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A pediatric teaching hospital developed a comprehensive leadership training program for midlevel nurse leaders with varying levels of management knowledge and experience. Content was based on American Organization for Nursing Leadership nurse manager competencies and data from a comprehensive needs assessment. Learners identified differentiating between leadership and management, influencing behavior, managing change, and communication as areas of increased confidence. This program is applicable to any hospital with multiple midlevel nurse leaders new to the role.

nerve V symptoms and positive CT and/or MR studies were reviewed. The principal purpose of this study was to (1) determine the efficacy of clinical localization,compare CT and MR for cranial nerve V imaging, (3) establish the most efficient MR imaging protocol, and (4) construct a differential diagnosis for lesions of cranial nerve V by anatomic segment.

Objective Induced therapeutic hypothermia after pediatric cardiac arrest is an important intervention. We assessed the feasibility, effectiveness, side effects, and adverse events associated with a standardized surface cooling protocol. Design Prospective intervention trial Setting Urban, tertiary care children’s hospital Patients 12 Pediatric cardiac arrest survivors Interventions Standardized surface cooling protocol Measurements and Main Results Patients (age: median 1.5 years, IQR[0.5, 6.25], CPR duration: median 18 min, IQR [10, 45]) were cooled by a standard surface cooling protocol for rapid induction and maintenance of goal rectal Temperature (T) 32–34°C for 24 hours, with prospectively defined rescue protocols. Side effects and clinical interventions were recorded. Median time to rectal T ≤34°C was 1.5 [1, 1.5] hours from cooling initiation and 6 [5, 6.5] hours from arrest. T was documented every 30 minutes. Maintenance target T 32–34°C was attained in 78% (414/531) of measurements, overshoot hypothermia <32°C in 15% (81/531), and overshoot hyperthermia >34°C in 7% (36/531). Mean bias between rectal vs esophageal T was −0.42 °C [95%CI, −0.49 to −0.35], and between rectal and bladder T was 0.16 °C [95%CI, 0.11 to 0.22]. Side effects observed included: hypokalemia <3.0mEq/L in 67% of patients and bradycardia < 2%ile for age in 58%. There were no episodes of bleeding or ventricular tachyarrhythmia that required treatment. Six of 12 (50%) patients survived to discharge. Conclusions A standard surface cooling protocol achieved rapid induction of hypothermia after pediatric cardiac arrest. During maintenance of hypothermia, 78% of measures were within target T 32–34°C. Commonly employed temperature sites (esophageal, rectal and bladder) were similar. Overshoot hypothermia and associated side effects were common, but there were no serious adverse events attributable to induced therapeutic hypothermia in this case series. Surface cooling protocols to induce and maintain therapeutic hypothermia after pediatric cardiac arrest are potentially feasible.