Sample records for pediatric nursing

  1. Pediatric Endocrinology Nurses Society (United States)

    ... Join Now International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development ... nurses in the art and science of pediatric endocrinology nursing. Learn More Text1 2018 PENS Call for ...

  2. Nursing 436A: Pediatric Oncology for Nurses. (United States)

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  3. Compassion Fatigue in Pediatric Nurses. (United States)

    Berger, Jill; Polivka, Barbara; Smoot, Elizabeth Ann; Owens, Heather


    Compassion fatigue in nursing has been shown to impact the quality of patient care and employee satisfaction and engagement. The aims of this study were to determine the prevalence and severity of compassion fatigue among pediatric nurses and variations in prevalence based on respondent demographics using a cross-sectional survey design. Nurses under 40 years of age, with 6-10 years of experience and/or working in a medical-surgical unit had significantly lower compassion satisfaction and higher levels of burnout. Secondary traumatic stress from caring for children with severe illness or injury or end of life was a key contributor to compassion fatigue. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Increasing nursing treatment for pediatric procedural pain. (United States)

    Bice, April A; Gunther, Mary; Wyatt, Tami


    Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  5. Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer (United States)

    Bell, Julie Ann


    Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

  6. Pediatric Inpatient Nurses' Perceptions of Child Maltreatment. (United States)

    Lavigne, Jenifer L; Portwood, Sharon G; Warren-Findlow, Jan; Brunner Huber, Larissa R

    The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Certified pediatric nurses' perceptions of job satisfaction. (United States)

    Wyatt, Janet; Harrison, Margaret


    The Pediatric Nursing Certification Board surveyed a national sample of 1354 hospital-based certified pediatric nurses (CPNs) to determine their perceptions of certification on job satisfaction and other factors. There is a substantial body of literature that demonstrates job satisfaction among nurses positively increases retention and reduces absenteeism and burnout. CPNs seek certification for a personal sense of achievement, professional recognition, and validation of clinical competency. The certified nurse survey respondents had self-reported high levels of job satisfaction and indicated that relationships with colleagues and a supportive work environment were very important to their levels of job satisfaction. The results of this study highlight important factors for hospitals to consider as they plan strategies and cost-effective ways to positively affect patient care and retain qualified pediatric nurses at the bedside.

  8. Pediatric nurse practitioners: influences on career choice. (United States)

    Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura


    The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  9. Pediatric central venous access devices: nursing interventions

    Directory of Open Access Journals (Sweden)

    Duffy EA


    Full Text Available Elizabeth A Duffy, Kathryn N Nelson Department of Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, MI, USA Abstract: A central venous catheter (CVC is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study 

  10. Perceived nursing work environment of acute care pediatric nurses. (United States)

    Kotzer, Anne Marie; Koepping, Dianne M; LeDuc, Karen


    Nurse job satisfaction is a complex phenomenon and includes elements of the work environment. The purpose of this study was to evaluate nurses' perception of their real (current) and ideal (preferred) work environment in a pediatric tertiary care setting. Using a descriptive survey design, a convenience sample of staff nurses from three inpatient units was surveyed using the Work Environment Scale (WES) by Moos (1994). The WES consists of 10 subscales characterizing three dimensions: Relationship, Personal Growth, and System Maintenance and Change. Overall, nurses affirmed a highly positive and supportive work environment on their units. Non-significant findings between the real and ideal scores for the Involvement and Managerial Control subscales suggest that staff are concerned about and committed to their work, and satisfied with their managers' use of rules and procedures. Statistically significant differences between selected real and ideal subscale scores will help target intervention strategies to enhance the nursing work environment.

  11. Pediatric Critical Care Nursing Research Priorities-Initiating International Dialogue. (United States)

    Tume, Lyvonne N; Coetzee, Minette; Dryden-Palmer, Karen; Hickey, Patricia A; Kinney, Sharon; Latour, Jos M; Pedreira, Mavilde L G; Sefton, Gerri R; Sorce, Lauren; Curley, Martha A Q


    To identify and prioritize research questions of concern to the practice of pediatric critical care nursing practice. One-day consensus conference. By using a conceptual framework by Benner et al describing domains of practice in critical care nursing, nine international nurse researchers presented state-of-the-art lectures. Each identified knowledge gaps in their assigned practice domain and then poised three research questions to fill that gap. Then, meeting participants prioritized the proposed research questions using an interactive multivoting process. Seventh World Congress on Pediatric Intensive and Critical Care in Istanbul, Turkey. Pediatric critical care nurses and nurse scientists attending the open consensus meeting. Systematic review, gap analysis, and interactive multivoting. The participants prioritized 27 nursing research questions in nine content domains. The top four research questions were 1) identifying nursing interventions that directly impact the child and family's experience during the withdrawal of life support, 2) evaluating the long-term psychosocial impact of a child's critical illness on family outcomes, 3) articulating core nursing competencies that prevent unstable situations from deteriorating into crises, and 4) describing the level of nursing education and experience in pediatric critical care that has a protective effect on the mortality and morbidity of critically ill children. The consensus meeting was effective in organizing pediatric critical care nursing knowledge, identifying knowledge gaps and in prioritizing nursing research initiatives that could be used to advance nursing science across world regions.

  12. A new assessment model and tool for pediatric nurse practitioners. (United States)

    Burns, C


    This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordon's Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

  13. Exploring communication difficulties in pediatric hematology: oncology nurses. (United States)

    Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora


    Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

  14. Effects of leadership characteristics on pediatric registered nurses' job satisfaction. (United States)

    Roberts-Turner, Reneé; Hinds, Pamela S; Nelson, John; Pryor, Juanda; Robinson, Nellie C; Wang, Jichuan


    Job satisfaction levels among registered nurses (RNs) influence RN recruitment, retention, turnover, and patient outcomes. Researchers examining the relationship between characteristics of nursing leadership and RN job satisfaction have treated RNs as a monolithic group with little research on the satisfaction of hospital-based pediatric RNs. This study assessed the relationship of transformational and transactional nursing leadership characteristics and RN job satisfaction reported by pediatric RNs. This single site study included 935 hospital-based pediatric RNs who completed validated survey items regarding nursing leadership and job satisfaction. A structural equation model (SEM) was applied to assess how autonomy (transformational leadership) and distributive justice (transactional leadership) influence RN job satisfaction, and how RN socio-demographic characteristics influence job satisfaction via autonomy and distributive justice. Findings revealed that both autonomy and distributive justice had significant positive effects on RN job satisfaction but the largest source of influence was autonomy.

  15. Research Priorities in Neonatal and Pediatric Nursing

    Directory of Open Access Journals (Sweden)

    Thaíla Corrêa Castral


    • Implement the participation of Brazilian scientific societies in establishing health care policies, guidelines and protocols, creating consensus committees. Furthermore, it is important to highlight the ABEn recommendations presented during the 65th Brazilian Nursing Congress, which took place in October of 2013 in Rio de Janeiro, particularly regarding the development of strategies to meet the National Curriculum Guidelines for Nursing Undergraduate Courses, especially concerning the development, participation and application of research and other types of knowledge production that aim at improving the quality of professional practice. Therefore, this number of the Revista Eletrônica de Enfermagem has five original articles that are relevant for Pediatric and Neonatal Nursing. The studies address themes such as nursing diagnosis in children with respiratory infections, child immunization, childhood vulnerability, factors related to peripheral vascular trauma in children, and using case studies to teach diagnostic thinking. The findings are relevant for the implementation of more effective interventions, thus improving the quality of health care delivered to newborns, children and their family.     REFERENCE 1. Carvalho V. Linhas de pesquisa e prioridades de enfermagem: proposta com distinção gnoseológica para o agrupamento da produção científica de pós-graduação em enfermagem. Esc. Anna Nery. 2002;6(1:145-54. 2. Lansky S, França E. Mortalidade infantil neonatal no Brasil: situação, tendências e perspectivas. In: Rede Interagencial de Informações para Saúde. Demografia e Saúde: contribuição para análise de situação e tendências [Internet]. Brasília: OPAS; 2009 [acesso em: 20 mar 2014]. p. 83-112. Disponível em: 3. Ministério da Saúde. Plano Nacional de Saúde–PNS:2012-2015. Brasília (Brasil: Ministério da Saúde;  2011 [acesso em: 20 mar 2014

  16. Pediatric nursing consultation in the perspective of nurses from the family health strategy

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Gasparino


    Full Text Available Qualitative study that analyzed conceptions and experiences of nurses about the pediatric nursing consultation and its systematization in the Family Health Strategy. Semi-structured interviews were recorded with ten nurses from four cities of the countryside of São Paulo, in 2011. The interviews were analyzed according to the method of Thematic Content Analysis, based on current assumptions of the systematization of nursing care and the comprehensive child health care. Generally, nursing consultations, and specifically, pediatric ones were defined as the nurses’ activity that allows them to know the life/health story, current needs and prevent future problems, having recognized the importance of its implementation and systematization. The experiences reported the paucity and lack of systematization in the pediatric nursing consultation in the context studied. Processes of ongoing health education are necessary to ensure quality and completeness to children's health.

  17. The Lived Experiences of Nurses Caring For Dying Pediatric Patients. (United States)

    Curcio, Danna L


    Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

  18. Mindfulness for Novice Pediatric Nurses: Smartphone Application Versus Traditional Intervention. (United States)

    Morrison Wylde, Chelsey; Mahrer, Nicole E; Meyer, Rika M L; Gold, Jeffrey I

    The current study compares the effects of a traditionally delivered mindfulness (TDM) intervention to a smartphone delivered mindfulness (SDM) intervention, Headspace, an audio-guided mindfulness meditation program, in a group of novice nurses. Novice nurses participating in a pediatric nurse residency program were asked to participate in either a TDM or SDM intervention. Participants (N=95) completed self-administered pencil and paper questionnaires measuring mindfulness skills, and risk and protective factors at the start of their residency and three months after entering the program. Nurses in the SDM group reported significantly more "acting with awareness" and marginally more "non-reactivity to inner experience" skills compared to the TDM group. The smartphone intervention group also showed marginally more compassion satisfaction and marginally less burnout. Additionally, nurses in the SDM group had lower risk for compassion fatigue compared to the TDM group, but only when the nurses had sub-clinical posttraumatic symptoms at the start of the residency training program. Smartphone delivered mindfulness interventions may provide more benefits for novice nurses than traditionally delivered mindfulness interventions. However, the smart-phone intervention may be better indicated for nurses without existing symptoms of posttraumatic stress. Mindfulness interventions delivered through smartphone applications show promise in equipping nurses with important coping skills to manage stress. Because of the accessibility of smartphone applications, more nurses can benefit from the intervention as compared to a therapist delivered intervention. However, nurses with existing stress symptoms may require alternate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The evolution of pediatric critical care nursing: past, present, and future. (United States)

    Foglia, Dorothy C; Milonovich, Lisa M


    Although current nursing literature is overflowing with information related to the history of nursing in general, and even pediatric nursing, very little is published about PICU nursing. The evolution of pediatric critical care nursing is presented based on a historical context, the current state, and future projections. More specifically, this treatise focuses on the environment, the patient and family, and of course, the PICU nurse. Concluding remarks provide an insight into how health care reforms and how the use of clinical information technology will affect the role of the pediatric critical care nurse in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Characteristics of caring self-efficacy in pediatric nurses: a qualitative study. (United States)

    Alavi, Azam; Bahrami, Masoud; Zargham-Boroujeni, Ali; Yousefy, Alireza


    The present study was conducted to clarify pediatric nurses' characteristics of caring self-efficacy. This study was conducted using a qualitative content analysis approach. The participants included 27 pediatric nurses and clinical instructors, selected purposively. Data were collected using semi-structured interviews and were analyzed using the content analysis method. Data analysis generated four main themes as attributes of a self-efficient pediatric nurse including: (a) professional communications; (b) management of care; (c) altruism; and (d) proficiency. Nursing managers and instructors can use these results to help develop nurses' empowerment and self-efficacy, especially in pediatric care. © 2015, Wiley Periodicals, Inc.

  1. Impact of Noise on Nurses in Pediatric Intensive Care Units. (United States)

    Watson, J'ai; Kinstler, Angela; Vidonish, William P; Wagner, Michael; Lin, Li; Davis, Kermit G; Kotowski, Susan E; Daraiseh, Nancy M


    Excessive exposure to noise places nurses at risk for safety events, near-misses, decreased job performance, and fatigue. Noise is particularly a concern in pediatric intensive care units, where highly skilled providers and vulnerable patients require a quiet environment to promote healing. To measure noise levels and noise duration on specialty pediatric intensive care units to explore sources of noise and its effects on the health of registered nurses. In a cross-sectional pilot study, levels and sources of noise in 3 different specialty pediatric intensive care units were assessed. Fifteen nurses were observed for 4-hour sessions during a 24-hour period. Sound pressure levels (noise) and heart rate were measured continuously, and stress ratings were recorded. Descriptive statistics were calculated for noise (level, source, location, and activity), heart rate, and stress. The Pearson correlation coefficient was calculated to analyze the relationship between heart rate and noise. Mean noise level was 71.9 (SD, 9.2) dBA. Mean heart rate was 85.2/min (SD, 15.8/min) and was significantly associated with noise, unit, within-unit location, nurse sources, and noise activities. The most frequent sources of noise were patients' rooms, care activities, and staff communications. Noise levels in pediatric intensive care units exceed recommended thresholds and require immediate attention through effective interventions. Although noise was not associated with stress, a significant correlation with increased heart rate indicates that noise may be associated with adverse health outcomes. ©2015 American Association of Critical-Care Nurses.

  2. [Liability of pediatric nurses for professional negligence in Taiwan: a case study]. (United States)

    Huang, Hui-Man; Sun, Fan-Ko


    Liability attribution and professional negligence in pediatric nursing are topics that have been neglected in Taiwan. (1) Identify the definitions of related criminal activities in accordance with domestic criminal law; (2) Elucidate the facts and the dispute in a current case involving a pediatric nurse; (3) Elucidate the principle of 'no punishment without law'; (4) Explore the reasons why the pediatric nurse in the current case received a verdict of 'not guilty'. A literature review and case study approach were used to analyze a sentence reconsideration of the first instance No. 1 (2011) issued by the Taiwan high court, Kaohsiung branch court. The conditions for the scrutiny of criminal activity under Taiwan criminal law are statement of facts, illegality (justifiable cause), and liability (excuse). In this case, the pediatric nurse was accused of failing to prevent an infant from suffocation and of not discharging her obligations as a nurse. The pediatric nurse rebutted the charge of criminal negligence. The intervening behaviors of the pediatric nurse were found to be legal and not culpable. In this case, the High Court and Supreme Court made a final criminal judgment based on the presumption of innocence, and the pediatric nurse was pronounced innocent of the charge. This article intends to assist pediatric nurses understand their liabilities under Taiwan's criminal law. Pediatric nurses should gain a better understanding of the nature of liability for professional negligence in order to clarify how actions that may be illegal do not necessarily make nurses culpable.

  3. Perceived value of national certification for pediatric nurses. (United States)

    Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill


    This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

  4. [Knowledge of nurses about medication doses at pediatric urgency departament]. (United States)

    Guerrero-Márquez, Gloria; Martínez-Serrano, Ana; Míguez-Navarro, Concepción; López-Mirón, Juan Antonio; Espartosa-Larrayad, Marta


    Errors in drug administration are the second cause of errors in hospitalized patients. Children are a high risk group. Besides, pressure in care interventions at emergency department leads to increase incidence errors. Determining nurses' knowledge about the most common drug doses at pediatric urgency department. Descriptive transversal study. We collected data from nurses of 14 pediatric emergency departments of Madrid. With an "ad hoc" questionnaire we collected the following data during five days in January of 2014: demographic, knowledge of responsibility in administration and doses of drugs. Global descriptive analysis was made and it was stratified by hospital and work experience. The answer rate was 114 (34.9%). Only 80 (70.8%) of nurses confirm doses before their administration; 20 (18.6%) think that a wrong prescription that they administer is not their responsibility. There is a high knowledge in the group with more than five years of work experience, except for sedative-analgesic drugs (p<0.05). The average score obtained was 3.8 of 10 (1.99). Nurses' knowledge about drug doses is low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Nursing safety management in onco-hematology pediatric wards

    Directory of Open Access Journals (Sweden)

    Marcelle Miranda da Silva


    Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

  6. School nurse perceptions and knowledge of pediatric toileting. (United States)

    Arlen, Angela M; Boyt, Margaret A; Cooper, Christopher S


    We surveyed school nurses on toileting conditions in schools, their level of understanding related to normal toileting patterns in school-age children, and whether they are in need of additional resources to promote healthy toilet habits for their students. An Institutional Review Board approved web-based survey with 34 questions was employed; 562 nurses completed the survey and 97% were currently employed as school nurses. Participants were invited via email blasts through national school nursing associations and the Iowa Department of Education. Only 48% and 33% of respondents suspected an underlying health problem in children with frequent urination and bladder or bowel accidents, respectively. Despite 61% reporting never receiving information about children's normal elimination patterns, 43% had been asked to provide such information to teachers. Only 42% felt they had adequate resources to respond to such requests. School nurses requested information about treatment of dysfunctional elimination (67%), health effects of childhood toileting habits (65%), fluid intake guidelines (44%) and improvement of bathroom facilities (39%); 70% were unaware of local providers specially trained to treat children with these problems. Our survey results suggest that school nurses need additional information and resources in order to promote healthy elimination patterns in school children. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  7. [Drug administration to pediatric patients: Evaluation of the nurses' preparation habits in pediatric units]. (United States)

    Ménétré, S; Weber, M; Socha, M; Le Tacon, S; May, I; Schweitzer, C; Demoré, B


    In hospitals, the nursing staff is often confronted with the problem of the preparation and administration of drugs for their pediatric patients because of the lack of indication, pediatric dosage, and appropriate galenic form. The goal of this study was to give an overview of the nurses' preparation habits in pediatric units and highlight their daily problems. This single-center prospective study was conducted through an observation of the nursing staff during the drug preparation process in medicine, surgery and intensive care units. We included 91 patients (55 boys and 36 girls), with an average age of 6.3 years (youngest child, 10 days old; oldest child, 18 years old). We observed a mean 2.16 drug preparations per patient [1-5]. We collected 197 observation reports regarding 66 injectable drugs and 131 oral drugs (71 liquid forms and 60 solid forms). The majority of these reports concerned central nervous system drugs (63/197), metabolism and digestive system drugs (50/197), and anti-infective drugs (46/197). The study highlights the nurses' difficulties: modification of the solid galenic forms, lack of knowledge on oral liquid form preservation or reconstitution methods, withdrawal of small volumes, and vague and noncompliant labeling. This study led to the creation of a specific working group for pediatrics. This multidisciplinary team meets on a regular basis to work toward improving the current habits to both simplify and secure drug administration to hospitalized children. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Pediatric nurse practitioners' clinical competencies and knowing patterns in nursing: Focus group interviews. (United States)

    Lee, Hyejung; Kim, Anna; Meong, Anna; Seo, Minjeong


    The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.

  9. Two decades have passed ... and still it is her eyes that I remember: reflections of a pediatric nurse. (United States)

    Tompkins, Joy M


    A pediatric nurse reflects on her practice by recounting her experience while caring for a child with Guillian Barre 20 years ago. Principles and lessons relevant to guide pediatric nursing practice in today's health care environment are identified.

  10. Effect of the clinical support nurse role on work-related stress for nurses on an inpatient pediatric oncology unit. (United States)

    Chang, Ann; Kicis, Jennifer; Sangha, Gurjit


    High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.

  11. Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic. (United States)

    Beaulieu, Richard; Humphreys, Janice


    Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

  12. Pediatric nurses' perception of factors associated with caring self-efficacy: A qualitative content analysis. (United States)

    Alavi, Azam; Bahrami, Masoud; Zargham-Boroujeni, Ali; Yousefy, Alireza


    Nurses, who are considered to form the largest group of professional healthcare providers, face the challenge of maintaining, promoting, and providing quality nursing care and to prepare themselves to function confidently and to care effectively. Among the factors affecting nursing performance, self-efficacy has been expected to have the greatest influence. However, the concept of caring self-efficacy was not considered and no research has been done in this field in Iran. This study was conducted to explore and identify the factors described by pediatric nurses as related to caring self-efficacy. This is a qualitative study conducted through content analysis in 2013 in Iran. Twenty-four participants were selected through purposive sampling method from pediatric nurses and educators. Data were collected through semi-structured interviews. Data were analyzed using conventional content analysis method. The analysis of the interviews in this study led to the development of four main themes: (1) Professional knowledge of children caring, (2) experience, (3) caring motivation, and (4) efficient educational system as the factors influencing caring self-efficacy perception of pediatric nurses. This article presents the factors associated with the perception of caring self-efficacy in pediatric nurses' perspective. This finding can be used by nursing administrators and instructors, especially in the area of pediatric caring, to enhance nursing professional practice and the quality of pediatric caring.

  13. The Development and Evaluation of a Measure Assessing School Nurses' Perceived Barriers to Addressing Pediatric Obesity (United States)

    Wu, Yelena P.; Steele, Ric G.


    School nurses represent an important resource for addressing pediatric obesity and weight-related health. However, school nurses perceive numerous barriers that prevent them from addressing the weight-related health of students. The current study developed and tested a new, comprehensive measure of nurses' perceptions of 10 types of barriers to…

  14. [Comparison between 2 groups of nursing professionals on the knowledge of pediatric pain]. (United States)

    Lobete Prieto, C; Rey Galán, C; Kiza, A H


    To compare infant pain knowledge between a group of nurses who work in a pediatric hospital and one that works in a general hospital. Descriptive study based on the use of a validated questionnaire for assessing the knowledge and attitudes of nurses about pediatric pain (Pediatric Nurses' Knowledge and Attitude Survey Regarding Pain [PNKAS]). PNKAS questionnaire was distributed to the nursing staff of a pediatric hospital and a general hospital and the results were compared. The average score obtained in the pediatric vs. the general hospital was: mean, 51.7% vs. 47.2%, 95% confidence interval, 47.5 to 56% vs. 43.6 to 50.8% (P=.098). There were no differences between the scores in the PNKAS questionnaire between nurses working exclusively with children and nurses working with general population. Training on pediatric pain needs to be improved in nurses caring for sick children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Advocating for continuing nursing education in a pediatric hospital: the Prince Scholar and Sabbatical Programs. (United States)

    Sperhac, A M; Goodwin, L D


    As nurses gain more experience, they often question the basis of nursing practice and want to find the most current and accepted methods of providing nursing care. Attending seminars, conferences, and continuing education programs is often difficult because of financial and staffing constraints. The authors describe the design and implementation of two funded programs--the Prince Scholars and Sabbatical Programs--that support continuing nursing education in a pediatric tertiary hospital.

  16. Iranian pediatric nurse's experience: The facilitators of the learning of ethical practices

    Directory of Open Access Journals (Sweden)

    Kobra Karami


    Full Text Available Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi-structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim. Results: Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1 individual competencies (knowledge, experience, emotional intelligence, and loving children, (2 ethical imprinting (responsibility, reflection, empathy, and ethical beliefs, and (3 an environment that nurtures moral values (organizational, spiritual, family, and cultural environments as facilitating factors. Conclusions: The promotion of nurses' competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.

  17. A unique strategy for pediatric community health nursing for ADN students. (United States)

    Janvier, K A


    Students were overwhelmingly positive when given the opportunity to evaluate the pilot project and the model of pediatric community health nursing. According to the students, the strong points of the model were the orientation before the community experience, the presence of faculty of the community, the ability to contact faculty when needed, and the postclinical conference. The students' comments confirmed the faculty's belief that a clinical experience in community health nursing must place more emphasis on the specialty of community health nursing to be meaningful for students. To do the of job of educating tomorrow's nurses, ADN faculty should develop new strategies for teaching the pediatric clinical component of community health nursing. Clearly, hospitals are no longer the exclusive sites where students learn about patient and family needs and nursing care delivery. Community-based and community-focused experiences will continue to be required so that nursing students are prepared to practice in a dynamic and changing healthcare environment.

  18. Review of pain content in three-year preregistration pediatric nursing courses in the United Kingdom. (United States)

    Twycross, Alison; Roderique, Lynda


    The results of several studies suggest that gaps remain in nurses' knowledge about pain in children, and particularly regarding pain assessment, analgesic drugs, and nondrug methods, suggesting a need to explore the pain content of preregistration nursing curricula. Over the past decade, the way nurse education is delivered has changed with the advent of the internet and the use of virtual learning environments. This study, therefore, explored the depth and breadth of pain content in 3-year preregistration pediatric nursing courses across the U.K. as well as ascertaining how this content is delivered. The leads for pediatric nursing at all 56 U.K. higher education institutions running the 3-year preregistration pediatric nursing course were e-mailed a questionnaire. Participants were asked to indicate whether topics are covered in the program, and if so how it was delivered. Results suggest that preregistration pediatric nursing courses in the U.K. do not always equip students to manage pain effectively in clinical practice. There appears to be limited content on pain in nursing curricula, with several institutions not covering key topics. Most teaching is delivered face to face with limited workbooks and virtual learning activities. Further research is needed in this area to ascertain the impact of this on the quality of care provided. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  19. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District. (United States)

    Souza, Bruna Marcela Lima de; Salviano, Cristiane Feitosa; Martins, Gisele


    To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  20. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District

    Directory of Open Access Journals (Sweden)

    Bruna Marcela Lima de Souza

    Full Text Available ABSTRACT Objective: To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. Method: This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Results: Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. Conclusion: This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  1. Childhood fever management program for Korean pediatric nurses: A comparison between blended and face-to-face learning method. (United States)

    Jeong, Yong Sun; Kim, Jin Sun


    A blended learning can be a useful learning strategy to improve the quality of fever and fever management education for pediatric nurses. This study compared the effects of a blended and face-to-face learning program on pediatric nurses' childhood fever management, using theory of planned behavior. A nonequivalent control group pretest-posttest design was used. A fever management education program using blended learning (combining face-to-face and online learning components) was offered to 30 pediatric nurses, and 29 pediatric nurses received face-to-face education. Learning outcomes did not significantly differ between the two groups. However, learners' satisfaction was higher for the blended learning program than the face-to-face learning program. A blended learning pediatric fever management program was as effective as a traditional face-to-face learning program. Therefore, a blended learning pediatric fever management-learning program could be a useful and flexible learning method for pediatric nurses.

  2. Self-Efficacy and Select Characteristics in Nurses Who Respond to a Pediatric Emergency (United States)

    McNeill, Nancy


    Nurses at a suburban northeastern U.S. community hospital reported that they felt unprepared to effectively respond to a pediatric emergency. Empirical data were not available to identify if this local problem was due to a lack of the nurses' self-confidence or if other factors were involved. The purpose of this study was to determine if there…

  3. The Impact of Simulation on Pediatric Nursing Students' Knowledge, Self-Efficacy, Satisfaction, and Confidence (United States)

    Saied, Hala


    The simulation technology is rapidly expanding and has been used in several nursing programs around the world and in Saudi Arabia too. The aim of this study was to evaluate the effect of using a simulation based scenarios on the pediatric nursing students' students' knowledge, self-efficacy, satisfaction, and confidence. This study used Bandura's…

  4. Inpatient Nursing and Parental Comfort in Managing Pediatric Tracheostomy Care and Emergencies. (United States)

    Pritchett, Cedric V; Foster Rietz, Melissa; Ray, Amrita; Brenner, Michael J; Brown, David


    Tracheostomy is a critical and often life-saving intervention, but associated risks are not negligible. The vulnerability of the pediatric population underlies the importance of caregiver comfort and competence in tracheostomy care. To assess inpatient nursing staff and parental perspectives in managing tracheostomy care. Cross-sectional analysis of survey data from (1) a volunteer sample of inpatient nurses in a tertiary care, freestanding pediatric hospital in the Midwest, assigned to clinical wards that provide care for children with tracheostomy tubes and (2) a consecutive sample of families whose child underwent tracheostomy tube placement at the same institution between March 1 and December 31, 2013. Nurse and parental comfort in managing acute and established tracheostomy tubes. Nursing data were analyzed with attention to years' experience and primary unit of practice. Respondents included 129 of 820 nurses (16% response rate) and family members of 19 of 38 children (50% response rate). When queried about changing established tracheostomies, 59 of 128 nurses (46%) reported being "totally comfortable," including 46 of 82 intensive care unit (ICU) nurses (56%) vs 13 of 46 floor nurses (28%) (P = .002) and 48 of 80 nurses with at least 5 years' experience (60%) vs 12 of 49 less experienced nurses (24%) (P tracheostomy, 61 nurses (47%) described being completely uncomfortable, including 27 of 83 ICU nurses (33%) vs 34 of 46 floor nurses (73%) (P = .006), and 33 of 80 nurses with at least 5 years' experience (41% ) vs 28 of 49 less experienced nurses (57%) (P = .03). Most families felt prepared for discharge (16 of 17 [94%]) and found the health care team accessible (16 of 17 [94%]), although only 5 of 18 families (28%) indicated that tracheostomy teaching was consistent. Nurses' comfort with tracheostomy was higher among nurses with at least 5 years' experience and primary ICU location. Whereas parental comfort with tracheostomy care was high

  5. Harlequin-Inspired Story-Based Learning: An Educational Innovation for Pediatric Nursing Communication. (United States)

    Shaw, Alison; Lind, Candace; Ewashen, Carol


    Effective communication with patients and families is essential for quality care in the pediatric environment. Despite this, the current structure and content of undergraduate nursing education often contributes to novice RNs feeling unprepared to manage complex pediatric communication situations. By merging the characteristics of the Harlequin persona with the structure of story-based learning, undergraduate students can be introduced to increasingly advanced pediatric communication scenarios in the classroom. Although story-based learning encourages students to identify and address the contextual and emotional elements of a story, the Harlequin encourages educators to challenge assumptions and upset the status quo. Nursing students can develop advanced communication abilities and learn to identify and cope with the emotions and complexities inherent in pediatric practice and communication. Harlequin-inspired story-based learning can enable nurse educators to create interesting, realistic, and challenging pediatric nursing stories designed to push students outside their comfort zones and enhance their advanced pediatric communication abilities. [J Nurs Educ. 2017;56(5):300-303.]. Copyright 2017, SLACK Incorporated.

  6. The role of the trauma nurse leader in a pediatric trauma center. (United States)

    Wurster, Lee Ann; Coffey, Carla; Haley, Kathy; Covert, Julia


    The trauma nurse leader role was developed by a group of trauma surgeons, hospital administrators, and emergency department and trauma leaders at Nationwide Children's Hospital who recognized the need for the development of a core group of nurses who provided expert trauma care. The intent was to provide an experienced group of nurses who could identify and resolve issues in the trauma room. Through increased education, exposure, mentoring, and professional development, the trauma nurse leader role has become an essential part of the specialized pediatric trauma care provided at Nationwide Children's Hospital.

  7. The effectiveness of risk management program on pediatric nurses' medication error. (United States)

    Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat


    Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P error-reporting rate was higher (P medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.

  8. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study. (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Pediatric Early Warning Score Systems, Nurses Perspective - A Focus Group Study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Nielsen, Pia Bonde; Olesen, Hanne Vebert


    PURPOSE: Pediatric early warning score (PEWS) systems are used to monitor pediatric patients' vital signs and facilitate the treatment of patients at risk of deteriorating. The aim of this study was to gain knowledge about nurses' experiences with PEWS and to highlight factors facilitating...... and impeding the use of PEWS tools in clinical practice. DESIGN AND METHODS: An exploratory qualitative design was chosen using focus group interviews to gain a deeper understanding of nurses' experiences with PEWS. A total of five focus group interviews were conducted at three hospitals, and a qualitative......'s - a challenge, v) PEWS helps to visualize the need for escalating care, vi) an inflexible and challenging tool, and vii) supportive tools enhance the nurses' experiences of PEWS positively. CONCLUSIONS: Our findings suggest that attention should be given to nurses' perceptions of how both clinical judgment...

  10. Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team

    International Nuclear Information System (INIS)

    Ruess, Lynne; O'Connor, Stephen C.; Mikita, Cecilia P.; Creamer, Kevin M.


    Objective. To develop a pathway to provide safe, effective, and efficient sedation for pediatric diagnostic imaging studies using non-radiology personnel. Materials and methods. A multidisciplinary team considered manpower and training requirements and national sedation standards before designing a sedation pathway, which included scheduling, pre-sedation history and physical, medication protocols, and monitoring. Oral and IV medication protocols were developed based on patient age and weight. Sedation delays were defined as >15 min (IV) or >30 min (PO) from start of sedation to start of imaging. A sedation failure resulted in an incomplete diagnostic imaging study. Failure rates of 124 sedations before and 388 sedations after the pathway were compared.Results. The sedation failure rate for 7 months prior to pathway initiation was 15% (19/124). In the first 25 months after pathway initiation, failures were significantly reduced to 1.5% (6/388) (P 55 min). Deviation from the recommended medication protocol accounted for most of the 115 delays. Only minor adverse events were seen (12/388, 3.1%).Conclusion. Implementing a pediatric sedation pathway significantly decreases the sedation failure rate. Pediatric residents and nurses can safely, effectively and efficiently sedate pediatric patients for routine diagnostic imaging procedures without the need for a radiology department sedation team in a department with a small-to-moderate volume of pediatric patients. (orig.)

  11. [Meanings attributed by family members in pediatrics regarding their interactions with nursing professionals]. (United States)

    Gomes, Giovana Calcagno; Xavier, Daiani Modernel; Pintanel, Aline Campelo; Farias, Dóris Helena Ribeiro; Lunardi, Valéria Lerch; Aquino, Deise Ribeiro


    Understanding the meanings attributed by family caregivers of children in hospital environments about their interactions with nursing professionals. This qualitative study used Symbolic Interactionism as a theoretical reference and Grounded Theory as the methodological framework. It was carried out in a Pediatrics Center in southern Brazil, in the first half of 2013. Participants were 15 family caregivers of hospitalized children. Data were collected through interviews and submitted to open and axial analysis. Interactions with the nursing team enable family to trust or distrust in the provided child care and to positively evaluate the care received. Interactions between family members and the nursing team contribute to the significance attributed by the family to the nursing care received by the child. Nurses should be aware of the attitudes of the nursing team regarding the child and their family, prioritizing humanized care.

  12. Meanings attributed by family members in pediatrics regarding their interactions with nursing professionals

    Directory of Open Access Journals (Sweden)

    Giovana Calcagno Gomes


    Full Text Available Abstract OBJECTIVE Understanding the meanings attributed by family caregivers of children in hospital environments about their interactions with nursing professionals. METHODS This qualitative study used Symbolic Interactionism as a theoretical reference and Grounded Theory as the methodological framework. It was carried out in a Pediatrics Center in southern Brazil, in the first half of 2013. Participants were 15 family caregivers of hospitalized children. Data were collected through interviews and submitted to open and axial analysis. RESULTS Interactions with the nursing team enable family to trust or distrust in the provided child care and to positively evaluate the care received. CONCLUSION Interactions between family members and the nursing team contribute to the significance attributed by the family to the nursing care received by the child. Nurses should be aware of the attitudes of the nursing team regarding the child and their family, prioritizing humanized care.

  13. Addressing the oral healthcare needs of special needs children: pediatric nurses' self-perceived effectiveness. (United States)

    Parish, Carrigan L; Singer, Richard; Abel, Stephen; Metsch, Lisa R


    To examine the oral health knowledge and practices of pediatric nurses who coordinate healthcare services for special needs children and to identify those factors that influenced their perceived effectiveness in managing their patients' oral health needs. Self-reported data were collected from 376 nurses employed at Children's Medical Services who responded to an online survey. Likert scale scores were used to specifically assess the nurses' perceived effectiveness in addressing the oral health needs of special needs children. Characteristics significantly associated with special needs pediatric nurses who described themselves as "effective or very effective" included: the self-perception of being very knowledgeable about basic oral health, receiving four or more hours of continuing education training, and securing dental appointments for the majority of their pediatric special needs patients with minimal waiting times. Findings reveal that oral health knowledge significantly influenced nurses' perceived effectiveness in addressing the oral health needs of special needs children, as well as their ability to secure timely dental appointments. These results support the need to incorporate oral health education into nursing curricula and expand upon the dental workforce available and willing to treat disabled patients. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  14. Knowledge and attitudes regarding neonatal pain among nursing staff of pediatric department: an Indian experience. (United States)

    Nimbalkar, Archana S; Dongara, Ashish R; Phatak, Ajay G; Nimbalkar, Somashekhar M


    Neonates receiving care in intensive care units are highly likely to experience pain due to investigations and/or treatments carried out by the health care providers. Neonates are a vulnerable population because they are unable to vocalize their pain. Unaddressed and mismanaged pain can not only affect the child's comfort, but also may alter the development and cognitive abilities of the child in a later part of his/her life. Therefore it is entirely the caregiver's responsibility to accurately assess and manage neonatal pain. We assessed and compared the knowledge and attitudes regarding neonatal pain among the nurses posted in the various units of a pediatric department [pediatric ward, pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU)]. An appropriately modified Knowledge and Attitudes Survey Regarding Pain questionnaire was consensually validated, pretested, and then administered to the nursing staff of the pediatric department at a department at a hospital in Gujarat. Data were entered in Epi-Info and analyzed with the use of SPSS 14.0. The questionnaire was administered to 41 nurses working in the Department of Pediatrics, and the response rate was 97.5%. Mean age of the nurses in the study sample was 25.75 years (SD 5.513). The mean total score of the participants was 8.75 out of 17 (SD 2.549), which was unsatisfactory. The mean correct answer rate was 49.67% among the staff of NICU and 48.67% among the pediatric ward and PICU staff. The attitudes among the nurses were assessed. It was concluded that the nurses lack knowledge and that their attitudes also were hindering pain management. One of the barriers identified by the nurses was that physicians do not prescribe analgesics for managing neonatal pain. So not only the nursing staff, but all of the caregivers involved in neonatal care may be lacking in knowledge and hold perceptions and attitudes that hamper neonatal pain management. Copyright © 2014 American Society for Pain

  15. Liaison Problems among Infant Psychiatry, Psychology, Pediatrics, Nursing, and Social Work in Infant Mental Health Care. (United States)

    Bry, Thea

    Discussed are attempts made by staff at the Community Mental Health Center of the New Jersey School of Medicine to develop an ongoing working relationship with pediatric neonatologists, house staff, and nursing staff in order to promote their attunement to mental health needs and obtain access to their expertise. After a description of the center…

  16. Altruism, the values dimension of caring self-efficacy concept in Iranian pediatric nurses. (United States)

    Alavi, Azam; Zargham-Boroujeni, Ali; Yousefy, Alireza; Bahrami, Masoud


    Self-efficacy is the most influential among factors affecting nurses' performance. Yet, understanding of the constituent elements of the caring self-efficacy concept was not considered. This study was to introduce altruism as one of the main aspects of caring self-efficacy in pediatric nurses. This is part of a larger study on the concept of caring self-efficacy conducted with qualitative content analysis approach in Iran. Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews and analyzed using conventional content analysis method. Theme "altruism" as one of the main themes extracted from the analysis of the interviews in this study. This theme includes two main categories of "humanistic care" and "caring attitude." This paper introduces altruism as one of the values aspects of caring self-efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through the provision of maternal care and family-centered care and caring attitudes resulting from religious beliefs and loving children to care for the children.

  17. A Multiinstitutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners. (United States)

    Brown, Kristen M; Mudd, Shawna S; Hunt, Elizabeth A; Perretta, Julianne S; Shilkofski, Nicole A; Diddle, J Wesley; Yurasek, Gregory; Bembea, Melania; Duval-Arnould, Jordan; Nelson McMillan, Kristen


    Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Prospective pre/post interventional pilot study. University simulation center. Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation-based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [SD], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p simulation. Median time improved overall "time to task" across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool ("Student Satisfaction and Self-Confidence in Learning"). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.7 ± 0.30) and performance confidence (4.8 ± 0.31) with the simulation experience. Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel approach to educating pediatric nurse practitioners from multiple academic centers. The course improved overall knowledge, and the

  18. Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective. (United States)

    Stayer, Debbie; Lockhart, Joan Such


    Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children's families. A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children's families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying. ©2016 American Association of Critical-Care Nurses.

  19. Responding to Emotional Stress in Pediatric Hospitals: Results From a National Survey of Chief Nursing Officers. (United States)

    Huetsch, Michael; Green, Jeremy


    The aim of this study was to identify leadership awareness of emotional stress and employee support efforts in pediatric hospitals. The current pediatric environment has seen increases in treatment intensity, care duration, and acuity of patients resulting in increased likelihood of being exposed to emotional events. Mail survey was sent to chief nursing officers at 87 pediatric hospitals. A total of 49 responses (56%) were received. Hospitals with less than 250 beds were significantly more likely to rate emotional stress as a large to very large problem, whereas ANCC Magnet® hospitals felt better about support efforts after patient deaths. Most commonly used support offerings focused on staff recovery after a traumatic event as opposed to training for prevention of emotional stress. Emotional stress is a well-recognized issue in pediatric hospitals with comparatively large resource commitment. Further focus on caregiver prevention training and unit leadership recognition of stress may be needed.

  20. [Revista Annaes de Enfermagem: nurses' publications about pediatrics (1932-1941)]. (United States)

    Fontes, Aline Silva; Santos, Tânia Cristina Franco; Oliveira, Alexandre Barbosa de


    Historic-social study whose object was the intellectual production of nurses and students about pediatric nursing in the journal Annaes de Enfermagem, in the period 1932-1941. The primary source refers to the issues of the journal Annaes de Enfermagem considering the established time limits for the study, as well as reports and correspondences. The secondary sources are constituted by books, articles, dissertations and thesis on the Brazilian history of nursing. On data analysis it was used the thought of the French sociologist Pierre Bourdieu. The results show that the journal Annaes de Enfermagem published important issues of nursing care to the child and contributed to the visibility of Brazilian nurses among the scientific community.

  1. Exploring the evidence in pediatric hematology and oncology nursing through the "article of the month". (United States)

    Linder, Lauri


    As the scope of pediatric hematology and oncology nursing expands, nurses are challenged with staying current in the evidence guiding their practice. Nurse-reported barriers to accessing and utilizing research include lack of time as well as difficulty in accessing, understanding, and synthesizing findings. Journal clubs provide a process to guide nurses in the review of current literature related to their practice and promote utilization of research and evidence-based practice among nurses. This article describes the transition of an in-person journal club to an electronically delivered "Article of the Month." The "Article of the Month" is offered six times each year and is posted on the service line's password-protected intranet website. Oversight of the "Article of the Month" is provided by the service line clinical nurse specialist who selects articles based on an annual learning needs assessment and develops a quiz to assess learning and promote critical thinking among nursing staff. Outcomes include anecdotal reports of increased staff confidence in managing emergent patient care needs and greater appreciation of nursing care issues for children with cancer. Areas for future development include exploring options for increasing in-person discussion of issues addressed in the "Article of the Month" among staff members, extending the "Article of the Month" to nurses in other service areas who care for children with cancer, and increasing staff participation in article selection and quiz item development. An ultimate goal is to develop formal evaluation strategies to link this educational strategy to clinical outcomes.

  2. Pediatric Asthma (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  3. The culture of patient safety from the perspective of the pediatric emergency nursing team

    Directory of Open Access Journals (Sweden)

    Taise Rocha Macedo

    Full Text Available Abstract OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.

  4. Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study. (United States)

    Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia


    This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

  5. The learning experiences of student nurses in pediatric medication management: a qualitative study. (United States)

    Lin, Fang-Yi; Wu, Wei-Wen; Lin, Hung-Ru; Lee, Tzu-Ying


    Traditionally, the 'five rights' (right patient, right route, right drug, right time, and right dose) principle is taught to be practiced during every medication administration process. Nursing educators use this principle to evaluate student performance. However, health care unit factors and education system characteristics that can contribute to student errors should not be underestimated. Students often felt stressed when medicating children during clinical practicum. The voices of these students are rarely represented. To understand students' experiences and perceptions of medication administration during their pediatric clinical practicum. A descriptive qualitative study design was adopted. A university in Northern Taiwan. A total of 34 undergraduate students who had completed a pediatric clinical practicum participated in a one-on-one interview. Each student was interviewed according to a semi-structured interview guide and was encouraged to disclose individual feelings and thoughts toward their experiences in pediatric medication administration. Eight themes emerged. The findings suggest that to decrease students' anxiety and increase their competence, pediatric instructors should improve their teaching strategies to better prepare students for clinical training. Providing self-directed learning activities and resources to improve students' familiarity with medication and medication safety knowledge is necessary. Instructors should provide students with a secure environment to discuss their medication errors. The 'nine rights' should be taught in fundamental nursing courses to enhance students' awareness during the medication administration process, and students should continue to practice the 'nine rights' in later pediatric clinical courses. Equal importance should be given to system failures that impact patient safety. © 2013.

  6. Development and content validity testing of a comprehensive classification of diagnoses for pediatric nurse practitioners. (United States)

    Burns, C


    Pediatric nurse practitioners (PNPs) need an integrated, comprehensive classification that includes nursing, disease, and developmental diagnoses to effectively describe their practice. No such classification exists. Further, methodologic studies to help evaluate the content validity of any nursing taxonomy are unavailable. A conceptual framework was derived. Then 178 diagnoses from the North American Nursing Diagnosis Association (NANDA) 1986 list, selected diagnoses from the International Classification of Diseases, the Diagnostic and Statistical Manual, Third Revision, and others were selected. This framework identified and listed, with definitions, three domains of diagnoses: Developmental Problems, Diseases, and Daily Living Problems. The diagnoses were ranked using a 4-point scale (4 = highly related to 1 = not related) and were placed into the three domains. The rating scale was assigned by a panel of eight expert pediatric nurses. Diagnoses that were assigned to the Daily Living Problems domain were then sorted into the 11 Functional Health patterns described by Gordon (1987). Reliability was measured using proportions of agreement and Kappas. Content validity of the groups created was measured using indices of content validity and average congruency percentages. The experts used a new method to sort the diagnoses in a new way that decreased overlaps among the domains. The Developmental and Disease domains were judged reliable and valid. The Daily Living domain of nursing diagnoses showed marginally acceptable validity with acceptable reliability. Six Functional Health Patterns were judged reliable and valid, mixed results were determined for four categories, and the Coping/Stress Tolerance category was judged reliable but not valid using either test. There were considerable differences between the panel's, Gordon's (1987), and NANDA's clustering of NANDA diagnoses. This study defines the diagnostic practice of nurses from a holistic, patient

  7. Pain Management Practices in a Pediatric Emergency Room (PAMPER) Study: interventions with nurses. (United States)

    Le May, Sylvie; Johnston, C Celeste; Choinière, Manon; Fortin, Christophe; Kudirka, Denise; Murray, Louise; Chalut, Dominic


    Children's pain in emergency departments (EDs) is poorly managed by nurses, despite evidence that pain is one of the most commonly presenting complaints of children attending the ED. Our objectives were 2-fold: to verify if tailored educational interventions with emergency pediatric nurses would improve nurses' knowledge of pain management and nurses' pain management practices (documentation of pain, administration of analgesics, nonpharmacological interventions). This intervention study with a pre-post design (baseline, immediately after the intervention [T-2], and 6 months after intervention [T-3]) used a sample of nurses (N = 50) and retrospective chart reviews of children (N = 450; 150 charts reviewed each at baseline, T-2, and T-3) who presented themselves in the ED with a diagnosis known to generate moderate to severe pain (burns, acute abdominal pain, deep lacerations, fracture, sprain). Principal outcomes: nurses' knowledge of pain management (Pediatric Nurses Knowledge and Attitudes Survey [PNKAS] on pain) and nurses' clinical practices of pain management (Pain Management Experience Evaluation [PMEE]). Response rate on the PNKAS was 84% (42/50) at baseline and 50% (21/42) at T-2. Mean scores on PNKAS were 28.2 (SD, 4.9; max, 42.0) at baseline and 31.0 (SD, 4.6) at T-2. Results from paired t test showed significant difference between both times (t = -3.129, P = 0.005). Nurses who participated in the capsules improved their documentation of pain from baseline (59.3%) to T-2 (80.8%; chi = 12.993, P nurses increased their nonpharmacological interventions from baseline (16.7%) to T-3 (31.9%; chi = 8.623, P = 0.003). Finally, we obtained significant differences on pain documentation between the group of nurses who attended at least 1 capsule and the group of nurses who did not attend any capsule at both times (T-2 and T-3; chi = 20.424, P nurses' knowledge of pain management and some of the practices over time. We believe that an intervention tailored to nurses

  8. A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings. (United States)

    Davis, Shoni; Lind, Bonnie K; Sorensen, Celeste


    To investigate differences in burnout among oncology nurses by type of work setting, coping strategies, and job satisfaction. Descriptive. A metropolitan cancer center. A convenience sample of 74 oncology nurses. Participants completed a demographic data form, the Nursing Satisfaction and Retention Survey, and the Maslach Burnout Inventory. Burnout, coping strategies, job satisfaction, and oncology work setting (inpatient versus outpatient and adult versus pediatric). The participants most often used spirituality and coworker support to cope. Emotional exhaustion was lowest for youngest nurses and highest for outpatient RNs. Personal accomplishment was highest in adult settings. Job satisfaction correlated inversely with emotional exhaustion and the desire to leave oncology nursing. The findings support that the social context within the work environment may impact emotional exhaustion and depersonalization, and that demographics may be more significant in determining burnout than setting. The findings raise questions of whether demographics or setting plays a bigger role in burnout and supports organizational strategies that enhance coworker camaraderie, encourage nurses to discuss high-stress situations, and share ways to manage their emotions in oncology settings. Spirituality and coworker relationships were positive coping strategies among oncology nurses to prevent emotional exhaustion. Nurses who rely on supportive social networks as a coping mechanism have lower levels of depersonalization. Age was inversely related to emotional exhaustion.

  9. [Investigation on job stress of pediatricians and nurses working in pediatric department]. (United States)

    Yao, San-qiao; Tian, Ling; Pang, Bao-dong; Bai, Yu-ping; Fan, Xue-yun; Shen, Fu-hai; Jin, Yu-lan


    To investigate the occupational stressors and modifiers of pediatricians and nurses in order to find the measurements for control of the job stress. 427 pediatricians and nurses working in five hospitals of a city served as subjects. Of them, the staff in section of pharmacy and toll offices in each hospital mentioned above served as control group. The General Job Stress Questionnaire was used to investigate the job stress by self-assessment. The scores of job demand, job risk, drug using, daily job stress, positive feelings, patient A behavior, physical environment and feeling balance in pediatricians and nurses were higher than those of control group, but the scores of job-person conflict, environmental control, technology utility, mental health, responsibility on things were lower than those of control group (Pdepression in nurses were higher than those of pediatricians, and non-work activities, job risk and daily life stress were lower than those of doctors (Pwork job, lower job control, more job risk, job future ambiguous, poorer social support, lower job locus control and lower self-esteem. The stress degree of pediatric staff is higher than that of controls. The pediatricians have more job stress than that of nurses. The main stressors of pediatric staff are job monotony, higher job demand, more non-worker activity, lower job control, higher job risk and ambiguous job future. The main modifiers are good social support, external job locus of control and higher self-esteem.

  10. Factors That Influence Mandatory Child Abuse Reporting Attitudes of Pediatric Nurses in Korea. (United States)

    Lee, In Sook; Kim, Kyoung Ja

    This study aimed to identify knowledge of child abuse, awareness of child abuse reporting, factors that influence attitudes toward mandatory reporting, and professionalism among a sample of pediatric nurses in Korea. One hundred sixteen pediatric nurses working at two university hospitals in Korea took part in the study and completed self-administered questionnaires. The data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis. Knowledge of child abuse, awareness of child abuse reporting, and attitudes toward mandatory reporting were low. Regarding nursing professionalism, social perceptions had the lowest mean score and nursing autonomy had the highest mean score. Attitudes toward mandatory reporting significantly correlated with professionalism. In the hierarchical regression model, the influences of nursing autonomy and intentions to report child abuse on attitudes toward mandatory reporting were statistically significant (F = 2.176, p = .013), explaining 32% of the variation in attitudes toward mandatory reporting. The results of this study could be used to improve systems and policies addressing child abuse and to further develop reporting procedures for identifying children at risk of abuse, to ensure their protection as a professional responsibility.

  11. Scope of Nursing Practice in a Tertiary Pediatric Setting: Associations With Nurse and Job Characteristics and Job Satisfaction. (United States)

    Déry, Johanne; Clarke, Sean P; D'Amour, Danielle; Blais, Régis


    While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for which they are qualified. There has been limited study of enacted (actual) scope of nursing practice (ESOP) or of its impacts on nurse job outcomes, such as job satisfaction. The aim of this study is to measure ESOP, as well as its predictors and impact on job satisfaction, in a specialty university-affiliated tertiary referral center in one of the few remaining jurisdictions outside the United States that continue to educate registered nurses at multiple educational levels. This was a correlational cross-sectional design using structural equation modeling. Self-administered questionnaires were completed by 301 registered nurses holding permanent positions in specific clinical areas for 6 months or longer in a pediatric hospital in the province of Quebec, Canada. ESOP or actual scope of practice was low-on average, nurses applied the range of skills within their theoretical scopes of practice only occasionally or "less than frequently" in their daily work (3.21 out of a possible 6 points). ESOP was strongly related to decision latitude (β = 0.319; p  = .012), role ambiguity (β = 0.297; p  = .011), and role overload (β  =  0.201; p  = .012). The personal characteristics that exerted the greatest direct influence on ESOP were education level (β  =  0.128; p  = .015) and growth need strength (β  =  0.151; p  = .008). Results also showed that ESOP exerts a direct positive influence on nurses' job satisfaction (β  =  0.118; p  = .006). Structural equation modeling analyses revealed a good fit of the data to the hypothesized conceptual model (χ²/df ratio index =  1.68, root mean square error of approximation  =  0

  12. Barriers to pediatric pain management: a nursing perspective. (United States)

    Czarnecki, Michelle L; Simon, Katherine; Thompson, Jamie J; Armus, Cheryl L; Hanson, Tom C; Berg, Kristin A; Petrie, Jodie L; Xiang, Qun; Malin, Shelly


    This study describes strategies used by the Joint Clinical Practice Council of Children's Hospital of Wisconsin to identify barriers perceived as interfering with nurses' (RNs) ability to provide optimal pain management. A survey was used to ascertain how nurses described optimal pain management and how much nurses perceived potential barriers as interfering with their ability to provide that level of care. The survey, "Barriers to Optimal Pain management" (adapted from Van Hulle Vincent & Denyes, 2004), was distributed to all RNs working in all patient care settings. Two hundred seventy-two surveys were returned. The five most significant barriers identified were insufficient physician (MD) orders, insufficient MD orders before procedures, insufficient time to premedicate patients before procedures, the perception of a low priority given to pain management by medical staff, and parents' reluctance to have patients receive pain medication. Additional barriers were identified through narrative comments. Information regarding the impact of the Acute Pain Service on patient care, RNs' ability to overcome barriers, and RNs' perception of current pain management practices is included, as are several specific interventions aimed at improving or ultimately eliminating identified barriers. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  13. Pediatric nurses' beliefs and pain management practices: an intervention pilot. (United States)

    Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward


    We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample.

  14. Mapping the literature of pediatric nursing: update and implications for library services

    Directory of Open Access Journals (Sweden)

    Carol L. Watwood, MLS, MPH, AHIP


    Conclusions: Compared with the 2006 study, the list of top-cited journals referenced by pediatric nursing researchers has remained relatively stable, but the number of cited journal titles has increased. Book citations have declined, and Internet and government document references have increased. These findings suggest that librarians should retain subscriptions to frequently cited journal titles, provide efficient document delivery of articles from infrequently used journals, deemphasize but not eliminate books, and connect patrons with useful open-access Internet resources.

  15. Perceptions of stress, burnout, and support systems in pediatric bone marrow transplantation nursing. (United States)

    Gallagher, Regan; Gormley, Denise K


    Bone marrow transplantation (BMT) is used to treat various conditions, ranging from immune disorders to many types of cancer. The critical complexity of patients and the environment in which BMT nurses work can lead to stress, burnout, and, ultimately, poor retention. This study aimed to investigate nurses' perceptions of work-related stress and burnout as well as current support systems for nurses. The study included 30 BMT staff nurses from a large pediatric medical center in the midwestern United States. Critical illness or acuity of patients was reported as the most stressful factor; long work hours was the least stressful factor. Most nurses perceived moderate to high levels of emotional exhaustion, and 33% reported moderate levels of depersonalization. Fifty percent perceived high levels of personal accomplishment, despite the critical illness or acuity of their patients, demanding patient families, rotating shifts, short staffing, and caring for dying patients. Most nurses felt that support systems were in place and that staff was accessible, but most respondents were undecided about the helpfulness of the support systems. Results suggest that support systems may significantly affect work satisfaction and feelings of accomplishment for BMT nurses.

  16. Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline. (United States)

    Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith


    In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  17. The Exploration of Culturally Sensitive Nursing Care in Pediatric Setting: a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh


    Full Text Available Background: One of the essential aspects of the provision of care is cultural issues. Cultural sensitivity is the key for cultural care. The aim of this study was to explore culturally sensitive care in pediatric nursing care in Iran.Materials and Methods: This study was a conventional content analysis. Participants were consisted of 25 nurses and 9 parents selected through purposive sampling from three pediatric referral centers in Tabriz and Tehran, Iran. Data was collected using semi-structured interviews and field notes and were concurrently analyzed by using Graneheim and Lundman (2004 method. Data was transcribed verbatim, words, sentences, and phrases were considered meaning units, abstracted, labeled and compared for developing categories.Results: Culturally sensitive care of a sick child was consisted of three themes: ‘cultural exposure’, ‘intercultural communication’ and ‘the reconciliation of cultural conflict in families/care’. During the ‘cultural exposure’ nurses were informed of the cultural manifestations, strived to identify and understand patients/families with cultural diversities and respect their cultural beliefs. The nurse used the native language in ‘intercultural communication’ or a combination of verbal and nonverbal communication methods to reach a common understanding. Finally, a nurse in the conflict between the culture of child/family and care took actions for making decisions to develop a compliance between care and the family culture and amended parents’ harmful desires through negotiation and appropriate care.Conclusion: Understanding the concept of culturally sensitive care, can help with resolving the problems of cultural exchanges in Pediatric wards. Providing cultural facilities and interpreters to communicate with patients/family increase their satisfaction.

  18. Communication in autism spectrum disorder: a guide for pediatric nurses. (United States)

    Brown, Amanda B; Elder, Jennifer H


    In the United States, one in every 68 children has autism spectrum disorder (ASD) (Centers for Disease Control and Prevention, 2014). ASD is a developmental disorder of the brain that is characterized by impairments in social interaction, communication, and repetitive patterns of behavior (American Psychiatric Association [APA], 2013). Nurses have a duty to provide high quality care to children with ASD. Effective communication is essential to providing quality care. Three main theories attempt to explain how the ASD brain functions and the implications on communication: lack of theory of mind, weak central coherence, and lack of executive function. Children with ASD have difficulties in vocalic, kinesthetic, and proxemic aspects of communication (Notbhom, 2006). Simple adaptations to environment and style can make the communication between nurses and children with ASD easier and more effective (Aylott, 2000; Green et al., 2010).

  19. Utilization of a biomedical device (VeinViewer® ) to assist with peripheral intravenous catheter (PIV) insertion for pediatric nurses. (United States)

    McNeely, Heidi L; Ream, Theresa L; Thrasher, Jodi M; Dziadkowiec, Oliwier; Callahan, Tiffany J


    Vascular access in pediatric patients can be challenging even with the currently available technological resources. This nurse-driven research study explored time, cost, and resources for intravenous access to determine if a biomedical device, VeinViewer ® Vision, would facilitate improvements in pediatric access. In addition, this study looked at nurse perceptions of skills and confidence around intravenous insertion and if the use of the VeinViewer ® impacted these perceptions. Literature examining pediatric intravenous access success rates compared with nurse perceived skills and confidence is lacking. Nonblinded randomized control trial of pediatric nurses working in an acute care hospital setting. A preliminary needs assessment solicited feedback from nurses regarding their practice, perceived skills, and confidence with placing peripheral intravenous catheters (PIVs). Due to the results of the preliminary needs assessment, a research study was designed and 40 nurses were recruited to participate. The nurses were randomized into either a VeinViewer ® or standard practice group. Nurse participants placed intravenous catheters on hospitalized pediatric patients using established procedures while tracking data for the study. Needs assessment showed a majority of nurses felt a biomedical device would be helpful in building their intravenous insertion skills and their confidence. The study results did not demonstrate any clinically significant differences between VeinViewer ® use and standard practice for intravenous catheter insertion in pediatric patients for success of placement, number of attempts, or overall cost. In addition, no difference was noted between nurses in either group on perceived skills or confidence with insertion of PIVs. The ongoing need for resources focused on building nurse skills and confidence for PIV insertion was highlighted and organizations should continue to direct efforts toward developing skills and competency for staff that


    Directory of Open Access Journals (Sweden)

    Renata Oliveira da Costa


    Full Text Available ABSTRACT: This is a historical study which focuses the scientific production on the “Child's Health” theme from Brazilian Nursing Congresses (CBEn in the 70's, highlighting official and free themes from the referred events. The objectives of the study are: Verifying the number of official and free themes presented on the CBEn and Identifying subjects related to Child's Health. It was stated that the referred theme was not very mentioned, although the XXVI CBEn, in 1975, and the XXX CBEn in 1978 presented the greatest rates, 1, 53% on official themes and 3, 08% on free themes related to the subject described. KEY WORDS: Pediatric Nursing; Congresses; Child Health.

  1. Community Palliative Care Nurses' Challenges and Coping Strategies on Delivering Home-Based Pediatric Palliative Care. (United States)

    Chong, LeeAi; Abdullah, Adina


    The aim of this study was to explore the experience of community palliative care nurses providing home care to children. A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports. These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.

  2. The practice of nurses caring for families of pediatric inpatients in light of Jean Watson

    Directory of Open Access Journals (Sweden)

    Maiara Rodrigues dos Santos


    Full Text Available Objective To know the facilities and the difficulties of nurses in caring practice of hospitalized children’s families in the light of Jean Watson’s Theory of Human Caring. Method It was used the descriptive qualitative approach. The data collection was conducted in three stages: presentation of theoretical content; engagement with families in the light of Watson’s theory; and semi-structured interview with 12 pediatric nurses. The interviews were analysed using inductive thematic analysis, being possible to form three themes: Recognizing a framework for care; Considering the institutional context; and Challenges in family’s relationship. Results The theory favored reflections about self, about the institutions and about nurses’ relationship with the family of the child, normalized by a consciousness toward caring attitudes. Conclusion In this process, it is imperative that nurses recognize the philosophical-theoretical foundations of care to attend the child’s family in hospital.

  3. Knowledge of and Attitudes Regarding Postoperative Pain among the Pediatric Cardiac Nursing Staff: An Indian Experience. (United States)

    Dongara, Ashish R; Shah, Shail N; Nimbalkar, Somashekhar M; Phatak, Ajay G; Nimbalkar, Archana S


    Pain following cardiac intervention in children is a common, but complex phenomenon. Identifying and reporting pain is the responsibility of the nursing staff, who are the primary caregivers and spend the most time with the patients. Inadequately managed pain in children may lead to multiple short- and long-term adverse effects. The aim of this cross-sectional study was to assess the knowledge and attitudes regarding postoperative pain in children among the nursing staff at B.M. Patel Cardiac Center, Karamsad, Anand, Gujarat, India. The study included 42 of the 45 nurses employed in the cardiac center. The nurses participating in the study were responsible for the care of the pediatric patients. A modified Knowledge and Attitudes Survey Regarding Pain and a sociodemographic questionnaire were administered after obtaining written informed consent. The study was approved by the institutional Human Research Ethics Committee. Mean (SD) experience in years of the nursing staff was 2.32 (1.69) years (range 1 month to 5 years). Of the nurses, 67% were posted in the cardiac surgical intensive care unit (ICU). The mean (SD) score for true/false questions was 11.48 (2.95; range 7,19). The average correct response rate of the true/false questions was 45.9%. Knowledge about pain was only affected by the ward in which the nurse was posted. In first (asymptomatic) and second (symptomatic) case scenarios, 78.6% and 59.5% underestimated pain, respectively. Knowledge and attitudes regarding pain and its management is poor among nurses. Targeted training sessions and repeated reinforcement sessions are essential for holistic patient care. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  4. Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices. (United States)

    Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E


    Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.

  5. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms. (United States)

    Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M


    The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

  6. Pediatric sexual assault nurse examiner care: trace forensic evidence, ano-genital injury, and judicial outcomes. (United States)

    Hornor, Gail; Thackeray, Jonathan; Scribano, Philip; Curran, Sherry; Benzinger, Elizabeth


    Although pediatric sexual assault nurse examiners (P-SANEs) have been providing care for over two decades there remain major gaps in the literature describing the quality of P-SANE care and legal outcomes associated with their cases. The purpose of this study was to compare quality indicators of care in a pediatric emergency department (PED) before and after the implementation of a P-SANE program described in terms of trace forensic evidence yield, identification of perpetrator DNA, and judicial outcomes in pediatric acute sexual assault. A retrospective review of medical and legal records of all patients presenting to the PED at Nationwide Children's Hospital with concerns of acute sexual abuse/assault requiring forensic evidence collection from 1/1/04 to 12/31/07 was conducted. Detection and documentation of ano-genital injury, evaluation and documentation of pregnancy status, and testing for N. gonorrhea and C. trachomatis was significantly improved since implementation of the P-SANE Program compared to the historical control. The addition of a P-SANE to the emergency department (ED) provider team improved the quality of care to child/adolescent victims of acute sexual abuse/assault. © 2012 International Association of Forensic Nurses.

  7. Factors associated with depression in pediatric cancer patients, and participation of nursing in its detection

    Directory of Open Access Journals (Sweden)

    Sandra Velásquez-Silva


    Full Text Available The objective of this work is to describe what are the factors associated with depression in pediatric patients with cancer and how nurses can participate in its detection. We conducted an integrative review of articles published between 2000 and 2012. Fifteen articles were selected and then critically analyzed and organized by subjects according to their purpose. Among factors associated with depression are the following: personal factors: adaptability, developmental level and physical functioning, cognitive and emotional level, gender, form of coping and psychological reactions, self-esteem, appearance and body image and changes in lifestyle; family and social factors: family support and social support; factors related to the disease and treatment: hospitalization, medical and nursing procedures, insulation, stage of cancer disease, side effects of chemotherapy, quality of care and non-opportune identification of psychological disorders. We concluded that there are personal and family and disease and treatment factors that are constituted as predictors and modulators of depression and are related to the risk or on set of depression in pediatric patients with cancer. Within nursing actions include the assessment of the factors, participation in interdisciplinary groups and promoting social support networks.

  8. The Cost of Caring: An Exploration of Compassion Fatigue, Compassion Satisfaction, and Job Satisfaction in Pediatric Nurses. (United States)

    Roney, Linda Nancy; Acri, Mary C

    The purpose of this study was to describe levels of compassion satisfaction, compassion fatigue, and job satisfaction among pediatric nurses in the United States and determine if there was a relationship among these constructs. All members Society of Pediatric Nurses were sent an electronic invitation to participate, and those who consented received three measures; a demographic questionnaire, the Job Satisfaction Survey (JSS) and the Professional Quality of Life (ProQOL) measure. Three hundred eighteen (10.6%) of members of the Society of Pediatric Nurses participated in the study: Over three quarters (245, 76%) of the sample had another career before nursing. The sample's mean job satisfaction level was 149.8 (SD=29.74), which was significantly higher than published reported means for nurses. Bivariate analyses revealed a significant relationship between gender and the compassion satisfaction, in that women were more likely to evidence compassion satisfaction than men (t=1.967, p=.05, df=298). No other significant relationships were found. The majority of nurses had high levels of compassion satisfaction and job satisfaction; further, female gender was associated with higher levels of compassion satisfaction. This current study had a very high response from second-career nurses (n=245, 76.8%) and overall, the sample had higher levels of compassion satisfaction. It is possible that second career nurses are better equipped in some way that helps them mediate negative responses of caring as a pediatric nurse and future research should explore this. Due to the significant financial costs to institutions of having nurses who have low levels of job satisfaction and high levels on compassion fatigue, it is imperative for hospital administrators to develop infrastructures to support employees. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Web-Based Evidence Based Practice Educational Intervention to Improve EBP Competence among BSN-Prepared Pediatric Bedside Nurses: A Mixed Methods Pilot Study (United States)

    Laibhen-Parkes, Natasha


    For pediatric nurses, their competence in EBP is critical for providing high-quality care and maximizing patient outcomes. The purpose of this pilot study was to assess and refine a Web-based EBP educational intervention focused on improving EBP beliefs and competence in BSN-prepared pediatric bedside nurses, and to examine the feasibility,…

  10. Quality Improvement Initiative on Pain Knowledge, Assessment, and Documentation Skills of Pediatric Nurses. (United States)

    Margonary, Heather; Hannan, Margaret S; Schlenk, Elizabeth A


    Pain treatment begins with a nurse’s assessment, which relies on effective assessment skills. Hospital settings have implemented pain assessment education, but there is limited evidence in pediatric transitional care settings. The purpose of this quality improvement (QI) initiative was to develop, implement, and evaluate an evidence-based pain education session with 20 nurses in a pediatric specialty hospital that provides transitional care. Specific aims were to assess nurses’ knowledge and attitudes of pain, and evaluate assessment skills based on nurses’ documentation. A prospective pre-post design with three assessments (baseline, post-intervention, and one-month follow-up) was used. The Shriner’s Pediatric Nurses’ Knowledge and Attitudes Regarding Pain questionnaire and an electronic health record review were completed at each assessment. There was significant improvement in nurses’ knowledge and attitudes of pain after the education session (F[2,6] = 50.281, p nurses significantly increased from 43.1% at baseline to 64.8% at post-intervention, and 67.7% at follow-up (χ²[2] = 20.55, p Nursing interventions for pain increased significantly, from 33.3% at baseline to 84.0% at post-intervention, and stabilized at 80.0% at follow-up (χ²[2] = 8.91, p = 0.012). Frequency of pain reassessments did not show a statistically significant change, decreasing from 77.8% at baseline to 44.0% at post-intervention and 40.0% at follow-up (χ²[2]= 3.538, p = 0.171). Nurses’ pain knowledge and documentation of assessment skills were improved in this QI initiative.

  11. Enhancing Pediatric Asthma Care and Nursing Education Through an Academic Practice Partnership. (United States)

    McClure, Natasha; Lutenbacher, Melanie; O'Kelley, Ellen; Dietrich, Mary S

    Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Assessment of knowledge of pediatric nurses related with drug administration and preparation. (United States)

    Bülbül, Ali; Kunt, Ayşe; Selalmaz, Melek; Sözeri, Şehrinaz; Uslu, Sinan; Nuhoğlu, Asiye


    Aim of this study is to determine the levels of knowledge related with drug administration and drug administration errors of nurses who care for pediatric patients. The study data were obtained from the nurses who were working in the departments of pediatrics in two education and research hospitals in the province of İstanbul and who accepted to participate in the study. The questionnaire form of the study was established by the investigators in accordance with the experiences and literature information. A total of 31 questions related with drug preparation, calculation and administration together with the general working properties of the individual were filled out by face to face interview. The data were evaluated using percent and chi-square tests. The study was initiated after ethics committee approval was obtained from Şişli Hamidiye Etfal Education and Research Hospital (365/2013). The study was conducted with 98 nurses who accepted the questionnaire. The education levels of the participants were as follows: undergraduate (48%), high school (32.7%), associate degree (12.2%), master's degree (6.1%) and postgraduate (1%). It was found that 88.8% of the participants worked in a patient-centered fashion and 11.2% worked in a work-centered fashion. The frequency of interruption/distraction during preparation of treatment was found to be 92.9%. It was found that the frequency of checking by two people during preparation or administration of high risk drugs was 64.3% and the conditions under which drugs should be kept were found to known correctly with a rate of 76.5%. It was found that undergraduate healthcare workers were more successful in converting units (p= 0.000). It was found that powder weight of drugs was considered with a rate of 85.7% in calculation. Conclusively, it was found that nurses who worked in pediatric wards did not receive a standard education in terms of drug administration and preparation. It was found that undergraduate nurses were more

  13. Assertion Practices and Beliefs Among Nurses and Physicians on an Inpatient Pediatric Medical Unit. (United States)

    Reese, Jennifer; Simmons, Ryan; Barnard, Juliana


    Teamwork and communication are critical elements of safe and effective patient care. Standardized communication tools have been implemented in many health care organizations, but little is known about attitudes and perceptions of assertion, the willingness to "speak up," by nurses and physicians at an academic pediatric institution. We conducted 6 focus groups with nurses, residents, and attending physicians using a standardized semistructured focus group guide to promote discussion. Focus groups were recorded and transcribed, and results were analyzed by 2 independent reviewers to identify thematic content. Three themes emerged: (1) interpersonal factors, (2) organizational factors, and (3) complexity of care environment. Subthemes were the roles of hierarchy, relationships, and communication and personality style; the value of using standardized communication tools such as SBAR (Situation, Background, Assessment, Recommendation), direct face-to-face communication, and geographic and technology factors; and the need for coordinated communication and agreement across care team members about the care plans. Nurses reported reliance on peers for decision-making, on when and how to assert on behalf of patient care. Nurses and residents experienced barriers to assertion from concerns of relationships and their position within professional hierarchies. Attending physicians were supportive of being asserted to by any care team provider. Interpersonal relationships, power dynamics, and organizational factors impact care team providers' willingness to assert in the inpatient setting. Standardized communication tools are effective. Further development and implementation of communication models that support experience, peer reliance, and direct face-to-face communication are warranted to improve assertion communication in the inpatient setting

  14. Supporting in grief and burnout of the nursing team from pediatric units in Chilean hospitals. (United States)

    Vega, Paula Vega; Rodriguez, Rina González; Galdamez, Natalie Santibáñez; Molina, Camila Ferrada; Orellana, Javiera Spicto; Villanueva, Antonia Sateler; Melo, Jose Bustos


    Objective To know the levels of Burnout Syndrome and perception of grief support in nursing teams of oncology and pediatric intensive care in public hospitals in Chile. Method A study of descriptive cross-sectional design. The Maslach Burnout Inventory and the Grief Support Health Care Scale were applied to university-level and technical nursing professionals between March and November 2015. An analysis to compare the means was performed with use of the Student's t-test, and the level of significance was set at 5%. Results The study included 153 professionals. Results show 4% of professionals have Burnout Syndrome (BS) and 89% are at risk of having it. Oncology professionals are at higher risk as they present higher levels of emotional exhaustion and lower levels of personal fulfillment. Half of professionals have a high level of perception of grief support, which is greater in the oncology team. Conclusion Professionals working in pediatric oncology units are at increased risk of Burnout Syndrome and grief support may be a mediating factor in this process.

  15. Child Maltreatment Screening and Anticipatory Guidance: A Description of Pediatric Nurse Practitioner Practice Behaviors. (United States)

    Hornor, Gail; Bretl, Deborah; Chapman, Evelyn; Herendeen, Pamela; Mitchel, Nancy; Mulvaney, Barbara; Quinones, Saribel Garcia; VanGraafeiland, Brigit

    Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors. The Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment. The content of the survey was derived from key characteristics from the evidence on child maltreatment. The survey was emailed to the more than 8500 NAPNAP members. Two hundred forty-three PNPs responded to the survey, which represents a response rate of 3%. Approximately half of the participants (n = 121; 51%) stated that they never/rarely ask parents questions about domestic violence, more than one-fourth (n = 71; 30%) reported that they never/rarely ask parents questions about discipline, and half of the responding PNPs (n = 120; 50%) reported that they perform an ano-genital exam at well visits. This study demonstrates that a significant number of PNPs do not routinely screen for child maltreatment and psychosocial risk factors. This is especially true in regards to sexual abuse screening and anticipatory guidance. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Actual implementation of sick children's rights in Italian pediatric units: a descriptive study based on nurses' perceptions. (United States)

    Bisogni, Sofia; Aringhieri, Corinna; McGreevy, Kathleen; Olivini, Nicole; Lopez, José Rafael Gonzalez; Ciofi, Daniele; Merlo, Alberta Marino; Mariotti, Paola; Festini, Filippo


    Several charters of rights have been issued in Europe to solemnly proclaim the rights of children during their hospital stay. However, notwithstanding such general declarations, the actual implementation of hospitalized children's rights is unclear. The purpose of this study was to understand to which extent such rights, as established by the two main existing charters of rights, are actually implemented and respected in Italian pediatric hospitals and the pediatric units of Italian general hospitals, as perceived by the nurses working in them. Cross-sectional study. A 12-item online questionnaire was set up and an invitation was sent by email to Italian pediatric nurses using professional mailing lists and social networks. Responders were asked to score to what extent each right is respected in their hospital using a numeric scale from 1 (never) to 5 (always). 536 questionnaires were returned. The best implemented right is the right of children to have their mothers with them (mean score 4.47). The least respected one is the right of children to express their opinion about care (mean 3.01). Other rights considered were the right to play (4.29), the right to be informed (3.95), the right to the respect of privacy (3.75), the right to be hospitalized with peers (3.39), the right not to experience pain ever (3.41), and the right to school (3.07). According to the majority of nurses, the most important is the right to pain relief. Significant differences in the implementation of rights were found between areas of Italy and between pediatric hospitals and pediatric units of general hospitals. According to the perception of pediatric nurses, the implementation of the rights of hospitalized children in Italian pediatrics units is still limited.

  17. The culture of patient safety from the perspective of the pediatric emergency nursing team. (United States)

    Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri


    To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento

  18. Pediatric novice nurses: examining compassion fatigue as a mediator between stress exposure and compassion satisfaction, burnout, and job satisfaction. (United States)

    Meyer, Rika M L; Li, Angela; Klaristenfeld, Jessica; Gold, Jeffrey I


    We investigated whether compassion fatigue mediated associations between nurse stress exposure and job satisfaction, compassion satisfaction, and burnout, controlling for pre-existing stress. The Life Events Checklist was administered to 251 novice pediatric nurses at the start of the nurse residency program (baseline) and 3 months after to assess pre-existing and current stress exposure. Compassion satisfaction, compassion fatigue, and burnout were assessed 3 months after baseline and job satisfaction 6 months after. Stress exposure significantly predicted lower compassion satisfaction and more burnout. Compassion fatigue partially mediated these associations. Results demonstrate a need for hospitals to prevent compassion fatigue in healthcare providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. The health care team. The role of pediatric nurse practitioners as viewed by California pediatricians. (United States)

    Schoen, E J; Erickson, R J; Barr, G; Allen, H


    A single-mailing questionnaire surveyed attitudes of members of District IX, American Academy of Pediatrics (California) toward the role of the pediatric nurse practitioner (pnp). Responses from 568 members (53%) represented a broad range of age, practice type (58% group, 25% solo, 17% "other"), geographic location, and opinion. The most favorable attitudes toward pnp use were expressed by young pediatricians in large-group and "other" categories; least favorable were solo practitioners older than 60 years. Practice type was more important than age. Most respondents expressed the opinion that a pediatrician-pnp team approach would enrich both professions, and that parental acceptance of the pnp was likely; but that pnp use would not reduce costs. Majorities favored the concept of the pnp as part of the practice team but under constant pediatrician surveillance: seeing the patient for part of the visit and participating under supervision in care for minor illness, but not replacing the pediatrician even in well-child care. Some pnps hope for a more independent role on the pediatrician-pnp team. Modification of both pediatrician and pnp ideas appears requisite to a team approach that will satisfy both professional groups and the public.

  20. High-Fidelity Simulation of Pediatric Emergency Care: An Eye-Opening Experience for Baccalaureate Nursing Students. (United States)

    Small, Sandra P; Colbourne, Peggy A; Murray, Cynthia L


    Background Little attention has been given to in-depth examination of what high-fidelity simulation is like for nursing students within the context of a pediatric emergency, such as a cardiopulmonary arrest. It is possible that such high-fidelity simulation could provoke in nursing students intense psychological reactions. Purpose The purpose of this study was to learn about baccalaureate nursing students' lived experience of high-fidelity simulation of pediatric cardiopulmonary arrest. Method Phenomenological methods were used. Twenty-four interviews were conducted with 12 students and were analyzed for themes. Results The essence of the experience is that it was eye-opening. The students found the simulation to be a surprisingly realistic nursing experience as reflected in their perceiving the manikin as a real patient, thinking that they were saving their patient's life, feeling like a real nurse, and feeling relief after mounting stress. It was a surprisingly valuable learning experience in that the students had an increased awareness of the art and science of nursing and increased understanding of the importance of teamwork and were feeling more prepared for clinical practice and wanting more simulation experiences. Conclusion Educators should capitalize on the benefits of high-fidelity simulation as a pedagogy, while endeavoring to provide psychologically safe learning.

  1. Pediatrics (United States)

    Spackman, T. J.


    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  2. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone


    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  3. Hydroxyurea in Pediatric Patients With Sickle Cell Disease: What Nurses Need to Know. (United States)

    Rees, Allison L


    Sickle cell disease (SCD) is an inherited disorder in which sickled red blood cells occlude the small vessels of the body, reducing oxygen delivery to tissues and ultimately negatively affecting many of the body's major organs. Hydroxyurea has proven beneficial in the treatment of SCD and prevention of disease-related complications. The 2014 guidelines put forth by the National Heart, Lung, and Blood Institute recommend hydroxyurea treatment in infants 9 months and older, children, and adolescents with SCD-SS or SCD-Sβ(0) thalassemia regardless of clinical severity. This is a change from the 2002 guidelines in which hydroxyurea was recommended for adolescents and children with SCD-SS or SCD-Sβ(0) thalassemia with frequent episodes of pain, a history of acute chest syndrome, severe and symptomatic anemia or other severe vaso-occlusive events. Nurses play a critical role in working with patients and families to provide education, guidance, and support to improve compliance to mitigate the long-term effects of SCD. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  4. [The development of a Nursing Research Agenda for Pediatrics for the years 2007 to 2017 as an integrative part of the national "Swiss Research Agenda"-project]. (United States)

    Cignacco, Eva


    In the German-speaking part of Europe research in the pediatric field has been dominated by research with a biomedical focus. Nursing research investigating and evaluating the treatment and care process in the pediatric field has been marginal and, in the last decades, provided little evidence to enhance the development of specific criteria for nursing sensitive outcomes in this patient population. This fact is all the more problematic as the linear transfer of evidence from nursing research in the adult care setting is not feasible, i.e. the pediatric population has unique needs which are different from those of adults. Given that 22% of the Swiss population are children and adolescents up to 19 years, there is an urgent need for developing interdisciplinary nursing research projects in order to promote research which is oriented towards a bio-psychosocial model. Such research will provide the evidence needed to enhance the general well-being of children and adolescents with acute and chronic diseases as well as the well-being of their parents. To date, there has been no nursing research agenda based on the literature and on expert opinion in the pediatric field in Switzerland. This report aims to bridge this gap: it presents suggestions for a nursing research agenda in the pediatric field for the time from 2007 to 2017. Three research priorities emerged from the development process of the present agenda: 1) Evaluation of the effectiveness of nursing interventions, 2) Conceptualization and evaluation of practical impacts of family systems on the treatment process of children, 3) Research-based development of new nursing care services in a changing health care system. This report was developed in the context of the national project, "Swiss Research Agenda for Nursing". The presented agenda can be used as a basis for discussions on the strategic direction and for the development of an action plan to promote nursing research in the pediatric field in Switzerland.

  5. Role of the pediatric nurse practitioner in promoting breastfeeding for late preterm infants in primary care settings. (United States)

    Ahmed, Azza H


    The preterm birth rate has been increasing steadily during the past two decades. Up to two thirds of this increase has been attributed to the increasing rate of late preterm births (34 to stamina; difficulty with latch, suck, and swallow; temperature instability; increased vulnerability to infection; hyperbilirubinemia, and more respiratory problems than the full-term infant. Late preterm infants usually are treated as full term and discharged within 48 hours of birth, so pediatric nurse practitioners in primary care settings play a critical role in promoting breastfeeding through early assessment and detection of breastfeeding difficulties and by providing anticipatory guidance related to breastfeeding and follow-up. The purpose of this article is to describe the developmental and physiologic immaturity of late preterm infants and to highlight the role of pediatric nurse practitioners in primary care settings in supporting and promoting breastfeeding for late preterm infants.

  6. Parents' Perception of Satisfaction With Pediatric Nurse Practitioners' Care And Parental Intent to Adhere To Recommended Health Care Regimen. (United States)

    Kinder, Frances DiAnna


    The purposes of this study were to explore parents' perceptions of satisfaction with care from primary care pediatric nurse practitioners (PNPs) and to explore the relationships of the four components of parental satisfaction with parents' intent to adhere to recommended health care regimen. The study used a descriptive correlational research design. A convenience sample of 91 participants was recruited from practices in southeastern Pennsylvania. The 28-item, Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners (PPSC-PNP) tool was developed to measure four components of satisfaction and overall satisfaction of parents with PNP care after the health visit. A 100 mm visual analog (VAS) scale measured parental intent to adhere to the care regimen recommended by the PNP. Parents' perceptions of overall satisfaction with care from PNPs and satisfaction with each of the four components (communication, clinical competence, caring behavior, and decisional control) were high as measured by the PPSC-PNP. Multiple regression analysis revealed that clinical competence had the strongest positive relationship with parental intent to adhere to PNP recommended health regimen and was the only variable to enter the regression equation. The findings of this study have implications for nursing practice. The PPSC-PNP instrument may be used with a variety of pediatric populations and settings as a benchmark for quality care. Clinical competence is important for the role of the PNP. Other variables of parental intent to adhere to the health regimen should be explored in future studies.

  7. Knowledge and Skill Retention of In-Service versus Preservice Nursing Professionals following an Informal Training Program in Pediatric Cardiopulmonary Resuscitation: A Repeated-Measures Quasiexperimental Study

    Directory of Open Access Journals (Sweden)

    Jhuma Sankar


    Full Text Available Our objective was to compare the impact of a training program in pediatric cardiopulmonary resuscitation (CPR on the knowledge and skills of in-service and preservice nurses at prespecified time points. This repeated-measures quasiexperimental study was conducted in the pediatric emergency and ICU of a tertiary care teaching hospital between January and March 2011. We assessed the baseline knowledge and skills of nursing staff (in-service nurses and final year undergraduate nursing students (preservice nurses using a validated questionnaire and a skill checklist, respectively. The participants were then trained on pediatric CPR using standard guidelines. The knowledge and skills were reassessed immediately after training and at 6 weeks after training. A total of 74 participants—28 in-service and 46 preservice professionals—were enrolled. At initial assessment, in-service nurses were found to have insignificant higher mean knowledge scores (6.6 versus 5.8, P=0.08 while the preservice nurses had significantly higher skill scores (6.5 versus 3.2, P<0.001. Immediately after training, the scores improved in both groups. At 6 weeks however, we observed a nonuniform decline in performance in both groups—in-service nurses performing better in knowledge test (10.5 versus 9.1, P=0.01 and the preservice nurses performing better in skill test (9.8 versus 7.4, P<0.001. Thus, knowledge and skills of in-service and preservice nurses in pediatric CPR improved with training. In comparison to preservice nurses, the in-service nurses seemed to retain knowledge better with time than skills.

  8. Sleep, quality of life and mood of nursing professionals of pediatric intensive care units

    Directory of Open Access Journals (Sweden)

    Priscilla Caetano Guerra


    Full Text Available Abstract OBJECTIVE To assess sleep, quality of life and mood of nursing professionals of pediatric intensive care units. METHOD Quantitative, cross-sectional and descriptive study. Professionals grouped by morning, afternoon and evening shifts were assessed by means of the instruments: Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Generic questionnaire for the assessment of quality of life (SF-36; Beck Depression Inventory; Beck Anxiety Inventory; State-Trait Anxiety Inventory. RESULTS Sample consisted of 168 professionals, with prevalence of neutral typology (57.49%. There was no statistical significance regarding sleep, despite scores showing a poor quality of sleep and excessive daytime sleepiness for the three shifts. Quality of life did not reveal any statistical significance, but in the field "social role functioning" of the evening shift, a lower score was observed (p<0.007. There was no statistical significance regarding levels of anxiety and depression. CONCLUSION The results suggest that these professionals may present sleeping problems, but they do not have lower scores of quality of life or mood disorders. Likely explanations for these findings may include an adaptation to their work type over time and the fact that working with children is rewarding.

  9. [Fear of child/family in pediatric intensive care units: what is the nurse's role?]. (United States)

    Machado, Cidália; Sousa, Pedro Jácome


    The fear is considered a negative emotion, lived with apprehension, uncertainty and a sense of threat or danger to the personal integrity (Torres & Guerra, 2003). It is often associated with hospitalization of the chid/family, and may be the cause to start an emotional crisis due to the separation from environment and the usual routines, the loss of independence and autonomy, and also due to be with strange people (Bicho, 2006; Festas 1994; Freitas &Freitas, 2005; Hockenberry, 2006). Hospitalization in a Pediatric Intensive Care Unit (PICU) may worsen an already existing crisis not only for the given reasons but also because the child may be in life danger. The environment "aggressive"and stressant characteristic of these units also contributes to this situation. To minimize the fear and his negative effects, the nurse has an important role to play. Because of his/her activities and function he/she is the closest health care professional to the child/family, and therefore in a better position to establish a relationship of trust and empathy that will minimize such effects, as well as to the interventions best suited to achieve this objective.

  10. Parental Evaluation of a Nurse Practitioner-Developed Pediatric Neurosurgery Website. (United States)

    Vogel, Tina Kovacs; Kleib, Manal; Davidson, Sandra J; Scott, Shannon D


    Parents often turn to the Internet to seek health information about their child's diagnosis and condition. Information, support, and resources regarding pediatric neurosurgery are scarce, hard to find, and difficult to comprehend. To address this gap, a pediatric nurse practitioner designed a website called the Neurosurgery Kids Fund (NKF). Analyzing the legitimacy of the NKF website for parents seeking health information and fulfilling their social and resource needs is critical to the website's future development and success. To explore parental usage of the NKF website, track visitor behavior, evaluate usability and design, establish ways to improve user experience, and identify ways to redesign the website. The aim of this study was to assess and evaluate whether a custom-designed health website could meet parents' health information, support, and resource needs. A multimethod approach was used. Google Analytic usage reports were collected and analyzed for the period of April 23, 2013, to November 30, 2013. Fifty-two online questionnaires that targeted the website's usability were collected between June 18, 2014, and July 30, 2014. Finally, a focus group was conducted on August 20, 2014, to explore parents' perceptions and user experiences. Findings were analyzed using an inductive content analysis approach. There were a total of 2998 sessions and 8818 page views, with 2.94 pages viewed per session, a 56.20% bounce rate, an average session duration of 2 minutes 24 seconds, and a 56.24% new sessions rate. Results from 52 eligible surveys included that the majority of NKF users were Caucasian (90%), females (92%), aged 36-45 years (48%), with a university or college degree or diploma (69%). Half plan to use the health information. Over half reported turning to the Internet for health information and spending 2 to 4 hours a day online. The most common reasons for using the NKF website were to (1) gather information about the 2 summer camps, (2) explore the Media

  11. Nurses' perceptions, acceptance, and use of a novel in-room pediatric ICU technology: testing an expanded technology acceptance model. (United States)

    Holden, Richard J; Asan, Onur; Wozniak, Erica M; Flynn, Kathryn E; Scanlon, Matthew C


    The value of health information technology (IT) ultimately depends on end users accepting and appropriately using it for patient care. This study examined pediatric intensive care unit nurses' perceptions, acceptance, and use of a novel health IT, the Large Customizable Interactive Monitor. An expanded technology acceptance model was tested by applying stepwise linear regression to data from a standardized survey of 167 nurses. Nurses reported low-moderate ratings of the novel IT's ease of use and low to very low ratings of usefulness, social influence, and training. Perceived ease of use, usefulness for patient/family involvement, and usefulness for care delivery were associated with system satisfaction (R 2  = 70%). Perceived usefulness for care delivery and patient/family social influence were associated with intention to use the system (R 2  = 65%). Satisfaction and intention were associated with actual system use (R 2  = 51%). The findings have implications for research, design, implementation, and policies for nursing informatics, particularly novel nursing IT. Several changes are recommended to improve the design and implementation of the studied IT.

  12. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology. (United States)

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha


    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at .

  13. Aerozoloterapia w praktyce zawodowej pielęgniarki pediatrycznej = Aerosolotherapy in professional practice pediatric nurse

    Directory of Open Access Journals (Sweden)

    Bogumiła Małecka


    any contribution of respiratory function of stress in the inspiration phase and is therefore widely used in pediatrics. The aim of the article is to present the proper techniques of nebulization. Lack of knowledge regarding nebulization techniques among both parents and medical personnel leads to errors that affect the therapeutic process. Widely understood development of medical science enforces continuous education not only health care workers, but as well   patients and their careers. Medication administration using aerosol therapy is complex and absolutely requires close cooperation between the child, parents and device based on detailed knowledge of the proper techniques of surgery.   Key words: nebulization, children, pediatric nurse, family.

  14. Sleep, quality of life and mood of nursing professionals of pediatric intensive care units. (United States)

    Guerra, Priscilla Caetano; Oliveira, Nilton Ferraro; Terreri, Maria Teresa de Sande E Lemos Ramos Ascensão; Len, Claudio Arnaldo


    To assess sleep, quality of life and mood of nursing professionals of pediatric intensive care units. Quantitative, cross-sectional and descriptive study. Professionals grouped by morning, afternoon and evening shifts were assessed by means of the instruments: Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Generic questionnaire for the assessment of quality of life (SF-36); Beck Depression Inventory; Beck Anxiety Inventory; State-Trait Anxiety Inventory. Sample consisted of 168 professionals, with prevalence of neutral typology (57.49%). There was no statistical significance regarding sleep, despite scores showing a poor quality of sleep and excessive daytime sleepiness for the three shifts. Quality of life did not reveal any statistical significance, but in the field "social role functioning" of the evening shift, a lower score was observed (pde vida e humor em profissionais de enfermagem em Unidades de Terapia Intensiva Infantil. Estudo quantitativo, transversal e descritivo. Profissionais agrupados por turnos matutino, vespertino e noturno foram avaliados pelos instrumentos: Questionário de identificação Matutinidade-Vespertinidade; Índice de qualidade do sono de Pittsburgh; Escala de sonolência Epworth; Questionário genérico de avaliação de qualidade de vida - SF-36; Inventário de depressão de Beck; Inventário de ansiedade de Beck; Inventário de ansiedade Traço-Estado. Amostra composta por 168 profissionais, predominando tipologia neutra, 57,49%. Não houve significância estatística quanto ao sono, apesar dos escores mostrarem qualidade ruim e sonolência diurna excessiva para os três turnos. A qualidade de vida não denotou diferença estatística, mas no domínio "aspecto social" do turno noturno, observou-se escore pior (pde ansiedade e depressão. Os resultados sugerem que estes profissionais podem apresentar problemas no sono, entretanto não apresentam escores mais baixos de qualidade de

  15. [Development and Evaluation of a Self-Reflection Program for Intensive Care Unit Nurses Who Have Experienced the Death of Pediatric Patients]. (United States)

    Kang, Hyun Ju; Bang, Kyung Sook


    This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis. The quantitative results showed that changes in personal growth (t=-6.33, pself-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses. © 2017 Korean Society of Nursing Science

  16. A comparison of pediatric basic life support self-led and instructor-led training among nurses. (United States)

    Vestergaard, Lone D; Løfgren, Bo; Jessen, Casper L; Petersen, Christina B; Wolff, Anne; Nielsen, Henrik V; Krarup, Niels H V


    Pediatric cardiac arrest carries a poor prognosis. Basic life support improves survival. Studies on pediatric basic life support (PBLS) training are sparse. The aim of our study was to investigate the effect of self-training in PBLS. We conducted a prospective controlled trial enrolling nurses from pediatric and maternity wards (n=29 in each group). Self-training, including a manikin and access to a web-based video on PBLS, was compared with a 2-h instructor-led course. Two weeks after training, all participants were tested in a mock scenario of pediatric cardiac arrest. Fifteen parameters equivalent to the steps in the PBLS algorithm - for example, effective ventilations, effective chest compressions, calling for help, and correct sequence of actions, were evaluated and rated dichotomously (1=approved or 0=not approved). No difference was observed in the baseline demographics between the self-training group and the instructor-led group. The participants in the self-training group accessed the website 2±1.5 times (mean±SD) and spent 41±25 min on the site. There was no significant difference between the two groups in the overall average score (10.5 in the self-training group vs. 10.0 in the instructor-led group, P=0.51) or in any of the 15 parameters. After the study, all participants felt that they had improved their skills and felt capable of performing PBLS. Self-training is not statistically different to instructor-led training in teaching PBLS. Self-evaluated confidence improved, but showed no difference between groups. PBLS may be disseminated through self-training.

  17. Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care. (United States)

    Lindley, Lisa C; Cozad, Melanie J


    To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = -.041, P < .05) and rural areas (β = -.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05). The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.

  18. Pressure Ulcer Risk and Prevention Practices in Pediatric Patients: A Secondary Analysis of Data from the National Database of Nursing Quality Indicators®. (United States)

    Razmus, Ivy; Bergquist-Beringer, Sandra


    Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status. Extracted data on pressure ulcer prevention included skin assessment, pressure-redistribution surface use, routine repositioning, nutritional support, and moisture management. These data were organized by unit type and merged with data on hospital characteristics for the analysis. The sample included 39 984 patients ages 1 day to 18 years on 678 pediatric acute care units (general pediatrics, pediatric critical care units, neonatal intensive care units, pediatric step-down units, and pediatric rehabilitation units). Descriptive statistics were used to analyze study data. Most of the pediatric patients (33 644; 89.2%) were assessed for pressure ulcer risk within 24 hours of admission. The Braden Q Scale was frequently used to assess risk on general pediatrics units (75.4%), pediatric step-down units (85.5%), pediatric critical care units (81.3%), and pediatric rehabilitation units (56.1%). In the neonatal intensive care units, another scale or method was used more often (55% to 60%) to assess pressure ulcer risk. Of the 11 203 pediatric patients (39%) determined to be at risk for pressure ulcers, the majority (10 741, 95.8%) received some kind of pressure ulcer prevention intervention during the 24 hours preceding the NDNQI pressure ulcer survey. The frequency

  19. Advocating for Continuing Nursing Education in a Pediatric Hospital: The Prince Scholar and Sabbatical Programs. (United States)

    Sperhac, Arlene M.; Goodwin, Laura D.


    A 5-year evaluation revealed positive outcomes of two nursing continuing education programs: a sabbatical program providing funding for completion of education/research projects and a nursing scholar program funding professional development. Knowledge and skills increased and the hospital practice environment was improved. (SK)

  20. Impact of an infection-control program on nurses' knowledge and attitude in pediatric intensive care units at Cairo University hospitals. (United States)

    Galal, Yasmine S; Labib, John R; Abouelhamd, Walaa A


    Healthcare-associated infection is a prominent problem among patients in pediatric intensive care units (PICU) as it could result in significant morbidity, prolonged hospitalization, and increase in medical care costs. The role of nurses is extremely important in preventing hazards and sequela of healthcare-associated infections. The aim of this study was to assess the effect of a health education program regarding infection-control measures on nurses' knowledge and attitude in PICUs at Cairo University hospitals. This was a pre-post test interventional study in which a convenient sample of 125 nurses was taken from the nursing staff in different PICUs at Cairo University hospitals. The study took place in three phases. In the first phase, the nursing staff's knowledge, attitude and practice concerning infection-control measures were tested using a self-administered pretested questionnaire and an observation checklist. The second phase included health education sessions in the form of powerpoint and video presentations; and in the third phase the nurses' knowledge and attitude on infection-control measures were reassessed. A significantly higher level of knowledge was revealed in the postintervention phase as compared with the preintervention phase with regards to the types of nosocomial infections (94.4 vs. 76.8%, Pcontrol nosocomial infections (89.6 vs. 68%, Pcontrol measures could protect them completely from acquiring infection (79.2 vs. 65.6%, P=0.033). Statistically significant higher total knowledge and attitude scores were revealed in the postintervention phase as compared with the preintervention one (PHospital (88%), whereas it was the lowest in the emergency pediatric unit (65%). There is scope for improvement in knowledge and attitude after educational program was offered to the nursing staff. Educational training programs should be multidisciplinary interventions in the era of quality control to help healthcare workers realize the importance of basic

  1. Nursing Students' Perceptions of the Educational Learning Environment in Pediatric and Maternity Courses Using DREEM Questionnaire (United States)

    Abusaad, Fawzia El Sayed; Mohamed, Hanan El-Sayed; El-Gilany, Abdel-Hady


    Background: Educational surroundings is one of the most vital factors in figuring out the fulfillment of an powerful curriculum and gaining of knowledge. Aim: To compare students' perceptions of the academic learning environment in Pediatric and Maternity courses using DREEM Questionnaire. Design: This is a comparative study. Subjects: Five…

  2. Using an iPad for Basic Communication Between Spanish-Speaking Families and Nurses in Pediatric Acute Care: A Feasibility Pilot Study. (United States)

    Jackson, Kylie H; Mixer, Sandra J


    The growing number of Spanish speakers in the United States poses communication challenges for healthcare providers. Language barriers in pediatric acute care have been associated with an increased risk for adverse events, longer hospital stays, and decreased quality of care. In addition, clinicians' usage of interpreter services is inconsistent. In fact, nurses often lack interpreter support during daily bedside care. Nursing staff at a pediatric children's hospital in the southeastern United States identified bedside communication with Spanish-speaking patients and families as a clinical challenge. To address this challenge, a basic communication interface, UTalk version 1.0 (the author is the owner and proprietor), supported by an Apple iPad, was developed by the researcher with input from nursing staff, a certified medical interpreter, and Spanish-speaking community members. A feasibility pilot study of the interface's usability and engagement was conducted on the hospital's pediatric medical-surgical unit through qualitative interviews with nurse-family dyads. Three themes emerged from the data: UTalk-facilitated communication, UTalk needs improvement, and interpreter miscommunication. These findings indicate that a mobile digital device interface is a feasible method for augmenting bedside communication with Spanish-speaking patients and families. These results also may serve as a reference for the development of similar mobile device interfaces. Further research with a larger sample size is needed.


    Directory of Open Access Journals (Sweden)

    Fitri Haryanti


    Full Text Available Background: Although the WHO strategy integrated management of childhood illness (IMCI for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies. Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004. Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities (nutritionist, pharmacist, laboratory in Cut Nyak Dien (CND Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis. Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up. The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster. Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a

  4. Development and Evaluation of a Continuing Education Program for Nursing Technicians at a Pediatric Cardiac Intensive Care Unit in a Developing Country. (United States)

    Borim, Bruna Cury; Croti, Ulisses A; Silveira, Patricia C; De Marchi, Carlos H; Moscardini, Airton C; Hickey, Patricia; Jenkins, Kathy


    The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care. The objective was to develop and evaluate a continuing education program for nursing technicians at a pediatric cardiac intensive care unit (PCICU) using a virtual learning environment entitled EDUCATE. From July to September 2015, a total of 24 nursing technicians working at the PCICU at a children's hospital located in the northwestern region of São Paulo state (Brazil) fully participated in the continuing education program developed in a virtual learning environment using Wix platform, allowing access to video classes and pre- and post-training theoretical evaluation questionnaires outside the work environment. The evaluation tools recorded participants' knowledge evolution, technological difficulties, educational, and overall rating. Knowledge development was descriptively presented as positive in more than 66.7%. Content and training were considered "excellent" by most participants and 90% showed an interest in the use of technological resources. Technical difficulties were found and quickly resolved by 40% of participants including Internet access, login, and lack of technical expertise. The continuing education program using a virtual learning environment positively contributed to the improvement in theoretical knowledge of nursing technicians in PCICU.

  5. Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics

    Directory of Open Access Journals (Sweden)

    Morgan C


    Full Text Available Colin Morgan,1,2 Catherine Barry,1,2 Katie Barnes2,31Liverpool Women’s Hospital, Crown Street, Liverpool, UK; 2Liverpool John Moores University, Liverpool, UK; 3Liverpool Community Health, Liverpool, UKAbstract: The advanced nurse practitioner (ANP role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master’s programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum. We explore the evidence for the importance of ANP role definition, supervision, and identity among other health professionals to secure a successful role transition. We describe how recent advances in technology can be used to innovate with new styles of teaching and learning to overcome some of the difficulties in running master’s programs for small subspecialties. We illustrate, through our own experience, how a thorough assessment of the available literature can be used to innovate and develop strategies to create an individual MSc programs that are designed to meet the needs of highly specialized advanced neonatal and pediatric nursing practice.Keywords: master’s program, advanced nurse practitioner, advanced practice, neonatal, pediatric, intensive care

  6. Applications of Midwives and Nurses Working at Pediatrics Clinics to Patients Security

    Directory of Open Access Journals (Sweden)

    Fatma Tas Arslan


    RESULT: The research 77.9% of them work as a nurse and %66.1 of them obtain information about patient security. In the applications to the patient security, and ldquo;I give the patients arm band and rdquo; constitutes 54. 1,% and ldquo;I have the concerned doctor sign the oral order form in 24 hours at the latest after it is filled and rdquo; constitutes 73.8%, and ldquo; I evaluate the patients in view of the risk of falling down and rdquo; constitutes 86.1%, and ldquo; I pay attention to asepsis in all invasive attempts and rdquo; constitutes 91% are among the regular ones. It was found out that among the nurses and midwives, 19 out of 103 made medical error during a year. CONCLUSiON: it has been achieved that nurses and midwives have different roles and pay attention to preventing the patients from falling down, providing the communication security, providing the infection security, providing the medicine security. It is thought that they should be supported in respect to identifying and confirming the patients ID [TAF Prev Med Bull 2014; 13(3.000: 209-216

  7. Strategic threat management: an exploration of nursing strategies in the pediatric intensive care unit. (United States)

    Durso, Francis T; Ferguson, Ashley N; Kazi, Sadaf; Cunningham, Charlene; Ryan, Christina


    Part of the work of a critical care nurse is to manage the threats that arise that could impede efficient and effective job performance. Nurses manage threats by employing various strategies to keep performance high and workload manageable. We investigated strategic threat management by using the Threat-Strategy Interview. Threats frequently involved technology, staff, or organizational components. The threats were managed by a toolbox of multifaceted strategies, the most frequent of which involved staff-, treatment- (patient + technology), examination- (patient + clinician), and patient-oriented strategies. The profile of strategies for a particular threat often leveraged work facets similar to the work facet that characterized the threat. In such cases, the nurse's strategy was directed at eliminating the threat (not working around it). A description at both a domain invariant level - useful for understanding strategic threat management generally - and a description at an operational, specific level - useful for guiding interventions-- are presented. A structural description of the relationship among threats, strategies, and the cues that trigger them is presented in the form of an evidence accumulation framework of strategic threat management. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  8. Nurse practitioner coverage is associated with a decrease in length of stay in a pediatric chronic ventilator dependent unit (United States)

    Rowan, Courtney M; Cristea, A Ioana; Hamilton, Jennifer C; Taylor, Nicole M; Nitu, Mara E; Ackerman, Veda L


    AIM: To hypothesize a dedicated critical care nurse practitioner (NP) is associated with a decreased length of stay (LOS) from a pediatric chronic ventilator dependent unit (PCVDU). METHODS: We retrospectively reviewed patients requiring care in the PCVDU from May 2001 through May 2011 comparing the 5 years prior to the 5 years post implementation of the critical care NP in 2005. LOS and room charges were obtained. RESULTS: The average LOS decreased from a median of 55 d [interquartile range (IQR): 9.8-108.3] to a median of 12 (IQR: 4.0-41.0) with the implementation of a dedicated critical care NP (P < 1.0001). Post implementation of a dedicated NP, a savings of 25738049 in room charges was noted over 5 years. CONCLUSION: Our data demonstrates a critical care NP coverage model in a PCVDU is associated with a significantly reduced LOS demonstrating that the NP is an efficient and likely cost-effective addition to a medically comprehensive service. PMID:27170929

  9. The Application of Multimedia Messaging Services via Mobile Phones to Support Outpatients:Home Nursing Guidance for Pediatric Intestinal Colostomy Complications

    Institute of Scientific and Technical Information of China (English)

    Qiao-Ling Yang; Qin Wei; Ying Huang; Yu-Xiu Jiang; Dai-Zhen Chen; Ping Huang; Li-Jun Liang


    Objective:To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home,to reduce colostomy complications caused by improper care,to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery.Methods:A combination of relevant clinical information,health care guidelines,and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization.A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol.During the 3 to 6 months of home care in-between the colostomy operations,the charge nurse initiated the phone follow-up and provided specific,individual guidance and feedback.If necessary,extended service at predetermined intervals was provided in the 1st week,the 1st month,the 2nd month and the 3rd month.Results:Extended assistance for the home care of patients with pediatric colostomy complications improved the quality of life of the patients and caregivers and was accepted by all parties involved upon introduction.The assistance provided support for the parents at all hours,efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergencies.Furthermore it paved the way to successful second stage surgeries,provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved.Conclusions:All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations.The response of the parents and the medical staff involved was very positive.This method is easy to use,economical to operate and could be applied

  10. The Application of Multimedia Messaging Services via Mobile Phones to Support Outpatients:Home Nursing Guidance for Pediatric Intestinal Colostomy Complications

    Institute of Scientific and Technical Information of China (English)

    Qiao-Ling Yang; Qin Wei; Ying Huang; Yu-Xiu Jiang; Dai-Zhen Chen; Ping Huang; Li-Jun Liang


    Objective: To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home, to reduce colostomy complications caused by improper care, to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery. Methods: A combination of relevant clinical information, health care guidelines, and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization. A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol. During the 3 to 6 months of home care in-between the colostomy operations, the charge nurse initiated the phone follow-up and provided specific, individual guidance and feedback. If necessary, extended serv-ice at predetermined intervals was provided in the 1st week, the 1st month, the 2nd month and the 3rd month. Results: Extended assistance for the home care of patients with pediatric colostomy complications im-proved the quality of life of the patients and caregivers and was accepted by all parties involved upon in-troduction. The assistance provided support for the parents at all hours, efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergen-cies. Furthermore it paved the way to successful second stage surgeries, provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved. Conclusions: All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations. The response of the parents and the medical staff involved was very positive. This method is easy to use, economical to

  11. Pediatric MS (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  12. Survey to child/adolescent psychiatry and developmental/behavioral pediatric training directors to expand psychiatric-mental health training to nurse practitioners. (United States)

    Schwartz, Richard H; O'Laughlen, Mary C; Kim, Joshua


    There is an ongoing shortage of child mental health professionals. Nurse practitioners (NPs) who completed behavioral and mental health training have proven that they can diagnose and manage many pediatric problems. To ask the training directors of both child/adolescent psychiatry (CAP) and developmental/behavioral pediatric (DBP) programs about their receptivity and willingness to give additional training for NPs who provide care to children with behavioral and mental health issues and examine the main obstacles to the development of such programs. A survey was sent to 151 CAP and DBP training directors in the United States. The return rate was 67% (N = 101). Only 12% expressed objection to the concept of additional NP training in CAP or DBP, but only 53% of training directors currently reported having sufficient faculty to do so. Some training directors reported already having advanced behavioral and mental health training programs for NPs (31%) and most (82%) would consider expanding, if funded. There is support for advanced training for NPs, but funding is needed to make this a reality. Expansion of such programs might rapidly improve accessibility and reduce waiting time of mental health providers for children and adolescents. ©2017 American Association of Nurse Practitioners.

  13. The influence of staff nurse perception of leadership style on satisfaction with leadership: a cross-sectional survey of pediatric nurses. (United States)

    Andrews, Diane Randall; Richard, David C S; Robinson, Patricia; Celano, Patricia; Hallaron, Jeanie


    There is evidence that transformational leadership style promotes nursing excellence. Differences in how supervisees and supervisors perceive the supervisor's leadership style may also be related to satisfaction with leadership. Research demonstrates that satisfaction with leadership is a critical element in the retention of nurses. To evaluate staff nurse and nurse leader perceptions of leadership style. 16 supervisors and 179 supervisees completed the Multifactor Leadership Questionnaire and a demographic survey. Data were analyzed using parametric statistical techniques. Although staff perceived leaders as employing largely transformative leadership strategies, differences existed in leader-staff congruence in interpretation of leadership style and as related to the role of the leader. Differences in interpretation of leadership style between supervisors and supervisees were associated with diminished satisfaction with leadership. In addition, those serving in a direct operational role (assistant nurse manager) were viewed as less transformative than leaders who maintained broader administrative responsibilities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. The Application of an Evidence-Based Clinical Nursing Path for Improving the Preoperative and Postoperative Quality of Care of Pediatric Retroperitoneal Neuroblastoma Patients: A Randomized Controlled Trial at a Tertiary Medical Institution. (United States)

    Liu, Yang; Mo, Lin; Tang, Yan; Wang, Qiuhong; Huang, Xiaoyan

    A clinical nursing path (CNP) that encourages patients and their families to become actively involved in healthcare decision-making processes may improve outcomes of pediatric retroperitoneal neuroblastoma (NB) patients. The aim of this study was to evaluate the utility and value of an evidence-based CNP provided to pediatric retroperitoneal NB patients undergoing resection surgery. One hundred twenty NB cases were assigned to a control group or a CNP group. The control group was provided with standard nursing care. The CNP group was provided with nursing care in accordance with an evidence-based CNP. The utility and value of the CNP were compared with standard nursing care. Outcome measures included rates of postoperative complications, lengths of hospital stay, and cost of hospitalization, as well as preoperative and postoperative quality of care and patient satisfaction with care. The rates of postoperative complications, length of preoperative hospitalization, total length of hospital stay, and costs of hospitalization were significantly lower for patients receiving the CNP compared with the control group. Preoperative and postoperative quality of care and patient satisfaction with care were significantly higher in patients receiving the CNP compared with the control group. Adoption of a CNP for preoperative and postoperative care of pediatric retroperitoneal NB patients undergoing resection surgery improves clinical outcomes and patient satisfaction with care. A CNP can increase families' participation in a patient's recovery process, enhance nurses' understanding of the services they are providing, and improve the quality of healthcare received by patients.

  15. Student nurses as school nurse extenders. (United States)

    Rossman, Carol L; Dood, Florence V; Squires, Darcy A


    The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the results that have the potential to impact on student health in an urban elementary school. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. The Headache Action Plan Project for Youth (HAPPY): School Nurses as Facilitators of System Change in Pediatric Migraine Care. (United States)

    Connelly, Mark; Bickel, Jennifer; Wingert, Tammie; Galemore, Cynthia


    Migraine is a common health problem in youth that is ranked highest for disability among neurological conditions and is one of the leading reasons for school absences. Children with migraines frequently are seen by the school nurse for care, sometimes before ever being seen by another healthcare provider for evaluation and treatment. As such, school nurses have the unique opportunity to provide education and resources to children with migraines and their family. This article provides information on the Headache Action Plan Program for Youth (HAPPY), a project involving the provision of live and online migraine education and management resources to school nurses, children, families, and primary care providers in an effort to improve migraine recognition and care in the community.

  17. Exploring Helpful Nursing Care in Pediatric Mental Health Settings: The Perceptions of Children with Suicide Risk Factors and Their Parents. (United States)

    Montreuil, Marjorie; Butler, Kat J D; Stachura, Michal; Pugnaire Gros, Catherine


    This qualitative descriptive study explored helpful nursing care from the perspective of children with suicide-associated risk factors, and their parents. Data were collected through participant observation followed by a debriefing session with children, and semi-structured interviews with parents. The inductive analysis revealed four themes of helpful interventions: (1) caring for the child as a special person; (2) caring for the parents; (3) managing the child's illness; and (4) creating a therapeutic environment. The study findings highlight the importance of the relational aspect of nursing care and provide important insights related to family-centered and strengths-based practice with children at increased risk for suicide later in life.

  18. Knowledge of Pediatric Critical Care Nurses Regarding Evidence Based Guidelines for Prevention of Ventilator Associated Pneumonia (VAP) (United States)

    Ahmed, Gehan EL Nabawy; Abosamra, Omyma Mostafa


    Ventilator associated pneumonia (VAP) is a costly, preventable, and often fatal consequence of medical therapy that increases hospital and intensive care stays in mechanically ventilated patients. The prevention of VAP is primarily the responsibility of the bedside nurse whose knowledge, beliefs, and practices influence the health outcome of ICU…

  19. Pediatric Specialists (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  20. Pediatric Palliative Care Resources for You | NIH MedlinePlus the Magazine (United States)

    ... Pediatric Palliative Care Resources for You Follow us Pediatric Palliative Care Resources for You Dealing with a ... The National Institute of Nursing Research (NINR) offers pediatric palliative care resources to help you, your family, ...


    Directory of Open Access Journals (Sweden)

    Ariyanti Saleh


    Full Text Available Introduction: The first five years of age of a child is a critical time that will affect the child growth development process. Any untreated disorders may impair the process that subsequently influences quality of life of the child in the future. Therefore, it is imperative for a mother to optimize the growth development process. This study aimed to identify the effectiveness of health education with modelling approach on mother's knowledge, practice ability and maternal confidence of infant (0-6 months growth and development. Method: A quasy eksperimental pre-post with control group design was used. The intervention given was health education with modelling approach related to lactation management and infant growth development stimulation. The research was conducted in Maros Regency wiht 81 samples (41 in the treatment group and 40 in the control group. Result: The wilcoxon test reveals that there was a signi fi cant difference between treatment and control group, accordingly, knowledge (p = 0.00, p = 0.01, practice ability (p = 0.00, p = 0,006 and maternal confidence (p = 0.03, p = 0.03. In addition, from mann whitney test, between the two group, the data obtained are: knowledge (p = 0,950, practice ability (p = 0.00 and maternal con fi dence (p = 0,061. Discussion: Health education with modelling approach conducting by nurse was effective in increasing knowledge, practice ability, maternal confidence breastfeeding and baby stimulation, which was in turn can optimize baby growth and development. That is why, community health nurses role should be increase by making community health nursing program as one of primary public health centre program.

  2. Investigation on job stress of pediatricians and nurses working in pediatric department%儿科医护人员职业应激状况调查

    Institute of Scientific and Technical Information of China (English)

    姚三巧; 田玲; 庞保东; 白玉萍; 范雪云; 沈福海; 金玉兰


    than those of control group,but the scores of job-person conflict,environmental control,technology utility, mental health, responsibility on things were lower than those of control group (P<0.05). The points of job future ,job locus of control, self-esteem,job satisfaction,job load variance,depression in nurses were higher than those of pediatricians,and non-work activities,job risk and daily life stress were lower than those of doctors (P<0.05). The main affecting factors on job strain of pediatric staff included job monotony,higher job demand, more non-work job, lower job control, more job risk,job future ambiguous, poorer social support, lower job locus control and lower self-esteem. Conclusion The stress degree of pediatric staff is higher than that of controls. The pediatricians have more job stress than that of nurses. The main stressors of pediatric staff are job monotony, higher job demand, more non-worker activity, lower job control, higher job risk and ambiguous job future. The main modifiers are good social support,external job locus of control and higher selfesteem.

  3. The effects of combining Web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial. (United States)

    Gustafson, David; Wise, Meg; Bhattacharya, Abhik; Pulvermacher, Alice; Shanovich, Kathleen; Phillips, Brenda; Lehman, Erik; Chinchilli, Vernon; Hawkins, Robert; Kim, Jee-Seon


    Asthma is the most common pediatric illness in the United States, burdening low-income and minority families disproportionately and contributing to high health care costs. Clinic-based asthma education and telephone case management have had mixed results on asthma control, as have eHealth programs and online games. To test the effects of (1) CHESS+CM, a system for parents and children ages 4-12 years with poorly controlled asthma, on asthma control and medication adherence, and (2) competence, self-efficacy, and social support as mediators. CHESS+CM included a fully automated eHealth component (Comprehensive Health Enhancement Support System [CHESS]) plus monthly nurse case management (CM) via phone. CHESS, based on self-determination theory, was designed to improve competence, social support, and intrinsic motivation of parents and children. We identified eligible parent-child dyads from files of managed care organizations in Madison and Milwaukee, Wisconsin, USA, sent them recruitment letters, and randomly assigned them (unblinded) to a control group of treatment as usual plus asthma information or to CHESS+CM. Asthma control was measured by the Asthma Control Questionnaire (ACQ) and self-reported symptom-free days. Medication adherence was a composite of pharmacy refill data and medication taking. Social support, information competence, and self-efficacy were self-assessed in questionnaires. All data were collected at 0, 3, 6, 9, and 12 months. Asthma diaries kept during a 3-week run-in period before randomization provided baseline data. Of 305 parent-child dyads enrolled, 301 were randomly assigned, 153 to the control group and 148 to CHESS+CM. Most parents were female (283/301, 94%), African American (150/301, 49.8%), and had a low income as indicated by child's Medicaid status (154/301, 51.2%); 146 (48.5%) were single and 96 of 301 (31.9%) had a high school education or less. Completion rates were 127 of 153 control group dyads (83.0%) and 132 of 148 CHESS

  4. Pediatric Sinusitis (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  5. Influences shaping nurses' use of distraction for children's procedural pain. (United States)

    Olmstead, Deborah L; Scott, Shannon D; Mayan, Maria; Koop, Priscilla M; Reid, Kathy


    This study explored pediatric nurses' choices to use distraction for managing painful procedures. Using interpretive description approaches, interviews with pediatric nurses provided descriptions of choices to manage procedural pain. Nurses' distress influenced distraction use to mitigate the suffering of children and themselves. Newer nurses described task mastery as influencing distraction choices. Nurses' accounts of performing painful procedures on children mirrored children's descriptions of pain from the literature. Nurses' distress and competency performing painful procedures on children influenced practice. Future qualitative studies could extend understanding of pain management choices by pediatric nurses and the impact on undermanaged pain. © 2014, Wiley Periodicals, Inc.

  6. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.


    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  7. Pediatric Stroke (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  8. Myocarditis - pediatric (United States)

    ... page: // Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  9. Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses. (United States)

    Cline, Genieveve J; Burger, Kristina J; Amankwah, Ernest K; Goldenberg, Neil A; Ghazarian, Sharon R

    The purpose of this descriptive study was to identify the perceived barriers and facilitators to research utilization and evidence-based practice among nurses employed in a tertiary care children's hospital. Results revealed seven facilitator and six barrier themes that contribute to the understanding of the problem. The themes can be utilized by nursing professional development specialists to customize organizational infrastructure and educational programs.

  10. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst


    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  11. [Nurses' professional satisfaction]. (United States)

    Del Cura, M L; Rodrigues, A R


    We carried out a study with 91 nurses, trying to find out about the feelings of these professionals regarding their satisfaction at work. We used the Work Satisfaction Assessment Questionnaire (WSAQ), drawn up and validated by Siqueira (1978) and adapted with the analysis of seven factors: General Satisfaction; Physical and Psychological Stress; "Status" of the Job; Location of the Company; Compensating Benefits; Recognition and Personal Development. Data showed nurses satisfied with their work, in its intrinsic aspects (Accomplishment, Recognition and Autonomy). The psychiatric nurses were the most mature, most experienced, showing a higher satisfaction level, whereas the pediatric nurses were the youngest, most inexperienced and presenting the highest level of dissatisfaction at work.

  12. School Nurses Make a Difference (United States)

    Kitchell, Susan


    Susan Kitchell decided to become a school-based healthcare provider after working for more than twenty years in pediatrics and pediatric critical care at Roosevelt Hospital in New York City. She needed a position with daytime hours within her field of expertise that allowed her time to spend with her family. She began working as a school nurse in…

  13. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan


    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  14. 以家庭为中心护理模式在儿科护理中的应用%Application of the family-centered care model in pediatric nursing care

    Institute of Scientific and Technical Information of China (English)

    何晓霞; 林少霞; 莫少芳; 石碧兰


    Objective To discuss the effects of the family-centered care model in the pediatric nursing care,in order to enhance the satisfaction of the children and parents and children' s safety.Methods A family-centered care model was created,which mainly includes as follows:to set up a family-style wards (about the reasonable ward structure,to create a sense of security and a warm atmosphere ward,to provide parents with convenient services and facilities),concerning about the needs of children and parents,children's education and life plans,to select the qualification standards for nurses,nurse's specific responsibilities clear,training and assessment nurses nursing theory and practical knowledge.Children's Hospital Boston in the United States developed the "family-centered care scale" as a research tool,the use of random sampling,193 family members of patients,and 31 health care managers,117 questionnaires were evaluated family-centered care model in pediatric care in the implementation results.Results Parents overall satisfaction was 93.58%,the incidence of children with safety indicators decreased significantly.Conclusion In the nursing process,family-centered care model mainly emphasize family harmony and health,while highlighting the parents in the maintenance of healthy children occupies an important position,properly instructs parents how to take care of the children,try to make the parents together with the children and to provide appropriate and necessary care for the children and parents.%目的 探讨以家庭为中心的护理模式在儿科护理中的效果,提升患儿及家长的满意度和患儿安全.方法 创建以家庭为中心的护理模式,主要包括:建立家庭式病房(包括合理的病房结构、营造病房安全感和温馨气氛、为家长提供便利的服务设施),关注孩子及家长的需求,患儿的教学及生活计划,选择资历达标的护士,明确护士的具体职责,培训和考核护士的护理理论和实践知

  15. Roles and responsibilities of the nursing scholar. (United States)

    Conard, Patricia L; Pape, Tess Theresa


    Scholarship is an important facet of the nursing profession. There are many components, virtues, and roles and responsibilities of a nursing scholar practicing in today's ever-changing health care environment. Scholarship was redefined by Boyer to include scholarly activities in addition to research. Boyer's Model of Scholarship includes four interrelated and overlapping domains of discovery, integration, application, and teaching. Each domain is explained with examples for the pediatric nurse scholar, which includes roles in academia as well as in the practice setting. Pediatric nurses are key to scholarship in nursing because they work to improve the care of children.

  16. Virtual Pediatric Hospital (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: | | Virtual Pediatric Hospital is curated by Donna M. D' ...

  17. Índice de segurança técnica da equipe de enfermagem da pediatria de um hospital de ensino Índice de seguridad técnica del equipo de enfermería de la pediatría de un hospital de enseñanza Technical safety index of a teaching hospital's pediatrics unit nursing staff

    Directory of Open Access Journals (Sweden)

    Karin Emilia Rogenski


    ausencias del equipo de enfermería, así como de que se identifiquen índices específicos de las unidades, como subsidio para la evaluación del cuadro de personal en las organizaciones de salud.This study was aimed at identifying the Technical Safety Index (ITS, in the Portuguese acronym of the nursing team of the University of São Paulo's Hospital Universitário's Pediatrics Unit (2001-2005. Percentages for each type of absence of nursing professionals were obtained from the Nursing Department or calculated based on the equations found in the literature. Absences due to days off were the highest percentage. Total percentages of unplanned absences were lower than those referring to planned absences, which contradict nurses who report this type of absence as the main cause for health institutions understaffing. IST variation highlights the importance of carrying out systematic evaluations of the nursing team's absences, as well as of identifying specific indexes for each unit, as subsidies for the evaluation of the personnel in health organizations.

  18. Assessing the Effect of an Educational Intervention on Nurses' and Patient Care Assistants' Comprehension and Documentation of Functional Ability in Pediatric Patients with Sickle Cell Disease. (United States)

    Bernier, Katherine M; Strobel, Megan; Lucas, Ruth


    In 2014, the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) was developed to investigate patient's self-rated functional ability during times of acute pain in the inpatient clinical setting. Although it has great potential, the application of this tool has not been made a standard of care. The purpose of this multiple methods study was to determine if, through an educational intervention, hospital staff could consistently document the YAPFAQ in children with sickle cell disease (SCD) during a vaso-occlusive episode. Twenty-two staff members participated in an educational intervention and semi-structured group discussions. Pre/post surveys measured knowledge of the YAPFAQ before and after the intervention. Group discussions were recorded, transcribed verbatim, and analyzed for thematic clusters. Retrospective chart reviews of children with SCD were reviewed for YAPFAQ documentation frequency before and after the intervention. Staff knowledge of who completes the YAPFAQ increased after the intervention, (pcontinues to hold high potential for directing nursing care, but requires staff investment for clinical practice change. A seamless integration between nursing education and translation through EHR is recommended as technology continues to integrate into nursing practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Pediatric Terminology (United States)

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  20. Pediatric MRI (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  1. Pediatric sleep apnea (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  2. The Simulation-Based Assessment of Pediatric Rapid Response Teams. (United States)

    Fehr, James J; McBride, Mary E; Boulet, John R; Murray, David J


    To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs. Pediatric RRTs, comprising a pediatric intensive care unit (PICU) registered nurse and respiratory therapist, led by a PICU intensivist-in-training or a pediatric nurse practitioner, managed 7 simulated acutely decompensating patients. Two raters evaluated the scenario performances and psychometric analyses of the scenarios were performed. The teams readily managed scenarios such as supraventricular tachycardia and opioid overdose but had difficulty with more complicated scenarios such as aortic coarctation or head injury. The management of any particular scenario was reasonably predictive of overall team performance. The teams led by the PICU intensivists-in-training outperformed the teams led by the pediatric nurse practitioners. Simulation provides a method for RRTs to develop decision-making skills in managing decompensating pediatric patients. The multiple scenario assessment provided a moderately reliable team score. The greater scores achieved by PICU intensivist-in-training-led teams provides some evidence to support the validity of the assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Revista Annaes de Enfermagem: publicações de enfermeiras sobre pediatria (1932-1941 Revista Annaes de Enfermagem: publicaciones de enfermeras sobre pediatria (1932-1941 Revista Annaes de Enfermagem: nurses' publications about pediatrics (1932-1941

    Directory of Open Access Journals (Sweden)

    Aline Silva Fontes


    Full Text Available Estudo histórico-social que tem como objeto a produção intelectual de enfermeiras e estudantes de enfermagem relativas à enfermagem pediátrica na revista Annaes de Enfermagem, no período entre 1932-1941. A fonte primária refere-se aos números da revista Annaes de Enfermagem pertencentes ao recorte temporal do estudo, além de relatórios e correspondências. As fontes secundárias estão constituídas de livros, artigos, dissertações e teses relativas à história do Brasil e da enfermagem. A análise dos dados teve o apoio das fontes secundárias e do pensamento do sociólogo francês Pierre Bourdieu. Os resultados evidenciam que a revista Annaes de Enfermagem publicou e divulgou temas importantes sobre a assistência de enfermagem à criança e contribuiu para a visibilidade da enfermeira brasileira junto à comunidade científica.Estudio de naturaleza historico-social que tiene como objeto la producción intelectual de las enfermeras y estudiantes de enfermería relativos a la enfermería pediátrica en el periodico Annaes de Enfermagem, en el período 1932-1941. Las fuentes primarias se refieren a los números de la Revista Annaes de Enfermagem pertenecientes al recorte temporal del estudio, además de los informes y correspondencia. Las fuentes secundarias están compuestas de libros, artículos, tesis y disertaciones sobre la historia de la enfermería de Brasil. El análisis de datos cuenta con el apoyo de fuentes secundarias y el pensamiento del sociólogo francés Pierre Bourdieu. Los resultados muestran que el periodico Annaes de Enfermería publicó sobre las importantes cuestiones de la asistencia de enfermería para el niño y ha contribuydo con la visibilidad de la enfermera brasileña en la comunidad científica.Historic-social study whose object was the intellectual production of nurses and students about pediatric nursing in the journal Annaes de Enfermagem, in the period 1932-1941. The primary source refers to the

  4. Nationwide survey on pediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects

    International Nuclear Information System (INIS)

    Ono, K.; Ban, N.; Ojima, M.; Yoshinaga, S.; Akahane, K.; Fujii, K.; Toyota, M.; Hamada, F.; Kouriyama, C.; Akiba, S.; Kunugita, N.; Shimada, Y.; Kai, M.


    A nationwide survey was conducted in Japan on paediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects. A survey questionnaire was sent out to 3173 public primary and junior high schools and 317 public health centres during October to December in 2009. According to the collected responses, 410 (16.2 %) children received the CT scans and the total number of CT scans was 585. Most of respondents expressed a high interest in radiation health effects and an intent to participate in the epidemiological study that will follow-up the health conditions of children. This study provides information to discuss the feasibility of the epidemiological study on health effects in children who received CT scans. (authors)

  5. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.


    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  6. Providing pediatric palliative care: PACT in action. (United States)

    Duncan, Janet; Spengler, Emily; Wolfe, Joanne


    High-quality pediatric palliative care should be an expected standard in the United States, especially since the publication of the numerous position statements such as "Precepts of Palliative Care for Children and Adolescents and Their Families," a joint statement created by the Association of Pediatric Oncology Nurses, the National Association of Neonatal Nurses, and the Society of Pediatric Nurses. Although many barriers still exist, dedicated individuals and teams strive to promote models of excellence and improve care for children with life-threatening conditions and their families. The Pediatric Advanced Care Team, a joint project of Dana-Farber Cancer Institute and Children's Hospital, Boston, is one such interdisciplinary pediatric palliative care consultation service. Founded in 1997, we have grown and learned from formal study and our extensive clinical work with families, children, and our colleagues. This article describes our journey as an interdisciplinary team forging a new service within two renowned medical institutions in which historically the primary emphasis of care has been on cure and innovation. Although these values remain, our work has resulted in an increased acceptance of balancing treatment of the underlying disease or condition along with treatment of the physical, psychosocial, and spiritual needs of the child and family through life or death. One of our goals is to help promote a balance of hope for cure with hope for comfort, dignity, and integrity for every child and family.

  7. [Burnout in nursing residents]. (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum


    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  8. Pediatric vasculitis. (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur


    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  9. Cognitive Dissonance and Pediatric Procedural Pain Management: A Concept Clarification. (United States)

    Bice, April A


    Pediatric nurses have often reported that pain management is a vital part of patient care. Evidence, however, suggests pediatric procedural pain treatments are often underused. Cognitive dissonance, the mental conflict leading to unpleasant thoughts and or feelings, may be related to this evidence-based gap found between what pediatric nurses claim about procedural pain management (that it is important) and what they actually do (underutilize pain treatments). The purpose of this manuscript is to clarify and further develop the concept of cognitive dissonance in terms of its relationship to nurses' mental struggles with underutilization of pediatric procedural pain treatments. A more relevant and extended definition of cognitive dissonance is presented. The concept of cognitive dissonance was examined using Rodgers' evolutionary concept analysis approach/framework. Analysis Methods: Through a six-step process of concept identification, setting and sample identification, data collection, data analysis, and future implication discussion, a more accurate and representative definition of cognitive dissonance is described. Databases used included CINAHL, Google Scholar, PsycINFO, ERIC, and PubMed. Seminal, recent, and relevant works were included in the review to adequately develop and clarify the concept. Procedural pain management breech among pediatric nurses is proposed to occur before the mental conflict produced. The unpleasant mental conflict created after the breech is followed by the nurse's determination to reduce mental conflict through attitude change followed by cognition change, which more closely reflects his or her behavior. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  10. Palliative nursing care for children and adolescents with cancer

    Directory of Open Access Journals (Sweden)

    Gilmer MJ


    Full Text Available Terrah L Foster,1,2 Cynthia J Bell,1 Carey F McDonald,2 Joy S Harris,3 Mary Jo Gilmer,1,21Vanderbilt University School of Nursing, Nashville, 2Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, 3Vanderbilt University, Nashville, TN, USAAbstract: Pediatric palliative care aims to enhance life and decrease suffering of children and adolescents living with life-threatening conditions and their loved ones. Oncology nurses are instrumental in providing palliative care to pediatric oncology populations. This paper describes pediatric palliative care and provides an overview of literature related to the physical, psychological, social, and spiritual domains of palliative nursing care for children and adolescents with cancer. Nurses can provide optimal palliative care by accounting for children's understanding of death, encouraging early initiation of palliative care services, and improving utilization of pediatric palliative care in cancer settings. Specific roles of registered nurses and advanced practice nurses in pediatric palliative care will be addressed. Recommendations for future research are made to further advance the science of pediatric palliative care and decrease suffering for children and teens with cancer.Keywords: pediatric palliative care, pediatric cancer, oncology, child, suffering

  11. [Novelties 2016 in pediatrics]. (United States)

    Fischer Fumeaux, Céline J; Fletgen Richard, Carole; Goncalves Pereira Pinto, Diana; Stadelmann, Corinne; Avignon, Valérie; Vial, Yvan; Tolsa, Jean-François; Ambresin, Anne-Emmanuelle; Armengaud, Jean-Baptiste; Castaneda, Monica; Coti-Bertrand, Pauline; Deppen, Alain; Duvoisin, Gilles; Gebhard, Sandra; Holzer, Laurent; Lier, Françoise; Monney Chaubert, Carole; Pauchard, Jean-Yves; Typaldou, Sofia Anna; Hofer, Michaël


    Nutrition is central in pediatric care : essential for growth and development, it plays also a role in the prevention of many diseases.Even if breastfeeding is highly recommended, its implementation may be difficult in particular for premature and ill newborns. The creation of a specific unit for breastfeeding support in neonatology allows to help mothers willing to nurse and to improve the rate of breastfeeding for these vulnerable infants.Eating disorders represent an important challenge for patient care. Early detection and rapid management of anorexia is essential for the prognosis. This article describes the challenges and the practical process underlying the development of a practical guideline to manage children and adolescents hospitalized for anorexia.

  12. Pediatric tracheostomy. (United States)

    Campisi, Paolo; Forte, Vito


    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T


    Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking such as ......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...... such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens...

  14. Pediatric stroke

    International Nuclear Information System (INIS)

    Hoermann, M.


    Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de

  15. Parceria nos cuidados de enfermagem em pediatria: do discurso à ação dos enfermeiros Asociación en la atención de enfermería en pediatría: del discurso a la acción de las enfermeras Partnership in pediatric nursing care: from words into nurses’ action

    Directory of Open Access Journals (Sweden)

    Maria Goreti Silva Ramos Mendes


    Full Text Available Introdução: apesar de se reconhecer que a enfermagem pediátrica é hoje particularmente sensível ao envolvimento dos pais na prática de cuidados à criança hospitalizada, inúmeros estudos continuam a evidenciar que não se é desenvolvida com os mesmos uma parceria efetiva. Na procura de conhecermos nos enfermeiros de pediatria a forma como percecionam o processo de construção da parceria na prática de cuidados com os pais e identificar no contexto as ações praticadas, desenvolvemos um estudo de natureza qualitativa com uma abordagem da grounded theory sustentada no referencial teórico do interacionismo simbólico. Tomando como ponto de partida a questão: como é que os enfermeiros de pediatria descrevem a parceria e o que evidenciam nas suas práticas quotidianas, entrevistamos 12 enfermeiros da unidade de pediatria de um hospital do norte do país e efetuamos observação no contexto de ocorrência do fenómeno. O corpus de dados foi submetido a análise, através do recurso ao software Nvivo8. Os achados obtidos do discurso revelam que o trabalho em parceria com os pais está presente no “pensar “ dos enfermeiros. Porém, as observações efetuadas evidenciaram lacunas na contemplação de dimensões fundamentais ao desenvolvimento de uma parceria efetiva com os pais. Em síntese, os enfermeiros contemplam a parceria no pensar mas não no agir.Si bien se reconoce que la enfermería pediátrica es actualmente particularmente sensible a la participación de los padres en la práctica del cuidado a los niños hospitalizados, numerosos estudios siguen mostrando que no establecen con los padres una asociación efectiva. Para procurar saber como las enfermeras de pediatría perciben el proceso de formación de asociación con los padres en la práctica de cuidados e identifican las acciones practicadas en contexto, desarrollamos un estudio de corte cualitativo, basado en la Teoría Fundamentada y sostenido en el referencial te

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  17. Pediatric heart surgery - discharge (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  19. Children's (Pediatric) Nuclear Medicine (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  2. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.


    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  3. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin


    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  4. Vulnerabilidades socioeconômicas e o cotidiano da assistência de enfermagem pediátrica: relato de enfermeiras Vulnerabilidad socioeconómica y el cuidado diario de la enfermería pediátrica: informe de enfermeras Socio-economic vulnerability and pediatric nursing care routine: nurses report

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Rodrigues Pedroso


    í: Vulnerabilidad socioeconómica y cuidado cotidiano de la enfermería pediátrica; Propuestas y alternativas para el manejo de situaciones de vulnerabilidad socioeconómica. Los resultados proporcionaron ejemplos prácticos e ofrecieron soluciones para solventar la vulnerabilidad socioeconómica vinculada al cuidado que brinda la enfermería al niño y su familia.By considering the vulnerabilities faced by a child and their family, a health care team can plan and execute an integrated plan to address these issues. The objective of this study, conducted in the environment of pediatric units at a University Hospital in the city of Porto Alegre, is aimed at understanding the perception of nurses regarding the influence of socioeconomic vulnerabilities on the care of a child and their family. This qualitative research is performed in the context of a descriptive exploratory study. Data collection was conducted using semistructured, individual interviews with nine participants, and then analyzed consistent with content analysis references. Three categories emerged from the analysis, and two are explored in this study: the impact of socio-economic vulnerabilities on the pediatric nursing care routine; and, proposals and alternatives for management of situations resulting from socioeconomic vulnerabilities. The results provide practical examples and solutions to socioeconomic vulnerabilities as related to the nursing care for children and their families.

  5. Find a Pediatric Dentist (United States)

    ... AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  6. Fatores que tornam estressante o trabalho de médicos e enfermeiros em terapia intensiva pediátrica e neonatal: estudo de revisão bibliográfica Factors that cause stress in physicians and nurses working in a pediatric and neonatal intensive care unit: bibliographic review

    Directory of Open Access Journals (Sweden)

    Monalisa de Cássia Fogaça


    Full Text Available OBJETIVOS: Revisão de literatura sobre estresse ocupacional e síndrome de burnout em médicos e enfermeiros que trabalham em unidade de terapia intensiva pediátrica e neonatal. MÉTODOS: Os artigos foram identificados a partir das bases de dados MedLine, LILACS e SciElo, usando as palavras-chave estresse, burnout, médicos, enfermagem, unidade de terapia intensiva, unidade de cuidados intensivos pediátricos e unidades de cuidados intensivos neonatais. O período pesquisado foi de 1990 a 2007. RESULTADOS: Médicos e enfermeiros que trabalham em unidade de terapia intensiva pediátrica e neonatal são candidatos a apresentarem estresse, alterações psicológicas e síndrome de Burnout. Pesquisas sobre o tema identificaram alterações importantes que acometem médicos e enfermeiros intensivistas: sobrecarga de trabalho, burnout, desejo de abandonar o trabalho e níveis elevados de cortisol entre outros fatores. CONCLUSÕES: Os profissionais que trabalham em unidade de terapia intensiva pediátrica e neonatal , pela especificidade do seu trabalho, estão expostos ao risco do estresse ocupacional e, conseqüentemente ao Burnout. Estes dados sugerem a necessidade de serem feitas pesquisas, com o objetivo de desenvolver medidas preventivas e modelos de intervenção.OBJECTIVES: Bibliographic review on occupational stress and burnout presence in physicians and nurses that work in pediatric and neonatal intensive care units. METHODS: The articles were selected from the MedLine, LILACS and SciElo data base using the key words: stress, burnout, physicians, nursing, intensive care unit, pediatric intensive care unit and neonatal intensive care unit. The studied period ranged from 1990 to 2007. RESULTS: Health professionals who work in pediatric and neonatal intensive care units are strong candidates for developing stress, psychological alterations and burnout syndrome. Researches on this subject identified important alterations suffered by these

  7. Pediatric fibromyalgia. (United States)

    Buskila, Dan


    Fibromyalgia is an idiopathic chronic pain syndrome defined by widespread nonarticular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, nonrefreshing sleep, irritable bowel, and more. Central nervous system sensitization is a major pathophysiologic aspect of fibromyalgia; in addition, various external stimuli such as trauma and stress may contribute to development of the syndrome. Fibromyalgia is most common in midlife, but may be seen at any age. This article reviews the epidemiology, clinical characteristics, etiology, management, and outcome of pediatric fibromyalgia.

  8. Pediatric radiology

    International Nuclear Information System (INIS)

    Silverman, F.N.


    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton

  9. Pediatric neuroimaging

    International Nuclear Information System (INIS)

    Tidwell, A.S.; Solano, M.; Schelling, S.H.


    In this article, some of the common and not-so-common neuropediatric disorders were discussed. As in the full-grown animal, abnormalities of the CNS in the pediatric animal patient may be classified according to the type of insult present (eg, malformation, injury, neoplasia, inflammation, or degeneration). To recognize the imaging manifestations of such disorders, an appreciation of normal anatomy, the pathological response of nervous system tissue to insult, and the principles of image interpretation is required. These fundamentals may then be applied to any CNS disease, regardless of frequency and to any animal patient, regardless of age

  10. Pediatric hospitalists and medical education. (United States)

    Ottolini, Mary C


    Pediatric hospital medicine (PHM) is moving toward becoming an American Board of Pediatrics (ABP) subspecialty, roughly a decade after its formal inception in 2003. Education has played a central role as the field has evolved. Hospitalists are needed to educate trainees, medical students, residents, fellows, and nurse practitioner and physician assistant students in inpatient pediatric practice. Continuous professional development is needed for hospitalists currently in practice to augment clinical skills, such as providing sedation and placing peripherally inserted central catheter lines, and nonclinical skills in areas such as quality improvement methodology, hospital administration, and health service research. To address the educational needs of the current and future state of PHM, additional training is now needed beyond residency training. Fellowship training will be essential to continue to advance the field of PHM as well as to petition the ABP for specialty accreditation. Training in using adult educational theory, curriculum, and assessment design are critical for pediatric hospitalists choosing to advance their careers as clinician-educators. Several venues are available for gaining advanced knowledge and skill as an educator. PHM clinician-educators are advancing the field of pediatric education as well as their own academic careers by virtue of the scholarly approach they have taken to designing and implementing curricula for unique PHM teaching situations. PHM educators are changing the educational paradigm to address challenges to traditional education strategies posed by duty hour restrictions and the increasing drive to shorten the duration of the hospitalization. By embracing learning with technology, such as simulation and e-learning with mobile devices, PHM educators can address these challenges as well as respond to learning preferences of millennial learners. The future for PHM education is bright. Copyright 2014, SLACK Incorporated.

  11. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.


    Computed tomography has made possible the excellent and basic work having to do with the characteristics of the trachea, its caliber, shape, and length in children. Another group of articles has to do with interventional pediatric radiology. This year there were a number of articles of which only a sample is included, dealing with therapeutic procedures involving drainage of abscesses, angioplasty, nephrostomy, therapeutic embolization, and the removal of esophageal foreign bodies. Obviously, there is no reason to think that techniques developed for the adult may not be applicable to the infant or child; also, there is no reason to believe that processes peculiar to the child should not be amenable to intervention, for instance, use of embolization of hepatic hemangioma and transluminal balloon valvuloplasty for pulmonary valvular stenosis. Among the reports and reviews, the author would add that sonography remains a basic imaging technique in pediatric radiology and each year its application broadens. For example, there is an excellent article having to do with sonography of the neonatal and infant hip and evaluation of the inferior vena cava and the gallbladder. Nuclear medicine continues to play a significant role in diagnosis, which is featured in two articles concerned with problems of the hip

  12. Management of natural health products in pediatrics: a provider-focused quality improvement project. (United States)

    Gutierrez, Emily; Silbert-Flagg, JoAnne; Vohra, Sunita


    The use of natural health products by pediatric patients is common, yet health care providers often do not provide management guidance. The purpose of this project was to improve management of natural health products by pediatric nurse practitioners. Pediatric nurse practitioners from large metropolitan city were recruited (n = 32). A paired pretest-posttest design was used. Study participants were engaged to improve knowledge of natural health products, and a management toolkit was created and tested. Mean knowledge scores increased from 59.19 to 76.3 (p improved with regard to patient guidance (p product use (p = .51) and drug/herb interactions (p = .35) were not significant. This investigation is the first known study to improve knowledge and management of natural health products in pediatric clinical practice. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  13. Use of music and play in pediatric nursing care in the hospital context Utilización de la música y del juego en el cuidado de enfermería pediátrico en ambiente hospitalario Utilização da música e do jogo no cuidado de enfermaria pediátrico em ambiente hospitalar

    Directory of Open Access Journals (Sweden)

    Paula Chadi Tondatti


    Full Text Available Objective. To identify and analyze scientific publications on the use of music and play in pediatric nursing care in the hospital context. Method. In this bibliographic study, papers were sought that were published in Portuguese or English between 2004 and 2009 and included the descriptors: hospitalized child, childhood, child recreation, nursing team, nursing, pediatric nursing, alternatives therapies, music, music therapy, play and playthings, play therapy, playing. For the review, the bibliographic databases used were MEDLINE, ScIELO and LILACS. Results. Seventeen publications were obtained, among which: 59% adopted a quantitative method; mainly nursing developed the activities (88%; per type of article, reviews on the theme and assessments of clinical changes associated with the use of music and play were frequent (59% and 18%, respectively; and the utility of this kind of therapies in nursing care is acknowledged (94%. Conclusion. Play and music are useful therapies that can be used in nursing care for pediatric patients.Objetivo. Identificar y analizar las publicaciones científicas que abordaran el uso de la música y del juego en el cuidado de enfermería pediátrico en ambiente hospitalario. Metodología. Estudio bibliográfico en el que se buscaron artículos en portugués o en inglés publicados entre 2004 - 2009 que incluyeran los descriptores: niño hospitalizado, niñez, recreación infantil, equipo de enfermería, enfermería, enfermería pediátrica, terapias alternativas, música, musicoterapia, juegos y juguetes, ludoterapia, jugar. Para la revisión se utilizaron las bases de datos bibliográficas MEDLINE, ScIELO y LILACS . Resultados. Se obtuvieron 17 publicaciones, de las cuales tienen metodología cuantitativa (59%, las actividades fueron desarrolladas principalmente por enfermería (88%, por tipo de artículo son frecuentes las revisiones de tema y la evaluación de cambios clínicos asociados al empleo de la música y del

  14. Pediatric Toxic Shock Syndrome

    Directory of Open Access Journals (Sweden)

    Jennifer Yee


    Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the diagnosis and management of a pediatric patient with toxic shock syndrome. The case is also appropriate for teaching of medical students and advanced practice providers, as well as a review of the principles of crisis resource management, teamwork, and communication. Introduction: Toxic shock syndrome is a low-frequency, high-acuity scenario requiring timely identification and aggressive management. If patients suffering from this condition are managed incorrectly, they may progress into multi-organ dysfunction and potentially death. Toxic shock syndrome has been associated with Streptococcus and Staphylococcus aureus (Staph. Approximately half of Staph cases are associated with menstruation, which was first described in the 1970s-1980s and was associated with the use of absorbent tampons.1 Group A Streptococcus may cause complications such as necrotizing fasciitis and gangrenous myositis.2 Pediatric patients may present critically ill from toxic shock syndrome. Providers need to perform a thorough history and physical exam to discern the source of infection. Management requires aggressive care with antibiotics and IV fluids. Objectives: By the end of this simulation session, the learner will be able to: 1 Recognize toxic shock syndrome. 2 Review the importance of a thorough physical exam. 3 Discuss management of toxic shock syndrome, including supportive care and the difference in antibiotic choices for streptococcal and staphylococcal toxic shock syndrome. 4 Appropriately disposition a patient suffering from toxic shock syndrome. 5 Communicate effectively with team members and nursing staff during a resuscitation of a critically ill patient. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on toxic shock syndrome.

  15. Estudo preliminar sobre a qualidade de vida de médicos e enfermeiros intensivistas pediátricos e neonatais Estudio preliminar sobre la calidad de vida de médicos y enfermeros intensivistas pediátricos y neonatales Preliminary study about qualify of life of physicians and nurses working in pediatric and neonatal intensive care units

    Directory of Open Access Journals (Sweden)

    Monalisa de Cássia Fogaça


    Full Text Available Comparar a Qualidade de Vida (QV de médicos e enfermeiros que trabalham em UTI Pediátrica (PED e Neonatal (NEO e, também, avaliar se há diferença entre a QV na mesma categoria profissional, mas diferindo de acordo com a unidade de trabalho. Estudo descritivo com 37 médicos e 20 enfermeiros. O WHOQOL-100 foi utilizado. Médicos da PED diferiram estatisticamente no domínio VI (p=0,003, quando comparados com médicos da NEO. Médicos e enfermeiros da PED apresentaram diferença estatística significante no domínio V (p Comparar la Calidad de Vida (QV de médicos y enfermeros que trabajan en UTI Pediátrica (PED y neonatal (NEO y, también evaluar si existe diferencia entre la QV en la misma categoría profesional, aunque variando de acuerdo con la unidad de trabajo. Estudio descriptivo con 37 médicos y 20 enfermeros. Fue utilizado el WHOQOL-100. Los médicos de PED diferían estadísticamente en el dominio VI (p=0,003 en comparación con los médicos de NEO. Médicos y enfermeros de PED presentaron una diferencia estadística significativa en el dominio V (pCompare the Quality of Life (QL of doctors and nurses who work in Pediatric (PED and Neonatal (NEO Intensive Care Units, and to evaluate whether there are differences between the QL in the same job category, but differing according to the work unit. This descriptive study was performed with 37 physicians and 20 nurses. The WHOQOL100 was used. Physicians from the PED differ statistically in the field VI (p=0.003 compared with physicians from the NEO. Physicians and nurses from the PED showed a statistically significant difference in field V (p<0.01, while physicians and nurses from the NEO showed a statistically significant difference in field VI (p=0.05. The QL assessment of physicians and nurses working in pediatric and neonatal intensive care units was below the scores found in scientific literature, compared to studies that evaluated patients with chronic pain and mental health

  16. Nursing and nursing education in Haiti. (United States)

    Garfield, Richard M; Berryman, Elizabeth


    Haiti has long had the largest proportion of people living in poverty and the highest mortality level of any country in the Americas. On January 12, 2010, the most powerful earthquake to hit Haiti in 200 years struck. Before the earthquake, half of all Haitians lacked any access to modern medical care services. Health care professionals in Haiti number around one-fourth of the world average and about one-tenth the ratio present in North America. The establishment of new primary care services in a country where half of the people had no access to modern health care prior to the earthquake requires advanced practice roles for nurses and midwives. With a high burden of infectious, parasitic, and nutritional conditions, Haiti especially needs mid-level community health workers and nurses who can train and supervise them for public health programs. As in many other developing countries, organized nursing lacks many of the management and planning skills needed to move its agenda forward. The public schools prepare 3-year diploma graduates. These programs have upgraded the curriculum little in decades and have mainly trained for hospital service. Primary care, public health program management, and patient education had often not been stressed. Specializations in midwifery and HIV care exist, while only informal programs of specialization exist in administration, surgery, and pediatrics. An advanced practice role, nonetheless, is not yet well established. Nursing has much to contribute to the recovery of Haiti and the revitalization if its health system. Professional nurses are needed in clinics and hospitals throughout the country to care for patients, including thousands in need of rehabilitation and mental health services. Haitian nursing colleagues in North America have key roles in strengthening their profession. Ways of supporting our Haitian colleagues are detailed. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Pediatric Uveitis. (United States)

    Chan, Nicole Shu-Wen; Choi, Jessy; Cheung, Chui Ming Gemmy


    Pediatric uveitis differs from adult-onset uveitis and is a topic of special interest because of its diagnostic and therapeutic challenges. Children with uveitis are often asymptomatic and the uveitis is often chronic, persistent, recurrent, and resistant to conventional treatment. Anterior uveitis is the most common type of uveitis in children; the prevalence of intermediate, posterior, and panuveitis varies geographically and among ethnic groups. Regarding etiology, most cases of pediatric uveitis are idiopathic but can be due to systemic inflammatory disorders, infections, or a manifestation of masquerade syndrome. Ocular complications include cataracts, hypotony or glaucoma, band keratopathy, synechiae formation, macular edema, optic disc edema, choroidal neovascular membranes, and retinal detachment. These complications are often severe, leading to irreversible structural damage and significant visual disability due to delayed presentation and diagnosis, persistent chronic inflammation from suboptimal treatment, topical and systemic corticosteroid dependence, and delayed initiation of systemic disease‒modifying agents. Treatment for noninfectious uveitis is a stepwise approach starting with corticosteroids. Immunomodulatory therapy should be initiated in cases where quiescence cannot be achieved without steroid dependence. Patients should be monitored regularly for complications of uveitis along with systemic and ocular adverse effects from treatments. The goals are to achieve steroid-free durable remission, to reduce the risk of sight-threatening complications from the uncontrolled ocular inflammation, and to avoid the impact of lifelong burden of visual loss on the child and their family. Multidisciplinary management will ensure holistic care of affected children and improve the support for their families. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

  18. Pediatric and neonatal cardiovascular pharmacology. (United States)

    Miller-Hoover, Suzan R


    Advances in cardiology, surgical techniques, postoperative care, and medications have improved the chances of long-term survival of the neonatal and pediatric patient with complex congenital cardiac anomalies. Rather than undergoing palliative repair, these children are now frequently taken to the operating room for complete repair. As complete repair becomes the norm, collaborative management and a thorough understanding of the pre and postoperative medications used become essential to the care of these patients. The nurse's ability to understand preop, postop, and management medications is enhanced by an understanding of the principles of cardiac anatomy and physiology, as well as developmental changes in cardiac function. All of these are reviewed. In addition, since the safe and effective administration of these drugs depends on the pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU) nurse's thorough knowledge of these medications and their effects on the cardiovascular system, a brief review of these medications is presented. While new technology and techniques are improving survival rates for children with congenital heart anomalies, it is the postoperative care that these children receive that enhances the patient's survival even more.

  19. Pediatric anesthesia in developing countries. (United States)

    Bösenberg, Adrian T


    To highlight the problems faced in developing countries where healthcare resources are limited, with particular emphasis on pediatric anesthesia. The fact that very few publications address pediatric anesthesia in the developing world is not surprising given that most anesthetics are provided by nonphysicians, nurses or unqualified personnel. In compiling this article information is drawn from pediatric surgical, anesthetic and related texts. In a recent survey more than 80% of anesthesia providers in a poor country acknowledged that with the limited resources available they could not provide basic anesthesia for children less than 5 years. Although many publications could be regarded as anecdotal, the similarities to this survey suggest that the lack of facilities is more generalized than we would like to believe. The real risk of anesthesia in comparison to other major health risks such as human immunodeficiency virus, malaria, tuberculosis and trauma remains undetermined. The critical shortage of manpower remains a barrier to progress. Despite erratic electrical supplies, inconsistent oxygen delivery, paucity of drugs or equipment and on occasion even lack of running water, many provide life-saving anesthesia. Perioperative morbidity and mortality is, however, understandably high by developed world standards.

  20. National Association of Pediatric Nurse Practitioners (United States)

    ... Cancer Prevention Resources Be Prepared Behavioral Health Resources Mental Health Facts ADHD Conversations Learning Disabilities Youth Violence Prevention Bullying Prevention Medicines and Vaccines Over-the-Counter Medicine ...

  1. Nursing, Nursing Education, and Anxiety. (United States)

    Biggers, Thompson; And Others

    In response to the current crisis in the field of nursing, a study examined nursing students' perceived work-related stress and differences among associate degree, diploma, and baccalaureate nursing programs in their preparation of nursing students. The 171 subjects, representing the three different nursing programs, completed a questionnaire…

  2. The development of pediatric anesthesia and intensive care in Scandinavia

    DEFF Research Database (Denmark)

    Nilsson, Krister; Ekström-Jodal, Barbro; Meretoja, Olli


    The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second...... World War. Relations for training and exchange of experiences between Scandinavian countries with centers in Europe and the USA were a prerequisite for development. Specialized pediatric practice was not a full-time position until during the 1950s, when the first pediatric anesthesia positions were...... created. Scandinavian anesthesia developed slowly. In contrast, Scandinavia pioneered both adult and certainly pediatric intensive care. The pioneers were heavily involved in the teaching and training of anesthetists and nurses. This was necessary to manage the rapidly increasing work. The polio epidemics...

  3. What Is a Pediatric Rheumatologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  4. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh


    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  5. Pediatric Celiac Disease (United States)

    ... a protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, ... physician. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Eosinophilic ...

  6. American Pediatric Surgical Association (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  7. Pediatric Voiding Cystourethrogram (United States)

    Scan for mobile link. Children's (Pediatric) Voiding Cystourethrogram A children’s (pediatric) voiding cystourethrogram uses fluoroscopy – a form of real-time x-ray – to examine a child’s bladder ...

  8. Pediatric MATCH Infographic (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  9. Pediatric Brain Tumor Foundation (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  10. Pediatric Thyroid Cancer (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  11. National Pediatric Program Update

    International Nuclear Information System (INIS)


    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis. [es

  12. Pediatric interventional radiology clinic - how are we doing?

    International Nuclear Information System (INIS)

    Rubenstein, Jonathan; Zettel, Julie C.; Lee, Eric; Cote, Michelle; Aziza, Albert; Connolly, Bairbre L.


    Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved. (orig.)

  13. Pediatric portal hypertension (United States)

    Vogel, Clarissa Barbon


    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  14. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.


    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

  15. Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices. (United States)

    Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q


    The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

  16. [Teamwork and negotiation with family in pediatrics]. (United States)

    Ramos-Mendes, Maria Goreti; Rodrigues Araújo, Beatriz; Pereira Martins, Manuela


    Analyze the negotiation and interaction process within nurses' practice with mothers of hospitalized children in pediatric unit from the teamwork perspective. A qualitative approach was used in this study, based on the Grounded Theory from the symbolic interaction perspective. The study included 12 nurses of the pediatric unit and 18 mothers who stayed in the hospital with their hospitalized children. The number of participants was defined according to data saturation. Participant observation and semi-structured interviews were chosen as data collection techniques and it was analyzed using the program NVivo8. From the analysis performed, the central category identified was «weaknesses in the negotiation process», within the interactions between nurses and mothers. Nurses revealed difficulties in the communication process, they did not include roles definition with mothers in order to establish their participation in the care process and a power imbalance was also evidenced. Within the studied settings, an important lack of collaborative work with hospitalized children's mothers was observed. The weaknesses in the negotiation process and specifically the difficulties found in communication; the lack of roles and tasks clarification and the perceived power imbalance regarding relationships, prevent mothers involvement in their children care process, considered a basic component to achieve a greater mother implication, better results in terms of health and a lower impact of hospitalization in the children. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  18. Pediatric neurocritical care. (United States)

    Murphy, Sarah


    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  19. Radiodiagnosis in pediatrics today

    International Nuclear Information System (INIS)

    Baklanova, V.F.


    The fields of radiodiagnosis application in pediatrics are considered. The improvement of roentgenologic methods and application of various contrast proparations enable to study and precisely differentiate congenital and acquired diseases. The scope of roentgenology application in pediatrics extends due to differentiation of pediatric specialities. New methods of investigation with decreasing radiation exposure to minimal are realized [ru

  20. Students with Chronic Health Conditions: The Role of The School Nurse. Position Statement (United States)

    Combe, Laurie G.; Mattern, Cheryl; Fleming, Laurie; Killingsworth, Suzie


    It is the position of the National Association of School Nurses (NASN) that to optimize student health, safety, and learning, a professional registered school nurse (hereinafter referred to as school nurse) be present all day, every day. The American Academy of Pediatrics' Council on School Health (2016) highlights the important role school nurses…

  1. Manejo da dor pós-operatória na Enfermagem Pediátrica: em busca de subsídios para aprimorar o cuidado El manejo del dolor postoperatorio en la Enfermería Pediátrica: en búsqueda de apoyo para mejorar el cuidado Managing postoperative pain in Pediatric Nursing: searching for subsides to improve nursing care

    Directory of Open Access Journals (Sweden)

    Fernanda Cristina Queiroz


    professionals and family members. The lack of studies in this area reveals the need for research, with a view to (reconsidering pediatric nursing care.

  2. Nurses who work outside nursing. (United States)

    Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M


    The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

  3. Malignant renal tumors in pediatrics

    International Nuclear Information System (INIS)

    Pena, C.; Torterolo, J.; Irigoyen, B.; Bel, M.; Elias, E.


    Introduction: Professionals who work in pediatric oncology, we see childhood cancer as a common disease, but in fact constitutes about 2% of all cancers diagnosed worldwide. Wilms tumor accounts for 6% of all childhood tumors and presentation bilateral accounts for 4-6% of all Wilms tumors diagnosed. Theoretical Framework: In the period between the year 1994-2003 period were attended in the Pediatric Hematology-Oncology Center, a total of 29 cases of malignant renal tumors, corresponding to 86% (25 cases) to Wilms tumor or nephroblastoma tumor. The Wilms is of embryonic origin, capable of metastatic spread, (85% lungs 15% liver). Very sensitive to chemotherapy and radiotherapy, which confers high cure rates (85%); having a multidisciplinary treatment model, combining surgery, chemotherapy, and radiotherapy. The role of nursing in comprehensive cancer care child is essential in the prevention and early detection of side effects or complications. Case report: S.D. currently 10 years old. In 10/1994, at 8 months of age, was diagnosed with bilateral Wilms tumor. On admission her weight was 8200gr with abdominal circumference 50cm. Conducted pre-operative MDT and 02/1995 nephrectomy of the left kidney and right kidney lumpectomy (tumor nodule 420gr. and a 250gr.). MDT begins in 03/1995 01/1996 ending. 09/2003 with abdominal pain and vomiting, and kidney failure. 10/2003 lumpectomy biopsy (sclerotic nodule associated with maturation nephroblastoma). Currently severe renal insufficiency plan enters dialysis. Nursing process: Objectives: 1) To prepare the child and family to the side effects and possible complications of chemotherapy and / or radiotherapy 2) Prevent and minimize related complications tumor and / or treatment. Care Plan comprises four stages: A) rating and customer income. B) Implement care chemotherapy C) post-operative Care D) Implement radiation care

  4. Pediatric oncologic emergencies

    International Nuclear Information System (INIS)

    Zietz, Hallie A.


    Oncologic emergencies arise in three ways: disease or therapy induced cytopenias; a space occupying lesion causing pressure on or obstruction of surrounding tissues; or leukemia or tumors creating life-threatening metabolic or hormonal problems. Knowledge of presenting signs and symptoms of these emergencies are essential in pediatric oncologic nursing. Neutropenia opens the door for all manner of infections, but the most life threatening is septicemia progressing to shock. A variety of organisms can cause septic shock in the neutropenic patient, but episodes are most often due to gram-negative organisms and the endotoxins they release. Shock, while still compensated, may present with a elevated or subnormal temperature, flushed, warm, dry skin, widening pulse pressure, tachycardia, tachypnoea and irritability, but without medical intervention will progress to hypo tension, cool, clammy extremities, decreased urinary out- put, and eventually to bradycardia and cardiogenic shock. Another emergency in the cytopenia category is bleeding as a result of thrombocytopenia. Of greatest concern is intracranial hemorrhage that may occur at platelet counts of less than 5,000/mm3. Space-occupying lesions of the chest may produce superior vena cava syndrome (SVGS), pleural and pericardial effusions, and cardiac tamponade. SVGS is most often caused by non-Hodgkin's lymphoma (NHL) and presents as cough, hoarseness, dyspnea, orthopnea and chest pain. Signs include swelling, plethora, cyanosis, edema of conjunctiva and wheezing. Pleural and pericardial effusions present with respiratory or cardiac distress as does cardiac tamponade. Abdominal emergencies arise because of inflammation, mechanical obstruction, hemorrhage (often from steroid induced ulcers), and perforation. Pain is the most common presenting symptom, although vital sign alterations, fever, blood in vomitus or stool, abdominal distension and cessation of flatus are also important components of the acute abdomen

  5. How can we cooperate better? The determinants of conflict solving competence in Polish pediatric nurses’ relations with parents of hospitalized children

    Directory of Open Access Journals (Sweden)

    Magdalena Chrzan-Dętkoś


    Full Text Available Background Our pilot study carried out at two Polish pediatric hospital departments revealed that conflicts with parents of hospitalized children represent the main concern of pediatric nurses. The aim of this study was to examine factors determining the conflict solving competence in pediatric nurses in order to develop effective communication training programs for pediatric ward staff. Participants and procedure A total of 78 pediatric nurses completed measures of occupational and perceived stress, conflict modes and competence in solving conflicts with parents of hospitalized children. Results The key factor influencing conflict solving competence was the level of perceived stress and supervisor support. Conclusions Systemic supervised activities aimed at reducing the level of stress, e.g. Balint groups or reflective supervision, could be helpful in mastering the conflict solving competences. Also a paradigm shift from the individual patient to his/her family considered as a patient could potentially improve nurse-parent relations.

  6. Nursing Homes (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  7. Age Limit of Pediatrics. (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M


    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  8. Nursing Reclaims its Role. (United States)

    Diers, Donna


    An attempt is made to explain the nurses' role: what the nurse is, what the nurse does, how the nurse is viewed by society, why nurses suffer burnout, nursing costs, and health care system reform. (CT)

  9. Neonatal Nursing


    Crawford, Doreen; Morris, Maryke


    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  10. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  11. What Is a Pediatric Gastroenterologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  12. What Is a Pediatric Endocrinologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  13. What Is a Pediatric Geneticist? (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  14. What is Pediatric Palliative Care? (United States)

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  15. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  16. What Is a Pediatric Urologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  17. Children's (Pediatric) Abdominal Ultrasound Imaging (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  18. The development of pediatric anesthesia and intensive care in Scandinavia. (United States)

    Nilsson, Krister; Ekström-Jodal, Barbro; Meretoja, Olli; Valentin, Niels; Wagner, Kari


    The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second World War. Relations for training and exchange of experiences between Scandinavian countries with centers in Europe and the USA were a prerequisite for development. Specialized pediatric practice was not a full-time position until during the 1950s, when the first pediatric anesthesia positions were created. Scandinavian anesthesia developed slowly. In contrast, Scandinavia pioneered both adult and certainly pediatric intensive care. The pioneers were heavily involved in the teaching and training of anesthetists and nurses. This was necessary to manage the rapidly increasing work. The polio epidemics during the 1950s initiated a combination of clinical development and technical innovations. Blood gas analyses technology and interpretation in combination with improved positive pressure ventilators were developed in Scandinavia contributing to general and pediatric anesthesia and intensive care practice. Scandinavian specialist training and accreditation includes both anesthesia and intensive care. Although pediatric anesthesia/intensive care is not a separate specialty, an 'informal accreditation' for a specialist position is obtained after training. The pleasure of working in a relatively small group of devoted colleagues and staff has persisted from the pioneering years. It is still one of the most inspiring and pleasant gifts for those working in this demanding specialty. © 2014 John Wiley & Sons Ltd.

  19. Nursing: What's a Nurse Practitioner? (United States)

    ... as advanced practice nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification ... NP training emphasizes disease prevention, reduction of health risks, and thorough patient education. Like doctors, NPs are ...

  20. School Nurses' Familiarity and Perceptions of Academic Accommodations for Student-Athletes Following Sport-Related Concussion (United States)

    Weber, Michelle L.; Welch, Cailee E.; Parsons, John T.; Valovich McLeod, Tamara C.


    The purpose of this study was to evaluate school nurses' familiarity and perceptions regarding academic accommodations for student-athletes following sport-related concussion. School nurses (N = 1,246) accessed the survey School Nurses' Beliefs, Attitudes and Knowledge of Pediatric Athletes with Concussions (BAKPAC-SN). The BAKPAC-SN contained…

  1. Noise, stress, and annoyance in a pediatric intensive care unit. (United States)

    Morrison, Wynne E; Haas, Ellen C; Shaffner, Donald H; Garrett, Elizabeth S; Fackler, James C


    To measure and describe hospital noise and determine whether noise can be correlated with nursing stress measured by questionnaire, salivary amylase, and heart rate. Cohort observational study. Tertiary care center pediatric intensive care unit. Registered nurses working in the unit. None. Eleven nurse volunteers were recruited. An audiogram, questionnaire data, salivary amylase, and heart rate were collected in a quiet room. Each nurse was observed for a 3-hr period during patient care. Heart rate and sound level were recorded continuously; saliva samples and stress/annoyance ratings were collected every 30 mins. Variables assessed as potential confounders were years of nursing experience, caffeine intake, patients' Pediatric Risk of Mortality Score, shift assignment, and room assignment. Data were analyzed by random effects multiple linear regression using Stata 6.0. The average daytime sound level was 61 dB(A), nighttime 59 dB(A). Higher average sound levels significantly predicted higher heart rates (p =.014). Other significant predictors of tachycardia were higher caffeine intake, less nursing experience, and daytime shift. Ninety percent of the variability in heart rate was explained by the regression equation. Amylase measurements showed a large variability and were not significantly affected by noise levels. Higher average sound levels were also predictive of greater subjective stress (p =.021) and annoyance (p =.016). In this small study, noise was shown to correlate with several measures of stress including tachycardia and annoyance ratings. Further studies of interventions to reduce noise are essential.

  2. Benefits and Barriers for Registered Nurses Undertaking Post-Graduate Diplomas in Paediatric Nursing. (United States)

    Johnson, Anne; Copnell, Beverley


    Responses from 391 of 885 pediatric nurses indicated that 133 had postgraduate qualifications; 70 intended to acquire postgraduate diplomas; 71% believed it enhanced employment opportunities. Barriers were course costs, loss of salary, lack of promotional opportunities, and the perception that employers did not value postgraduate qualifications.…

  3. Advances in pediatric dentistry. (United States)

    Yoon, Richard K; Best, Jed M


    This article addresses advances in 4 key areas related to pediatric dentistry: (1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries-risk assessment tools, and (4) trends in pediatric procedures and dental materials. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Pediatric magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cohen, M.D.


    This book defines the current clinical potential of magnetic resonance imaging and focuses on direct clinical work with pediatric patients. A section dealing with the physics of magnetic resonance imaging provides an introduction to enable clinicians to utilize the machine and interpret the images. Magnetic resonance imaging is presented as an appropriate imaging modality for pediatric patients utilizing no radiation

  5. Nursing students assess nursing education. (United States)

    Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert


    This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

  6. Pediatric oncologic endosurgery. (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J


    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  7. Burnout in Nurses Working With Youth With Chronic Pain: A Mixed-Methods Analysis. (United States)

    Rodrigues, Nikita P; Cohen, Lindsey L; Swartout, Kevin M; Trotochaud, Karen; Murray, Eileen


    Nursing is a rewarding but also challenging profession. Nurses are at risk for burnout and premature exit from the profession, which is detrimental to them, their patients, and the healthcare system. There are few studies examining the unique correlates of burnout in nurses working with pediatric populations. The current 2-study project used mixed-methods (qualitative and then quantitative) analysis to explore burnout in nurses working in an inpatient unit with youth with chronic pain. Study I participants included all of the 32 nurses who worked in an inpatient pediatric unit, which admits patients with chronic pain. Qualitative analyses of focus groups were used to extract themes. These themes were examined via a quantitative battery completed by 41 nurses from 2 inpatient pediatric units with youth with chronic pain. The themes were burnout, moral distress, negative beliefs about chronic pain, barriers to pain management, fear of losing compassion, coworker support as a coping method, time worked in the unit, professional self-efficacy, and negative views of the hospital environment. Quantitative results supported most of the qualitative findings, and taken together, the findings supported a model of burnout in nurses working with youth with chronic pain. Conclusions We integrated qualitative and quantitative findings to develop a model of nurse burnout. This model provides a framework for evaluating and targeting burnout in nurses working with pediatric patients with chronic pain.

  8. Social pediatrics: weaving horizontal and vertical threads through pediatric residency. (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle


    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  9. Estresse ocupacional e suas repercussões na qualidade de vida de médicos e enfermeiros intensivistas pediátricos e neonatais Occupational stress and repercussions on the quality of life of pediatric and neonatal intensivist physicians and nurses

    Directory of Open Access Journals (Sweden)

    Monalisa de Cássia Fogaça


    Full Text Available OBJETIVO: Investigar as relações entre trabalho e qualidade de vida de médicos e enfermeiros em unidades de terapia intensiva pediátrica e neonatal. MÉTODOS: Estudo transversal com 37 médicos e 20 enfermeiros. O Job Content Questionnarie (JCQ, Effort-Reward Imbalance (ERI e World Health Organization Quality of Life (WHOQOL-100 foram utilizados. A correlação foi estimada através do coeficiente de correlação de Spearman. RESULTADOS: O esforço é inversamente correlacionado com os domínios: físico, psicológico, nível de independência, meio ambiente (pOBJECTIVE: To investigate the relationship between work and quality of life of doctors and nurses in pediatric intensive care units and neonatal. METHODS: Cross-sectional study with 37 doctors and 20 nurses. The Job Content Questionnarie (JCQ e Effort-Reward Imbalance (ERI, and World Health Organization Quality of Life (WHOQOL-100 were used. The correlation was estimated by Spearman correlation coefficient. RESULTS: The effort is inversely correlated with the areas physical, psychological, level of independence, environment (p<0.01 and social relationship (p<0.05. The reward is inversely correlated with the areas and psychological (p<0.05 level of independence (p<0.01. Control over the work is directly correlated with the physical domain (p<0.05. The psychological demands are inversely correlated with the areas physical (p<0.05, psychological (p<0.01 and level of independence (p<0.01. The physical demand is inversely correlated with physical areas, level of independence, environmental (p<0.01 and psychological (p<0.05. Job insecurity is inversely correlated with the psychological fields, level of independence (p<0.05 and the environment (p<0.01. Support the supervisor is directly correlated with degree of independence (p <0.05. CONCLUSION: Doctors and nurses showed high efforts, demands psychological, physical and job insecurity that impact on quality of life.

  10. Enfermagem pediátrica e abordagem da família: subsídios para o ensino de graduação Enfermería pediátrica y abordaje de la familia: aportes para la enseñanza de pre-grado Pediatric nursing and the family approach: subsidies for undergraduate teaching

    Directory of Open Access Journals (Sweden)

    Semiramis Melani Melo Rocha


    Full Text Available O objetivo deste artigo é apresentar instrumentos utilizados na abordagem de enfermagem da família, divulgados na literatura internacional, e fornecer subsídios para sua utilização, pela enfermagem brasileira, na assistência à crianças, em abordagens de saúde da família. As autoras apresentam a experiência de introduzir, no ensino de Enfermagem Pediátrica, uma metodologia de assistência sistematizada cujos instrumentos para levantamento de dados são o APGAR da família, geneograma e ecomapa. Argumentam que esses instrumentos não substituem a fundamentação teórica da assistência nem tão pouco a razão e o discernimento para dar sentido e significado aos dados e encontrar as melhores soluções para o cuidado à criança e sua família.El objetivo de este artículo es presentar instrumentos utilizados en el abordaje de enfermería de la familia, divulgados en la literatura internacional y ofrecer aportes para su utilización, por la enfermería brasileña, en la atención a niños, en abordajes de salud de la familia. Las autoras presentan la experiencia de introducir en la enseñanza de Enfermería Pediátrica, una metodología de atención sistematizada cuyos instrumentos para levantamiento de datos son el APGAR de la familia, genograma y ecomapa. Argumentan que estos instrumentos no van a substituir la fundamentación teórica de la atencion ni tan poco la razón y el discernimiento para dar sentido y significado a los datos y encontrar las mejores soluciones para el cuidado al niño y a su familia.This work aims at presenting the instruments used in the family nursing approach as depicted in the international literature as well as at providing subsidies for their utilization by Brazilian nursing professionals in family health approaches to child care. The authors present the experience of introducing a methodology for systematized care in Pediatric Nursing programs using instruments for data collection such as the family

  11. Pediatric maxillary fractures. (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit


    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  12. Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG) (United States)

    Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan


    Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring

  13. Become the PPUPET Master: Mastering Pressure Ulcer Risk Assessment With the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). (United States)

    Sterken, David J; Mooney, JoAnn; Ropele, Diana; Kett, Alysha; Vander Laan, Karen J


    Hospital acquired pressure ulcers (HAPU) are serious, debilitating, and preventable complications in all inpatient populations. Despite evidence of the development of pressure ulcers in the pediatric population, minimal research has been done. Based on observations gathered during quarterly HAPU audits, bedside nursing staff recognized trends in pressure ulcer locations that were not captured using current pressure ulcer risk assessment tools. Together, bedside nurses and nursing leadership created and conducted multiple research studies to investigate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). Copyright © 2015 Elsevier Inc. All rights reserved.

  14. [Robotics in pediatric surgery]. (United States)

    Camps, J I


    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  15. Nursing informatics and nursing ethics

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer


    All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...

  16. A Study of Patient Satisfaction in the Pediatrics Clinic at Water Reed Army Medical Center (United States)


    Coordinated Care Program set forth by the Assistant Secretary of Defense for Health Affairs, Dr. Mendez , (January, 1992): "The Coordinated Care Program...William Walker, MC, Chief, Pediatric Clinic; CPT Kurt Allebach, MS, Administrator, Department of Pediatrics; Ms Carol Tross, Nursing Supervisor...of Defense moves to Coordinated Care with mandatory enrollment ( Mendez , 1992). The impact on this research may be an overestimation of the true level

  17. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience. (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P


    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  18. Nursing students' attitudes about home health nursing. (United States)

    Prestia, Mindy; Murphy, Susan; Yoder, Marian


    In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

  19. Fostering nursing ethics for practical nursing


    森田, 敏子; モリタ, トシコ; Morita, Toshiko


    Higher nursing ethics can raise nursing quality. The author attempts to define theproblem from the seedling of sensibility in practical nursing and focuses on the clinical environment surrounding nursing ethics from its pedagogical and historicalaspects. On the basis of these standpoints, the author discusses issues on the practical nursing as a practitioner of nursing ethics.

  20. Tecnologia educacional em saúde: contribuições para a enfermagem pediátrica e neonatal Tecnología educativa en salud: contribuciones para la enfermería pediátrica y neonatal Educational technology in health: contributions for pediatric and neonatal nursing

    Directory of Open Access Journals (Sweden)

    Luciana Mara Monti Fonseca


    pediatric and neonatal nursing teaching and practice, is pointed out. Technological resources in educational materials have been used in a progressively motivating and interactive pedagogical relationship, aiming to offer a more motivating learning for students, nursing teams, children and their families. This report describes the experience of a research and study group in the development of materials targeting permanent training and education in the area of pediatric and neonatal nursing. Health education for children and their relatives on different themes that permeates this care was also targeted. The developed educational materials permit students, health professionals and clients to experience the teaching and learning process in a stimulating way, facilitating the clarification of doubts and transforming learning through attractive, innovative and illustrative situations.

  1. Knowledge of oxygen administration, aerosol medicine, and chest physiotherapy among pediatric healthcare workers in Italy. (United States)

    Esposito, Susanna; Brivio, Anna; Tagliabue, Claudia; Galeone, Carlotta; Tagliaferri, Laura; Serra, Domenico; Foà, Michela; Patria, Maria Francesca; Marchisio, Paola; Principi, Nicola


    Oxygen administration, aerosol devices and drugs, or the use of chest physiotherapy are common practices in pediatrics; however, little is known about the knowledge of pediatric healthcare workers concerning the right utilization of these tools. The aim of this study was to fill this gap as a preliminary step in the implementation of appropriate educational programs. This cross-sectional survey of a nationally representative sample of Italian pediatricians and nurses was carried out between September 1 and October 8, 2008. A self-administered, anonymous questionnaire concerning the approach to respiratory disease in infants and children was distributed to all of the participants at the Annual Congress of the Italian Society of Pediatrics, together with a stamped envelope addressed to the trained study researchers. Of the 900 distributed questionnaires, 76.7% were completed and returned by 606 physicians (199 primary care pediatricians, 245 hospital pediatricians, and 162 pediatric residents) and 84 pediatric nurses. The vast majority of the respondents did not know the percentage of hemoglobin saturation indicating hypoxemia that requires oxygen administration. Most of the nurses admitted to overusing mucolytics and inhalatory corticosteroids, did not know the role of ipratropium bromide, were unable to indicate the first-line drug for respiratory distress, and did not know the correct dose of salbutamol. Only a minority of the respondents were able to specify the indications for chest physiotherapy. The nurses gave the fewest correct answers regardless of their age, gender, work setting, or the frequency with which they cared for children with respiratory distress in a year cared. The knowledge of primary care pediatricians, hospital pediatricians, and pediatric nurses in Italy concerning the use of pulse oximetry, aerosol devices and drugs, and chest physiotherapy is far from satisfactory and should be improved. Educational programs are therefore required for

  2. American Nurses Association Nursing World (United States)

    ... Standards Nursing Quality Ethics / Genetics & Genomics Code of Ethics Workplace Safety / Safe Patient Handling Needlestick Prevention Environmental Health Policy & Advocacy / Take Action Position Statements Member ...

  3. A survey on training in pediatric cardiopulmonary resuscitation in Latin America, Spain, and Portugal. (United States)

    López-Herce, Jesús; Carrillo, Angel


    To determine how training in pediatric cardiopulmonary resuscitation is provided in the Iberoamerican countries. Survey. Latin America, Spain, and Portugal. Experts in pediatric cardiopulmonary resuscitation education. A questionnaire was sent to experts in pediatric cardiopulmonary resuscitation training in 21 countries in Latin America, Spain, and Portugal; we received 15 replies. Pediatric cardiopulmonary resuscitation training is not included in medical undergraduate or nursing training in any of these countries and pediatric residents receive systematic cardiopulmonary resuscitation training in only four countries. Basic pediatric life support courses, pediatric advanced life support courses, and pediatric cardiopulmonary resuscitation instructors courses are given in 13 of 15, 14 of 15, and 11 of 15 respondent countries, respectively. Course duration and the number of hours of practical training were variable: basic life support, 5 hrs (range, 4-8 hrs); practical training, 4 hrs (range, 2-5 hrs); advanced life support, 18 hrs (range, 10-30 hrs); and practical training, 14 hrs (range, 5-18 hrs). Only nine countries (60%) had a national group that organized pediatric cardiopulmonary resuscitation training. Thirteen countries (86.6%) had fewer than five centers offering pediatric cardiopulmonary resuscitation training. Respondents considered the main obstacles to the expansion of training in pediatric cardiopulmonary resuscitation to be the shortage of instructors (28.5%), students' lack of financial resources (21.4%), and deficiencies in educational organization (21.4%). Pediatric cardiopulmonary resuscitation training is not uniform across the majority of Iberoamerican countries, with poor organization and little institutional involvement. National groups should be created in each country to plan and coordinate pediatric cardiopulmonary resuscitation training and to coordinate with other Iberoamerican countries.

  4. Αpproach techniques and psychological support in pediatric patients: literature review

    Directory of Open Access Journals (Sweden)

    Anthoula Patsiala


    Full Text Available Effective approaches and psychological support of pediatric patients provided by health professionals are complex processes. The negative reactions and fear that pediatric patients develop during their hospitalization hamper cooperation with health professionals. The pediatric nursing staff is called upon to apply appropriate techniques for managing these situations.The purpose of this paper was to investigate, through contemporary literature review, methods of technical and psychological support of pediatric patients, applied by nurses in everyday clinical practice. The management of negative reactions and fear of pediatric patients requires individualized approach, given the uniqueness of each one of them. However, there are some general measures which may bring the ultimate results. According to literature some of them are: creation of a sincere relationship through targeted discussion, application of documented interactive educational programs to familiarize with nursing and medical procedures, distraction during painful acts, such as venipuncture or bladder catheterization, and finally high perception to identify nonverbal reactions.Awareness and familiarization of health professionals with appropriate methods will improve the relationship between pediatric patients and healthcare providers.

  5. Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice

    Directory of Open Access Journals (Sweden)

    D. Hallas


    Full Text Available Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP program at New York University College of Nursing (NYUCN have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.

  6. Secondary traumatic stress in nurses: a systematic review. (United States)

    Beck, Cheryl Tatano


    Is there a "cost of caring" for health care providers of traumatized patients? The aim of this study is to review the literature on secondary traumatic stress in nurses in order to answer the following questions: What studies have been conducted on secondary traumatic stress in nurses in all clinical specialties? What instruments were used to measure secondary traumatic stress in nurses and what psychometric properties were reported? A systematic review. CINAHL, PubMed, and PsycINFO databases were searched for the years 1981 to the present. Keywords used in the database searches included secondary traumatic stress, compassion fatigue, vicarious traumatization, secondary trauma, PTSD, and nurses. Research studies were reviewed for the following inclusion criteria: the sample included nurses, the secondary traumatic stress symptoms were measured, and the language was English. Seven studies were found in which researchers examined secondary traumatic stress in nurses. The samples in five of these studies consisted of all nurses, whereas in the remaining two studies, nurses were included in the samples but the results were not specifically reported for the subgroup of nurses. Presence of secondary traumatic stress was reported in forensic nurses, emergency department nurses, oncology nurses, pediatric nurses, and hospice nurses. Three instruments were identified that measured secondary traumatic stress in practitioners who care for traumatized populations: Secondary Traumatic Stress Scale, Compassion Fatigue Self Test for Helpers, and the Compassion Fatigue Scale-Revised. Presence of secondary traumatic stress in nurses was reported in all of the studies included in this literature review. The use of small samples and a number of different instruments to measure secondary traumatic stress symptoms, however, hindered the ability to make comparisons across studies and to draw conclusions. None of the studies conducted to date have focused on secondary traumatic stress in

  7. [Complications in pediatric anesthesia]. (United States)

    Becke, K


    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders that are congenital (present at birth) or that develop during childhood. Physicians use nuclear medicine imaging to ...

  9. Pediatric Urinary Tract Infection (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

  10. Pediatric Nephrolithiasis: A Review. (United States)

    Miah, Tayaba; Kamat, Deepak


    The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis. [Pediatr Ann. 2017;46(6):e242-e244.]. Copyright 2017, SLACK Incorporated.

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special ... is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... imaging techniques. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... interventions. Children's (pediatric) nuclear medicine refers to imaging examinations done in babies, young children and teenagers. Nuclear ... nuclear medicine procedure work? With ordinary x-ray examinations, an image is made by passing x-rays ...

  14. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... at birth) or that develop during childhood. Physicians use nuclear medicine imaging to evaluate organ systems, including ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... child is taking as well as vitamins and herbal supplements and if he or she has any ... What are the limitations of Children's (Pediatric) Nuclear Medicine? Nuclear medicine procedures can be time consuming. It ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Children's (Pediatric) Nuclear Medicine? What are some common uses of the procedure? How does the nuclear medicine procedure work? What does the equipment look like? How is ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... to Children's (Pediatric) Nuclear Medicine Sponsored by Please note is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ...

  1. Causes of Pediatric Cardiomyopathy (United States)

    ... inherited metabolic or congenital muscle disorder such as Noonan syndrome, Pompe disease, fatty acid oxidation defect or Barth ... where a specific chromosome is deleted or duplicated. Noonan syndrome is the most common form associated with pediatric ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media General Nuclear Medicine Children's (Pediatric) CT ( ... About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 Radiological Society of ...

  3. The pediatric knee. (United States)

    Orth, Robert C


    Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

  4. Analysis of a Pediatric Home Mechanical Ventilator Population. (United States)

    Amirnovin, Rambod; Aghamohammadi, Sara; Riley, Carley; Woo, Marlyn S; Del Castillo, Sylvia


    The population of children requiring home mechanical ventilation has evolved over the years and has grown to include a variety of diagnoses and needs that have led to changes in the care of this unique population. The purpose of this study was to provide a descriptive analysis of pediatric patients requiring home mechanical ventilation after hospitalization and how the evolution of this technology has impacted their care. A retrospective, observational, longitudinal analysis of 164 children enrolled in a university-affiliated home mechanical ventilation program over 26 years was performed. Data included each child's primary diagnosis, date of tracheostomy placement, duration of mechanical ventilation during hospitalization that consisted of home mechanical ventilator initiation, total length of pediatric ICU stay, ventilator settings at time of discharge from pediatric ICU, and disposition (home, facility, or died). Univariate, bivariate, and regression analysis was used as appropriate. The most common diagnosis requiring the use of home mechanical ventilation was neuromuscular disease (53%), followed by chronic pulmonary disease (29%). The median length of stay in the pediatric ICU decreased significantly after the implementation of a ventilator ward (70 d [30-142] vs 36 d [18-67], P = .02). The distribution of subjects upon discharge was home (71%), skilled nursing facility (24%), and died (4%), with an increase in the proportion of subjects discharged on PEEP and those going to nursing facilities over time ( P = 0.02). The evolution of home mechanical ventilation has allowed earlier transition out of the pediatric ICU and with increasing disposition to skilled nursing facilities over time. There has also been a change in ventilator management, including increased use of PEEP upon discharge, possibly driven by changes in ventilators and in-patient practice patterns. Copyright © 2018 by Daedalus Enterprises.

  5. As práticas lúdicas no cotidiano do cuidar em enfermagem pediátrica Prácticas lúdicas en el contexto del cuidado en enfermería pediátrica The playful in the daily practices of care in pediatric nursing

    Directory of Open Access Journals (Sweden)

    Tábatta Renata Pereira de Brito


    la Unidad de Pediatría? Una mejor percepción de los resultados se presentó al organizar el material bajo las siguientes categorías: la motivación/gratificación, la falta de compromiso e iniciativa, y la impotencia. Por lo tanto, se concluyó que la inclusión de elementos lúdicos en las prácticas pediátricas se presentó de forma paulatina, y que el hecho de realizar prácticas lúdicas implica hacer una revisión de la formación académica, convirtiendo la coyuntura enseñanza-investigación - educación en un vínculo fuerte y coherente, logrando así, que los contenidos enfaticen la humanización e integración de la asistencia.Although the playfultherapy has therapeutic value in the hospitalization and need to be incorporate in the process of taking care in Pediatric Nursing, her use is not effective in the Brazilian institutions. Being like this, it is aimed to apprehend from the academics of Nursing doing playful practices with children hospitalized during the professional studies. Methodologically was adopted the approach qualitative phenomenological, with sample of 16 academics of the eighth period of the Nursing Course at the Universidade Federal de Alfenas, after Free Consent and Clarification. It was used open interviews with the subject oriented: How are the playful activities applied in the daily of work in Pediatric Unit? The results are evidenced by the categories motivation/gratification, lack of pledge and initiative, and impotence. Consequently, it was considered that the insert of the playful in pediatrics is a gradual process, and that doing playful practices implicates in reviewing the academic studies, turning the articulation strong and coherent teaching/research/extension, for the contents to emphasize the humanization and the assistance integralization.

  6. Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients. (United States)

    Agulnik, Asya; Forbes, Peter W; Stenquist, Nicole; Rodriguez-Galindo, Carlos; Kleinman, Monica


    To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. We performed a retrospective matched case-control study, comparing the highest documented Pediatric Early Warning Score within 24 hours prior to unplanned PICU transfers in hospitalized pediatric oncology and hematopoietic stem cell transplant patients between September 2011 and December 2013. Controls were patients who remained on the inpatient unit and were matched 2:1 using age, condition (oncology vs hematopoietic stem cell transplant), and length of hospital stay. Pediatric Early Warning Scores were documented by nursing staff at least every 4 hours as part of routine care. Need for transfer was determined by a PICU physician called to evaluate the patient. A large tertiary/quaternary free-standing academic children's hospital. One hundred ten hospitalized pediatric oncology patients (42 oncology, 68 hematopoietic stem cell transplant) requiring unplanned PICU transfer and 220 matched controls. None. Using the highest score in the 24 hours prior to transfer for cases and a matched time period for controls, the Pediatric Early Warning Score was highly correlated with the need for PICU transfer overall (area under the receiver operating characteristic = 0.96), and in the oncology and hematopoietic stem cell transplant groups individually (area under the receiver operating characteristic = 0.95 and 0.96, respectively). The difference in Pediatric Early Warning Score results between the cases and controls was noted as early as 24 hours prior to PICU admission. Seventeen patients died (15.4%). Patients with higher Pediatric Early Warning Scores prior to transfer had increased PICU mortality (p = 0.028) and length of stay (p = 0.004). We demonstrate that our institution's Pediatric Early Warning Score is highly correlated with the need for unplanned PICU transfer in hospitalized oncology and

  7. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.


    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  8. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I [London, Great Ormond Street Hospital for Children (United Kingdom)


    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  9. From Mendel to the Human Genome Project: The Implications for Nurse Education. (United States)

    Burton, Hilary; Stewart, Alison


    The Human Genome Project is brining new opportunities to predict and prevent diseases. Although pediatric nurses are the closest to these developments, most nurses will encounter genetic aspects of practice and must understand the basic science and its ethical, legal, and social dimensions. (Includes commentary by Peter Birchenall.) (SK)

  10. Integrative Literature Review: Ascertaining Discharge Readiness for Pediatrics After Anesthesia. (United States)

    Whitley, Deborah R


    Unplanned hospital readmissions after the administration of general anesthesia for ambulatory procedures may contribute to loss of reimbursement and assessment of financial penalties. Pediatric patients represent a unique anesthetic risk. The purpose of this integrative literature review was to ascertain specific criteria used to evaluate discharge readiness for pediatric patients after anesthesia. This study is an integrative review of literature. An integrative literature search was conducted and included literature sources dated January 2008 to November 2013. Key words included pediatric, anesthesia, discharge, criteria, standards, assessment, recovery, postoperative, postanesthesia, scale, score, outpatient, and ambulatory. Eleven literature sources that contributed significantly to the research question were identified. Levels of evidence included three systematic reviews, one randomized controlled trial, three cohort studies, two case series, and two expert opinions. This integrative literature review revealed evidence-based discharge criteria endorsing home readiness for postanesthesia pediatric patients should incorporate consideration for physiological baselines, professional judgment with regard to infant consciousness, and professional practice standards/guidelines. Additionally, identifying and ensuring discharge to a competent adult was considered imperative. Nurses should be aware that frequently used anesthesia scoring systems originated in the 1970s, and this review was unable to locate current literature examining the reliability and validity of their use in conjunction with modern anesthesia-related health care practices. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  11. An Integrative Review of Pediatric Fall Risk Assessment Tools. (United States)

    DiGerolamo, Kimberly; Davis, Katherine Finn

    Patient fall prevention begins with accurate risk assessment. However, sustained improvements in prevention and quality of care include use of validated fall risk assessment tools (FRATs). The goal of FRATs is to identify patients at highest risk. Adult FRATs are often borrowed from to create tools for pediatric patients. Though factors associated with pediatric falls in the hospital setting are similar to those in adults, such as mobility, medication use, and cognitive impairment, adult FRATs and the factors associated with them do not adequately assess risk in children. Articles were limited to English language, ages 0-21years, and publish date 2006-2015. The search yielded 22 articles. Ten were excluded as the population was primarily adult or lacked discussion of a FRAT. Critical appraisal and findings were synthesized using the Johns Hopkins Nursing evidence appraisal system. Twelve articles relevant to fall prevention in the pediatric hospital setting that discussed fall risk assessment and use of a FRAT were reviewed. Comparison between and accuracy of FRATs is challenged when different classifications, definitions, risk stratification, and inclusion criteria are used. Though there are several pediatric FRATs published in the literature, none have been found to be reliable and valid across institutions and diverse populations. This integrative review highlights the importance of choosing a FRAT based on an institution's identified risk factors and validating the tool for one's own patient population as well as using the tool in conjunction with nursing clinical judgment to guide interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children's Oncology Group. (United States)

    Smolik, Suzanne; Arland, Lesley; Hensley, Mary Ann; Schissel, Debra; Shepperd, Barbara; Thomas, Kristin; Rodgers, Cheryl

    Peripheral neuropathy is a known side effect of several chemotherapy agents, including vinca alkaloids and platinum-based chemotherapy. Early recognition and monitoring of this side effect is an important role of the pediatric oncology nurse. There are a variety of peripheral neuropathy assessment tools currently in use, but the usefulness of these tools in identifying and grading neuropathy in children varies, and there is currently no standardized tool in place to evaluate peripheral neuropathy in pediatric oncology. A systematic review was performed to identify the peripheral neuropathy assessment tools that best evaluate the early onset and progression of peripheral neuropathy in pediatric patients receiving vincristine. Because of the limited information available in pediatric oncology, this review was extended to any pediatric patient with neuropathy. A total of 8 studies were included in the evidence synthesis. Based on available evidence, the pediatric-modified Total Neuropathy Scale (ped-m TNS) and the Total Neuropathy Score-pediatric version (TNS-PV) are recommended for the assessment of vincristine-induced peripheral neuropathy in children 6 years of age and older. In addition, several studies demonstrated that subjective symptoms alone are not adequate to assess for vincristine-induced peripheral neuropathy. Nursing assessment of peripheral neuropathy should be an integral and regular part of patient care throughout the course of chemotherapy treatment.

  13. Do pediatric gastroenterology doctors address pediatric obesity?


    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra


    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  14. [Perception of safety climate in outpatient pediatric care]. (United States)

    Baldegger, Claudia; Zeller, Adelheid


    In ambulant pediatric care, patients situations are becoming increasingly complex, because the lenght of hospital stay is reduced since the introduction of Diagnosis Related Groups (DRG). Consequently, the patients' safety is constantly becoming more important. The patients' safety is closely associated with the nurses' awareness of risks and the safety climate within the institution. This study is investigating how nurses of a pediatric outpatient service estimate the patients' safety and how that can be optimized, if necessary. As part of a cross-sectional study, a total of 106 nurses of the pediatric outpatient service were interviewed with a modified German version of the "Patient Safety Climate Inventory (Patientensicherheitsklima-Inventar, PaSKI)". Data was analysed by a descriptive statistical method. The return rate was 80.2 percent. The results show a very high awareness of patients' safety issues as well as a high level of satisfaction concerning team collaboration. Both results have a positive influence on the safety-climate. Problems are associated mainly with the incident reporting system, e.g. with reporting critical incidents and communicating after reporting. This indicates the importance of a useable incident reporting system, which--in combination with staff training--may be an important step towards a structured risk management. Furthermore, it clarifies the importance of transparent communication after a reported incident, as also described in the literature.

  15. Nurses' Experiences of Spiritual Communication with Seriously III Children. (United States)

    Ferrell, Betty; Wittenberg, Elaine; Battista, Vanessa; Walker, Gay


    The goal of this study was to explore nurse experiences in communication with children about spiritual topics in order to develop training in this area. Although spiritual care is essential in pediatric palliative care, few providers receive training about communication with ill children about spirituality. Researchers developed a brief survey to prompt nurses to reflect on pediatric palliative care experiences that included spiritual discussions. Nurses attending training courses voluntarily submitted stories. Qualitative data were thematically analyzed by members of the research team, consisting of two researchers with expertise in palliative care, spirituality, and communication and two expert pediatric palliative care clinicians. Nurses' spiritual conversations with children revealed that children question God and the reason for their illness, have a desire to talk about the afterlife as a way of understanding their limited lifespan, and to share descriptions of an afterlife, in these cases described as heaven. Nurses conveyed the importance of being present and engaging in spiritual communication with children. Communication training is needed and should prepare providers to respond to a child's spiritual questioning, assist parents when the child initiates discussion about the afterlife, and help parent and child understand the spiritual meaning of their illness. Chaplains serve as spiritual care experts and can help train nurses to screen for spiritual distress, have greater competence in spiritual communication, and to collaborate with chaplains in care. Quality palliative care is incomplete without attention to spiritual care.

  16. Differences in nursing practice environment among US acute care unit types: a descriptive study. (United States)

    Choi, JiSun; Boyle, Diane K


    The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered

  17. Mapping the nursing competences in neonatology: a qualitative research. (United States)

    Alfieri, Emanuela; Alebbi, Alessia; Bedini, M Giovanna; Boni, Laura; Foà, Chiara


    There are several studies that support the importance of advanced expertise and specialization of the neonatal pediatric nurse. However, proceeding with a analysis of the scientific literature regarding the nursing advanced competence in neonatology, very few studies specify and define these competences. The aim of the study is investigate and analyze skills, tasks and responsibilities of the neonatal pediatric nurse, to map a "neonatal nurse competence profile", offered from the points of view of the Neonatology Units professionals. 32 professionals (nurses, physicians, psychologists, healthcare assistants) operating in the Neonatal Intensive Care Unit of two Italian Hospitals were interviewed. The semi-structured interviews have been performed, transcribed and analyzed following the Levati's model (based on Activity, Expectations and Evaluation system). About the nurses activities, the participants underlined the newborn care, the care of the caregiver and the "bureaucratic" activities. About the system of expectations, the participants marked on specific skills but those are described only comprehensively. About the evaluation system there are different perceptions among the professionals, but the nurses themselves feel that they have to answer for their actions primarily to infants and families, indicating a sense of responsibility towards the patients. On the basis of the interviews a profile of a neonatal nurse competences has been drawn up. This consists of 42 competences that future studies can further specify, integrate and expand.

  18. Naturalistic nursing. (United States)

    Hussey, Trevor


    Where nurse education aims to provide an overarching intellectual framework, this paper argues that it should be the framework of naturalism. After an exposition of the chief features of naturalism and its relationship to science and morality, the paper describes naturalistic nursing, contrasting it with some other perspectives. There follows a defence of naturalism and naturalistic nursing against several objections, including those concerning spirituality, religion, meaning, morality, and alternative sources of knowledge. The paper ends with some of the advantages of the naturalistic approach. © 2010 Blackwell Publishing Ltd.

  19. Estudo do estresse do enfermeiro com dupla jornada de trabalho em um hospital de oncologia pediátrica de Campinas Estudio del estrés del enfermero con doble jornada de trabajo en un hospital de oncologia pediátrica de Campinas Study on the stress over the nurse who works in two shifts at a pediatric oncology hospital in Campinas

    Directory of Open Access Journals (Sweden)

    Roberta Cova Pafaro


    who don't have it at a pediatric oncology hospital in Campinas. The population was made of 33 nurses in which 24 work in two shifts and 9 work in just one. In the methodology, it was used the LIPP Stress Symptom Inventory and the Visual Analogical Scale. The results enabled us to confirm that nurses classified regarding to their stress phases were on the resistance phase, regarding to the stress level they were on the average stress level. There was a predominance of psychological symptoms and nurses who had two work shifts were more stressed than the ones with only one shift.

  20. O conhecimento em Enfermagem Pediátrica: livros editados no Brasil de 1916 a 1988 El conocimiento en Enfermería Pediátrica: libros editados en Brasil de 1916 a 1988 Pediatric nursing knowledge: books published in Brazil from 1916 to 1988

    Directory of Open Access Journals (Sweden)

    Semiramis Melani Melo Rocha


    Full Text Available Para a apreensão do conhecimento em enfermagem pediátrica no Brasil fez-se um levantamento em uma obra de referencia bibliográfica de enfermagem brasileira. A postura teórica metodológica adotada concebe a enfermagem em uma perspectiva histórica, parte de um processo coletivo de trabalho e o saber como instrumental que permite a transformação do objeto no produto desejado, de acordo com a finalidade do trabalho, imprimindo racionalidade ao processo. Foram encontradas quarenta títulos sobre assistência à criança (8% em um total de quinhentos e quatro, proporção considerada pequena. A produção foi classificada em prescritiva e analítica. Prescritiva refere-se aos textos que normalizam o trabalho com vistas a sua racionalidade e produtividade. Os analíticos abrem a possibilidade de diversificar o cuidado de enfermagem atendendo com alguma especificidade a clientela, redimensionando a finalidade do trabalho de enfermagem.Para aprehensión del conocimiento en Enfermería Pediátrica en Brasil, se hizo una estadística en obra de referencia bibliografica de Enfermería Brasileira. La posición teórica metodológica adoptada concibe a la Enfermería una perspectiva histórica, parte de un proceso colectivo de trabajo y el saber como instrumental que permite la transformación del objeto en producto deseado, de acuerdo con la finalidad del trabajo imprimiendo racionalidad en el proceso. Fueron encontrados 40 títulos sobre Asistencia al Niño (8% en un total de quinientos y cuatro. La producción fué clasificada en prescriptiva y analítica. Prescriptiva, textos que normatizan el trabajo objetivando su racionalidad y productividad. Analítica, abre la posibilidad de diversificar el ciudad de enfermeria atendiendo con alguna especificidad la clientela, redimensionando la finalidad del trabajo de Enfermería.From the apprehension of the knowledge in pediatrics nursing in Brazil, a research was done in a Brazilian historical

  1. Challenges to code status discussions for pediatric patients.

    Directory of Open Access Journals (Sweden)

    Katherine E Kruse

    Full Text Available In the context of serious or life-limiting illness, pediatric patients and their families are faced with difficult decisions surrounding appropriate resuscitation efforts in the event of a cardiopulmonary arrest. Code status orders are one way to inform end-of-life medical decision making. The objectives of this study are to evaluate the extent to which pediatric providers have knowledge of code status options and explore the association of provider role with (1 knowledge of code status options, (2 perception of timing of code status discussions, (3 perception of family receptivity to code status discussions, and (4 comfort carrying out code status discussions.Nurses, trainees (residents and fellows, and attending physicians from pediatric units where code status discussions typically occur completed a short survey questionnaire regarding their knowledge of code status options and perceptions surrounding code status discussions.Single center, quaternary care children's hospital.203 nurses, 31 trainees, and 29 attending physicians in 4 high-acuity pediatric units responded to the survey (N = 263, 90% response rate. Based on an objective knowledge measure, providers demonstrate poor understanding of available code status options, with only 22% of providers able to enumerate more than two of four available code status options. In contrast, provider groups self-report high levels of familiarity with available code status options, with attending physicians reporting significantly higher levels than nurses and trainees (p = 0.0125. Nurses and attending physicians show significantly different perception of code status discussion timing, with majority of nurses (63.4% perceiving discussions as occurring "too late" or "much too late" and majority of attending physicians (55.6% perceiving the timing as "about right" (p<0.0001. Attending physicians report significantly higher comfort having code status discussions with families than do nurses or trainees

  2. Simulation in pediatric anesthesiology. (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J


    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  3. The Case for the Use of Nurse Practitioners in the Care of Children with Medical Complexity

    Directory of Open Access Journals (Sweden)

    Cheryl Samuels


    Full Text Available Although children with medically complex illness represent less than one percent of the total pediatric population, their health care expenditures and health care system utilization far exceed the numbers of other pediatric patients. Nurse practitioners, with their educational background focused on health care promotion and education, are uniquely qualified to reduce this inequity with cost effective care. Currently, nurse practitioners are used in a variety of health care settings and can provide acute and chronic care. Incorporating nurse practitioners at each step in the care of children with medical complexity can improve the quality of life for these children and their families, increase family satisfaction and decrease costs.

  4. [Prevalence of burnout syndrome in health professionals of an onco-hematological pediatric hospital]. (United States)

    Zanatta, Aline Bedin; Lucca, Sergio Roberto de


    To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in São Paulo. An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome - namely emotional exhaustion, alienation, and low job performance/satisfaction- in the hospital work.

  5. Prevalence of Burnout syndrome in health professionals of an onco-hematological pediatric hospital

    Directory of Open Access Journals (Sweden)

    Aline Bedin Zanatta


    Full Text Available OBJECTIVE To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in São Paulo. METHOD An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS which is a biosocial data form, and a non-participant observation guide. RESULTS High depersonalization for nurses (29.8%, low job performance for physicians (27.8%, and of nursing technicians (25.5%. High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. CONCLUSION Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome - namely emotional exhaustion, alienation, and low job performance/satisfaction- in the hospital work.

  6. Demystifying Nursing Theory: A Christian Nursing Perspective. (United States)

    Schaffer, Marjorie A; Sandau, Kristin; Missal, Bernita

    How does nursing theory apply to nursing practice? Nursing theory can explain the why and how of nursing practice, guide nursing interventions, and provide a framework for measuring outcomes. This article briefly explains nursing theory, provides examples for applying theory to nursing practice, and proposes questions for examining the consistency of nursing theories with Christian perspectives. A helpful table illustrating grand, middle-range, and situation-specific theories and their application to nursing practice and research, along with references, is provided online as supplemental digital content. Three caring theories are analyzed from biblical beliefs.

  7. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  8. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  9. NCI Pediatric Preclinical Testing Consortium (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... need to be returned to the transducer for analysis. top of page This page was reviewed on ... using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric ...

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... in CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to ... Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific ...

  12. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... A child being prepared for a CT scan. View full size with caption Pediatric Content Some imaging ...

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Imaging? Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of ... 30 minutes. top of page What will my child experience during and after the procedure? Ultrasound examinations ...

  17. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Catheter Angiography Magnetic Resonance, ...

  18. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... scans, your doctor may ask you to withhold food and drink for several hours before your child's ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  19. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg


    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  20. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.


    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  1. Pediatric Electrocardiographic Imaging (ECGI) Applications (United States)

    Silva, Jennifer N. A.


    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  2. Children's (Pediatric) Magnetic Resonance Imaging (United States)

    ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  3. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging ( ... the limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a ...

  5. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)


    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  6. Sleeping beauties in pediatrics. (United States)

    Završnik, Jernej; Kokol, Peter


    Sleeping beauties (SBs) in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that "sleeps" for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more "SB fertile" than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  7. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    Gelfand, M.J.; Hannon, D.W.


    Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

  8. Pediatric nuclear medicine

    International Nuclear Information System (INIS)


    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base

  9. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology


    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  10. Association between Nurses' Education about Research and Their Research Use. (United States)

    McCleary, Lynn; Brown, G. Ted


    Responses from 178 of 528 pediatric nurses showed that higher education levels or courses in research design and use were associated with positive attitudes toward research. Higher education levels were associated with self-reported research use; completing research-related courses was not independently associated with higher research use.…

  11. Nurses and Aides (United States)

    Franklin, John


    Gerontological nursing (the care of the elderly) as a specialization for registered nurses, licensed practical nurses, and nursing aides is discussed with respect to training and qualifications, employment outlook, and earnings for each group. (JT)

  12. Primary Nurse - Role Evolution (United States)

    Mundinger, Mary O'Neil


    Primary nursing means that each patient has an individual nurse who is responsible for assessing his nursing needs and planning and evaluating his nursing care. The article describes the advantages and problems connected with this approach to patient care. (AG)

  13. Dificuldades do Profissional Enfermeiro ao Cuidar de Pacientes Pediátricos Portadores de Câncer/ Difficulties of the Professional Nurse when Taking Care of Pediatric Patients with Cancer

    Directory of Open Access Journals (Sweden)

    Renata Pinto Ribeiro


    Full Text Available Objetivo: O objetivo desse estudo foi de identificar as dificuldades do profissional enfermeiro frente à criança com câncer, verificar se há preparo adequado para atender às necessidades de uma criança com doenças oncológicas; e qual a forma de enfrentamento utilizada pelo profissional diante das dificuldades encontradas, no atendimento a essa criança. Metodologia: Trata-se de uma pesquisa qualitativa, objetivando identificar quais dificuldades o profissional de enfermagem enfrenta no cuidado de criança com câncer e de seus familiares, os mecanismos de enfrentamento dessas dificuldades no atendimento dos mesmos e se há preparo adequado dos mesmos para atender as necessidades dessas crianças. Os sujeitos foram quatro enfermeiras que cuidam ou já cuidaram de crianças com câncer no Hospital Bom Pastor – Varginha/MG. A coleta de dados foi desenvolvida por uma entrevista semiestruturada. Resultados: Constatou-se que as dificuldades são: cuidar de criança em estado grave, seus pais e o envolvimento emocional. Aos meios de enfrentamento referem à oração e a distração. Quanto ao preparo do profissional referem despreparo para atuar nesta área. Conclusão: Conclui-se que há falta de preparo aos profissionais, embora os mesmos cuidem com humanização dessas crianças. Objective: The aim of this study was to identify the difficulties of the professional nurse when taking care of a child with cancer, check the adequate preparation to meet the needs of children with oncological diseases; and what form of coping with the situation the professionals used when taking care of this child. Methodology: This was a qualitative study , aiming to identify the difficulties the professional faces in the care of children with cancer and their families , the coping mechanisms of these difficulties in the care and if there is adequate preparation thereof to meet the needs of these children. The subjects were four nurses who care or have cared

  14. Risk in pediatric anesthesia. (United States)

    Paterson, Neil; Waterhouse, Peter


    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  15. Contact Dermatitis in Pediatrics. (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E


    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

  16. Value of intensified nursing


    Raymann, Cornelia; Konta, Brigitte; Prusa, Nina; Frank, Wilhelm


    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. ...

  17. Percepção de acompanhantes-usuários e enfermeiros sobre qualidade assistencial em Unidades Pediátricas Percepción de acompañantes-usuarios y enfermeros sobre la calidad asistencial en Unidades Pediátricas Perception of companions-users and nurses about the quality of care in Pediatric Units

    Directory of Open Access Journals (Sweden)

    Marta Maria Melleiro


    relevancia de los registros de enfermería; y, en lo que se refiere al resultado se observó la importancia de las orientaciones para el alta y la satisfacción con la asistencia. En lo que se refiere al resultado favorable de los puntajes de las tres dimensiones evaluadas se verificó que el de estructura obtuvo el menor puntaje. CONCLUSIÓN: La dimensión de estructura requiere mayor atención de los gerentes de ese servicio de salud.OBJECTIVE: This study aimed to describe the perception of companions-users and nurses about the quality of care; it was developed with nursing workers of Pediatric Units and Pediatric Neonatal Intensive Care. The study was based on the donabedian model. METHOD: The location of the study was the University Hospital of the University of Sao Paulo, and the population consisted of 22 nurses and 192 companions. Data collection occurred between August and October 2006 using a questionnaire. The data were analyzed using percentages and rates of the statistical tests. RESULTS: The issues that were statistically significant in the area of structure were those related to materials and human resources and to hospital resources for accommodation; in the processing area was the relationship of users with the team and relevance of the nursing records; and, the result showed the importance of the guidelines for patient discharge and the satisfaction with care. In regard to the successful outcome of the scores of the three areas evaluated, it was found that the structure had the lowest score. CONCLUSION: The parameter structure requires greater attention from health service managers.

  18. The first official schools for nursing education in Greece: over a century of tradition. (United States)

    Tsoucalas, Gregory; Kousoulis, Antonis A; Karamanou, Marianna; Tsoucalas, Ioannis; Androutsos, George


    The pressing need for educated nursing staff in Greece was first recognized by Queen Olga and Crown Princess Sofia, at the end of the nineteenth century with significant international aid.As a result, the School of Nursing Sisters of the Sanatorium "Evangelismos" was founded in 1875 and the first Greek "School of Certified Nurses" of the "Saint Sophia" Children's Hospital was established in 1897. This Children's Hospital has provided Greece with excellent trained nurses in Pediatric as well as Neonatal and Infant Nursing ever since. Distinguished nurses from abroad as well as a plethora of professors and physicians have taught at the school which has effectively made a mark in forming a tradition until today. The international concept of the school, including enhancing the young nurses' practice with experience from abroad is one of its most interesting features. The first Greek nursing schools rank among the first in the world.

  19. Attention for pediatric interventional radiology

    International Nuclear Information System (INIS)

    Zhu Ming; Cheng Yongde


    Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

  20. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra


    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  1. [ISO 9002 at the Center of Pediatric Intensive Care at the Albert Einstein Israeli Hospital]. (United States)

    Gé Lacerda, D P; Rocha, M L; Santos, R P


    This study shows the process of implementation of a quality program in Pediatric Intensive Therapy Center of "Hospital Israelita Albert Einstein" which resulted in the certification of this service for the Standards ISO 9002/94. It points out the nurse's role as a leader in this process.

  2. Advanced practice nursing in child maltreatment: practice characteristics. (United States)

    Hornor, Gail; Herendeen, Pamela


    Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine ...

  5. Pediatric acute lung injury

    NARCIS (Netherlands)

    Dahlem, P.; van Aalderen, W. M. C.; Bos, A. P.


    Among ventilated children, the incidence of acute lung injury (ALI) was 9%; of that latter group 80% developed the acute respiratory distress syndrome (ARDS). The population-based prevalence of pediatric ARDS was 5.5 cases/100.000 inhabitants. Underlying diseases in children were septic shock (34%),


    African Journals Online (AJOL)

    Pediatric Refractive Errors in Lautech Teaching Hospital Eye. Clinic ... carry on into adulthood and become a problem later in life such as ... Children with refractive errors but without associated organic ..... for which elevated intraocular pressure (IOP) is a primary risk factor. .... Medicine, University of Ibadan, Ibadan, Nigeria.

  7. Pediatric brainstem oligodendroglioma

    Directory of Open Access Journals (Sweden)

    Sandeep Mohindra


    Full Text Available The authors present the first report of pediatric brainstem oligodendroglioma, infiltrating midbrain, and medulla oblongata. The report details clinical features, radiological findings, and surgical steps. As this entity is exceedingly uncommon, the overall epidemiology, prognosis, and long-term outcome remain far from established.

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Pediatric) Nuclear Medicine Sponsored by Please note is not a medical facility. Please contact your ... links: For the convenience of our users, RadiologyInfo .org provides links to relevant websites. , ACR ...

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help ...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... both imaging exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders ...

  11. Pharmacotherapy of Pediatric Insomnia (United States)

    Owens, Judith A.


    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... radioactive energy that is emitted from the patient's body and converts it into an image. The gamma camera itself does not emit any ... bear denotes child-specific content. Related Articles and Media General Nuclear ... (Pediatric) Nuclear Medicine Videos related ...

  13. Pediatric Low Vision (United States)

    ... Asked Questions Español Condiciones Chinese Conditions Pediatric Low Vision What is Low Vision? Partial vision loss that cannot be corrected causes ... and play. What are the signs of Low Vision? Some signs of low vision include difficulty recognizing ...

  14. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. ... Nonconventionalmesocaval prosthetic shunt interposition in refractory case with portal hypertension in a 10-kg female infant · EMAIL FREE FULL TEXT EMAIL FREE FULL ...

  15. Pediatric acquired brain injury. (United States)

    Bodack, Marie I


    Although pediatric patients are sometimes included in studies about visual problems in patients with acquired brain injury (ABI), few studies deal solely with children. Unlike studies dealing with adult patients, in which mechanisms of brain injury are divided into cerebral vascular accident (CVA) and traumatic brain injury (TBI), studies on pediatric patients deal almost exclusively with traumatic brain injury, specifically caused by accidents. Here we report on the vision problems of 4 pediatric patients, ages 3 to 18 years, who were examined in the ophthalmology/optometry clinic at a children's hospital. All patients had an internally caused brain injury and after the initial insult manifested problems in at least one of the following areas: acuity, binocularity, motility (tracking or saccades), accommodation, visual fields, and visual perceptual skills. Pediatric patients can suffer from a variety of oculo-visual problems after the onset of head injury. These patients may or may not be symptomatic and can benefit from optometric intervention. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  17. Pitfalls in pediatric radiology

    International Nuclear Information System (INIS)

    Engelkemier, Dawn R.; Taylor, George A.


    This essay depicts some of the diagnostic errors identified in a large academic pediatric imaging department during a 13-year period. Our aim is to illustrate potential situations in which errors are more likely to occur and more likely to cause harm, and to share our difficult cases so other radiologists might learn without having to experience those situations themselves. (orig.)

  18. Pediatric heart surgery (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  19. American Academy of Pediatrics (United States)

    ... this site from a secured browser on the server. Please enable scripts and reload this page. Early Career Pediatric Trainees Medical Students International Become a Member Sign In Professional Resources Practice Transformation Economics of Healthcare Managing Your ...

  20. Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada. (United States)

    Mott, Antonio R; Neish, Steven R; Challman, Melissa; Feltes, Timothy F


    The treatment of children with cardiac disease is one of the most prevalent and costly pediatric inpatient conditions. The design of inpatient medical services for children admitted to and discharged from noncritical cardiology care units, however, is undefined. North American Pediatric Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice. An online survey that explored institutional and functional domains for noncritical cardiac care unit was crafted. All questions were multi-choice with comment boxes for further explanation. The survey was distributed by email four times over a 5-month period. Most programs (n = 45, 60%) exist in free-standing children's hospitals. Most programs cohort cardiac patients on noncritical cardiac care units that are restricted to cardiac patients in 39 (54%) programs or restricted to cardiac and other subspecialty patients in 23 (32%) programs. The most common frontline providers are categorical pediatric residents (n = 58, 81%) and nurse practitioners (n = 48, 67%). However, nurse practitioners are autonomous providers in only 21 (29%) programs. Only 33% of programs use a postoperative fast-track protocol. When transitioning care to referring physicians, most programs (n = 53, 72%) use facsimile to deliver pertinent patient information. Twenty-two programs (31%) use email to transition care, and eighteen (25%) programs use verbal communication. Most programs exist in free-standing children's hospitals in which the noncritical cardiac care units are in some form restricted to cardiac patients. While nurse practitioners are used on most noncritical cardiac care units, they rarely function as autonomous providers. The majority of programs in this survey do not incorporate any postoperative fast-track protocols in their practice. Given the current era of focused handoffs within hospital systems, relatively few programs utilize verbal handoffs to the referring pediatric

  1. The importance of communication in pediatric oncology palliative care: focus on Humanistic Nursing Theory Importancia de la comunicación en los cuidados paliativos en oncología pediátrica: un enfoque en la Teoría Humanística de Enfermería Importância da comunicação nos cuidados paliativos em oncologia pediátrica: enfoque na Teoria Humanística de Enfermagem

    Directory of Open Access Journals (Sweden)

    Jael Rúbia Figueiredo de Sá França


    Full Text Available OBJECTIVE: to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. METHOD: this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. RESULTS: two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." CONCLUSION: communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory. OBJETIVO: investigar y analizar la comunicación en los cuidados paliativos en oncología pediátrica, bajo el punto de vista de los enfermeros, con base en la Teoría Humanística de Enfermería. MÉTODO: se trata de una investigación de campo, con abordaje cualitativo, de la cual participaron diez enfermeros actuantes en oncología pediátrica en un hospital público brasileño. Para la recolección de los datos, fue utilizada la técnica de entrevista semiestructurada. Las declaraciones fueron analizadas cualitativamente, bajo el marco de la Teoría Humanística de Enfermería, y de las cinco fases de la Enfermería Fenomenológica. RESULTADOS: del análisis del material empírico del estudio, surgieron dos categorías temáticas: "estrategia para humanizar el cuidar en enfermería, con énfasis en el alivio del sufrimiento del niño", y "estrategia para fortalecer el vínculo de confianza entre el enfermero y el niño". CONCLUSÍON: la comunicación se configura como un elemento eficaz del cuidado

  2. Children in foster care: what forensic nurses need to know. (United States)

    Hornor, Gail


    Children living in foster care are a unique population with specialized healthcare needs. This article will assist forensic nurses and advanced practice forensic nurses, particularly those working in pediatrics, in understanding the needs of children in foster care and implementing a practice plan to better meet their healthcare needs. To that end, a basic understanding of the foster care system is crucial and involves an appreciation of the interface between the legal system and the child welfare system. Most important to providing care to children in foster care is a true understanding of trauma exposure and its potential effects on the lives of children: physically, developmentally, emotionally, and psychologically. This article will assist forensic nurses working with pediatric populations to more fully understand the needs of children in foster care and to develop innovative interventions to appropriately meet their unique needs.

  3. Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study. (United States)

    Seefeldt, Julanne; Wood, Stacey; Bolton, Pamela; Fitzpatrick, Tara; Stegenga, Kristin; Roberts, Cristine


    Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment. Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit. Qualitative descriptive data collection, inductive content analysis. Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety. Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  4. Stereotyping and nurses' recommendations for treating pain in hospitalized children. (United States)

    Griffin, Ruth A; Polit, Denise F; Byrne, Mary W


    The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.

  5. Selection of quality indicators for nutritional therapy in pediatrics: a cross-sectional study conducted in Brazil


    Julia Bertoldi; Aline Ferreira; Luiza Scancetti; Patricia Padilha


    Background Quality indicators for nutritional therapy (QINT) are important in assessing care and monitoring of resources. Among the 30 indicators proposed by International Life Sciences Institute, Brazil, there is still no evaluation of the most pertinent for Pediatrics. Objective To list the 10 main quality indicators for nutritional therapies (QINTs) for Pediatrics. Methods This was a two-phase cross-sectional study. Firstly, a questionnaire was answered by physicians, nutritionists, nurses...

  6. Orthopaedic nurses' knowledge and interrater reliability of neurovascular assessments with 2-point discrimination test. (United States)

    Turney, Jennifer; Raley Noble, Deana; Kim, Son Chae


    : This study was conducted to evaluate the effects of education on knowledge and interrater reliability of neurovascular assessments with 2-point discrimination (2-PD) test among pediatric orthopaedic nurses. : A pre- and posttest study was done among 60 nurses attending 2-hour educational sessions. Neurovascular assessments with 2-PD test were performed on 64 casted pediatric patients by the nurses and 5 nurse experts before and after the educational sessions. : The mean neurovascular assessment knowledge score was improved at posteducation compared with the preeducation (p < .001). The 2-PD test interrater reliability also improved from Cohen's kappa value of 0.24-0.48 at posteducation. : The 2-hour educational session may be effective in improving nurses' knowledge and the interrater reliability of neurovascular assessment with 2-PD test.

  7. A pediatric FOUR score coma scale: interrater reliability and predictive validity. (United States)

    Czaikowski, Brianna L; Liang, Hong; Stewart, C Todd


    The Full Outline of UnResponsiveness (FOUR) Score is a coma scale that consists of four components (eye and motor response, brainstem reflexes, and respiration). It was originally validated among the adult population and recently in a pediatric population. To enhance clinical assessment of pediatric intensive care unit patients, including those intubated and/or sedated, at our children's hospital, we modified the FOUR Score Scale for this population. This modified scale would provide many of the same advantages as the original, such as interrater reliability, simplicity, and elimination of the verbal component that is not compatible with the Glasgow Coma Scale (GCS), creating a more valuable neurological assessment tool for the nursing community. Our goal was to potentially provide greater information than the formally used GCS when assessing critically ill, neurologically impaired patients, including those sedated and/or intubated. Experienced pediatric intensive care unit nurses were trained as "expert raters." Two different nurses assessed each subject using the Pediatric FOUR Score Scale (PFSS), GCS, and Richmond Agitation Sedation Scale at three different time points. Data were compared with the Pediatric Cerebral Performance Category (PCPC) assessed by another nurse. Our hypothesis was that the PFSS and PCPC should highly correlate and the GCS and PCPC should correlate lower. Study results show that the PFSS is excellent for interrater reliability for trained nurse-rater pairs and prediction of poor outcome and in-hospital mortality, under various situations, but there were no statistically significant differences between the PFSS and the GCS. However, the PFSS does have the potential to provide greater neurological assessment in the intubated and/or sedated patient based on the outcomes of our study.

  8. Acute pediatric stroke: contributors to institutional cost. (United States)

    Turney, Colin M; Wang, Wei; Seiber, Eric; Lo, Warren


    Recent studies examined the overall cost of pediatric stroke, but there are little data regarding the sources of these costs. We examined an administrative database that collected charges from 24 US children's hospitals to determine the sources of costs for acute hospital care of stroke. We used International Classification of Diseases, 9th Revision codes to search the Pediatric Health Information System. From 2003 to 2009 there were 1667 patients who had a primary diagnosis of stroke, 703 of which were hemorrhagic and 964 were ischemic. Individual costs, excluding physician charges, were gathered under 7 categories that were ranked to determine which contributed the most to total cost. Individual costs were ranked within their categories. We analyzed costs based on stroke type. Total costs were adjusted using the US Consumer Price Index to compare increases with the rate of inflation. Median total cost for any stroke was $19,548 (interquartile range, $10,764-$40,721). The category "other/nursing" contributed the most to hospital costs followed by imaging, laboratory, and pharmacy. Brain MRI and CT contributed the most to imaging costs. Hemorrhagic strokes (median $24,843) were more expensive than ischemic strokes (median $16,954). Total cost increased from 2003 to 2009, but no overall annual trend emerged after controlling for gender, age, race, and hospital. This is the first in-depth analysis of cost for pediatric stroke care. The highest cost categories are potential targets for cost containment but are also crucial for effective diagnosis and treatment. Necessary yet prudent use of imaging technologies and inpatient stays may be strategies for cost containment.

  9. Emergency Severity Index version 4: a valid and reliable tool in pediatric emergency department triage. (United States)

    Green, Nicole A; Durani, Yamini; Brecher, Deena; DePiero, Andrew; Loiselle, John; Attia, Magdy


    The Emergency Severity Index version 4 (ESI v.4) is the most recently implemented 5-level triage system. The validity and reliability of this triage tool in the pediatric population have not been extensively established. The goals of this study were to assess the validity of ESI v.4 in predicting hospital admission, emergency department (ED) length of stay (LOS), and number of resources utilized, as well as its reliability in a prospective cohort of pediatric patients. The first arm of the study was a retrospective chart review of 780 pediatric patients presenting to a pediatric ED to determine the validity of ESI v.4. Abstracted data included acuity level assigned by the triage nurse using ESI v.4 algorithm, disposition (admission vs discharge), LOS, and number of resources utilized in the ED. To analyze the validity of ESI v.4, patients were divided into 2 groups for comparison: higher-acuity patients (ESI levels 1, 2, and 3) and lower-acuity patients (ESI levels 4 and 5). Pearson χ analysis was performed for categorical variables. For continuous variables, we conducted a comparison of means based on parametric distribution of variables. The second arm was a prospective cohort study to determine the interrater reliability of ESI v.4 among and between pediatric triage (PT) nurses and pediatric emergency medicine (PEM) physicians. Three raters (2 PT nurses and 1 PEM physician) independently assigned triage scores to 100 patients; k and interclass correlation coefficient were calculated among PT nurses and between the primary PT nurses and physicians. In the validity arm, the distribution of ESI score levels among the 780 cases are as follows: ESI 1: 2 (0.25%); ESI 2: 73 (9.4%); ESI 3: 289 (37%); ESI 4: 251 (32%); and ESI 5: 165 (21%). Hospital admission rates by ESI level were 1: 100%, 2: 42%, 3: 14.9%, 4: 1.2%, and 5: 0.6%. The admission rate of the higher-acuity group (76/364, 21%) was significantly greater than the lower-acuity group (4/415, 0.96%), P group was

  10. [Nurse practitioner's capability]. (United States)

    Cheng, Chen-Hsiu; Chen, Shih-Chien


    Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.

  11. Toward Enteral Nutrition in the Treatment of Pediatric Crohn Disease in Canada: A Workshop to Identify Barriers and Enablers

    Directory of Open Access Journals (Sweden)

    Johan Van Limbergen


    Full Text Available The treatment armamentarium in pediatric Crohn disease (CD is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet], which is used more frequently by pediatric gastroenterologists to induce remission. In pediatric CD, EEN is now recommended by the pediatric committee of the European Crohn’s and Colitis Organisation and the European Society for Paediatric Gastroenterology Hepatology and Nutrition as a first-choice agent to induce remission, with remission rates in pediatric studies consistently >75%. To chart and address enablers and barriers of use of EEN in Canada, a workshop was held in September 2014 in Toronto (Ontario, inviting pediatric gastroenterologists, nurses and dietitians from most Canadian pediatric IBD centres as well as international faculty from the United States and Europe with particular research and clinical expertise in the dietary management of pediatric CD. Workshop participants ranked the exclusivity of enteral nutrition; the health care resources; and cost implications as the top three barriers to its use. Conversely, key enablers mentioned included: standardization and sharing of protocols for use of enteral nutrition; ensuring sufficient dietetic resources; and reducing the cost of EEN to the family (including advocacy for reimbursement by provincial ministries of health and private insurance companies. Herein, the authors report on the discussions during this workshop and list strategies to enhance the use of EEN as a treatment option in the treatment of pediatric CD in Canada.

  12. Pediatric digital chest imaging. (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J


    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  13. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.


    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  14. Hippocrates on Pediatric Dermatology. (United States)

    Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George


    Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. © 2015 Wiley Periodicals, Inc.

  15. Telemedicine: Pediatric Applications (United States)

    Burke, Bryan L.; Hall, R. W.


    Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine’s current use bears testimony to its effectiveness and potential. Telemedicine’s widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits. PMID:26122813

  16. Pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Poussaint, Tina Y. [Department of Radiology, Boston, MA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Huisman, Thierry A.G.M. [Charlotte R. Bloomberg Children' s Center, Johns Hopkins Hospital, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD (United States)


    Among all causes of death in children from solid tumors, pediatric brain tumors are the most common. This article includes an overview of a subset of infratentorial and supratentorial tumors with a focus on tumor imaging features and molecular advances and treatments of these tumors. Key to understanding the imaging features of brain tumors is a firm grasp of other disease processes that can mimic tumor on imaging. We also review imaging features of a common subset of tumor mimics. (orig.)


    Directory of Open Access Journals (Sweden)

    O.V. Zaitseva


    Full Text Available The article considers one of the most critical issues in the pediatrics: the problem of children's hyperthermia. The article features the fever pathogenesis and 'points of application' for antipyretics, the data on efficiency and side effects of this group of medications, as well as indications to reduce heightened body temperature of children. The author demonstrates her own experience: an application of an antipyretic — ibuprofen.Key words: fever, antipyretics, medications of choice, medical indications, children.

  18. Acitretin in pediatric dermatoses

    Directory of Open Access Journals (Sweden)

    Manjyot Gautam


    Full Text Available Acitretin, a synthetic retinoid and the active metabolite of etretinate has been increasingly used over the past two decades. It has proved effective in the treatment of many conditions associated with hyperkeratosis and dyskeratosis. A Google scholar search for the use of acitretin in pediatric dermatoses was done using the words “pediatric dermatoses,” “acitretin,” “etretinate,” “systemic retinoids,” “psoriasis,” “pityriasis rubra pilaris,” “ichthyoses,” “disorders of keratinization,” “Darier's disease,” “palmoplantar keratoderma,” “verrucae,” “lichen planus,” “lupus erythematosus,” and “lichen sclerosus.” All the articles were retrieved and classified into review articles, studies, double-blinded trials, and case reports. The final data were then analyzed and presented in a narrative fashion. It has been found that acitretin is useful in a number of pediatric dermatoses. It is preferred over other drugs in pustular psoriasis. Good results can be obtained in various disorders of keratinization, and it may even prove life-saving in conditions like harlequin ichthyosis. However, long-term maintenance therapy is required and exacerbations are known on discontinuing the drug. It can also be used as alternative therapy for many other pediatric dermatoses where the primary treatment has failed. Acitretin should be used even in children for the proper indications. However, proper clinical and laboratory surveillance has to be maintained in patients on long-term acitretin.

  19. Pediatric esophagopleural fistula


    Cui, Yun; Ren, Yuqian; Shan, Yijun; Chen, Rongxin; Wang, Fei; Zhu, Yan; Zhang, Yucai


    Abstract Esophagopleural fistula (EPF) is rarely reported in children with a high misdiagnosis rate. This study aimed to reveal the clinical manifestations and managements of EPF in children. Two pediatric cases of EPF in our hospital were reported. A bibliographic search was performed on the PubMed, WANFANG, and CNKI databases for EPF-related reports published between January 1980 and May 2016. The pathogeny, clinical manifestations, diagnosis, treatments, and prognosis of EPF patients were ...

  20. Men student nurses: the nursing education experience. (United States)

    Meadus, Robert J; Twomey, J Creina


    This study explored the phenomenon of being a male in a predominately female-concentrated undergraduate baccalaureate nursing program. Men remain a minority within the nursing profession. Nursing scholars have recommended that the profile of nursing needs to change to meet the diversity of the changing population, and the shortfall of the worldwide nursing shortage. However, efforts by nursing schools and other stakeholders have been conservative toward recruitment of men. Using Giorgi's method, 27 students from a collaborative nursing program took part in this qualitative, phenomenological study. Focus groups were undertaken to gather data and to develop descriptions of the experience. Five themes highlighted men students' experience of being in a university nursing program: choosing nursing, becoming a nurse, caring within the nursing role, gender-based stereotypes, and visible/invisible. The experiences of the students revealed issues related to gender bias in nursing education, practice areas, and societal perceptions that nursing is not a suitable career choice for men. Implications for nurse educators and strategies for the recruitment and retention of men nursing students are discussed. © 2011 Wiley Periodicals, Inc.

  1. Nursing shortages and international nurse migration. (United States)

    Ross, S J; Polsky, D; Sochalski, J


    The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

  2. What Is a Pediatric Allergist / Immunologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Allergist/Immunologist? Page Content Article Body If your ... immune system problems. What Kind of Training Do Pediatric Allergists/Immunologists Have? Pediatric allergists/immunologists are medical ...

  3. What Is a Pediatric Infectious Diseases Specialist? (United States)

    ... Text Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If ... the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists ...

  4. What Is a Pediatric Heart Surgeon? (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  5. What Is a Pediatric Critical Care Specialist? (United States)

    ... Text Size Email Print Share What is a Pediatric Critical Care Specialist? Page Content Article Body If ... in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care specialists ...

  6. Pediatric Acute Kidney Injury. (United States)

    Fragasso, Tiziana; Ricci, Zaccaria; Goldstein, Stuart L


    Acute kidney injury (AKI) in children is a serious condition with an important impact on morbidity and mortality. Onset can be insidious and it is frequently unrecognized in the early phase when the therapeutic opportunities are theoretically more effective. The present review focuses on the most recent epidemiology studies and the progress in pediatric AKI (pAKI) research. Standardization of definition (presented in the Kidney Disease: Improving Global Outcomes) and novel biomarkers have been developed to help clinicians recognize kidney injury in a timely manner, both in adult and pediatric populations. Strengths and weaknesses of these diagnostic tools are discussed and the clinical scoring system (Renal Angina Index), which aims to provide a rational context for biomarker utilization, is also presented. Even if effective treatments are not currently available for established AKI, specific preventive approaches and some promising pharmacological treatments will be detailed. Renal replacement therapy is currently considered the most effective way to manage fluid balance when severe AKI occurs. Key Messages: Great efforts in pAKI research have today led to new strategies for early AKI detection and prevention strategies. Further studies have to be conducted in the next future in order to definitely improve the outcomes of pediatric patients experiencing this deadly syndrome. © 2018 S. Karger AG, Basel.

  7. Obesity in pediatric trauma. (United States)

    Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P


    The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The Pediatric Obesity Initiative: development, implementation, and evaluation. (United States)

    Sample, Denise A; Carroll, Heather L; Barksdale, Debra J; Jessup, Ann


    Pediatric obesity rates have nearly tripled over the past three decades contributing to increased morbidity and mortality in the United States and around the world. Pediatric obesity is most prevalent in developed countries and affects all races, ethnicities, cultures, and age groups. To combat this epidemic locally, a team of dedicated providers developed a comprehensive evidenced-based toolkit and training program for clinical practices providing primary care services to children in a North Carolina county. The toolkit and training program were developed using the most current treatment guidelines for pediatric obesity and included resources developed by Healthy Carolinians. One unique feature of the training was a demonstration of motivational interviewing with additional resources included in the toolkit. Staff and providers in three pediatric practices and the local Health Department received the training. In a 3 months follow-up survey after the training, the providers indicated that the toolkit and training program were useful but that they still did not consistently use the guidelines or tools. Ensuring the use of available guidelines and resources by providers remains a challenge. Further study is needed on how to improve implementation of guidelines in primary care settings. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  9. Accuracy of a pediatric early warning score in the recognition of clinical deterioration

    Directory of Open Access Journals (Sweden)

    Juliana de Oliveira Freitas Miranda

    Full Text Available ABSTRACT Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likelihood ratios and post-test probability. Results: the Brighton Pediatric Early Warning Score for the Brazilian context showed sensitivity of 73.9%, specificity of 95.5%, positive predictive value of 73.3%, negative predictive value of 94.7%, area under Receiver Operating Characteristic Curve of 91.9% and the positive post-test probability was 80%. Conclusion: the Brighton Pediatric Early Warning Score for the Brazilian context, presented good performance, considered valid for the recognition of clinical deterioration warning signs of the children studied.

  10. Pediatric Critical Care in Resource-Limited Settings-Overview and Lessons Learned. (United States)

    Slusher, Tina M; Kiragu, Andrew W; Day, Louise T; Bjorklund, Ashley R; Shirk, Arianna; Johannsen, Colleen; Hagen, Scott A


    Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas. PICU can improve the quality of pediatric care in general and, if properly organized, can effectively treat the severe complications of high burden diseases, such as diarrhea, severe malaria, and respiratory distress using low-cost interventions. Setting up a PICU in a LMIC setting requires planning, specific resources, and most importantly investment in the nursing and permanent medical staff. A thoughtful approach to developing pediatric critical care services in LMICs starts with fundamental building blocks: training healthcare professionals in skills and knowledge, selecting resource appropriate effective equipment, and having supportive leadership to provide an enabling environment for appropriate care. If these fundamentals can be built on in a sustainable manner, an appropriate critical care service will be established with the potential to significantly decrease pediatric morbidity and mortality in the context of public health goals as we reach toward the sustainable development goals.

  11. Pediatric Critical Care in Resource-Limited Settings—Overview and Lessons Learned

    Directory of Open Access Journals (Sweden)

    Tina M. Slusher


    Full Text Available Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU and high dependency areas. PICU can improve the quality of pediatric care in general and, if properly organized, can effectively treat the severe complications of high burden diseases, such as diarrhea, severe malaria, and respiratory distress using low-cost interventions. Setting up a PICU in a LMIC setting requires planning, specific resources, and most importantly investment in the nursing and permanent medical staff. A thoughtful approach to developing pediatric critical care services in LMICs starts with fundamental building blocks: training healthcare professionals in skills and knowledge, selecting resource appropriate effective equipment, and having supportive leadership to provide an enabling environment for appropriate care. If these fundamentals can be built on in a sustainable manner, an appropriate critical care service will be established with the potential to significantly decrease pediatric morbidity and mortality in the context of public health goals as we reach toward the sustainable development goals.

  12. Sharing life-altering information: development of pediatric hospital guidelines and team training. (United States)

    Wolfe, Adam D; Frierdich, Sharon A; Wish, Joel; Kilgore-Carlin, Joyce; Plotkin, Julie A; Hoover-Regan, Margo


    Abstract Background: Despite parent and physician reports of inadequate skill development, there are few guidelines for training the pediatric care team in sharing life-altering information (SLAI), i.e., "breaking bad news." The necessary skills for SLAI differ between pediatric and adult medical environments. We set out to establish evidence-based guidelines and multidisciplinary team training for SLAI in pediatrics, and to demonstrate an improvement in immediate self-efficacy of training participants. A multidisciplinary task force, which included parent participation and feedback, and which received input from parents of patients in multiple pediatric subspecialties, crafted children's hospitalwide guidelines for SLAI. A one-hour training module on the guidelines was presented to several multidisciplinary pediatric team audiences; 159 voluntary pre- and post-presentation self-efficacy surveys were collected. Responses were analyzed by paired t-test (within groups) and ANOVA (between groups). All evaluated groups of care team members reported significant improvements in self-efficacy among four learning objectives after the training. Medical trainees, newer physicians, and nonphysician (e.g., midlevel providers including nurses) team members reported the greatest improvements, regardless of whether they had received previous training in SLAI. We propose pediatric-focused SLAI guidelines based on a modified SPIKES protocol. Focus on patient- and family-centered, culturally sensitive pediatric practices should be the basis for development of training that can be periodically reinforced. Future comprehensive training will incorporate experiential learning. SLAI requires a skill set that benefits from lifelong learning.

  13. Leaders from Nursing's History. (United States)

    Fondiller, Shirley H.; And Others


    Looks at the lives and accomplishments of four leaders in professional nursing: (1) Loretta Ford, who championed the cause of nurse practitioners; (2) Mable Staupers, a pioneer in community health and nursing; (3) Janet Geister, a leader in private nursing; and (4) Isabel Stewart, who led the movement to standardize nursing education. (JOW)

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  15. Pediatric Melanoma and Drug Development

    Directory of Open Access Journals (Sweden)

    Klaus Rose


    Full Text Available Importance—Pediatric melanoma occurs, albeit rarely. Should patients be treated by today’s medical standards, or be subjected to medically unnecessary clinical studies? Observations—We identified international, industry-sponsored pediatric melanoma studies triggered by regulatory demands in and further pediatric melanoma studies demanded by European Union pediatric investigation plans. We retrieved related regulatory documents from the internet. We analyzed these studies for rationale and medical beneficence on the basis of physiology, pediatric clinical pharmacology and rationale. Regulatory authorities define children by chronological age, not physiologically. Newborns’ organs are immature but they develop and mature rapidly. Separate proof of efficacy in underage patients is justified formally/regulatorily but lacks medical sense. Children—especially post-puberty—and adults vis-a-vis medications are physiologically very similar. Two adolescent melanoma studies were terminated in 2016 because of waning recruitment, while five studies in pediatric melanoma and other solid tumors, triggered by European Union pediatric investigation plans, continue recruiting worldwide. Conclusions and Relevance—Regulatory-demanded pediatric melanoma studies are medically superfluous. Melanoma patients of all ages should be treated with effective combination treatment. Babies need special attention. Children need dose-finding and pharmacokinetic studies but adolescents metabolize and respond to drugs similarly to adults. Institutional Review Boards/ethics committees should suspend ongoing questionable pediatric melanoma studies and reject newly submitted questionable studies.

  16. Pediatric imaging. Rapid fire questions and answers

    International Nuclear Information System (INIS)

    Quattromani, F.; Lampe, R.


    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies

  17. Pediatric imaging. Rapid fire questions and answers

    Energy Technology Data Exchange (ETDEWEB)

    Quattromani, F.; Lampe, R. (eds.) [Texas Tech Univ. Health Sciences Center, School of Medicine, Lubbock, TX (United States); Handal, G.A. [Texas Tech Univ. Health Sciences Center, School of Medicine, El Paso, TX (United States)


    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies.

  18. Sodium valproate-induced enuresis in a pediatric bipolar patient

    Directory of Open Access Journals (Sweden)

    Cheng W


    Full Text Available Wentao Cheng,1,* Xiaoling Lin,2,* Dali Lu1 1Department of Pediatric and Geriatric Psychiatry, Fuzhou Neuropsychiatric Hospital, Fuzhou, Fujian, People's Republic of China; 2School of Nursing of Central South University, Changsha, Hunan, People's Republic of China *These authors contributed equally to this work Abstract: Sodium valproate (SV is effective and well tolerated for the treatment of epilepsy and mood disorders. There are several cases of SV-induced enuresis noted in epileptic patients. No alternative medication has been suggested to manage this problem. We present the first case of a pediatric bipolar patient who developed diurnal and nocturnal enuresis during SV therapy. Clinicians should be aware of this side effect, as it has not been reported in nonepileptic patients, and it may be detrimental to treatment adherence. Keywords: sodium valproate, enuresis, bipolar disorder

  19. Survivability of Existing Peripheral Intravenous Access Following Blood Sampling in a Pediatric Population. (United States)

    O'Neil, Sheree W; Friesen, Mary Ann; Stanger, Debra; Trickey, Amber Williams


    Although pediatric patients report venipuncture as their most feared experience during hospitalization, blood sampling from peripheral intravenous accesses (PIVs) is not standard of care. Blood sampling from PIVs has long been considered by healthcare personnel to harm the access. In an effort to minimize painful procedures, pediatric nursing staff conducted a prospective, observational study to determine if blood sampling using existing PIVs resulted in the loss of the access. The ability to obtain the sample from the PIV was measured along with patient and PIV characteristics. Specimen collection using 100 existing PIVs was attempted on pediatric inpatients. Each PIV was observed for functionality, infiltration, occlusion, and dislodgement following collection and again in 4h. Frequencies of PIV loss and successful blood sampling were calculated. Patient age, PIV gauge, access site, and PIV age were evaluated for associations with successful sampling using chi-square tests, Fisher's exact tests, and logistic regression. PIV survivability was reported at 99%. The ability to obtain a complete specimen was reported at 76% and found to be significantly related to PIV age and site. Size of PIV and patient's age were not significantly related to successful sampling. Encouraging rates of PIV survivability and collectability suggest blood sampling from PIVs to be a valuable technique to minimize painful and distressful procedures. Nursing practice was changed in this pediatric department. Patients and families are saved the pain and distress of venipuncture. Nurses reported saving time and personal distress by avoiding the venipuncture procedure. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Developing nursing care plans. (United States)

    Ballantyne, Helen


    This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.

  1. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... into the bloodstream. The radiologist , technologist or a nurse may ask if your child has allergies of ... sedation. Your child will be discharged when the nurses and physicians believe he/she is sufficiently awake ...

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... also be discussed with the CT technologist or nurse at the time of the CT examination. If ... difficulty breathing, you should notify the technologist or nurse, as it may indicate a more severe allergic ...

  3. Radiologic procedures, policies and protocols for pediatric emergency medicine

    International Nuclear Information System (INIS)

    Woodward, George A.


    Protocol development between radiology and pediatric emergency medicine requires a multidisciplinary approach to manage straightforward as well as complex and time-sensitive needs for emergency department patients. Imaging evaluation requires coordination of radiologic technologists, radiologists, transporters, nurses and coordinators, among others, and might require accelerated routines or occur at sub-optimal times. Standardized protocol development enables providers to design a best practice in all of these situations and should be predicated on evidence, mission, and service expectations. As in any new process, constructive feedback channels are imperative for evaluation and modification. (orig.)

  4. Nursing specialty and burnout. (United States)

    Browning, Laura; Ryan, Carey S; Thomas, Scott; Greenberg, Martin; Rolniak, Susan


    We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest burnout, whereas nurse practitioners had the most control and the least burnout. Mediational analyses showed that expected control, hostility, and stressor frequency explained differences between specialties in burnout. The implications of these findings for interventions that reduce burnout and promote nursing retention are discussed.

  5. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... information about radiation dose. There always is a risk of complications from general anesthesia or sedation. Every measure will be taken to ... in X-Ray and CT Exams Contrast Materials Anesthesia Safety Children and Radiation Safety ... (Pediatric) CT (Computed Tomography) Videos related to Children's (Pediatric) ...

  6. Archives: Annals of Pediatric Surgery

    African Journals Online (AJOL)

    Items 1 - 32 of 32 ... Archives: Annals of Pediatric Surgery. Journal Home > Archives: Annals of Pediatric Surgery. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 32 of 32 Items ...

  7. Psychosocial Issues in Pediatric Oncology (United States)

    Marcus, Joel


    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

  8. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses ... of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  9. Obesity and Pediatric Drug Development. (United States)

    Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J


    There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

  10. Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care. (United States)

    Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew


    The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

  11. Pediatric ambulatory anesthesia. (United States)

    August, David A; Everett, Lucinda L


    Pediatric patients often undergo anesthesia for ambulatory procedures. This article discusses several common preoperative dilemmas, including whether to postpone anesthesia when a child has an upper respiratory infection, whether to test young women for pregnancy, which children require overnight admission for apnea monitoring, and the effectiveness of nonpharmacological techniques for reducing anxiety. Medication issues covered include the risks of anesthetic agents in children with undiagnosed weakness, the use of remifentanil for tracheal intubation, and perioperative dosing of rectal acetaminophen. The relative merits of caudal and dorsal penile nerve block for pain after circumcision are also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. News on pediatric urology

    Directory of Open Access Journals (Sweden)

    Giuseppe Masnata


    Full Text Available Pediatric urology is a pediatric speciality dedicated to the diagnosis and treatment of congenital and acquired genitourinary tract diseases. It is a speciality that is rapidly changing, thanks to the technological development that has been emerging in recent years. There have been important diagnostic and therapeutic news.Congenital anomalies of the kidneys and urinary tract (CAKUT include various entities of structural malformations that result from defects in their morphogenesis. Clinical research and genetic studies on the origins of CAKUT are quickly evolving, with significant growth of high-quality research.Management goals of CAKUT include prevention of febrile urinary tract infections (UTIs in newborns and toddles and renal injury, while minimizing the morbidity of treatment and follow-up. Treatment options include observation with or without continuous antibiotic prophylaxis (CAP and surgical correction. Now, randomized controlled studies show that children with normal urinary tracts or low-grade vesicoureteral reflux (VUR do not benefit from prophylaxis.All children with known mechanical or functional obstructions of the urinary tract are considered to have UTI. Functional obstruction often results from lower urinary tract dysfunction (LUTD of either neurogenic or non-neurogenic origin and dilating VUR.The role of bladder and bowel dysfunction (BBD in children with UTI and the long-term risk of renal scarring have shed new light on treatment strategies. Often it is BBD, rather than reflux, that causes UTI in children older than 2 years.Pediatric urology has evolved in recent years, with a greater focus on bladder and renal function, minimally invasive treatment, evidence-based interventions, and guideline adherence. Other topics in pediatric urology include urinary incontinence in children with special needs and the use of robot-assisted laparoscopic surgery (RALS in children, with advantages over conventional laparoscopic surgery


    Directory of Open Access Journals (Sweden)

    A.E. Aleksandrov


    Full Text Available The present overview is dedicated to the issue of the unpleasant emotions among the patients of the pediatric in patient departments. Among the children, the admission to the in patient department is accompanied with the relative effects predominance of the adrenal link of the sympathoadrenal system, which may lead to their depletion against the background of the rapid decrease of their reserves if accompanied with the excessive emotional and psychic or attached painful loads. The authors give recommendations as to the use of the benzodiazepines among children, who are frightened about the treatment and diagnostic manipulations to come.Key words: children, stress, sedation, benzodiazepines.

  14. Pediatric obesity: Current concepts. (United States)

    Greydanus, Donald E; Agana, Marisha; Kamboj, Manmohan K; Shebrain, Saad; Soares, Neelkamal; Eke, Ransome; Patel, Dilip R


    This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21 st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity. We conclude with a discussion of future directions in pediatric obesity management. Copyright © 2018 Mosby, Inc. All rights reserved.

  15. Incarcerated Pediatric Hernias. (United States)

    Abdulhai, Sophia A; Glenn, Ian C; Ponsky, Todd A


    Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias can be reduced nonoperatively. It is recommended to repair them in a timely fashion, even in premature infants. Laparoscopic repair of incarcerated inguinal hernia repair is considered a safe and effective alternative to conventional open herniorrhaphy. Other incarcerated pediatric hernias are extremely rare and may be managed effectively with laparoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Apheresis training for nurses and physicians around the World. (United States)

    Neyrinck, Marleen; Vrielink, Hans


    A training program for apheresis nurses in leukocyte collection and therapeutic apheresis was developed by the Joint Task Force for Apheresis Education and Certification. This is a modular program with theoretical and practical information and knowledge. On request of the Indonesian authorities, in the capital of Indonesia Jakarta, a certification course for apheresis nurses/operators based on the training program described above was organized in December 2013. The course existed of themes related to apheresis, such as hematology, anatomy, physiology, calculations, adverse events, basics of apheresis, nursing aspects, quality, collection of cells for cellular therapies, pediatrics, and therapeutic collections (cell reductions and exchange procedures). A pretest and post-test regarding the knowledge and judgment in the themes described was taken in Bahasa Indonesia or in English. In total, 38 apheresis nurses and 32 physicians participated in the course. In the post-test, the nurses scored in a mean 72/100 and the physicians 77/100 (nurses vs. physicians: P = 0.005), which was significantly better than the results of the pretest (54/100 and 53/100, respectively (P nurses/operators proved a significant increase of knowledge in the theory behind apheresis. This educational program provides an approach to educate and certificate apheresis nurses. It is also shown that also for physicians working in the field of apheresis, this course is of use increasing their knowledge regarding apheresis. © 2014 Wiley Periodicals, Inc.

  17. Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice. (United States)

    Gaffney, Kathleen F; Kitsantas, Panagiota; Brito, Albert; Kastello, Jennifer


    The aim of this paper is to present an overview of the infancy-related guidelines from the Institute of Medicine (IOM, 2011) report “Early Childhood Obesity Prevention Policies” and highlight research studies that support their implementation in pediatric practice. Findings from recent studies of infant growth monitoring, feeding, sleep, and physical activity are presented. Research strategies that may be applied to today's clinical assessments and interventions are specified. Participation by pediatric nurses in the development of future multi-component interventions to prevent rapid infant weight gain is recommended.

  18. A gap between need and reality: neonatal nursing staff requirements on a German intensive care unit

    Directory of Open Access Journals (Sweden)

    Christian Patry


    Full Text Available Recently, new staffing rules for neonatal nurses in intensive care units (ICU were issued in Germany, using categories of care of the British Association of Perinatal Medicine as blueprint. Neonates on intensive care require a nurse-to-patient ratio of 1:1, on intensive surveillance (high dependency care of 1:2. No requirements exist for special care, transitional care, and pediatric ICU patients. Using these rules, nursing staff requirement was calculated over a period of 31 consecutive days once a day in a combined pediatric and neonatal ICU of a metropolitan academic medical center in south-west Germany. Each day, 18.9±0.98 patients (mean±standard deviation were assessed (14.26±1.21 neonatal, 4.65±0.98 pediatric. Among neonates, 9.94±2.56 received intensive therapy, 3.77±1.85 intensive surveillance, and 0.65±0.71 special care. Average nursing staff requirement was 12.10±1.81 full time equivalents (FTE per shift. Considering additional pediatric patients in the ICU and actual nursing staff availability (8.97±0.87 FTE per shift, this ICU seems understaffed.


    African Journals Online (AJOL)


    health worker performance and patient outcome. In 2009, International ... benefits and incentives for nurses in order to guarantee nurses wellbeing and retention in the profession. ..... Flexibility / demand for work in different areas. 8. 4.8. 23.

  20. Nurse Bullying: Impact on Nurses' Health. (United States)

    Sauer, Penny A; McCoy, Thomas P


    Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

  1. Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients. (United States)

    Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

    There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

  2. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting (United States)


    ...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...

  3. Virtually Nursing: Emerging Technologies in Nursing Education. (United States)

    Foronda, Cynthia L; Alfes, Celeste M; Dev, Parvati; Kleinheksel, A J; Nelson, Douglas A; OʼDonnell, John M; Samosky, Joseph T

    Augmented reality and virtual simulation technologies in nursing education are burgeoning. Preliminary evidence suggests that these innovative pedagogical approaches are effective. The aim of this article is to present 6 newly emerged products and systems that may improve nursing education. Technologies may present opportunities to improve teaching efforts, better engage students, and transform nursing education.

  4. Pediatric endocrine surgery development

    Directory of Open Access Journals (Sweden)

    Ivan I. Dedov


    Full Text Available Department of pediatric surgery at the Endocrinology Research Centre has been around for nearly two years. During operation, surgical treatment has received more than 500 patients with various endocrine disorders. The article discusses modern diagnostic approaches and surgical options for diseases included in the new direction of pediatric surgery – endocrine surgery in children. There are discussions about options for radical treatment of Graves disease in children, positive and negative aspects of surgical and radioactive iodine treatment. Is own stats of postoperative hyperparathyroidism. Is proposed to optimize the algorithm of actions in identifying thyroid nodules in children. In primary hyperparathyroidism, the emphasis is on the complexity of the postoperative management of patients related to the feature of children’s age in determining the severity of the reactions on the water-electrolyte disorders. Separately reviewed the literature of the adrenal glands diseases in children, demonstrating their own clinical cases which required surgical intervention. The authors describe the possibilities of modern neurosurgical equipment in the Endocrinology Research Centre in operations on the pituitary gland in children. Patients of different age groups performed transnasal transsphenoidal removal of tumors of the chiasm-sellar region using endoscopic assistance. The article also cited research data of pancreas diseases and their surgical treatment. Much attention is paid to the gender section of endocrine surgery in children. Discusses the tactics in disorders of sex development, gonadal tumors in children, diseases of the breast. In conclusion outlines the prospects for the development of endocrine surgery in children.

  5. Pediatric contact dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Vinod


    Full Text Available Allergic contact dermatitis (ACD in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  6. Pharmacology of pediatric resuscitation. (United States)

    Ushay, H M; Notterman, D A


    The resuscitation of children from cardiac arrest and shock remains a challenging goal. The pharmacologic principles underlying current recommendations for intervention in pediatric cardiac arrest have been reviewed. Current research efforts, points of controversy, and accepted practices that may not be most efficacious have been described. Epinephrine remains the most effective resuscitation adjunct. High-dose epinephrine is tolerated better in children than in adults, but its efficacy has not received full analysis. The preponderance of data continues to point toward the ineffectiveness and possible deleterious effects of overzealous sodium bicarbonate use. Calcium chloride is useful in the treatment of ionized hypocalcemia but may harm cells that have experienced asphyxial damage. Atropine is an effective agent for alleviating bradycardia induced by increased vagal tone, but because most bradycardia in children is caused by hypoxia, improved oxygenation is the intervention of choice. Adenosine is an effective and generally well-tolerated agent for the treatment of supraventricular tachycardia. Lidocaine is the drug of choice for ventricular dysrhythmias, and bretylium, still relatively unexplored, is in reserve. Many pediatricians use dopamine for shock in the postresuscitative period, but epinephrine is superior. Most animal research on cardiac arrest is based on models with ventricular fibrillation that probably are not reflective of cardiac arrest situations most often seen in pediatrics.

  7. Pediatric spinal infections

    Directory of Open Access Journals (Sweden)

    Raj Kumar


    Full Text Available The infections of the spinal axis in children are rare when compared with adults. They encompass a large spectrum of diseases ranging from relatively benign diskitis to spinal osteomyleitis and to the rapidly progressive, rare, and potentially devastating spinal epidural, subdural, and intramedullary spinal cord infections. We present a comprehensive review of the literature pertaining to these uncommon entities, in light of our experience from northern India. The most prevalent pediatric spinal infection in Indian scenario is tuberculosis, where an extradural involvement is more common than intradural. The craniovertebral junction is not an uncommon site of involvement in children of our milieu. The majority of pyogenic infections of pediatric spine are associated with congenital neuro-ectodermal defects such as congenital dermal sinus. The clinico-radiological findings of various spinal infections commonly overlap. Hence the endemicity of certain pathogens should be given due consideration, while considering the differential diagnosis. However, early suspicion, rapid diagnosis, and prompt treatment are the key factors in avoiding neurological morbidity and deformity in a growing child.

  8. Abdominal emergencies in pediatrics. (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E


    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  9. PET applications in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Shulkin, B. L. [Ann Arbor, Univ. of Michigan Medical Center (United States). Pediatric Nuclear Medicine Section


    This article summarizes the major PET studies which have been performed in pediatric patients to elucidate and characterize diseases and normal development. Issues special for the application of the technique in children, such as dosimetry, patient preparation, and image acquisition are discussed. Studies of central nervous system (CNS) development and pathology, including epilepsy, intraventricular hemorrhage, neonatal asphyxia, tumors, and effects on the CNS from treatment of other tumors are reviewed. These have contributed information fundamental to their understanding of CNS development and pathology. PET investigations into the pathophysiology of congenital heart disease have begun and hold great promise to aid their understanding of these conditions. The second major area in which PET has been applied is the study of non CNS neoplasms. Neuroblastoma has been investigated with tracers which explore basic biochemical features which characterize this tumor, as well as with tracers which explore biochemical events relatively specific for this malignancy. Other common and uncommon tumors of childhood are discussed. The PET technique has been shown useful for answering questions of clinical relevance for the management of these uncommon neoplasms. PET is likely to continue to aid their understanding of many pediatric diseases and may gain more widespread clinical acceptance as the technology continues to disseminate rapidly.

  10. Pediatric Hypovitaminosis D

    Directory of Open Access Journals (Sweden)

    Rafiu Ariganjoye MD, MBA, FAAP, FAIHQ, CPE, CHCQM


    Full Text Available Vitamin D, a secosteroid, is essential for the development and maintenance of healthy bone in both the adult and pediatric populations. Low level of 25-hydroxy vitamin D (25-(OH-D is highly prevalent in children worldwide and has been linked to various adverse health outcomes including rickets, osteomalacia, osteomalacic myopathy, sarcopenia, and weakness, growth retardation, hypocalcemia, seizure and tetany, autism, cardiovascular diseases, diabetes mellitus, cancers (prostate, colon, breast, infectious diseases (viral, tuberculosis, and autoimmune diseases, such as multiple sclerosis and Hashimoto’s thyroiditis. Risk factors for hypovitaminosis D are people with darker skin pigmentation, use of sunscreen, insufficient ultraviolet B exposure, prematurity, living in northern latitudes, malnutrition, obesity, exclusive breastfeeding, low maternal vitamin D level, certain medications, drinking unfortified cow’s milk, liver failure, chronic renal insufficiency, cystic fibrosis, asthma, and sickle cell hemoglobinopathy. This review highlights and summarizes the molecular perspectives of vitamin D deficiency and its potential adverse health outcomes in pediatric age groups. The recommended treatment regimen is beyond the scope of this review.

  11. Pediatric DXA: clinical applications

    International Nuclear Information System (INIS)

    Binkovitz, Larry A.; Sparke, Paul; Henwood, Maria J.


    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. (orig.)

  12. Pediatric Palliative Care at a Glance (United States)

    ® ™ ® Pediatric Palliative Care at a Glance A child’s serious illness affects the entire family. Pediatric palliative (pal-lee-uh-tiv) care can support ... extra support, palliative care can help. What is pediatric palliative care? Pediatric palliative care is supportive care ...

  13. Taiwanese Parents' Experience of Making a “Do Not Resuscitate” Decision for Their Child in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shu-Mei Liu, RN, MN


    Conclusion: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.

  14. Commentary: Pediatric Epilepsy: A Good Fit for Pediatric Psychologists (United States)

    Modi, Avani; Smith, Gigi


    While there are an abundance of pediatric neuropsychologists working with youth with epilepsy (YWE), other subspecialty psychologists have played minimal roles in clinical and research endeavors in pediatric epilepsy. Thus, the purpose of this commentary was to describe (a) the needs of YWE due to the intermittent nature of seizures and difficulties with disease management, (b) increased risk for psychosocial comorbidities, (c) limited access to care, and (d) provide recommendations for how pediatric psychologists can become involved in the clinical care and research activities for YWE. PMID:21148174

  15. Os Doutores da Alegria na unidade de internação pediátrica: experiências da equipe de enfermagem Los Doctores de la Alegría en una unidad pediátrica de internación: experiencias del equipo de enfermería The Clown Doctors in a pediatric unit of internment: experiences of the nursing staff

    Directory of Open Access Journals (Sweden)

    Roberta Ramos de Oliveira


    cuales pueden/deben ser utilizados en el contexto hospitalario, causando nuevos significados al cuidado.The study was focused on the nursing staff experience with Clown Doctors intervention at one unit of pediatric internment. The objectives were to describe the nursing staff knowledge regarding the Clown Doctors’ performance and to analyze the nursing staff experience with this group. A qualitative study was conducted with ten members of the nursing staff by applying non-directive interview in group. The results highlighted the recognition of the benefits of this intervention over the children illness recovery during their internment, as well as the triad of relations between clowns, accompanying mother and nursing staff. It is concluded that the clowns act as helpers agents, attempting against for the fact of that tricks and toys constitute resources, that may/might to be used in the hospital context, causing new meanings to the taking care of.

  16. Workplace violence against nurses: A cross-sectional study. (United States)

    Zhang, Liuyi; Wang, Anni; Xie, Xia; Zhou, Yanhong; Li, Jing; Yang, Lijun; Zhang, Jingping


    Workplace violence is a serious problem for clinical nurses, as it leads to a series of adverse consequences. However, little information is available on the prevalence and influencing factors of workplace violence in China. To determine the prevalence of workplace violence against Chinese nurses, and its influencing factors. A multi-center, cross-sectional study. The seven geographical regions (i.e., northeast, north, central, east, south, northwest, and southwest) of China. Four thousand one hundred and twenty-five nurses. We randomly selected 28 hospitals, located in 14 cities over 13 provinces across the seven geographical regions. We distributed 4125 questionnaires between May 4 and September 23, 2014. The questionnaire included demographic information, the Workplace Violent Incident Questionnaire, the Jefferson Scale of Empathy-Health Professionals, and the Practice Environment Scale of Nursing Work Index. Workplace violence was assessed in terms of physical violence, non-physical violence, sexual harassment, and organized healthcare disturbances. We then performed descriptive analyses and logistic regressions on the collected data. The response rate was 92.97% (n=3835). Additionally, we obtained valid questionnaires from 3004 individuals. Of these, 25.77% reported experiencing physical violence, 63.65% non-physical violence, 2.76% sexual harassment, and 11.72% organized healthcare disturbances. A logistic regression analysis revealed that nurses who have less experience, work a rotating roster, work in emergency rooms and pediatrics departments, have low empathy levels, and who work in poor nursing environments have greater odds of experiencing violence. Experiences of workplace violence are prevalent among Chinese nurses, and several complex factors are associated with a greater risk of such violence, including nurses' personal characteristics, work settings, and work environments. Our results might help nursing managers understand their employees' work

  17. Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives. (United States)

    Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine


    Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.

  18. Provider Training to Screen and Initiate Evidence-Based Pediatric Obesity Treatment in Routine Practice Settings: A Randomized Pilot Trial. (United States)

    Kolko, Rachel P; Kass, Andrea E; Hayes, Jacqueline F; Levine, Michele D; Garbutt, Jane M; Proctor, Enola K; Wilfley, Denise E

    This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Participants (N = 63) were randomized to live interactive training or Web-facilitated self-study training. Pretraining, post-training, and 1-month follow-up assessments evaluated training feasibility, acceptability, and impact (knowledge and skill via simulation). Moderator (previous experience) and predictor (content engagement) analyses were conducted. Nearly all participants (98%) completed assessments. Both types of training were acceptable, with higher ratings for live training and participants with previous experience (ps pediatric obesity services. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  19. District nurse training


    Elliott, Arnold; Freeling, Paul; Owen, John


    Training for district nursing is being reviewed. By 1981 district nurses will have a new administrative structure, a new curriculum, and a new examination. Training for nursing, like that for general practice, is to become mandatory. The history of the development of district nurse training is briefly described.

  20. The 2011 Tuscaloosa tornado: integration of pediatric disaster services into regional systems of care. (United States)

    Kanter, Robert K


    To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Data were obtained in interviews with key informants including professional staff and managers from public health and emergency management agencies, prehospital emergency medical services, fire departments, hospital nurses, physicians, and the trauma program coordinator. A single hospital in Tuscaloosa served 800 patients on the night of the tornado. More than 100 of these patients were children, including more than 20 with critical injuries. Many children were unaccompanied and unidentified on arrival. Resuscitation and stabilization were performed by nonpediatric prehospital and emergency department staff. More than 20 children were secondarily transported to the nearest children's hospital an hour's drive away under the care of nonpediatric local emergency medical services providers. No preventable adverse events were identified in the resuscitation and secondary transport phases of care. Stockpiled supplies and equipment were adequate to serve the needs of the disaster victims, including the children. Essential aspects of preparation include pediatric-specific clinical skills, supplies and equipment, operational disaster plans, and interagency practice embedded in everyday work. Opportunities for improvement identified include more timely response to warnings, improved practices for identifying unaccompanied children, and enhanced child safety in shelters. Successful responses depended on integration of pediatric services into regional systems of care. Copyright © 2012 Mosby, Inc. All rights reserved.

  1. The conceptualization of childhood in North American pediatric dentistry texts: a discursive case study analysis. (United States)

    Makansi, Nora; Carnevale, Franco A; Macdonald, Mary Ellen


    In recent years, conceptions of childhood have been evolving towards an increased recognition of children as active agents, capable of participating in the determination of their wellbeing. In pediatric dentistry, the extent to which these conceptions are being discursively endorsed is not well known. The aim of this investigation was to examine the discursive construction of childhood in seminal North American pedagogical dentistry materials. We conducted a qualitative discourse analysis of a sample of prominent texts using a sociological discourse analysis approach. We analyzed the latest edition of Macdonald and Avery's textbook (Chapter: Non pharmacologic management of children's behaviors) and the clinical practice guidelines published by the American Academy of Pediatric Dentistry, AAPD (Behavior guidance for the pediatric dental patient). The analysis produced five salient discursive categories: socialization through behavior modification; development and behavior; paternalism; the utility of child-centered communication; and consequentialism. While there were instances of a child-centered focus in the texts, the main discourses were rooted in developmentalism and behaviorism. There was scant acknowledgment of the importance of children's agency or voice, which runs contrary to child-centered discourses and practices in related disciplines (e.g., pediatric medicine, nursing). Predominant discourses in pediatric dentistry suggest a paternalistic, behaviorist approach to the 'management' of children in the dental office, focused primarily on completing interventions. Priorities for the future development of pediatric dentistry are discussed, integrating more child-centered approaches. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Work-related stress and reward: an Australian study of multidisciplinary pediatric oncology healthcare providers. (United States)

    Bowden, M J; Mukherjee, S; Williams, L K; DeGraves, S; Jackson, M; McCarthy, M C


    Managing staff stress and preventing long-term burnout in oncology staff are highly important for both staff and patient well-being. Research addressing work-related stress in adult oncology is well documented; however, less is known about this topic in the pediatric context. This study examined sources of work-related stress and reward specific to multidisciplinary staff working in pediatric oncology in Australia. Participants were 107 pediatric oncology clinicians, including medical, nursing, and allied health staff from two Australian pediatric oncology centers. Participants completed an online survey using two newly developed measures: the work stressors scale-pediatric oncology and the work rewards scale-pediatric oncology. The most commonly reported sources of both stress and reward are related to patient care and interactions with children. Results indicated that levels of work-related stress and reward were similar between the professional disciplines and between the two hospitals. Regression analyses revealed no demographic or organizational factors that were associated with either stress or reward. Work-related stress and reward are not mutually exclusive; particular situations and events can be simultaneously stressful and rewarding for healthcare providers. Although patient care and interactions with children was found to be the most stressful aspect of working in this speciality, it was also the greatest source of reward. Results are discussed in relation to workplace approaches to staff well-being and stress reduction. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Seminar Pediatrics. Medical and Technical Applications

    International Nuclear Information System (INIS)

    Montivero, M.; Nespral, D.O.; Alak, Maria del Carmen


    The Association of Biology and Nuclear Medicine has organized the 'Seminar Pediatrics - Medical and Technical Applications', held in Buenos Aires in May 2012, in order to collaborate with the scientific growth of nuclear medicine in pediatrics. The main topics covered were: management of pediatric patients and medical application in childhood, dosimetry in pediatric nuclear medicine, scope of radioisotope - studies in nephrourological pathologies, PET in pediatrics, among others.

  4. SAFETY: an integrated clinical reasoning and reflection framework for undergraduate nursing students. (United States)

    Hicks Russell, Bedelia; Geist, Melissa J; House Maffett, Jenny


    Nurse educators can no longer focus on imparting to students knowledge that is merely factual and content specific. Activities that provide students with opportunities to apply concepts in real-world scenarios can be powerful tools. Nurse educators should take advantage of student-patient interactions to model clinical reasoning and allow students to practice complex decision making throughout the entire curriculum. In response to this change in nursing education, faculty in a pediatric course designed a reflective clinical reasoning activity based on the SAFETY template, which is derived from the National Council of State Boards of Nursing RN practice analysis. Students were able to prioritize key components of nursing care, as well as integrate practice issues such as delegation, Health Insurance Portability and Accountability Act violations, and questioning the accuracy of orders. SAFETY is proposed as a framework for integration of content knowledge, clinical reasoning, and reflection on authentic professional nursing concerns. Copyright 2012, SLACK Incorporated.

  5. MRI imaging in pediatric appendicitis

    Directory of Open Access Journals (Sweden)

    Robin Riley


    Full Text Available An 8-year-old male presents with two days of abdominal pain and emesis. Computed tomography was concerning for obstruction or reactive ileus with an apparent transition point in the right lower quadrant, possibly due to Crohn's. Magnetic resonance imaging was concerning for perforated appendicitis. As demonstrated by this case MRI can be as sensitive as CT in detecting pediatric appendicitis [2]. We recommend using MRI instead of CT to diagnose appendicitis to avoid ionizing radiation and increased cancer risk in the pediatric population. Keywords: Computer tomography, Magnetic resonance imaging, Pediatric appendicitis

  6. Pediatric neuropsychology: toward subspecialty designation. (United States)

    Baron, Ida Sue; Wills, Karen; Rey-Casserly, Celiane; Armstrong, Kira; Westerveld, Michael


    Clinical neuropsychology is a rapidly expanding field of study in the psychological sciences whose practitioners are expert in the assessment, treatment, and research of individuals with known or suspected central nervous system disease or disorder. Pediatric neuropsychology has emerged as a distinct subspecialty area with related education, training, and clinical expertise for a growing number of neuropsychologists. This paper details the numerous steps taken by two affiliated organizations, the American Board of Clinical Neuropsychology and its membership organization, the American Academy of Clinical Neuropsychology, in the interest of the larger pediatric neuropsychology community and in pediatric neuropsychology subspecialty development.

  7. Pediatric trampoline injuries. (United States)

    Hurson, Conor; Browne, Katherine; Callender, Orla; O'Donnell, Turlough; O'Neill, Anthony; Moore, David P; Fogarty, Esmond E; Dowling, Francis E


    The recreational use of trampolines has increased dramatically during the last 10 years. There has been a striking increase in the number of children presenting to fracture clinics with injuries associated with trampoline use. This increase in trampoline injuries has been reported in North America, but there has been a paucity of research in this area in Europe. We prospectively recorded details of patients presenting to our institution, Our Lady's Children's Hospital, Crumlin (Dublin, Ireland), during the busy summer months of June, July, and August 2005. Details recorded included type and mechanism of injury, the mode of referral, treatment, inpatient days, outpatient visits, specific details relating to trampoline safety, and an analysis of the cost of medical care. There were 101 patients treated for trampoline-related injuries in 3 months from June to August 2005. This represented 1.5% of the total attendances to the emergency department. The average age was 8.5 years (range, 1.4-17.4 years). There were 55 fractures, 38 soft tissue injuries, 5 head injuries, and 5 neck injuries, with an average Pediatric Trauma Score of 11.4. Fifty seven percent (58/101) of patients were on the trampoline with at least 1 other person. Twenty patients (19.8%) were admitted to hospital requiring 71 inpatient days. Twelve patients were treated in theatre. There were 163 fracture clinic visits, 212 x-rays, and 2 magnetic resonance imaging scans. Trampolines are a high-risk activity with the potential for significant orthopaedic injury. In Ireland, we have recently seen a dramatic increase in pediatric trampoline-related injuries mirroring the trend in the United States during the last 10 to 15 years. We found that more than 1 individual on a trampoline is a major risk factor for injury, where the lightest person is 14 times more likely to be injured than the heavier. The lighter person also has a greater chance of being injured with smaller numbers on the trampoline. We reiterate

  8. Nursing in Turkey. (United States)

    Baumann, Steven L


    The current discussion on the nursing shortage needs to focus as much on nursing job satisfaction and retention as on nursing recruitment and education. Selected aspects of the motivational psychology of Abraham Maslow, Mihaly Csikszentmihalyi, and Frederick Hertzberg are here discussed in light of the challenges-opportunities of nursing in Turkey and elsewhere. Also discussed is an innovative program to support the application of nursing theory and professional development in Toronto, Canada.

  9. Pediatric Headache: An Overview. (United States)

    Langdon, Raquel; DiSabella, Marc T


    Headache represents the most common neurologic disorder in the general population including children and is increasingly being recognized as a major source of morbidity in youth related to missed school days and activities. In this article, we take a holistic approach to the child presenting with headache with a focus on the detailed headache history, physical and neurologic examinations, and diagnostic evaluation of these patients. Clinical presentations and classification schema of multiple primary and secondary headache types in children are discussed using the International Headache Criteria (IHCD-3) as a guide, and a summary provided of the various treatment modalities employed for pediatric headache including lifestyle modifications, behavioral techniques, and abortive and preventive medications. Copyright © 2017 Mosby, Inc. All rights reserved.

  10. Pediatric thoracic CT angiography

    International Nuclear Information System (INIS)

    Frush, Donald P.; Herlong, J. Rene


    One of the principal benefits of contemporary multidetector row computed tomography (MDCT) has been the ability to obtain high-data sets for evaluation of the cardiovascular system. The benefits of the greater number of detector rows and submillimeter image thicknesses were quickly recognized and are especially advantageous in children. For example, since imaging is performed so quickly, issues with motion are minimized. This is a substantial benefit of CTA compared with MR imaging, the traditional noninvasive cross sectional modality for pediatric cardiovascular imaging. This, together with faster and more powerful computers, including improved transfer and storage capabilities, offers improved depiction of the heart, great vessels, other vasculature and adjacent intrathoracic structures in a fashion that is well accepted by clinical colleagues. In order to be successful, however, one must have an understanding of the technology and often unique technical considerations in infants and children. With this familiarity, excellent cardiovascular examinations can be performed even in the most challenging case. (orig.)

  11. Pediatric nuclear oncology

    International Nuclear Information System (INIS)

    Howman Giles, R.; Bernard, E.; Uren, R.


    Nuclear medicine plays an important and increasing role in the management of childhood malignancy. This is particularly true in the solid tumours of childhood. It is also helpful in the management of the complications of cancer treatment such as the infections which often accompany immune suppression in oncology patients. Scintigraphy is a complementary investigation to other radiological techniques and adds the functional dimension to anatomical investigations such as CT, MRI and ultrasound. In selected malignancies radionuclides are also used in treatment. This review discusses the technical considerations relating to children and the specific techniques relating to pediatric oncology. Specific tumours and the various applications of radionuclides are discussed in particular lymphoma, primary bone tumours, soft tissue sarcomas, neuroblastoma, Wilms' tumour, brain tumours and leukemia. Uncommon tumours are also discussed and how radionuclides are useful in the investigation of various complications which occur in oncology patients

  12. Moral Hazard in Pediatrics. (United States)

    Brunnquell, Donald; Michaelson, Christopher M


    "Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties.

  13. Pediatric oncology in Slovenia. (United States)

    Jereb, B; Anzic, J


    Slovenia, a new country and formerly a part of Yugoslavia, has had its Childrens Hospital in Ljubljana since 1865. This became a part of the University Hospital in 1945, and in the early 1960s the Department of Pediatric Hematology-Oncology was established. The Oncological Institute of Slovenia was established in 1938 and has developed into a modern facility for comprehensive cancer care, research, and teaching. In close cooperation, established in the 1960s, a team from these two institutions takes care of the approximately 60 children per year who develop cancer in Slovenia. Consisting of pediatricians, radiation oncologists, pathologists, cytologists, surgeons, and other ad hoc specialists, the team meets at least twice weekly to plan treatment, follow the patients, discuss the results, and teach. All patients are subject to regular follow-up indefinitely. A separate team has been formed to study the late effects of cancer treatment on survivors, who by now are mostly adults.

  14. Pediatric chronic nonbacterial osteomyelitis. (United States)

    Borzutzky, Arturo; Stern, Sara; Reiff, Andreas; Zurakowski, David; Steinberg, Evan A; Dedeoglu, Fatma; Sundel, Robert P


    Little information is available concerning the natural history and optimal treatment of chronic nonbacterial osteomyelitis (CNO). We conducted a retrospective review to assess the clinical characteristics and treatment responses of a large cohort of pediatric CNO patients. Children diagnosed with CNO at 3 tertiary care centers in the United States between 1985 and 2009 were identified. Their charts were reviewed, and clinical, laboratory, histopathologic, and radiologic data were extracted. Seventy children with CNO (67% female patients) were identified. Median age at onset was 9.6 years (range 3-17), and median follow-up was 1.8 years (range 0-13). Half of the patients had comorbid autoimmune diseases, and 49% had a family history of autoimmunity. Patients with comorbid autoimmune diseases had more bone lesions (P coexisting autoimmunity was a risk factor for multifocal involvement and treatment with immunosuppressive agents. Disease-modifying antirheumatic drugs and biologics were more likely to lead to clinical improvement than NSAIDs.

  15. Iopamidol in pediatric angiocardiography

    International Nuclear Information System (INIS)

    Strife, J.L.; Kirks, D.R.; Bisset, G.S. III; Hannon, D.; Schwartz, D.


    Iopamidol (ISOVUE-370) has been used extensively in adult angiocardiography, but clinical trials in pediatric patients with congenital heart disease are limited. The authors study group comprised 25 children referred for elective cardiac catheterization and cineangiocardiography. Patients were aged 3 months to 15 years (mean, 2 years) and weighted 14-62 kg (mean, 17 kg). Depending on the congenital heart lesion, the total amount of contrast agent injected ranged from 1 to 5 ml/kg. The potential benefits of iopamidol include fewer minor side effects, decreased movement or reaction of the child, and fewer direct effects of contrast agent on biochemical changes, compared with published results of using ionic contrast media. In addition, there were fewer electrocardiographic changes during iopamidol injection, and less change in the end-diastolic pressures after injection compared to results obtained with ionic contrast media. Visual rating of the cineangiograms revealed that all were of diagnostic quality, and 75% were rated as showing ''superior opacification.''

  16. Genetics of pediatric obesity. (United States)

    Manco, Melania; Dallapiccola, Bruno


    Onset of obesity has been anticipated at earlier ages, and prevalence has dramatically increased worldwide over the past decades. Epidemic obesity is mainly attributable to modern lifestyle, but family studies prove the significant role of genes in the individual's predisposition to obesity. Advances in genotyping technologies have raised great hope and expectations that genetic testing will pave the way to personalized medicine and that complex traits such as obesity will be prevented even before birth. In the presence of the pressing offer of direct-to-consumer genetic testing services from private companies to estimate the individual's risk for complex phenotypes including obesity, the present review offers pediatricians an update of the state of the art on genomics obesity in childhood. Discrepancies with respect to genomics of adult obesity are discussed. After an appraisal of findings from genome-wide association studies in pediatric populations, the rare variant-common disease hypothesis, the theoretical soil for next-generation sequencing techniques, is discussed as opposite to the common disease-common variant hypothesis. Next-generation sequencing techniques are expected to fill the gap of "missing heritability" of obesity, identifying rare variants associated with the trait and clarifying the role of epigenetics in its heritability. Pediatric obesity emerges as a complex phenotype, modulated by unique gene-environment interactions that occur in periods of life and are "permissive" for the programming of adult obesity. With the advent of next-generation sequencing techniques and advances in the field of exposomics, sensitive and specific tools to predict the obesity risk as early as possible are the challenge for the next decade.

  17. Predictors of stethoscope disinfection among pediatric health care providers. (United States)

    Muniz, Jeanette; Sethi, Rosh K V; Zaghi, Justin; Ziniel, Sonja I; Sandora, Thomas J


    Stethoscopes are contaminated with bacteria, but predictors of stethoscope disinfection frequency are unknown. We sought to describe health care provider stethoscope disinfection attitudes and practices and determine predictors of frequent disinfection. We used an anonymous online survey of nurses, nurse practitioners, and physicians at a pediatric hospital. We assessed frequency and methods of disinfection, perceptions of contamination, and barriers to disinfection. Multivariate logistic regression models were used to identify independent predictors of disinfecting after every use. One thousand four hundred one respondents completed the survey: 76% believed that infection transmission occurs via stethoscopes, but only 24% reported disinfecting after every use. In multivariate analyses, belief that infection transmission occurs via stethoscopes significantly increased the odds of disinfection after every use (odds ratio [OR], 2.06 [95% confidence interval (CI): 1.38-3.06]). The odds of disinfection after every use were significantly decreased in those who perceived the following barriers: lack of time (OR, 0.31 [95% CI: 0.18-0.54]), lack of access to disinfection material (OR, 0.41 [95% CI: 0.29-0.57]), or lack of visual reminders to disinfect (OR, 0.22 [95% CI: 0.14-0.34]). Only a minority of pediatric health care providers reported disinfecting their stethoscopes after every use. Increasing access to disinfection materials and visual reminders in health care facilities may improve stethoscope disinfection practices. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Patrícia de Menezes Castilhos Azevedo


    Full Text Available The objective of this study was to characterize and evaluate the measures of prevention and control of HI in pediatric hospitalization units. It was adopted as the method literature review. The following databases were consulted: Scielo, LILACS, PubMed and Google Scholar, as well as text books and legislation on the subject. The research was carried out from May to December 2015. Inclusion criteria were publications in the period between 1996 and 2015 that were available in the Portuguese or Spanish language. Nineteen publications were eligible, among them: 14 articles, 3 book chapters, 1 final graduation paper and 1 doctoral thesis. Data was consulted in existing legislation with regard to infection control. The results showed as key measures for proper prevention and Hospital Infection control in pediatric inpatient units: the proper use of insulation and precautions, the guidance and education of relatives and companions of hospitalized children and continuing education of staff nursing, highlighting the importance of hand washing in hospital infection control. It is important that the nursing professional has adequate knowledge of the country's legislation on the infection control in the hospital environment, so you can require that guidelines and regulations described in this are met by health care facilities, thereby helping to quality care to hospitalized children.

  19. [New parenting education in maternal child nursing]. (United States)

    Chen, Jih-Yuan


    Taiwan society is today typified by low birth rates amongst Taiwanese and a rising number of children born to immigrant and trans-cultural marriage families. Unhealthy behavior and anxiety on the part of pregnant women increase postpartum depression and complications and negatively affect neonatal heath. Such may further negatively impact upon romantic feelings between the new parents and the nascent parent-child relationship. New parenting education is a proactive and innovative strategy that may be used to improve maternal and child health. Therefore, it is worthy to explore how best to achieve cost-effective education interventions. First, the importance of new parenting education and its influence factors must be understood. Factors of women's health and nursing responsibilities potentially addressed by new parenting education include pregnancy complications, fetal death and malformation, accidents and traumas during childhood and adolescence, childhood obesity, and pediatric health-care delivery systems. It is the responsibility of nursing professionals to collect and interpret information on health promotion, disease prevention and childcare in cooperation with other disciplines. Nurses are also responsible to participate in family education and services that target new parents. Therefore, nursing professionals participate in planning and intervention actions related to health promotion, develop support group and counseling centers, collect and organize relevant information, and develop family education and health promotion models. Achieving preventive health service goals while maintaining family competencies and empowerment is an essential aspect of the parenthood mission and vision.

  20. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... images removable dental work pens, pocket knives and eyeglasses body piercings In most cases, an MRI exam ... and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media ...

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... wear during the procedure. Metal objects including jewelry, eyeglasses, hearing aids, non-permanent retainers and hairpins may ... and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media ...

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) ... uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, ...

  3. Cardiomyopathy in the pediatric patients

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan


    Full Text Available Pediatric cardiomyopathies are a group of myocardial diseases with complex taxonomies. Cardiomyopathy can occur in children at any age, and it is a common cause of heart failure and heart transplantation in children. The incidence of pediatric cardiomyopathy is increasing with time. They may be associated with variable comorbidities, which are most often arrhythmia, heart failure, and sudden death. Medical imaging technologies, including echocardiography, cardiac magnetic resonance, and nuclear cardiology, are helpful in reaching a diagnosis of cardiomyopathy. Nevertheless, endomyocardial biopsy is the final diagnostic method of diagnosis. Patients warrant surgical operations, such as palliative operations, bridging operations, ventricular septal maneuvers, and heart transplantation, if pharmaceutical therapies are ineffective. Individual therapeutic regimens due to pediatric characteristics, genetic factors, and pathogenesis may improve the effects of treatment and patients' survival. Key Words: cardiomyopathy, classification, pediatrics

  4. Radionuclide methods in pediatric cardiology

    International Nuclear Information System (INIS)

    Reich, O.; Ruth, C.; Samanek, M.


    The use of radionuclide methods in pediatric cardiology is discussed for non-invasive evaluation of myocardial function and perfusion, regional lung perfusion and ventilation, and for measuring central and peripheral hemodynamics. (H.W.). 16 refs

  5. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... and may add approximately 15 minutes to the total exam time. top of page What will my ... are the limitations of Children’s (Pediatric) MRI? High-quality images are assured only if your child is ...

  6. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  7. Childhood obesity for pediatric gastroenterologists. (United States)

    Huang, Jeannie S; Barlow, Sarah E; Quiros-Tejeira, Ruben E; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P; Xanthakos, Stavra A


    Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology.

  8. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  9. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  10. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  11. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - ... computer or television monitor. The image is created based on the amplitude (loudness), frequency (pitch) and time ...

  12. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local ... Related Articles and Media Catheter Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic ...

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... CT scans that are not clearly needed. Another strategy is to consider other tests, such as MRI ... for Radiation Safety in Pediatric Imaging's "Image Gently" Campaign top of page This page was reviewed on ...

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... to Children's (Pediatric) Ultrasound - Abdomen Sponsored by Please note is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Children's (Pediatric) CT (Computed Tomography) Sponsored by Please note is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  16. Preventable Pediatric Stroke via Vaccination?

    Directory of Open Access Journals (Sweden)

    Craig A. Press


    Full Text Available Investigators from the Vascular Effects of Infection in Pediatric Stroke (VIPS group studied the risk of arterial ischemic stroke (AIS associated with minor infection and routine childhood vaccinations.

  17. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... it is useful to bring that to the attention of the technologist or scheduler before the exam. ... patient for magnetic resonance imaging (MRI) exam. View full size with caption Pediatric Content Some imaging tests ...

  18. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) ...

  19. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Related Articles and Media Catheter Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic ... the possible charges you will incur. Web page review process: This Web page is reviewed regularly by ...

  20. New Horizons in Pediatric Psychopharmacology. (United States)

    Khan, Sarah; Rathore, Vijaylaxmi; Khan, Shahida


    Preclinical Research Recent advances in pediatric psychopharmacology have been rather uneven. Increased use of psychotropic drugs among the pediatric population has raised concerns regarding their inappropriate use and safety. While clinical trials have been conducted on various pediatric psychopharmacological drugs, there has been an insignificant amount of importance to innovation in holistic treatment. A rational approach toward elucidating the various challenges would be contingent on the convergence of the development of novel efficacious psychotropic drugs with concrete conceptual frameworks and guidelines fostering enhanced outcomes. A research infrastructure concerning the relevance of the clinician's perspective, combining drugs with alternative therapies, the need for pediatric specific formulations and relevance of these in developing countries provides a basis on which innovative treatment/development can be constructed. The current commentary highlights these comprehensive and targeted treatment guidelines as aspects necessary for building the future of the field. Drug Dev Res 77 : 474-478, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. Compassion Satisfaction and Compassion Fatigue Among Critical Care Nurses. (United States)

    Sacco, Tara L; Ciurzynski, Susan M; Harvey, Megan Elizabeth; Ingersoll, Gail L


    Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. ©2015 American Association of Critical-Care Nurses.

  2. The Role and Impact of Animals with Pediatric Patients. (United States)

    Goddard, Anna Tielsch; Gilmer, Mary Jo


    Animal-facilitated therapy (AFT), more specifically known as animal-assisted therapy (AAT) or "pet therapy," has had an increased presence in the literature with a surge of recent research methodologies exploring this complementary alternative medicine (CAM) intervention. However, limited studies have been conducted in the pediatric population, with many articles anecdotal in nature. A literature review included primary data sources PubMed, PsychINFO, Medline, and CINAHL, and yielded positive and beneficial outcomes to be gained through AAT in the pediatric population. Primary outcome variables of decreased anxiety and pain are the most commonly reported results. Further research studies are indicated to include the effects of AFT with children with different diseases and diagnoses. Exploration of other psychosocial and physical variables, such as self-esteem, would be useful. Interdisciplinary strategies are needed to develop interventions to help reduce patient symptoms and treatment-associated stress, as well as to facilitate healing and wellness beyond traditional medical treatment plans. Complementary therapies are of continued interest to the health care community, especially for pediatric nurses. Effective use of animals to facilitate conversation, lead discussion, or break communication barriers has been demonstrated through both research and anecdotal reports.

  3. Burnout Syndrome in Pediatric Practice


    Al-Youbi, Reem A.; Jan, Mohammed M.


    Objectives: Burnout is a common work-related syndrome consisting of emotional exhaustion, depersonalization and diminished feelings of personal accomplishment. Burnout influences the performance and efficiency of the healthcare professionals and therefore the quality of the care provided. This study aims to assess the burnout rates and potential determinants in pediatrics.Methods: A cross-sectional, descriptive study involving physicians practicing pediatrics in the Jeddah area of Saudi Arabi...

  4. What is a pediatric tumor?

    Directory of Open Access Journals (Sweden)

    Mora J


    Full Text Available Jaume Mora1,21Department of Oncology, 2Developmental Tumor Biology Laboratory, Hospital Sant Joan de Deu, Fundacio Sant Joan de Deu, Barcelona, SpainAbstract: Working together with medical oncologists, the question of whether a Ewing sarcoma in a 25-year-old is a pediatric tumor comes up repeatedly. Like Ewing's, some tumors present characteristically at ages that cross over what has been set as the definition of pediatrics (15 years, 18 years, or 21 years?. Pediatric oncology textbooks, surprisingly, do not address the subject of defining a pediatric tumor. They all begin with an epidemiology chapter defining the types of tumors appearing at distinct stages of childhood, adolescence, and young adulthood. Describing the epidemiology of tumors in relation to age, it becomes clear that the disease is related to the phenomenon of aging. The question, however, remains: is there a biological definition of what pediatric age is? And if so, will tumors occurring during this period of life have anything to do with such biological definition? With the aim of finding an objective definition, the fundamental concepts of what defines "pediatrics" was reviewed and then the major features of tumors arising during development were analyzed. The tumors were explored from the perspective of a host immersed in the normal process of growth and development. This physiological process, from pluripotential and undifferentiated cells, makes possible the differentiation, maturation, organization, and function of tissues, organs, and apparatus. A biological definition of pediatric tumors and the infancy–childhood–puberty classification of developmental tumors according to the infancy–childhood–puberty model of normal human development are proposed.Keywords: growth and development, pediatric tumor, infant, childhood and adolescence, pubertal tumors

  5. Pediatric Obesity: Etiology and Treatment


    Crocker, Melissa K.; Yanovski, Jack A.


    This paper reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Virtually all of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remain...

  6. The development of an internet-based knowledge exchange platform for pediatric critical care clinicians worldwide*. (United States)

    Wolbrink, Traci A; Kissoon, Niranjan; Burns, Jeffrey P


    Advances in Internet technology now enable unprecedented global collaboration and collective knowledge exchange. Up to this time, there have been limited efforts to use these technologies to actively promote knowledge exchange across the global pediatric critical care community. To develop an open-access, peer-reviewed, not-for-profit Internet-based learning application, OPENPediatrics, a collaborative effort with the World Federation of Pediatric Intensive and Critical Care Societies, was designed to promote postgraduate educational knowledge exchange for physicians, nurses, and others caring for critically ill children worldwide. Description of program development. International multicenter tertiary pediatric critical care units across six continents. Multidisciplinary pediatric critical care providers. A software application, providing information on demand, curricular pathways, and videoconferencing, downloaded to a local computer. In 2010, a survey assessing postgraduate educational needs was distributed through World Federation of Pediatric Intensive and Critical Care Societies to constituent societies. Four hundred and twenty-nine critical care providers from 49 countries responded to the single e-mail survey request. Respondents included 68% physicians and 28% nurses who care for critically ill children. Fifty-two percent of respondents reported accessing the Internet at least weekly to obtain professional educational information. The five highest requests were for educational content on respiratory care [mechanical ventilation] (48% [38%]), sepsis (28%), neurology (25%), cardiology (14%), extracorporeal membrane oxygenation (10%), and ethics (8%). Based on these findings, and in collaboration with researchers in adult learning and online courseware, an application was developed and is currently being used by 770 registered users in 60 countries. We describe here the development and implementation of an Internet-based application which is among the first

  7. Sexual harassment of nurses and nursing students. (United States)

    Bronner, Gila; Peretz, Chava; Ehrenfeld, Mally


    Nursing has dealt with sexual harassment long before the term was coined during the 1970s. The current study investigated sexual harassment of nurses and nursing students in Israel following new legislation against sexual harassment in the workplace. A self-report questionnaire was administered to 281 nurses and 206 nursing students (80% women) from five medical centres in Israel. Seven types of sexual harassment behaviour patterns were evaluated. Frequency of sexual harassment decreased as the behaviour became more intimate and offensive. Ninety percent of subjects reported experiencing at least one type of sexual harassment and 30% described at least four types. A significant difference was found between nurses and nursing students. Furthermore, "severe" types of behaviour were experienced by 33% of nurses, in comparison with 23% of nursing students. Women were significantly more exposed than men to "mild" and "moderate" types of sexual harassment, while 35% of men vs. 26% of women were exposed to "severe" types of harassment. However, women responded significantly more assertively than men to "severe" sexual harassment. Particular attention is needed when sexual harassment occurs to male students and nurses because they may be subjected to the more offensive sexual conducts and at the same time may lack the ability to respond assertively.

  8. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G


    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

  9. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.


    Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. in the ongoing Danish nursing home debate it is claimed that a new type...... of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home....... This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20...

  10. A concept analysis of holistic nursing care in paediatric nursing


    A.A. Tjale; J. Bruce


    Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...

  11. Hospice and Palliative Nurses Association (United States)

    ... Press Release Patients & Families About Serious Illness Certified Nurses are Everywhere Advocacy Palliative Nursing Summit Recent Activity ... Principles State Ambassadors Advocacy Resources Healthcare Resources Certified Nurses Day Certified Nurses are Everywhere Certification is Transformational ...

  12. Succession Planning for Nursing Leaders in a College of Nursing (United States)

    Tucker, Cheryl A.


    The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous…

  13. Using Nursing Languages in School Nursing Practice. Second Edition (United States)

    Denehy, Janice


    The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…

  14. Nursing and Nursing Education: Public Policies and Private Actions. (United States)

    Institute of Medicine (NAS), Washington, DC.

    Results are presented of a study of nursing and nursing education that focused on the need for continued federal support of nursing education, ways to attract nurses to medically underserved areas, and approaches to encourage nurses to stay in the profession. Findings are presented on whether the aggregate supply of generalist nurses will be…

  15. Development and validation of a pediatric IBD knowledge inventory device: the IBD-KID. (United States)

    Haaland, Derek; Day, Andrew S; Otley, Anthony


    Questionnaires exist to assess inflammatory bowel disease (IBD)-related knowledge of adults. Owing to wording and content concerns, these were believed to be inappropriate for use in pediatric patients. The aim of this study was to develop a questionnaire to assess disease-related knowledge of pediatric patients with IBD and their parents. Following a formal process of item generation and reduction, the IBD-Knowledge Inventory Device was developed and pilot tested. It was administered to 10- to 17-year-old patients with IBD, and to 1 of each of their parents. To evaluate its discriminatory validity, pediatric residents, nurses, and ward clerks completed the questionnaire. A total of 99 patients (mean 42, Crohn disease 46, age 14(±2) years) and 99 parents completed the IBD-Knowledge Inventory Device. Parent knowledge scores, 15(±4), were higher than those of patients, 11(±4), P sex (girls scored higher, P = 0.014), postsecondary education (P < 0.001), and perceived knowledge level (P = 0.002). The questionnaire scores of 23 were 19, 16, and 10, respectively, for residents, nurses, and ward clerks. Both residents and nurses scored significantly higher than ward clerks (P = 0.001 for both). A valid IBD-related knowledge assessment questionnaire was developed for use in older children and adolescents with IBD and their parents.

  16. Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil.

    Directory of Open Access Journals (Sweden)

    Luana Sicuro Correa

    Full Text Available The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system.Cross-sectional study (2012 with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test and in the ranking assigned to each of them (Kruskal-Wallis were assessed according to health care occupation and level of care (p<0.05.The final sample comprised 474 participants (97%, mean age of 37 years (standard deviation = 10.3, mainly females (83.8%, physicians (40.1% and from tertiary care (75.1%. The majority (91% reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary, abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care.Although most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding.

  17. Evaluation of a Pilot Project to Introduce Simulation-Based Team Training to Pediatric Surgery Trauma Room Care

    Directory of Open Access Journals (Sweden)

    Markus Lehner


    Full Text Available Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings. Each scenario incorporated elements of pediatric trauma management as well as Crew Resource Management (CRM educational objectives. Participants completed anonymous pre- and postcourse questionnaires and rated the course itself as well as their own medical qualification and knowledge of CRM. Results. Participants found the course very realistic and selected scenarios highly relevant to their daily work. They reported a feeling of improved medical and nontechnical skills as well as no uncomfortable feeling during scenarios or debriefings. Conclusion. To our knowledge this pilot-project represents the first successful implementation of a simulation-based team-training course focused on pediatric trauma care in German-speaking countries with good acceptance.

  18. Pediatric Pulmonary Abscess

    Directory of Open Access Journals (Sweden)

    Kyle Barbour


    Full Text Available History of present illness: A 6-year-old previously healthy male presented to the emergency department with three days of left upper quadrant abdominal pain. Family endorsed one week of fevers, cough productive of yellow sputum, and non-bilious, non-bloody emesis. He denied shortness of breath and chest pain. On exam, the patient was febrile with otherwise normal vital signs. He had diffuse tenderness to his abdomen but clear lungs. Laboratory studies revealed leukocytosis to 25,000/mm3 with a left shift. Significant findings: Upright posterior-anterior plain chest films show a left lower lobe consolidation with an air-fluid level and a single septation consistent with a pulmonary abscess (white arrows. A small left pleural effusion was also present, seen as blunting of the left costophrenic angle and obscuration of the left hemidiaphragm (black arrows. Discussion: Pediatric pulmonary abscesses are rare, most commonly caused by aspiration, and the majority consequently arise in dependent portions of the lung.1 The most common pathogens in children are Streptococcus pneumoniaeand Staphylococcus aureus.1 Immunocompromised patients and those with existing pulmonary disease more commonly contract Pseudomonas aeruginosaor Bacteroides, and fungal pathogens are possible.1 Common symptoms include tachypnea, fever, and cough. Imaging is necessary to distinguish pulmonary abscesses from pneumonia, empyema, pneumatocele, and other etiologies. Plain film radiography may miss up to 18% of pulmonary abscesses yet is often the first modality to visualize an intrathoracic abnormality.2 If seen, pulmonary abscesses most often appear as consolidations with air-fluid levels. Generally, pulmonary abscesses are round with irregular, thick walls, whereas empyemas are elliptical with smooth, thin walls.3 However, these characteristics cannot definitively distinguish these processes.2 Advantages of plain films include being low cost and easily obtained. Computed

  19. Features of Teaching Third-Year Students the Subject «Assessment of the General State of a Child. Anthropometry. Measuring and Recording Body Temperature. Work with Newborn Children» by the Module «Nursing in Pediatrics» at the Department of Propedeut

    Directory of Open Access Journals (Sweden)

    A.A. Koniushevska


    Full Text Available The paper presents the methodology of teaching at the department of propedeutics of pediatrics the subject «Assessment of the general state of a child. Anthropometry. Measuring and recording body temperature. Work with newborn children». Objectives of the lesson, the skills needed to achieve the goal are provided. Stages of lessons are presented.

  20. Reconsidering the concept of nursing as handled by Japanese nursing teachers : The nursing network formed by innovative nursing teachers


    山梨, 八重子; ヤマナシ, ヤエコ; Yamanashi, Yaeko


    The purpose of this paper is to clarify the originality of nursing given by nursing teachers. From the results, I concluded that, taking nursing from the viewpoint of Kant education, all teachers including the nursing teachers, and nursing teachers make teachers and others to bring out the important nursing skills in themselves. Further the network formed from these interactions is the origin of the nursing provided by nursing teachers.