Over the last 30 years, diagnosis and treatment of childhood cancers have improved significantly due to medical research and advancements in technology. Increasingly, parents are taking on the role of providing "nursing"...Over the last 30 years, diagnosis and treatment of childhood cancers have improved significantly due to medical research and advancements in technology. Increasingly, parents are taking on the role of providing "nursing" care for their children, including managing emergency situations as well as everyday treatment needs. This study investigated the perceptions and experiences of parents caring for newly diagnosed children with acute lymphoblastic leukemia (ALL) in relation to education given prior to the first discharge from hospital. Using a grounded theory approach, 12 parents of children with ALL from a tertiary pediatric hematology and oncology setting in New Zealand were interviewed using a semi-structured interview technique. Key findings of relevance to clinical practice include the importance of recognizing the emotional strain parents experience following diagnosis and the resultant impact upon how education is understood. Findings may also be applicable to other complex child health areas where education is provided, both in a local and international context. Understanding the family perspective is crucial to enabling clinicians to provide appropriate and informative education to children with ALL and their families.
Roberts-Turner R, Hinds PS, Nelson J
… +3 more, Pryor J, Robinson NC, Wang J
Pediatr Nurs
· 2014 · PMID 25929114
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 s...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.
The treatment of Pediculosis capitis, or head lice, is fraught with misinformation, myths, and mismanagement. Common myths include the need to exclude children from school, the need to remove all visible nits ("no-nit" p...The treatment of Pediculosis capitis, or head lice, is fraught with misinformation, myths, and mismanagement. Common myths include the need to exclude children from school, the need to remove all visible nits ("no-nit" policies), the need for massive environmental cleaning, that head lice live for long periods of time, and that schools are a common location for lice transmission. Head lice are a common childhood nuisance, causing embarrassment and emotional trauma in both children and families. This article explores and challenges the commonly held beliefs about the identification, management, and treatment of Pediculosis by presenting current recommended evidence-based practice. It also challenges pediatric nurses, and school nurses in particular, in alignment with the National Association of School Nurses (NASN) Position Statement on Pediculosis Management in the School Setting, to act as change agents for reasonable and effective school policies and practices.
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 s...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).
Spirometry is an essential part of diagnosing a child with asthma. The National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA) expert panels recommend spirometry to be perform...Spirometry is an essential part of diagnosing a child with asthma. The National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA) expert panels recommend spirometry to be performed on children five years of age and older as an objective assessment of lung function, to diagnosis asthma, and for ongoing yearly management of asthma (GINA, 2012; NAEPP, 2007). According to the NAEPP expert panel, history and physical examination alone are not reliable to accurately diagnose asthma, exclude alternative diagnosis, or determine lung impairment (NAEPP, 2007 Dombkowski, Hassan, Wasilevich, and Clark (2010) found 52% of physicians who provide primary care to children used spirometry, but only 21% used spirometry according to the national guidelines, and only 35% of physicians surveyed were comfortable interpreting the test results. Zanconato, Meneghelli, Braga, Zacchello, and Baraldi (2005) found that 21% of spirometry readings were interpreted incorrectly, concluding that proper training and quality control were important to provide if spirometry in the primary care office setting is to be used. The purpose of this article is to review the appropriate use of spirometry in pediatric primary care.
Sobotka SA, Danielson KK, Drum ML
… +2 more, Estrada CL, Lipton RB
Pediatr Nurs
· 2014 · PMID 25269359
OBJECTIVE: Investigate the cross-sectional association of glycemic control of ethnically diverse youth with diabetes mellitus with family characteristics. DESIGN: Family study of 91 youth (probands) with diabetes mellitu...OBJECTIVE: Investigate the cross-sectional association of glycemic control of ethnically diverse youth with diabetes mellitus with family characteristics. DESIGN: Family study of 91 youth (probands) with diabetes mellitus and 142 parents. RESULTS: Children's age and HbA1c averaged 11.9 years and 8.9%, respectively; 69% were minorities. After adjustment, poor glycemic control was associated with minority race/ethnicity, more television viewing, and higher maternal body mass index (BMI). Average HbA1c was 1.2 and 1.9% units higher for children of overweight and obese mothers, respectively (p = 0.004). CONCLUSIONS: The positive association between maternal body composition and child HbA1c likely represents the unique behavioral influence of mothers.
School-age siblings experience a traumatic injury to their brothers or sister in unique ways, yet little research has been undertaken regarding the sibling perspective. Understanding what it is like to be a well school-a...School-age siblings experience a traumatic injury to their brothers or sister in unique ways, yet little research has been undertaken regarding the sibling perspective. Understanding what it is like to be a well school-age sibling of a child with a traumatic injury is largely unknown. The aim of this study was to describe and understand the experience of being a well school-age sibling of a child recovering from a traumatic injury. Phenomenology was the method of inquiry used. Interviews were conducted with seven school-age siblings ranging in age from eight to 12 years, and were audio-recorded, transcribed, and analyzed using traditional qualitative techniques (Ely, Anzul, Friedman, Garner, & Steinmetz, 1991). Identification of patterns and themes common to the experience were identified and described. Two major themes that emerged were the changes and constants that this experience brought to the siblings. The self-expressed needs of the siblings important to health professionals regarding communication and individual identity are shared. Research-based implications for the clinical practice of pediatric nursing are presented.
PURPOSE: A pilot study was conducted to learn about the Internet usage of adolescents with spina bifida. The purpose of this study is to investigate the feasibility for developing an online health care transition interve...PURPOSE: A pilot study was conducted to learn about the Internet usage of adolescents with spina bifida. The purpose of this study is to investigate the feasibility for developing an online health care transition intervention. METHODS: Use of the Internet was examined in a convenience sample of 50 adolescents with spina bifida in the Spina Bifida Clinic at Children's Hospital, Los Angeles. Participants were between 14 to 18 years of age. Data are reported as percentages and frequency distributions. RESULTS: Ninety-two percent of adolescents with spina bifida used the Internet, and of those, 87% used it at home, with an average rate of 2.4 hours per dat. The majority of adolescents used the Internet for homework purposes (83%). Leisure activities, such as listening to music (76%), playing games (70%), meeting new friends/social networking (63%), and watching YouTube videos (61%), were also reported. Most participants have never used the Internet to obtain spina bifida information (67%) or to meet other adolescents with spina bifida (85%). CONCLUSION: Internet application as an outreach tool for education and transition planning should be further explored in future studies. Given the widespread reported access to the Internet among our participants, results suggest that a Web-based outreach tool for education and health care transition planning have the potential to be accessible and beneficial to adolescents with spina bifida with the facilitated support of health care professionals.
This review aimed to determine best nursing practice by systematically and critically reviewing the appropriate literature and expert guidelines. Using keyword and literature databases, over 480 journal titles were revie...This review aimed to determine best nursing practice by systematically and critically reviewing the appropriate literature and expert guidelines. Using keyword and literature databases, over 480 journal titles were reviewed. Twenty-four articles and three expert guidelines were chosen. The majority of articles selected as evidence were Level IV--opinions of respected authorities based clinical experiences, descriptive studies, case reports, or reports of experts. Two articles were Level I-II--experimental studies. Results of the review showed that traditional supportive interventions also have a body of evidence for their use. Although there is much research regarding neonatal abstinence syndrome (NAS), the majority of future research needs to be at a higher level of evidence. Nursing applications include obtaining evidence for best practice through diligent searches of the literature and expert guidelines.
Challenges in professional nursing education today can be astonishing. Cognizant of the commitment to provide the most valuable learning experiences for our future nurses, academia and service organizations strive to mee...Challenges in professional nursing education today can be astonishing. Cognizant of the commitment to provide the most valuable learning experiences for our future nurses, academia and service organizations strive to meet this challenge. The escalation in nursing school enrollment, along with the increase in patient acuity and ongoing health care changes, requires hospitals and schools to continually review their practices to ensure positive outcomes. Providing pediatric nursing experiences to over 1,300 students annually, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC) implemented a process to meet this need. A Faculty Advisory Council was established to provide a venue for representative nursing instructors to meet with the Nursing Education Department at the hospital. The commonality of focus by nursing faculty and Children's Hospital continues to strengthen both academia and service. This well-defined process supports positive pediatric experiences for nursing students at Children's Hospital of Pittsburgh of UPCM.
Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in...Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation," which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time. Validation does not mean there is agreement or acceptance of unsafe behaviors, only that the nurse acknowledges that the family member's concerns and feelings are important and should be listened to and taken seriously, even in the presence of disagreement. Validation, which should be individualized, can take many forms, ranging from providing complete attention to reflection of statements, identification of possible unexpressed emotions, normalization, and finally, a full and genuine sense of connection. Understanding and practicing validation can empower nurses and family members, as well as support effective family-centered communication and problem solving, even in challenging circumstances.
The Joint Commission requires pediatric hospitals to implement fall prevention programs and evaluate the efficacy of such programs. The Humpty Dumpty Falls Scale (HDFS), a seven-item assessment scale used to document age...The Joint Commission requires pediatric hospitals to implement fall prevention programs and evaluate the efficacy of such programs. The Humpty Dumpty Falls Scale (HDFS), a seven-item assessment scale used to document age, gender, diagnosis, cognitive impairments, environmental factors, response to surgery/sedation, and medication usage, is one of several instruments developed to assess fall risk in pediatric patients. To determine the specificity and sensitivity of the HDFS in predicting falls in children hospitalized for pediatric specialty care, a team at a pediatric specialty hospital conducted a nonexperimental retrospective study that used a matched case-control design and chart review analysis. The discoveries suggest that the HDFS lacks accuracy in pediatric specialty patients. Using the HDFS cut-off score of 12 and above to indicate a high risk for falls in these children yields a high false-positive rate. Investigators and staff at pediatric specialty hospitals need to continue their pursuit of valid instruments and tools that contribute to fall reduction.