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Journal of Pediatric Nursing 2020Priority setting for pediatric nursing is important to plan, coordinate and direct future research. The aim of this scoping review was to systematically identify and... (Review)
Review
PROBLEM
Priority setting for pediatric nursing is important to plan, coordinate and direct future research. The aim of this scoping review was to systematically identify and synthesise the nature, range and extent of published pediatric nursing research priorities.
ELIGIBILITY CRITERIA
English language full text publications focusing generic nursing research priorities for the child or adolescent, indexed in CINAHL, EMBASE, The Cochrane Database of Systematic Reviews, AMED, MEDLINE and PsycINFO and published from 2008 to 2019.
SAMPLE
A total of 789 citations were identified, 44 full text articles were retrieved and assessed for eligibility and eight studies were finally reviewed, quality assessed (CREDES) and synthesised.
RESULTS
All eight studies used a consensus building method to identify research priorities reported by nurses. Six used Delphi technique, one Nominal Group Technique (NGT) and one consensus workshop. CREDES score range was 10-14 of a possible 16. Synthesis of the 234 nursing research priorities generated four themes; evidenced-based practice, pediatric context, child and family-centered care; pediatric nursing, with 14 subthemes.
CONCLUSION
The nursing research priorities reported appear to be still current and important to nurses. There was a focus on acute care, with fewer priorities reflecting areas of child-, school-, or mental- health. Consumer and community priorities have not been reported.
IMPLICATIONS
These nursing research priorities can be used to inform the national or local research agenda, although there is a need to establish priorities from the perspective of all stakeholders and in particular, identify what is important to consumers.
Topics: Adolescent; Child; Consensus; Critical Care; Delphi Technique; Humans; Nursing Research; Pediatric Nursing
PubMed: 32008833
DOI: 10.1016/j.pedn.2020.01.006 -
Journal of Emergency Nursing May 2024The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing...
INTRODUCTION
The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool.
METHODS
This quality-improvement project used the plan, do, study, act model to design/refine the Emergency Behavioral Health Acuity Assessment Tool and a non-experimental descriptive design to assess outcomes. The setting was a 47-bed urban level 1 pediatric trauma center with more than 60,000 annual visits. The team designed the tool using published evidence, emergency nurse feedback, and expert opinion. The tool objectively captured patient acuity and suggested acuity-specific nursing interventions. Project outcomes included acuity, length-of-stay, restraint use, and patient/staff injuries. Analyses included descriptive statistics and correlations.
RESULTS
With over 3000 annual mental/behavioral-related visits, the emergency department had an average daily census of 23 mental and behavioral health patients. Implementation occurred in August 2021. The Emergency Behavioral Health Acuity Assessment Tool dashboard provided the number of patients, patient location, and acuity. Length-of-stay did not change; however, patient restraint use and patient/staff injuries declined. Number of restraints positively correlated with moderate acuity levels (r = 0.472, P = 0.036).
DISCUSSION
For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.
Topics: Humans; Emergency Nursing; Emergency Service, Hospital; Child; Pediatric Nursing; Quality Improvement; Mental Disorders; Nursing Assessment; Patient Acuity; Female; Male
PubMed: 38597852
DOI: 10.1016/j.jen.2024.02.005 -
AACN Advanced Critical Care Jun 2023One of the biggest challenges that clinical nurse educators at the unit level face today is measuring the ongoing competency of nursing staff members to ensure provision...
One of the biggest challenges that clinical nurse educators at the unit level face today is measuring the ongoing competency of nursing staff members to ensure provision of high-quality, evidence-based care. Pediatric nursing leaders at an urban, level I trauma teaching institution in the southwestern United States used a shared governance approach to create a standardized competency assessment tool for pediatric intensive care unit nurses. Donna Wright's competency assessment model was used as a framework to guide the tool's development. The adoption of the standardized competency assessment tool was aligned with the organization's institutional goals and enabled clinical nurse educators to comprehensively evaluate staff members on a regular basis. This standardized competency assessment system for pediatric intensive care nurses is more effective than use of a practice-based, task-oriented assessment method and has improved nursing leaders' ability to staff the pediatric intensive care unit safely.
Topics: Child; Humans; Nursing Staff; Pediatric Nursing; Southwestern United States; Clinical Competence; Critical Care; Nurses
PubMed: 37289627
DOI: 10.4037/aacnacc2023556 -
Pediatrics Aug 2021To longitudinally examine the nature of moral distress (MoD) experienced by clinicians caring for extremely low gestational age neonates.
BACKGROUND AND OBJECTIVES
To longitudinally examine the nature of moral distress (MoD) experienced by clinicians caring for extremely low gestational age neonates.
METHODS
Neonatologists, medical trainees, and nurses were surveyed at regular intervals on their experience of MoD and their preferred level of care in relation to 99 neonates born <28 weeks' gestational age managed from birth until discharge or death in 2 tertiary NICUs. Clinicians reporting significant distress (≥6 of 10 on Wocial's Moral Distress Thermometer) were asked to provide open-ended responses on why they experienced MoD. Descriptive statistics were used to analyze frequency and intensity of MoD across different clinician characteristics. Open-ended responses were analyzed by using mixed methods.
RESULTS
Over 18 months, 4593 of 5332 surveys (86% response rate) were collected. MoD was reported on 687 (15%) survey occasions; 91% of neonates elicited MoD during their hospitalization. In their open-ended answers, clinicians invoked 5 main themes to explain their distress: (1) infant-centered reasons (83%), including illness severity, predicted outcomes, and disproportionate care; (2) management plans (26%); (3) family-centered reasons (19%); (4) parental decision-making (16%); and (5) provider-centered reasons (15%). MoD was strongly associated with the perception of "parents wanting too much." Neonatologists experienced less distress and were more likely than nurses and trainees to align preferred levels of care with family wishes.
CONCLUSIONS
The majority of preterm infants will generate some MoD; however, it is rarely shared and of a sustained nature. The main constraint reported by clinicians was "parents wanting too much," leading to disproportionate care.
Topics: Attitude of Health Personnel; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Longitudinal Studies; Male; Morals; Neonatal Nursing; Neonatologists; Neonatology; Nurses, Neonatal; Psychological Distress; Self Report
PubMed: 34285081
DOI: 10.1542/peds.2020-031864 -
Neonatal Network : NN Jul 2022
Topics: Academies and Institutes; Humans; Infant, Newborn; Neonatal Nursing
PubMed: 35840329
DOI: 10.1891/NN.41.4.news -
Neonatal Network : NN Aug 2022
Topics: Academies and Institutes; Humans; Infant, Newborn; Neonatal Nursing
PubMed: 36002276
DOI: 10.1891/NN.41.5.news -
Revista Brasileira de Enfermagem 2021Reflect on the evolution of pediatric nursing care from the perspective of emotions, from the conceptions of Florence Nightingale to the present.
OBJECTIVE
Reflect on the evolution of pediatric nursing care from the perspective of emotions, from the conceptions of Florence Nightingale to the present.
METHOD
Reflective study based on theoretical and experiential aspects of emotional care in pediatric nursing.
RESULTS
From Nightingale, there were many definitions regarding the nursing care in an integrative and humanist logic; and with certain bond to emotional dimension. That time, nursing care was based on the religious conceptions of charity and love of our neighbor and, despite the conceptualization that shapes nursing science today, such conceptions have not ceased to be its attribute, mainly in the care of pediatric nurses.
FINAL CONSIDERATIONS
In pediatric nursing, nurture care with affection and facilitate emotions management in each interaction nurse-child-family is crucial for caring. This emotional care should evolve into a competence that recognizes the expertise and merit of professional action.
Topics: Child; Emotions; Family; History of Nursing; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Nursing Care; Pediatric Nursing; Professional Competence
PubMed: 34105638
DOI: 10.1590/0034-7167-2020-0377 -
Journal of Advanced Nursing Jun 2023
Topics: Humans; Child; Pediatric Nursing; Cooperative Behavior
PubMed: 36433659
DOI: 10.1111/jan.15514 -
Nurse Education Today Nov 2019The aim of this review was to analyze the effectiveness of teaching healthcare professionals in perinatal palliative care, methods of evaluating the teaching, and the... (Review)
Review
OBJECTIVES
The aim of this review was to analyze the effectiveness of teaching healthcare professionals in perinatal palliative care, methods of evaluating the teaching, and the teaching strategies used.
DESIGN
An integrative review.
METHODS
A systematic search was conducted for English language peer reviewed publications of any research design via SCOPUS, Medline/PubMed, EBSCOhost, Science Direct, ERIC, Web of Science, Wiley, Nursing Ovid, and ProQuest databases. Fourteen research papers published between 2002 and 2017 that met the selection criteria were included in the review.
FINDINGS
All 14 studies considered perinatal bereavement education to be effective. Eight studies reported statistical improvements in knowledge, security/comfort in providing end-of-life care, or increased perceptions of the emotional care needs of bereaved families, after attending an educational program. Questionnaires or interviews were used to evaluate the educational programs. Innovative teaching strategies, in particular, were evaluated positively (e.g., simulation, discussion, and arts-based methods).
CONCLUSION
Perinatal palliative care education is essential in pregradual education for midwives and neonatal nurses. Other research is vital for finding out the effectiveness of this education for pregraduate nursing students. Perinatal palliative care education programs need to be available in postgraduate education for professionals who encounter perinatal death and bereaved families in hospital and community care.
Topics: Bereavement; Education, Nursing; Humans; Neonatal Nursing; Palliative Care; Students, Nursing
PubMed: 31442632
DOI: 10.1016/j.nedt.2019.08.003 -
Journal of Nursing Management Nov 2022This study examined the effect on pediatric nursing handover quality and efficiency when a standardized e-handover system was implemented.
AIM
This study examined the effect on pediatric nursing handover quality and efficiency when a standardized e-handover system was implemented.
BACKGROUND
Handover quality is an important aspect of nursing quality management; however, handover quality among nursing staff is poor.
METHODS
A prospective interventional study was carried out in a general pediatrics ward from December 2019 to November 2020. The tools included a standardized e-handover system. The intervention strategies included workflow remodeling and employee training on oral handover using the standardized e-handover system.
RESULTS
The omission frequency of critical handover elements decreased from 47.32% to 2.94% (p < .01), among which the omission frequencies of nine out of 16 key elements significantly decreased. Integrity also showed improvement. Specifically, the integrity of five types of critical information was significantly improved, including vital signs, signs and symptoms, laboratory test results, radiologic examination results, and treatment regimen (2.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 5.00 vs. 5.00, p = .009; 3.00 vs. 4.00, p < .01, respectively). Information accuracy was 100%. Workflow and efficiency significantly improved, communication duration with patient/family during work hours significantly increased (24.00 vs. 56.00, p < .01), and prehandover preparation duration significantly decreased (32.00 vs. 2.50, p < .01). Nurse handover satisfaction showed improvement (56.88 ± 15.08 vs. 74.31 ± 9.22, p < .01).
CONCLUSION
The standardized e-handover system effectively improved nurse handover quality, optimized workflow, increased work efficiency, and promoted teamwork.
IMPLICATIONS FOR NURSING MANAGEMENT
Standardized e-handover systems have great potential for ensuring the safety of pediatric patients and improving the quality of handover.
Topics: Humans; Child; Patient Handoff; Prospective Studies; Pediatric Nursing; Nursing Care; Nursing Staff
PubMed: 35066952
DOI: 10.1111/jonm.13549