-
Medicine Nov 2023To summarize the nursing experience of treating pediatric fulminant myocarditis with extracorporeal membrane oxygenation (ECMO). The intensive care unit of our hospital...
To summarize the nursing experience of treating pediatric fulminant myocarditis with extracorporeal membrane oxygenation (ECMO). The intensive care unit of our hospital treated 6 children with fulminant myocarditis with ECMO from 2019 to 2022. The main nursing measures included establishing an ECMO rescue team, preparing before initiation of ECMO, management of arterial and venous catheters, enteral nutrition support, reducing the risk of infection aggravation, anticoagulation management, prevention of bleeding and thrombosis, management of ECMO pump failure, and post-ECMO care. One child's family abandoned treatment and left the hospital, while the other 5 children were transferred to the cardiovascular department after stable weaning from ECMO and continued treatment, with good condition, and eventually discharged. Pediatric fulminant myocarditis has a high mortality rate, but detailed evaluation and nursing care can improve the outcome of these patients.
Topics: Child; Humans; Myocarditis; Extracorporeal Membrane Oxygenation; Treatment Outcome; Heart; Nursing Care; Retrospective Studies
PubMed: 37932983
DOI: 10.1097/MD.0000000000035682 -
Journal of Education and Health... 2023The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of...
BACKGROUND
The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care.
MATERIALS AND METHODS
The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases.
RESULTS
The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation.
CONCLUSION
It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.
PubMed: 38333170
DOI: 10.4103/jehp.jehp_1445_22 -
SAGE Open Nursing 2023The care of a child receiving chemotherapy has a significant impact on the parents and family structure, which has been explored in depth in a few studies in Saudi...
BACKGROUND
The care of a child receiving chemotherapy has a significant impact on the parents and family structure, which has been explored in depth in a few studies in Saudi Arabia. The purpose of this study is to further explore the lived experiences of Saudi Arabian parents in caring for their children receiving chemotherapy.
METHODOLOGY
A qualitative descriptive design was used in this study with a sample of 17 parents of children receiving chemotherapy. The participants were recruited using the snow-balling technique throughout the community, as well as from the University Hospital, Pediatric Oncology Department. The data were collected via in-person and virtual methods using semi-structured, open-ended interviews and analyzed using thematic analysis.
RESULTS
The findings of the study were placed into two main themes: family experience and stages of disease. Family experiences include the parents and siblings' experiences. The stages of disease include three sub-themes: the pre-diagnosis phase, diagnosis phase, and treatment phase.
CONCLUSION
The cancer journey had a huge impact on the parents and siblings. The study revealed important findings related to the experiences during the stages of diseases and lived experiences of parents and siblings including psychological, physiological, social, and financial impacts.
PubMed: 37920748
DOI: 10.1177/23779608231207233 -
BMC Pediatrics Oct 2023A error in intravenous injection in pediatric wards can cause irreparable injuries. This study aimed to determine the level of knowledge and performance of nurses in...
BACKGROUND
A error in intravenous injection in pediatric wards can cause irreparable injuries. This study aimed to determine the level of knowledge and performance of nurses in terms of preparation and injection of intravenous drugs in pediatric wards of hospitals affiliated to Isfahan University of Medical Sciences.
METHODS
This cross-sectional study was conducted in 2022 on 156 nurses working in pediatric wards. The data was collected with demographic information questionnaire and the knowledge and performance of the participants were determined using a researcher-made questionnaire, including the five rights of medication administration (preparation and injection, medication error, drug side effects, family empowerment, and documentation) using self-reporting and observation methods. Formal and content validity was calculated using the opinions of 10 experts and Cronbach's alpha with 40 samples.
RESULTS
The mean and standard deviation of total nurses' knowledge and performance scores were 58.31 + 10.1 and 66.1 + 14.4, respectively. Moreover, the mean and standard deviation of nurses' knowledge scores were 63.55 + 14.3 for documentation, 46.1 + 7.9 for preparation and injection, 73.9 + 12.3 for drug side effects, 58.4 + 10.2 for medication error, and 69.4 + 9.4 for family empowerment. Besides, the mean performance was 69.1 + 17.6 for documentation, 61.3 ± 9.9 for preparation and injection, 78.21 + 12 for drug side effects, 58.6 + 15 for medication error, and 65.4 + 17.7 for family empowerment.
CONCLUSION
The results showed that the mean knowledge and pharmacological performance of nurses working in pediatric wards in different areas of the principles of medicine were not at the desired level, and this can affect children adversely.
Topics: Humans; Child; Clinical Competence; Iran; Cross-Sectional Studies; Hospitals; Surveys and Questionnaires; Drug-Related Side Effects and Adverse Reactions
PubMed: 37884932
DOI: 10.1186/s12887-023-04336-z -
Regenerative Therapy Dec 2023The skin, being the largest organ in the human body, plays a vital role in shielding internal organs from external physical and chemical factors. However, skin damage...
The skin, being the largest organ in the human body, plays a vital role in shielding internal organs from external physical and chemical factors. However, skin damage caused by various factors such as injuries, surgeries, diabetes, or burns can lead to wounds that diminish the skin's protective function. Monitoring essential physiological parameters like temperature, moisture, and pH is crucial to facilitate antibiotic treatment, remote physician monitoring, patient comfort, cost reduction, and prevention of hospital-acquired infections. To this end, innovative wound coverings made of biological materials like gelatin, carboxymethyl chitosan, and titanium nanoparticles have been developed, mainly for hospital and pediatric applications. These wound coverings come equipped with sensors to monitor temperature, pH, and moisture and are suitable for pediatric hospitals where children experience difficulty in wound healing due to their sensitive skin. The temperature monitoring feature allows physicians to accurately assess the wound's temperature, detect potential infections, and take prompt actions. These wound coverings can significantly enhance wound treatment for patients, as real-time monitoring of physiological parameters enables informed decision-making by physicians, leading to better therapeutic outcomes. Furthermore, the use of these wound coverings can minimize the risk of hospital-acquired infections. Their adaptability and flexibility make them ideal for various wound types and sizes, ensuring patient comfort and compliance with the treatment plan. In conclusion, the development of innovative and flexible wound coverings using biological materials and equipped with sensors represents a significant breakthrough in wound management. The use of these wound coverings has the potential to revolutionize wound care and improve patient outcomes, particularly in pediatric hospitals where wound healing is often challenging.
PubMed: 37384240
DOI: 10.1016/j.reth.2023.06.005 -
PloS One 2023The number of adult patients with childhood-onset chronic diseases is increasing. However, the process of transitioning these patients from child- to adult-centered...
Fact-finding survey of doctors at the departments of pediatrics and pediatric surgery on the transition of patients with childhood-onset chronic disease from pediatric to adult healthcare.
BACKGROUND
The number of adult patients with childhood-onset chronic diseases is increasing. However, the process of transitioning these patients from child- to adult-centered medical services faces many difficulties. Despite the key role that doctors in the pediatric field are considered to play in transition, few fact-finding surveys about transition have been conducted among these doctors.
OBJECTIVE
The aim of this study was to demonstrate the current status and challenges in the transition of patients with childhood-onset chronic diseases by a fact-finding survey of pediatricians and pediatric surgeons at a university hospital.
METHODS
A cross-sectional survey was performed using an anonymous self-administered questionnaire. Seventy-six doctors of pediatrics and pediatric surgery (excluding junior residents) in a university hospital were asked to answer an anonymous self-report questionnaire. A multidisciplinary research team selected items related to the transitional process.
RESULTS
Sixty (79%) doctors participated, of whom 52 (87%) showed awareness of transition. No doctor answered that "Transition is conducted smoothly." Doctors with shorter pediatric department experience had lower awareness and poorer experience with transition. In contrast to pediatric surgeons, pediatricians explained "job-seeking activities" and "contraceptive methods" to the patient, and reported a higher patient age at which to initiate explanation of transition to the patient and his/her family. Among factors inhibiting transition, 39 (65%) respondents selected "The patient's family members do not desire transition" and 34 (57%) selected "Although a relevant adult healthcare department is available, it will not accept the patient." The medical providers most frequently considered to have responsibility for playing a central role in the transition process were "pediatrician/pediatric surgeon," "medical social worker," and "regional medical liaison office."
DISCUSSION
To promote transition, pediatric and adult healthcare departments should share concerns about and cooperate in the establishment of more effective methods of transition, and provide multidisciplinary collaboration to support patients and their families.
Topics: Humans; Adult; Male; Female; Child; Cross-Sectional Studies; Delivery of Health Care; Surveys and Questionnaires; Chronic Disease; Surgeons; Pediatrics
PubMed: 37561779
DOI: 10.1371/journal.pone.0289927 -
Pediatric Quality & Safety 2023Firearm injuries are a leading cause of morbidity and mortality for US youth. Secure storage is protective against firearm injuries in children. Despite this evidence...
BACKGROUND
Firearm injuries are a leading cause of morbidity and mortality for US youth. Secure storage is protective against firearm injuries in children. Despite this evidence and national recommendations, rates of firearm safety screening among pediatric providers are low, particularly in the inpatient setting. Therefore, we aimed to increase the frequency of firearm safety screening among patients admitted to the Pediatric Hospital Medicine service.
METHODS
This project occurred in a tertiary pediatric hospital with a medium-sized pediatric residency program. The initial intervention was a firearm safety screening tool embedded into the electronic health record history and physical note template. Subsequent interventions included nursing education, monthly reminder emails, and gun violence discussions during intern orientation. Patients who screened positive were provided with educational materials and a free gun lock. Data collection occurred by chart review to determine the frequency of screening documentation in the H&P. A survey was also conducted among pediatric residents to identify persistent barriers to screening.
RESULTS
The percentage of inpatient firearm safety screening increased from 0.01% to 39% over 25 months, with a centerline shift noted after 2 months. Residents cited a lack of time with the patient and a belief that it was not the appropriate time to screen as persistent barriers to screening.
CONCLUSIONS
This study identified an effective approach to improving firearm safety screening in an academic pediatric hospital. Hospitalization represents a unique opportunity for firearm safety screening and counseling, and inpatient providers should feel empowered to intervene in this setting.
PubMed: 37780602
DOI: 10.1097/pq9.0000000000000689 -
Journal of Child Health Care : For... Aug 2023Pain is frequently experienced by children in hospital, and international guidelines for appropriate pain assessment and management are available. Optimal management of...
Pain is frequently experienced by children in hospital, and international guidelines for appropriate pain assessment and management are available. Optimal management of paediatric pain has important long-term health, psychosocial, and economic benefits. However, evidence indicates that globally there are deficits in nurses' understanding of paediatric pain assessment and management. This study explored knowledge and attitudes regarding paediatric pain assessment and management among nurses at a tertiary children's hospital in Nepal. In this cross-sectional study all 140 nurses at a tertiary children's hospital in Nepal, were invited to complete the validated Paediatric Nurses Knowledge and Attitudes Survey. Findings revealed substantial deficits in nurse's knowledge and erroneous attitudes towards pain assessment and management in children. Test scores ranged from 14% to 56%, with mean scores of 38%, with no nurses achieving a recommended pass score of 80% regarding knowledge and attitudes in paediatric pain management. Consistent with previous research, nurses had insufficient knowledge and attitudes that did not reflect best practice regarding pain assessment and management in children. Education programmes targeting both trainees and registered nurses are essential to enable nurses to deliver evidence-based care and improve outcomes for children and their families.
PubMed: 37571842
DOI: 10.1177/13674935231195133 -
Cureus Oct 2023The potential interplay between domestic violence and masticatory outcomes in children and adolescents has garnered increasing attention. Understanding the association... (Review)
Review
The potential interplay between domestic violence and masticatory outcomes in children and adolescents has garnered increasing attention. Understanding the association between domestic abuse and specific oral health parameters, such as biting habits, temporomandibular disorders (TMDs), and bruxism, holds implications for holistic healthcare interventions. This systematic review aims to synthesize the available evidence to elucidate the potential relationships between domestic abuse and targeted oral health outcomes in the pediatric population. A comprehensive search strategy was conducted across eight databases, namely, PubMed, Embase, Scopus, PsycINFO, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Google Scholar. Boolean operators and Medical Subject Headings (MeSH) keywords were strategically employed to optimize search precision. Clinical studies investigating the relationships between domestic abuse and TMDs, or bruxism, in children and adolescents were included. Two reviewers extracted the data independently. The methodological quality and risk of bias of the selected studies were critically appraised using the Newcastle-Ottawa scale. The systematic search identified three papers investigating the associations between domestic abuse and the targeted oral health parameters. Children in the age group of 6-19 years were assessed. The synthesized evidence revealed a consistent association between domestic abuse and masticatory outcomes. Individuals subjected to domestic abuse exhibited a greater percentage of masticatory anomalies. The methodological assessment of the included studies showed good quality. This systematic review provides a notable synthesis of evidence regarding the associations between domestic abuse and masticatory outcomes in children and adolescents. The complex nature of these relationships necessitates further research to unravel the underlying mechanisms and establish causality. The insights from this review highlight the significance of integrating abuse assessment within oral health evaluations and underscore the need for interdisciplinary collaborations to address the potential impact of abusive experiences on the oral health and well-being of the pediatric population.
PubMed: 37954731
DOI: 10.7759/cureus.46764 -
Journal of Caring Sciences Sep 2023Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival.... (Review)
Review
INTRODUCTION
Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature.
METHODS
This integrative review was conducted in 2021 using Whittemore and Knafl's method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl.
RESULTS
After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life".
CONCLUSION
The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival.
PubMed: 38020738
DOI: 10.34172/jcs.2023.31768