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Journal of Pediatric Nursing 2020Adverse events occur in up to 19% of pediatric hospitalized patients, often associated with delays in recognition or treatment. While early detection is recognized as a... (Review)
Review
PROBLEM
Adverse events occur in up to 19% of pediatric hospitalized patients, often associated with delays in recognition or treatment. While early detection is recognized as a primary determinant of recovery from deterioration, most research has focused on profiling patient risk and testing interventions, and less on factors that impact surveillance efficacy. This integrative review explored actions and factors that influence the quality of pediatric nursing surveillance.
ELIGIBILITY CRITERIA
Original research on nursing surveillance, escalation of care, or cardiopulmonary deterioration in hospitalized pediatric patients in non-critical environments, published in English in peer reviewed journals.
SAMPLE
Twenty-four studies from a literature search within the databases of CINAHL, PubMed, and Web of Science were evaluated and synthesized using a socio-technical systems theory framework. Study quality was assessed using The Mixed Methods Appraisal Tool.
RESULTS
Assessment, documentation, decision-making, intervening and communicating were identified as activities associated with surveillance of deterioration. Factors that influenced nurses' detection of deterioration were patient acuity, nurse education, experience, expertise and confidence, staffing, standardized assessment and communication tools, availability of emergency services, team composition and opportunities for multidisciplinary care planning.
CONCLUSIONS
Research provides insight into some aspects of nursing surveillance but does not adequately explore factors that affect clinical data interpretation and synthesis, and role integration between nurse and parents, and nurse and other clinicians on surveillance of clinical stability.
IMPLICATIONS
Research is needed to enhance understanding of the contextual factors that impact nursing surveillance to inform intervention design to support nurses' timely recognition and mitigation of clinical deterioration.
Topics: Child; Clinical Deterioration; Humans; Nursing Assessment; Pediatric Nursing
PubMed: 31770679
DOI: 10.1016/j.pedn.2019.10.008 -
Nursing Children and Young People Nov 2019Early intervention in children and young people with mental health issues is important to ensure that these issues do not persist into adulthood. However, while children... (Review)
Review
Early intervention in children and young people with mental health issues is important to ensure that these issues do not persist into adulthood. However, while children and young people with mental health issues have traditionally been cared for in specialist facilities to ensure their safety, a lack of inpatient beds means that these patients are being admitted to children's wards in general hospitals. Children's nurses require education and training in mental health to provide optimal care for these children and young people. This article explains how the development of evidence-based clinical practice guidelines for children and young people with mental health issues could increase patient safety. Similarly, postgraduate mental health education and training for children's nurses could support enhanced care. The article also discusses how the Nursing and Midwifery Council's revised proficiency standards will require nursing students and registered nurses to enhance their knowledge of caring for people with mental health issues.
Topics: Child; Child Health Services; Evidence-Based Nursing; Humans; Mental Disorders; Mental Health Services; Nurse's Role; Nursing Diagnosis; Pediatric Nursing; Practice Guidelines as Topic
PubMed: 31696689
DOI: 10.7748/ncyp.2019.e1216 -
The Journal of Perinatal & Neonatal...Positive tactile experiences in the newborn period are critical to normal sensory development. Universal gloving in the neonatal intensive care unit has become a...
Positive tactile experiences in the newborn period are critical to normal sensory development. Universal gloving in the neonatal intensive care unit has become a controversial issue in neonatal nursing practice. Intended to prevent infection among neonatal patients, universal gloving also hinders the provision of human touch. The purpose of this survey study was to (1) describe gloving policies in neonatal intensive care units, and (2) describe the gloving and touch practices of neonatal nurses and identify associations between these practices and demographic characteristics. The investigators developed a 19-question, anonymous survey. The survey link was distributed through the National Association of Neonatal Nurses' social media and newsletter. Of the 137 responses, only 22.1% of nurses reported unit policy requiring universal gloving. While nurses reported some ambiguity about gloving policies, surveyed nurses commonly used gloves when performing general care activities. Institutional gloving policies varied in this geographically diverse sample, but routine, bare-handed touch was an uncommon practice among neonatal nurses. Research evidence is needed to guide nursing practice and inform policy decisions regarding glove use in the neonatal intensive care unit.
Topics: Humans; Infant, Newborn; Intensive Care Units, Neonatal; Neonatal Nursing; Nurses, Neonatal; Touch
PubMed: 35089182
DOI: 10.1097/JPN.0000000000000626 -
Journal of Pediatric Nursing 2023The present study to determine the level of therapeutic communication skills among the students undertaking the pediatric nursing course and explore the associated...
AIM
The present study to determine the level of therapeutic communication skills among the students undertaking the pediatric nursing course and explore the associated influencing factors.
METHODS
This descriptive cross-sectional study was conducted with 140 nursing students who took the pediatric nursing course. Data were collected using a Nursing Student Information Form and the Therapeutic Communication Skills Scale for Nursing Students. The mean and percentage calculations, t-test, ANOVA test, and regression analysis were conducted to analyze the correlations between the participants' descriptive characteristics and their mean scores on the scales.
RESULTS
The participants' mean scores obtained on the total Therapeutic Communication Skills Scale for Nursing Students and all of its subdimensions were observed to have a statistically significant correlation with variables such as gender, grade point average, willingness to select the nursing department, satisfaction with the nursing department, difficulty in establishing communication, perceived ability to establish social relations, difficulty in communicating with a child, perception of childhood life, experience with child care, fondness for children, interest in playing therapeutic games with children, and perceived ability to communicate with children. In Model 1, certain descriptive characteristics (satisfaction with the nursing department, difficulty in communicating with a child, experience with child care, interest in playing therapeutic games with children, and perceived ability to communicate with children) explained 52.4% of the therapeutic communication skills scores of the pediatric nursing students and were statistically significantly.
CONCLUSIONS
In this study, it was determined that some of the descriptive characteristics of the students who took the pediatric nursing course had a significant effect on their therapeutic communication skills.
IMPLICATIONS FOR PRACTICE
In order to develop the therapeutic communication skills of students undertaking a pediatric nursing course, it is necessary to support these students with a standard curriculum that includes student-centered, innovative, and interactive educational methods, such as role play, case analysis, and video-based learning. It is also recommended to conduct comparative studies on different educational approaches for nursing students undertaking pediatric nursing courses or meta-analyses to evaluate the effectiveness of such approaches.
Topics: Humans; Child; Cross-Sectional Studies; Students; Pediatric Nursing; Communication; Curriculum; Students, Nursing; Education, Nursing, Baccalaureate
PubMed: 37603925
DOI: 10.1016/j.pedn.2023.08.015 -
Journal of Pediatric Nursing 2022The purpose of this study was to translate and culturally adapt the Family Centered Care Assessment Scale (FCCAS) to evaluate family-centered care in the context of...
PURPOSE
The purpose of this study was to translate and culturally adapt the Family Centered Care Assessment Scale (FCCAS) to evaluate family-centered care in the context of Finnish pediatric nursing.
DESIGN AND METHODS
The translation and cultural adaptation were done according guidelines of International Society for Pharmacoeconomics and Outcomes (ISPOR), which constitute a systematic process including ten phases. The presented research included cognitive interviews conducted with the end user of the scale: parents of hospitalized children.
RESULTS
The FCCAS was successfully translated and culturally adapted to the Finnish context. Translational, clinical and parental expertise were used to develop the scale. Conceptual equivalence was achieved in the translation. In the cultural adaptation, some of the items were modified based on experts' assessments to make them comprehensible and appropriate to the Finnish culture. The scale showed good evidence of content. Reporting of the study adheres to the COSMIN checklist.
CONCLUSIONS
Combining ISPOR guidelines and cognitive interviews are recommended to use in the translation and cultural adaptation process. Nursing staff and parents' involvement and awareness of family-centered care have been concretized. Systematic translation and cultural adaptation have prepared a Finnish version of the scale for psychometric testing.
PRACTICE IMPLICATIONS
The study outlines how rigorous methodological approaches can be applied to the translation and cultural adaptation of a measurement tool. The developed scale includes items which comprehensively cover family-centered care characteristics. In following study, it will be possible to evaluate the extent to which family-centered care is implemented in Finnish pediatric nursing.
Topics: Child; Finland; Humans; Patient-Centered Care; Pediatric Nursing; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Translating; Translations
PubMed: 34801323
DOI: 10.1016/j.pedn.2021.11.004 -
The American Journal of Tropical... Nov 2022After Port-au-Prince's 2010 earthquake, Hospital Bernard Mevs (HBM) developed a collaboration with international medical volunteers to provide clinical care and medical...
After Port-au-Prince's 2010 earthquake, Hospital Bernard Mevs (HBM) developed a collaboration with international medical volunteers to provide clinical care and medical resources; that evolved to include medical education as local Haitian staffing developed. There has been limited coordination among volunteers and local providers about ways in which volunteers can best serve the hospital, and literature that addresses how to coordinate volunteer efforts to support the educational needs of the local nursing staff is scant. Our objectives were to complete an educational needs assessment of the most common diagnoses encountered, requested topics for education, and preferred learning modalities as reported by Haitian pediatric nurses, and categorize the strengths of HBM and barriers to care to understand more fully the context within which nurses function, and how education and international volunteers may be related. In October 2019, 10 HBM pediatric nurses participated in small-group interviews. Questions were based on an interview guide and responses were coded and analyzed for recurring themes. The most common diagnoses were sepsis, hydrocephalus, and hypoxic ischemic encephalopathy. Topics for review included chest tubes, ventilator management, and ventriculoperitoneal shunts. Preferred learning modalities were didactics and hands-on workshops. Strengths of the hospital were team dynamics and education provided by HBM and international volunteers, whereas the most common barrier to care was lack of clinical supplies. This information is useful to guide future educational interventions, and this model may inform other programs with a volunteer presence in resource-limited settings to promote collaboration and self-directed learning.
Topics: Humans; Child; Haiti; Pediatric Nursing; Qualitative Research; Earthquakes; Volunteers
PubMed: 36191875
DOI: 10.4269/ajtmh.22-0299 -
Journal For Specialists in Pediatric... Jan 2021The neuroscience nurse must possess advanced knowledge and skills to care for a wide range of unique congenital and acquired neurological diagnoses. For each of these...
PURPOSE
The neuroscience nurse must possess advanced knowledge and skills to care for a wide range of unique congenital and acquired neurological diagnoses. For each of these clinical scenarios, the measurement of complexity and acuity of patient care is key to informing staffing models and patient assignments. The Inpatient Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO ) acuity tool measures patient acuity in terms of nursing cognitive workload complexity. We describe the implementation and evaluation of the Inpatient CAMEO in a pediatric neuroscience unit in a large free-standing children's hospital in the northeast United States.
DESIGN AND METHODS
Using a quality improvement approach, the Inpatient CAMEO was implemented and evaluated over a 12-month period by a neuroscience clinical lead and unit-based ambassadors. Monthly data reports evaluating unit-level completion and the level of acuity (I-V) were generated for unit leadership. Data were further stratified by type of admission to the neuroscience unit. Five categories of patients included neurology medical, epilepsy, neurosurgical, neurooncology, and other, which is defined as nonneurology patients, admitted to unit.
RESULTS
The monthly proportion of Inpatient CAMEO s Classified as III-V ranged from 62.3% to 83.3% with a median of 78.2%. The type of neuroscience admissions varied in level of acuity. Patients identified as neurology (68.7%) and epilepsy (67.5%) had the lowest acuity, patients identified as neurosurgery (82.8%) and other (80.2%) had moderate acuity, and neurooncology (94.5%) had the highest acuity.
PRACTICE IMPLICATIONS
Using the Inpatient CAMEO , the acuity of neuroscience pediatric care was demonstrated to be increased and variable across disease categories. Neurooncology patients were identified as having the highest acuity as compared to other pediatric neuroscience admissions.
Topics: Child; Humans; Inpatients; Neuroscience Nursing; Nursing Staff, Hospital; Pediatric Nursing; Personnel Staffing and Scheduling
PubMed: 32851806
DOI: 10.1111/jspn.12307 -
Nursing in Critical Care Mar 2023Nursing checklists have been shown to improve communication, reduce the occurrence of adverse events, and promote safe, quality care in different care settings. However,... (Review)
Review
BACKGROUND
Nursing checklists have been shown to improve communication, reduce the occurrence of adverse events, and promote safe, quality care in different care settings. However, to date, there is no validated patient care safety checklist for nurses caring for infants in Neonatal Intensive Care Units (NICU).
AIM
To describe development and content validation of the "Safe Nursing Care Checklist for Infants Hospitalized in the Neonatal Intensive Care Unit".
STUDY DESIGN
Online Survey.
METHODS
Based upon an integrative literature review, we developed a checklist focused on safe nursing care for infants in the NICU. Nursing experts participated in three rounds of a content validation process where they rated the items online. An agreement level ≥0.90 was required for inclusion in the checklist. Forty- three expert nurses with experience working in the NICU and who were certified in neonatal nursing or had a master's or doctoratal degree in child health provided content validation of the patient care checklist.
RESULTS
The final checklist contained 45 items with content validation index scores greater than 90%. The instrument was structured into six dimensions including patient identification, effective communication, medication safety, infection prevention, fall prevention, and pressure injuries/skin injuries prevention.
CONCLUSION
Content validity was established for the "Safe Nursing Care Checklist for Infants Hospitalized in the Neonatal Intensive Care Unit" which can identify strengths and weaknesses in safe nursing care for infants in the NICU as well as direct educational interventions to promote nursing care based on scientific evidence.
RELEVANCE TO CLINICAL PRACTICE
This checklist can potentially be used by bedside nurses to promote provision of safe care to infants in the NICU and to guide corrective strategies and encourage evidence-based decision-making. Validation in the clinical setting is needed.
Topics: Infant, Newborn; Infant; Child; Humans; Checklist; Intensive Care Units, Neonatal; Surveys and Questionnaires; Neonatal Nursing; Communication
PubMed: 35920678
DOI: 10.1111/nicc.12831 -
Journal of Pediatric Nursing 2020Physiologic measurement of patient acuity has been used to predict patient outcomes, length of stay, and resource utilization. To date, these tools are not sufficiently...
PURPOSE
Physiologic measurement of patient acuity has been used to predict patient outcomes, length of stay, and resource utilization. To date, these tools are not sufficiently comprehensive to inform nurse staffing assignments and have limited practical application. The Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO©) acuity tool was initially developed and validated to quantify patient acuity in terms of complexity of nursing cognitive workload in pediatric intensive care units (ICU). This article describes development and implementation of the Inpatient CAMEO© in the pediatric inpatient setting.
DESIGN AND METHODS
Utilizing a modified Delphi technique, an expert panel convened to scale and implement the Inpatient CAMEO© in the pediatric inpatient units through four Delphi rounds.
RESULTS
The expert panel identified care items unique to the pediatric inpatient setting and assigned a cognitive workload scale of 1-5. To consolidate the tool, the panel identified items to be classified as "Standard of Care" and developed a new baseline score for the Inpatient CAMEO©. Expert panel members served as unit-based ambassadors to foster the expansion and implementation of the new Inpatient CAMEO©.
CONCLUSIONS
The Inpatient CAMEO© describes and quantifies acuity beyond the intensive care setting. The implementation and use of the Inpatient CAMEO© was accomplished through unit-based ambassadors and the support of leadership.
PRACTICE IMPLICATIONS
Quantifying nursing cognitive workload in both direct and indirect care is important to determining nursing assignments and comprehensive staffing models in the pediatric inpatient setting.
Topics: Child; Female; Humans; Inpatients; Intensive Care Units, Pediatric; Nursing Staff, Hospital; Patient Acuity; Pediatric Nursing; Personnel Staffing and Scheduling; Workforce; Workload
PubMed: 31887720
DOI: 10.1016/j.pedn.2019.12.005 -
Journal of Pediatric Health Care :... 2022The purpose was to identify the educational needs of pediatric nurses and pediatric nurse practitioners providing direct care to transition-aged youth with chronic...
INTRODUCTION
The purpose was to identify the educational needs of pediatric nurses and pediatric nurse practitioners providing direct care to transition-aged youth with chronic illness and disability and to identify strategies to develop health care transition planning (HCTP) expertise.
METHOD
Mixed-methods descriptive analyses were performed on survey data extracted from a larger national study exploring the provision of HCTP activities performed by nurses of two pediatric nursing professional organizations.
RESULTS
Items querying educational needs were completed by 1,162 pediatric nurses serving in advanced practice and staff roles. Twenty percent reported having specialized HCTP education. Of which more than half received it outside of the workplace. Factor analysis revealed two constructs explaining 73.4% of the variance in nurses' reported level of knowledge.
DISCUSSION
HCTP education and the development of nurse-led services to facilitate optimal health care transitions outcomes are necessitated. Academia and service have a shared responsibility in educating nurses.
Topics: Adolescent; Aged; Child; Humans; Nurse Practitioners; Nurses, Pediatric; Patient Transfer; Pediatric Nurse Practitioners; Pediatric Nursing; Transition to Adult Care
PubMed: 35501202
DOI: 10.1016/j.pedhc.2022.04.001