deep tissue pressure injuries and 10.1% were unstageable pressure injuries. Acutely ill children develop pressure injuries, including HAPI. Study findings provide data on HAPI from a large sample of hospitalized children and by pediatric unit type for comparison purposes.
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Abstract This study investigated the usefulness of a Modified Comfort Scale to evaluate adequacy of sedation for muscle relaxed children. The Comfort Scale was modified to address the muscle relaxed child. Parameters of the Comfort Scale... more
Abstract This study investigated the usefulness of a Modified Comfort Scale to evaluate adequacy of sedation for muscle relaxed children. The Comfort Scale was modified to address the muscle relaxed child. Parameters of the Comfort Scale that could not be valid in a paralyzed child were replaced with objective measurements of skin perfusion, pupillary size and response and cardiovascular response to auditory and tactile stimulation. Parameters of agitation, alertness, physical movement, respiratory response and muscle movement were removed. The scale was altered from an eight-parameter scale to a six-parameter scale. The Modified Comfort Scale was evaluated with a technique similar to the one described in the original Comfort Scale study. The child was evaluated simultaneously by four raters, two using the Modified Comfort Scale and two using a Likert type Adequacy of Sedation Scale (previously known as Physician Adequacy of Sedation Scale). A comparison was made between the two sca...
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for... more
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for hospitalized children. Adult instruments were the only valid tools for fall risk assessment, and they were being used in populations where the validity had not been established. A prospective cohort study was conducted to analyze the sensitivity and specificity of the CHAMPS pediatric fall risk assessment tool. Analysis was conducted to further establish validity. The CHAMPS instrument had a sensitivity of 0.75 and a specificity of 0.79, with a relative risk of 3.5, excess risk of 200%, and an odds ratio of 10.8. This instrument can be categorized as moderate to strong in prediction of pediatric falls, while specificity was found to be slightly stronger than sensitivity.
Research Interests:
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart... more
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart review coded the presence or absence of risk factors and completed both the Morse Fall Scale and Hendrich II Fall Risk Model. Overall, a significant difference was detected between pediatric fallers and non-fallers on the Morse Fall Scale. The Morse Fall Scale's sensitivity, specificity and false positive rate suggested that the scale does little better than chance at detecting true fallers and may inaccurately identify non-fallers as high risk. Episodes of disorientation and fall history were the best predictors of pediatric falls for this sample.
Research Interests:
To describe current newborn circumcision pain interventions and to identify which forms of analgesia were most effective. Each male newborn was assessed for pain during the circumcision procedure and at 15-minute intervals after the... more
To describe current newborn circumcision pain interventions and to identify which forms of analgesia were most effective. Each male newborn was assessed for pain during the circumcision procedure and at 15-minute intervals after the procedure using the FLACC pain scale. The type and combination of analgesia was also recorded on the pain assessment record. Pain scores were highest for newborns receiving no analgesia during circumcision. Newborns circumcised with the dorsal block and the ring block in combination with the concentrated oral sucrose had the lowest pain scores. The sucrose alone did not provide sufficient analgesia; however, it did reduce the FLACC score somewhat when used in conjunction with other analgesics/anesthesia. Information obtained from this project facilitated a change in policy wherein newborn circumcision is performed only with the use of analgesia and not concentrated oral sucrose alone.
Research Interests: Nursing, Pain, Male Circumcision, Treatment Outcome, Pediatric nursing, and 15 moreHumans, Male, Analgesia, Total Quality Management, Sucrose, Newborn Infant, Analysis of Variance, Lidocaine, Nerve Block, Nursing Assessment, Pain Measurement, Clinical Nursing Research, Prilocaine, Combined Modality Therapy, and Severity of Illness Index
In our journey to nursing excellence, our institution launched unit based councils (UBC). Each UBC discusses practice issues and ways to improve care in the department that each represents. Our newborn nursery staff asked the question:... more
In our journey to nursing excellence, our institution launched unit based councils (UBC). Each UBC discusses practice issues and ways to improve care in the department that each represents. Our newborn nursery staff asked the question: “Why are we doing 4-limb blood pressures?” “Do they really pick up coarctation of the aorta?” “Is there a better method of assessment in picking up this heart defect?”
Research Interests:
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart... more
To identify risk factors in hospitalized children using two validated adult fall risk scales. For each fall patient identified, a non-fall patient was matched for chronological age and year of hospitalization. The retrospective chart review coded the presence or absence of risk factors and completed both the Morse Fall Scale and Hendrich II Fall Risk Model. Overall, a significant difference was detected between pediatric fallers and non-fallers on the Morse Fall Scale. The Morse Fall Scale's sensitivity, specificity and false positive rate suggested that the scale does little better than chance at detecting true fallers and may inaccurately identify non-fallers as high risk. Episodes of disorientation and fall history were the best predictors of pediatric falls for this sample.
Research Interests:
Evaluation of pain and sedation in the PICU patient population is challenging. This article provides an overview of sedation and analgesia assessment tools developed for the critical pediatric patient who is mechanically ventilated and... more
Evaluation of pain and sedation in the PICU patient population is challenging. This article provides an overview of sedation and analgesia assessment tools developed for the critical pediatric patient who is mechanically ventilated and pharmacologically paralyzed. Studies reviewed include adult critical care, pediatric, and neonatal patients. No single tool has emerged that can adequately address pain management in the mechanically ventilated pharmacologically paralyzed pediatric patient. Nurses, as an integral part of the health care of critical pediatric patients, should endeavor to develop evidence-based methods for the evaluation of simple yet accurate scales to monitor sedation and pain in the pharmacologically paralyzed pediatric patient.
Research Interests:
To describe current newborn circumcision pain interventions and to identify which forms of analgesia were most effective. Each male newborn was assessed for pain during the circumcision procedure and at 15-minute intervals after the... more
To describe current newborn circumcision pain interventions and to identify which forms of analgesia were most effective. Each male newborn was assessed for pain during the circumcision procedure and at 15-minute intervals after the procedure using the FLACC pain scale. The type and combination of analgesia was also recorded on the pain assessment record. Pain scores were highest for newborns receiving no analgesia during circumcision. Newborns circumcised with the dorsal block and the ring block in combination with the concentrated oral sucrose had the lowest pain scores. The sucrose alone did not provide sufficient analgesia; however, it did reduce the FLACC score somewhat when used in conjunction with other analgesics/anesthesia. Information obtained from this project facilitated a change in policy wherein newborn circumcision is performed only with the use of analgesia and not concentrated oral sucrose alone.
Research Interests: Nursing, Pain, Male Circumcision, Treatment Outcome, Pediatric nursing, and 15 moreHumans, Male, Analgesia, Total Quality Management, Sucrose, Newborn Infant, Analysis of Variance, Lidocaine, Nerve Block, Nursing Assessment, Pain Measurement, Clinical Nursing Research, Prilocaine, Combined Modality Therapy, and Severity of Illness Index
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for... more
This study was conducted to validate the CHAMPS pediatric fall risk assessment tool for hospitalized children. At the time of this study, there was a lack of published evidence for a valid pediatric fall risk assessment tool for hospitalized children. Adult instruments were the only valid tools for fall risk assessment, and they were being used in populations where the validity had not been established. A prospective cohort study was conducted to analyze the sensitivity and specificity of the CHAMPS pediatric fall risk assessment tool. Analysis was conducted to further establish validity. The CHAMPS instrument had a sensitivity of 0.75 and a specificity of 0.79, with a relative risk of 3.5, excess risk of 200%, and an odds ratio of 10.8. This instrument can be categorized as moderate to strong in prediction of pediatric falls, while specificity was found to be slightly stronger than sensitivity.
Research Interests:
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of... more
Hereditary non-polyposis colon cancer is a common form of colorectal cancer, accounting for 5%-10% of all colorectal cancers. This cancer is inherited in an autosomal dominant fashion, occurring as early as age 25, with an average age of 45 at diagnosis. Nurses are an integral part of educating patients and families with a history of colon and uterine cancer.
Research Interests:
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks,... more
... Assessment and Management of Children With Abdominal Wall Defects. Razmus, Ivy S. ... Author Information. Ivy S. Razmus, MSN, Quality Analyst at Saint Francis Health System, Tulsa Oklahoma and WOC Student, LaSalle University, Jenks, Oklahoma. ...
Research Interests:
Research Interests:
Research Interests:
Journal of Pediatric Nursing, Volume 21, Issue 2, Pages 139, April 2006, Authors:Ivy Razmus, MSN, RN; David Wilson, MS, RN,C; Julia Jackson, BSN, RN; Maria Castillo, BSN, RN; Julie Sluss, MLIS; Veronica Stewart. ...