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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 -
The Nursing Clinics of North America Jun 2020Over the past several decades there has been a dramatic change in the landscape of youth sports. This article provides an overview of sport-related injuries in the child... (Review)
Review
Over the past several decades there has been a dramatic change in the landscape of youth sports. This article provides an overview of sport-related injuries in the child and adolescent populations, looking at changes over the past 10 to 15 years. A closer look at frequently seen injuries, including assessment, diagnosis, and management in osteochondritis dissecans, sprains, fractures, anterior cruciate ligament, and meniscus tears, is provided. Current protocols and screening tools for this population are discussed, including preparticipation screening. The nursing implications in the clinical and community setting are identified, with ways to incorporate this information into practice.
Topics: Adolescent; Athletic Injuries; Humans; Pediatric Nursing; Sports Medicine
PubMed: 32389257
DOI: 10.1016/j.cnur.2020.02.005 -
The Journal of Perinatal & Neonatal...The opioid epidemic has greatly increased the number of pregnant women with opioid use and newborns exposed to opioids in utero. Mothers with opioid use disorder can...
The opioid epidemic has greatly increased the number of pregnant women with opioid use and newborns exposed to opioids in utero. Mothers with opioid use disorder can face stigma by nurses in perinatal care settings, contributing to negative care experiences. A survey was distributed to nurses caring for mothers and newborns exposed to opioids in a large urban hospital in the Pacific Northwest United States (n = 89) from March to July 2019. Survey measures included participant characteristics, attitude toward substance use in pregnancy and postpartum (stigma, compassion satisfaction, comfort, and knowledge), and open-ended questions. Relationships among variables and questionnaire items were examined using Pearson's correlations, 2-sample t tests, and simultaneous multiple linear regression. Qualitative description was used to analyze open-ended questions. Nurses' stigma was negatively correlated with compassion satisfaction (r = -0.63), feeling knowledgeable (r = -0.36), and comfortable in providing care to this population (r = -0.44). Nurses identified defensiveness, lack of trust, and inadequate social support as key challenges in this patient population. Nurses suggested more support for mothers and nurses, increased nursing education, and clinical guidelines to improve clinical practice and foster therapeutic relationships. Findings highlight potential strategies to improve nursing care for chemically dependent mothers and their infants. These strategies may offer practical approaches to reduce stigma, develop therapeutic relationships, and improve patient outcomes.
Topics: Infant; Humans; Female; Infant, Newborn; Pregnancy; Empathy; Neonatal Nursing; Analgesics, Opioid; Nursing Care; Opioid-Related Disorders
PubMed: 36288441
DOI: 10.1097/JPN.0000000000000587 -
Journal For Nurses in Professional...The role of pediatric hospitals in the COVID-19 pandemic changed quickly. The team of clinical nurse specialists and clinical nurse educators in a large pediatric...
The role of pediatric hospitals in the COVID-19 pandemic changed quickly. The team of clinical nurse specialists and clinical nurse educators in a large pediatric hospital were instrumental in the institutional response through simulations, serving as change agents, collaboration, and implementing systems thinking. Leveraging the expertise of this team during this historical and unprecedented time optimized patient and associate safety as part of a pediatric hospital's COVID-19 response.
Topics: COVID-19; Child; Humans; Pandemics; Pediatric Nursing; SARS-CoV-2
PubMed: 33899785
DOI: 10.1097/NND.0000000000000753 -
Nursing & Health Sciences Jun 2020Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an...
Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an educational intervention using authentic stimulus material centered on a clinical case study of a family with a baby with Down syndrome. Quantitative and qualitative data were collected from a sample of 15 nurses and 27 students from three universities in Japan before and after completing an entry-level workshop on competency-based genetics nursing. Participants reported increased perceived genetics knowledge and clinical confidence. Despite more than 90% of the participants reporting that they understood the underlying genetics knowledge, their confidence and the ethical aspects of genetics nursing had not been promoted after the seminar. In contrast, the reflections, coded into three categories, showed they recognized families' needs for psychological support, family decision making, and protection and privacy and suggested that nurses had undergone a profound shift in understanding about these issues. Although indicating that a single seminar was insufficient, the study findings will be useful to develop educational materials on genetics for both students and nurses.
Topics: Adult; Clinical Competence; Female; Genetics; Humans; Japan; Male; Middle Aged; Pediatric Nursing; Perinatal Care; Pilot Projects; Prospective Studies; Students, Nursing
PubMed: 31912654
DOI: 10.1111/nhs.12680 -
Scandinavian Journal of Caring Sciences Sep 2019Cultural sensitivity is a core concept to establish awareness and knowledge about various ethnicities, cultures, genders and additional diversity characteristics to... (Review)
Review
BACKGROUND
Cultural sensitivity is a core concept to establish awareness and knowledge about various ethnicities, cultures, genders and additional diversity characteristics to understand individual's requests and respond appropriately to them. A need for further development of the concept is warranted, especially in the context of paediatric nursing.
AIMS
The purpose of this paper was to determine the main elements of cultural sensitivity in the context of paediatric nursing in Iran.
METHODS
The Hybrid method was implemented consisting of three phases: theoretical, fieldwork and final analysis. In the theoretical phase, articles from 2007 to 2017 were reviewed for relevance. In the phase of fieldwork, 25 nurses and nine parents were interviewed to explore the aspects of cultural sensitivity in paediatric nursing. The interviews were transcribed, and content analysis was conducted. In the final phase, an overall analysis of the two previous phases was performed.
RESULTS
In the theoretical phase, the following attributes were determined: cultural encounter and awareness, acceptance of cultural diversity and designing programmes in accordance with family culture. The fieldwork phase explored three themes of intercultural encounters, intercultural communication and adapting the care plan with family culture. The final synthesis yielded that sensitivity to family requests and beliefs, effective intercultural communication and integration of family culture with the care plan are the main elements of cultural sensitivity in Iranian paediatric nursing.
CONCLUSION
With a deeper understanding of the term cultural sensitivity, nurses will have a foundation to improve paediatric nursing care and align the care plan with the patient's culture to provide trust, child/parent participation, secure care, effective communication and satisfaction. Since the concepts are the building blocks that underpin theory, the present concepts identified can help to serve as the foundation for the development of a theoretical model.
Topics: Adolescent; Adult; Attitude of Health Personnel; Child; Child, Preschool; Cultural Competency; Family Nursing; Female; Humans; Infant; Infant, Newborn; Iran; Male; Middle Aged; Nursing Staff, Hospital; Pediatric Nursing; Qualitative Research
PubMed: 30628722
DOI: 10.1111/scs.12654 -
Respiratory Medicine Jan 2022Advances in medical care and ventilator technologies increase the number of children with tracheostomy and home mechanical ventilation (HMV). Data on severe adverse...
BACKGROUND
Advances in medical care and ventilator technologies increase the number of children with tracheostomy and home mechanical ventilation (HMV). Data on severe adverse events in home care and in specialized nursing care facilities are limited.
PATIENTS AND METHODS
Retrospective analysis of incidence and type of severe adverse events in children with tracheostomy and HMV in home care compared to a specialized nursing care facility over a 7-year period.
RESULTS
163.9 patient-years in 70 children (home care: 110.7 patient-years, 24 patients; nursing care facility: 53.2 patient-years, 46 patients) were analyzed. In 34 (48.6%) patients tracheostomy was initiated at the age of <1 year. 35 severe adverse events were identified, incidence of severe adverse events per patient-year was 0.21 (median 0.0 (0.0-3.0)). We observed no difference in the rate of severe adverse events between home care and specialized nursing care facility (0.21 [y-1]; median 0.0 (0.0-3.0) versus 0.23 [y-1]; median 0.0 (0.0-1.6); p = 0.690), however, significantly more tracheostomy related incidents and infections occurred in the home care setting. Young age (<1 year) (Odds ratio 3.27; p = 0.045) and feeding difficulties (nasogastric tubes and percutaneous endoscopic gastrostomy) (Odds ratio 9.08; p = 0.016) significantly increased the risk of severe adverse events. Furthermore, the rate of severe adverse events was significantly higher in patients with a higher nursing score.
CONCLUSION
Pediatric home mechanical ventilation via tracheostomy is rarely associated with emergencies or adverse events in home care as well as in a specialized nursing care facility setting.
Topics: Child; Home Care Services; Humans; Pediatric Nursing; Respiration, Artificial; Retrospective Studies; Tracheostomy
PubMed: 33865662
DOI: 10.1016/j.rmed.2021.106392 -
Cancer Medicine Oct 2020Hospitalized pediatric hematology-oncology (PHO) patients are at high risk for critical illness, especially in resource-limited settings. Unfortunately, there are no... (Review)
Review
BACKGROUND
Hospitalized pediatric hematology-oncology (PHO) patients are at high risk for critical illness, especially in resource-limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), an assessment tool to evaluate the capacity and quality of pediatric critical care services offered to PHO patients.
METHODS
A comprehensive literature review identified relevant indicators in the areas of structure, performance, and outcomes. An international focus group sorted potential indicators using the framework of domains and subdomains. A modified, three-round Delphi was conducted among 36 international experts with diverse experience in PHO and critical care in high-resource and resource-limited settings. Quality indicators were ranked on relevance and actionability via electronically distributed surveys.
RESULTS
PROACTIVE contains 119 indicators among eight domains and 22 subdomains, with high-median importance (≥7) in both relevance and actionability, and ≥80% evaluator agreement. The top five indicators were: (a) A designated PICU area; (b) Availability of a pediatric intensivist; (c) A PHO physician as part of the primary team caring for critically ill PHO patients; (d) Trained nursing staff in pediatric critical care; and (e) Timely PICU transfer of hospitalized PHO patients requiring escalation of care.
CONCLUSIONS
PROACTIVE is a consensus-derived tool to assess the capacity and quality of pediatric onco-critical care in resource-limited settings. Future endeavors include validation of PROACTIVE by correlating the proposed indicators to clinical outcomes and its implementation to identify service delivery gaps amenable to improvement.
Topics: Adult; Clinical Competence; Consensus; Critical Care; Critical Care Nursing; Critical Illness; Delphi Technique; Female; Hematopoietic Stem Cell Transplantation; Hospitalization; Humans; Intensive Care Units, Pediatric; Male; Middle Aged; Neoplasms; Patient Care Team; Patient Transfer; Pediatric Nursing; Pediatrics; Quality Improvement; Quality Indicators, Health Care
PubMed: 32777172
DOI: 10.1002/cam4.3351 -
The Lancet. Child & Adolescent Health Jan 2022
Topics: Child; Child, Hospitalized; Emotions; Female; Humans; Parent-Child Relations; Patient Education as Topic; Pediatric Nursing; Pediatrics; Preoperative Care; Surgical Procedures, Operative
PubMed: 34921805
DOI: 10.1016/S2352-4642(21)00379-5 -
Journal of Nursing Scholarship : An... Jan 2023Nursing-sensitive indicators (NSIs) measure factors influencing nursing care quality and patient outcomes. Established NSIs reflect general and select specialty nursing...
INTRODUCTION
Nursing-sensitive indicators (NSIs) measure factors influencing nursing care quality and patient outcomes. Established NSIs reflect general and select specialty nursing practices. However, a core set of NSIs for international pediatric oncology nursing practice does not currently exist. Without valid and reliable quality indicators, the impact of nursing care on children and adolescents with cancer cannot be effectively measured and improved. The purpose of this study was to develop a preliminary core set of NSIs for international pediatric oncology nursing that would be important, actionable, and feasible to measure across varied resource settings and countries.
DESIGN/METHODS
A multiphase sequential mixed methods research design, intersected with a classical Delphi method, was utilized. Through purposive snowball sampling, 122 expert pediatric oncology nurses from 43 countries participated. Round One: Panelists identified five potential NSIs and constructs. Open-ended responses were coded and categorized through descriptive content analysis and integrated into the next round. Round Two: Panelists selected their top 10 NSIs and constructs and ranked them by importance to patient care quality. Mean importance scores were calculated through reverse scoring; the top 10 NSIs and constructs were integrated into the next round. Round Three: Panelists ranked the top 10 NSIs and constructs by order of importance for this particular population, then rated each NSI/Construct for actionability and feasibility of measurement by Likert-scale. Rounds Two and Three were analyzed using descriptive statistics. Mixed methods meta-inferences were derived from the integration of Rounds One and Three findings.
RESULTS
Eighty-five (70%) panelists from 38 countries completed all Delphi survey rounds. The preliminary core set of NSIs and constructs identified by the expert panel, and ranked in order of importance, were as follows: safe chemotherapy administration and handling, infection prevention/control, pediatric oncology nursing orientation program, early warning score system/recognition of patient deterioration, chemotherapy/biotherapy education/course, pain assessment/management, symptom assessment/management, patient and family education, palliative/end of life care, and continuing nursing education/competency. All NSIs and constructs were rated as actionable; all but palliative/end of life care were rated as feasible to measure. Each of the 10 NSIs and constructs were nominated in Round One by at least one expert panelist from low- and middle-income and high-income countries, and at least one panelist from the Americas.
CONCLUSION
Preliminary core NSIs and constructs provide insight into common attributes of international pediatric oncology nursing practice that are important, actionable, and feasible for quality measurement.
CLINICAL RELEVANCE
NSIs have the potential to drive quality improvement, guide comparison with other institutions, promote knowledge-sharing, and advance pediatric oncology nursing outcomes around the world. These NSIs and constructs may also be relevant to other pediatric and adult oncology settings.
Topics: Adult; Adolescent; Humans; Child; Quality Indicators, Health Care; Delphi Technique; Nursing Care; Pediatric Nursing; Neoplasms
PubMed: 35790072
DOI: 10.1111/jnu.12798