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Grand Rounds: Scholarly Activity - Does Initiation of a Small Baby Unit Impact Primary Outcomes and <30 Weeks Gestation? The Effects of Low Dose Morphine Protocol on Post-Operative Congenital Heart Patients?


By Mackenzie Dreher, DO, MPH, and Kayla Schlosser, DO , Pediatric Residency Program, Akron Children's, Akron, OH

Objectives (Educational Content) :

1. Understand the pharmacokinetics and pharmacodynamics of morphine. 2. Explain the protocol and its effectiveness in post-op cardiac patients. 3. Understand the role of small baby programs in neonatal intensive care units. 4. Compare primary neonatal outcomes before and after initiation of a small baby unit at a single institution.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.

Identified Gap:

The science behind the practice of medicine changes ever more rapidly creating knowledge gaps for all providers. Scholarly activity grand rounds series is focused on helping close these knowledge gaps by presenting work done by Akron Children’s faculty and trainees who are answering important questions through implementation of quality improvement and research methods.

Estimated Time to Complete the Educational Activity:

1 hour(s)

Expiration Date for CE/CME Credit:


Method of Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.


The following presenters have identified that they have no financial relationships with any ineligible companies: Mackenzie Dreher, DO and Kayla Schlosser, DO The planning committee/CME committee members have indicated that they have no financial relationships with any ineligible companies.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.


Stoll B, et all. Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network. Pediatrics. 2010 September; 126(3):443-456

Morris M, et al. Small baby unit improves quality and outcomes in extremely low birth weight infants. Pediatrics. 2015;136(4):e1007-e1015

Staveski SL, Pickler RH, Khoury PR, et al. Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery Patients. Pediatr Crit Care Med. Jan 2021;22(1):68-78. doi:10.1097/PCC.0000000000002591

Valkenburg AJ, Calvier EA, van Dijk M, et al. Pharmacodynamics and Pharmacokinetics of Morphine After Cardiac Surgery in Children With and Without Down Syndrome. Pediatr Crit Care Med. 10 2016;17(10):930-938. doi:10.1097/PCC.0000000000000904

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