Nurses are mandated reporters of actual or suspected child maltreatment or the threat thereof. The purpose of this quality improvement project was to determine the knowledge and comfort of nurses in telephone triage in p...Nurses are mandated reporters of actual or suspected child maltreatment or the threat thereof. The purpose of this quality improvement project was to determine the knowledge and comfort of nurses in telephone triage in pediatric clinics when dealing with suspected or actual child abuse calls. Nurses (N = 17) from three pediatric primary care clinics and one specialty care orthopedic clinic were surveyed. Based on results of the survey showing a lack of knowledge and adequate referral resources perceived by the nursing staff, resources and staff education were developed, along with a script for guiding maltreatment calls toward standardization of care. Following the intervention, nurses reported an increased comfort level when doing telephone triage for child maltreatment calls, an increase in knowledge of risk factors for county resources. Further, they reported a substantial shift in opinion about the need for a standardized script when responding to child maltreatment telephone calls. Nurses undertaking telephone triage of high-risk child maltreatment calls can improve their comfort and knowledge through a survey of their needs and directed education and resource development for the management of child maltreatment telephone triage.
Macías M, Zornoza C, Rodriguez E
… +4 more, García JA, Fernández JA, Luque R, Collado R
Pediatr Nurs
· 2015 · PMID 26837098
The time of admission to a hospital, especially when unplanned, has been reported as the most stressful moment of hospitalization for both parents and children (Odievre, 2001). This qualitative study explored parents and...The time of admission to a hospital, especially when unplanned, has been reported as the most stressful moment of hospitalization for both parents and children (Odievre, 2001). This qualitative study explored parents and hospital staff's perceptions and experiences related to the process of admission to a pediatric unit. Focus groups, two with parents (total n = 12) and one with health care professionals (n = 6), were conducted, and content analysis inspired by Graneheim and Lundman (2004) was performed. Parents identified four categories of perceptions: 1) management of an uncertain situation at the time of admission, 2) feelings related to the child's illness, 3) parent perception of professional's performance, and 4) parent experience of their role. Health care professionals identified two categories: 1) hospital admission as a continuous care process, and 2) undertaking improvements in the admission process. A common theme emerged about the importance of parents' trust in professionals in order to build a therapeutic relationship. Findings underscore the need for strategies to improve the hospital pediatric admission process based on a parent-professional relationship of trust and confidence through continuous quality communication and support. These strategies would include providing a nurse in charge of the admission process to assure continuity of care throughout the child's hospitalization.
Siblings of patients with diabetes mellitus have a unique experience that demands attention from health care providers. The purpose of this article is to explore the sibling experience, identify common fears, and provide...Siblings of patients with diabetes mellitus have a unique experience that demands attention from health care providers. The purpose of this article is to explore the sibling experience, identify common fears, and provide the clinician with practical guidance on family-centered care for diabetes management. A comprehensive understanding of factors surrounding sibling adjustment is vital to ensure the best possible outcomes for children and families affected by diabetes.
Unnecessary prescribing of antibiotics is costly, leads to serious unintended side effects, and increases the risk of developing antibiotic resistance. Children are at high risk of receiving unnecessary antibiotics becau...Unnecessary prescribing of antibiotics is costly, leads to serious unintended side effects, and increases the risk of developing antibiotic resistance. Children are at high risk of receiving unnecessary antibiotics because they consume more antibiotics than any other age group, likely due to inaccurate prescribing by health care providers. Treatment of acute otitis media is the most common reason children are prescribed antibiotics. Evidence-based guidelines regarding the appropriate treatment of nonsevere acute otitis media in children have been established. A retrospective, descriptive, chart review project was completed comparing the diagnosis and treatment of acute otitis media in children six months to 12 years of age in clinics and the emergency department of a large academic medical center with the American Academy of Pediatrics' treatment guidelines. Findings of the chart review included 100 patient encounters. Documentation indicated that although none of these children with acute otitis media met the guideline criteria for antibiotics, 92 of the 100 children were prescribed antibiotics.
Children with chronic conditions experience physical, social, emotional, and developmental challenges that include physical differences, negative body image, social isolation, decreased emotional functioning, and develop...Children with chronic conditions experience physical, social, emotional, and developmental challenges that include physical differences, negative body image, social isolation, decreased emotional functioning, and developmental concerns. Summer camps are a way to help these children overcome their difficulties. They provide an enjoyable experience, encourage goal achievement, give children a sense of community and friendship, improve children's self-concept, increase children's disease knowledge and management, and contribute to campers' positive development. Nurses can encourage families to use these camps as a therapeutic intervention and help families evaluate individual camps to find a good fit for their child.
This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years...This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years was reviewed to raise awareness of factors associated with developmental delay after extensive hospitalization. Findings from the literature suggest that neonatal and pediatric intensive care unit (NICU/PICU) graduates are most at risk for developmental delays, but even non-critical hospital stays interrupt development to some extent. Primary care practitioners (PCPs) may be able to minimize risk for delays through the use of formal developmental screening tests and parent report surveys. References and resources are described for developmental assessment to help clinicians recognize delays and to educate families about optimal toddler development interventions. Pediatric PCPs play a leading role in coordinating health and developmental services for the young child following an extensive hospital stay.
Bohl B, Evetts J, McClain K
… +2 more, Rosenauer A, Stellitano E
Pediatr Nurs
· 2015 · PMID 26665422
A review of the current evidence on primary treatment modalities of head lice demonstrates increasing resistance to current regimens. New and alternative therapies are now available. A treatment algorithm was created to...A review of the current evidence on primary treatment modalities of head lice demonstrates increasing resistance to current regimens. New and alternative therapies are now available. A treatment algorithm was created to address safety and efficacy of treatments, as well as to guide clinicians through navigation of the regimens. Through an online journal search, 59 articles were selected for the review. Literature searches were performed through PubMed, Medline, Ebsco Host, and CINAHL, with key search words of "Pediculosis capitis" and "head lice" in the title, abstract, and index. Meta-analyses and controlled clinical trials were viewed with greater weight if they had a large sample size, were statistically significant, and did not allude to bias. When resistant infestations are well-documented in a locality, changes to the treatment regimen are indicated, and alternative treatments should be considered. Recent studies and U.S. Food and Drug Administration (FDA) approvals have changed the available treatment options for Pediculosis capitis, including benzyl alcohol, topical ivermectin, spinosad, and the LouseBuster. Further, environmental management and prevention measures should be taken to avoid reinfestation and to prevent the spread of head lice. Continued study is recommended to establish long-term safety of new and alternative agents.
Jennings P, Cullen M, Mark R
… +3 more, Meloche ME, Jaeger S, Lile T
Pediatr Nurs
· 2015 · PMID 26665421
There are 120,000 pediatric burn injuries annually in the United States (Center for Research Injury and Policy [CRIP], 2010). Although many pediatric thermal injuries are not severe, referral to a burn unit for any burn...There are 120,000 pediatric burn injuries annually in the United States (Center for Research Injury and Policy [CRIP], 2010). Although many pediatric thermal injuries are not severe, referral to a burn unit for any burn regardless of depth, size, location, or severity is common. Many patients with smaller burns can be effectively managed in a community hospital, which allows children and their families to remain close to home, reducing costs and some stress associated with hospital stays. This article describes the process of creating a community pediatric burn care program at St. John Hospital in Detroit, Michigan, and initial outcomes of the program.
Patient- and family-centered care began in pediatrics more than two decades ago, and pediatric care has continued to lead the way in acknowledging and supporting family presence and participation in patient care and deci...Patient- and family-centered care began in pediatrics more than two decades ago, and pediatric care has continued to lead the way in acknowledging and supporting family presence and participation in patient care and decision-making. However, many adult hospitals still have "visiting" policies that restrict the potential for true partnerships with families and other care partners. A national campaign, Better Together: Partnering with Families, developed by the Institute for Patient- and Families-Centered Care (IPFCC), urges all hospitals--pediatric and adult--to welcome families 24/7. Despite the leadership of pediatrics in family-centered care, even in children's hospitals, policy and practice must continue to evolve to strengthen partnerships with families, as described in a profile of C.S. Mott Children's Hospital and the University of Michigan Health System.
BACKGROUND: Many children present to the emergency department (ED) in pain and/or experience pain as a result of interventions necessary to manage their illness. Pediatric pain assessment and management is complex and ch...BACKGROUND: Many children present to the emergency department (ED) in pain and/or experience pain as a result of interventions necessary to manage their illness. Pediatric pain assessment and management is complex and challenging. Despite the presence of published standards of care specific to pain assessment and management, nurses in the ED may not know about and/or consistently use these evidence-based practices. In particular, pediatric patients are inconsistently and/or inappropriately assessed for pain in the ED. METHODS: The aim of this project was to make standard the utilization of evidence-based practices regarding pediatric pain assessment in the ED at a community hospital. The purpose of this project was to develop, implement, and evaluate a pediatric pain education program and pain assessment protocol to improve nurses' knowledge and standardize care in a community hospital emergency department. RESULTS: Seventy-eight ED nurses completed the education program, consisting of an online module with content addressing pediatric pain assessment and management, and then used the protocol. Education program evaluations were very positive. A statistically significant difference in the mean pre- and post-test scores indicated significant learning gains among participants; strong reliability of this test was demonstrated. Sixty patient medical records were reviewed two weeks after the educational program. Pain assessment at triage and use of an appropriate pain scale for all assessments were the most consistently used components of the protocol. A low percentage of protocol adherence was found regarding assessment of pain characteristics. CONCLUSION: Significant improvements in nurses' pain knowledge are demonstrated via an education program. Implementation of a pain assessment protocol is one mechanism to standardize nursing practice with pediatric patients in the ED setting.