LEXINGTON, Ky. — Kelsey Wagler, a registered nurse at Golisano Children's at UK, is completing her Doctor of Nursing Practice degree with a focus on using virtual reality simulation to help nurses better recognize and treat pediatric sepsis—a potentially life-threatening condition that requires rapid intervention.

Wagler, who works in the pediatric intensive care unit, chose to complete her D.N.P. at her alma mater rather than pursue a Ph.D., driven by her desire to maintain bedside clinical work while advancing evidence-based practice. The University of Kentucky College of Nursing is home to the only Acute Care Pediatric Nurse Practitioner program in Kentucky, a doctoral-level program that emphasizes translating research into clinical practice.

"D.N.P. felt like the best mix — still doing research and making changes in practice but also staying at the bedside with these kids," Wagler said.

Her research project, completed through a quality improvement initiative at the 16-bed PICU, developed an immersive virtual reality simulation featuring an 8-year-old patient with pneumonia progressing to sepsis. Nurses used VR headsets and hand-held devices to assess vital signs, work of breathing, perfusion status and recognize deterioration. The simulation was followed by structured debriefing and targeted education.

Results showed statistically significant improvements across all measures of self-reported confidence and knowledge in pediatric sepsis recognition and management. "This project did both — empowering nurses while improving patient care," Wagler noted.

Early recognition of sepsis is critical. Golisano Children's at UK's PICU provides intensive care through a multidisciplinary team of nurses, respiratory therapists, pharmacists and pediatric intensivists. The hospital implemented a new sepsis protocol in August 2024 that includes an algorithm and predictive model.

Wagler's decision to stay in pediatric nursing stems from witnessing the profound impact of critical care. She recalled a 2-year-old patient who was gravely ill as a newborn but later returned running and talking. "Our work means so much when these kids get better," she said. "Adults have lived their lives. Kids are just at the start."