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Emergency nursing paediatric

Cecilia Bartholdson, Bert Molewijk, Kim Lützén, Klas Blomgren, Pernilla Pergert
BACKGROUND: In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions...
March 2018: Nursing Ethics
Taffy Makaya, Jennifer Gilbert, Fiona Ryan, Wendy Watts
Clinical governance processes are important for improving patient care. Patients with adrenal insufficiency are at significant risk if they have an adrenal crisis and require steroid therapy. Families should receive education on managing illness or stress, that is, steroid sick day rules. Most of this education is delivered by children's nurses. Two local cases of mortality related to adrenal insufficiency were reviewed and a questionnaire audit was undertaken to compare the steroid sick day rules education provided to patients and their families with published standards...
March 7, 2018: Nursing Children and Young People
Michelle Long, Ken J Farion, Roger Zemek, Debby Voskamp, Nick Barrowman, Salwa Akiki, Sarah Reid
Background: Hyperbilirubinemia is a common neonatal condition requiring timely management to prevent acute bilirubin encephalopathy. Management protocols allow nonphysicians to initiate designated actions prior to physician assessment. Objective: To assess the effectiveness of a nurse-initiated neonatal jaundice management protocol for serum bilirubin sampling and phototherapy for neonates presenting with hyperbilirubinemia to the Paediatric Emergency Department (PED)...
August 2017: Paediatrics & Child Health
James McGann, Jaqueline Manohar, Harriet Hiscock, Denise O'Connor, Jan Hodgson, Franz Babl, Valerie Sung
AIM: The aim of this study was to determine the barriers and enablers influencing the uptake of two recommendations from a tertiary paediatric hospital's clinical practice guidelines by maternal and child health nurses (MCHNs) and emergency department (ED) doctors: (i) explaining normal crying; and (ii) avoiding attributing crying to gastro-oesophageal reflux (GOR) and limiting anti-reflux medication use. METHODS: The study was designed as 1-h focus group discussions, guided by the Theoretical Domains Framework, and a short questionnaire, with a purposive sample of MCHNs and ED doctors in Victoria, Australia in (March to September) 2015...
February 22, 2018: Journal of Paediatrics and Child Health
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
Susan L Bannister, Mark S Dolson, Lorelei Lingard, David A Keegan
CONTEXT: As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. METHODS: A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning...
February 15, 2018: Medical Education
R Martinez, A D Rogers, A Numanoglu, H Rode
BACKGROUND: Telemedicine is increasingly applied in developed settings to facilitate transfer of information to and from burn surgeons across vast geographic areas. WhatsApp is a widely available and extremely user-friendly encrypted smartphone application that does not require the expensive physical and personnel infrastructure that characterizes many of these telemedicine systems. The aim of this study was to review the use of WhatsApp to facilitate paediatric burn injury consultations to a regional burn centre in a developing country, where burn care continues to be thwarted by administrative apathy, poor resource allocation and lack of attention to medical and nursing education at all levels...
January 27, 2018: Burns: Journal of the International Society for Burn Injuries
Carina King, Nicholas Boyd, Isabeau Walker, Beatiwel Zadutsa, Abdullah H Baqui, Salahuddin Ahmed, Mazharul Islam, Esther Kainja, Bejoy Nambiar, Iain Wilson, Eric D McCollum
OBJECTIVE: To gain an understanding of what challenges pulse oximetry for paediatric pneumonia management poses, how it has changed service provision and what would improve this device for use across paediatric clinical settings in low-income countries. DESIGN: Focus group discussions (FGDs), with purposive sampling and thematic analysis using a framework approach. SETTING: Community, front-line outpatient, and hospital outpatient and inpatient settings in Malawi and Bangladesh, which provide paediatric pneumonia care...
January 30, 2018: BMJ Open
Lisa Langton, Adam Bonfield, Damian Roland
OBJECTIVE: The primary objective of this study was to determine the level of inter-rater reliability between nursing staff for the Paediatric Observation Priority Score (POPS). DESIGN: Retrospective observational study. SETTING: Single-centre paediatric emergency department. PARTICIPANTS: 12 participants from a convenience sample of 21 nursing staff. INTERVENTIONS: Participants were shown video footage of three pre-recorded paediatric assessments and asked to record their own POPS for each child...
January 12, 2018: Archives of Disease in Childhood
Fabienne N Jaeger, Mahamat Bechir, Moumini Harouna, Daugla D Moto, Jürg Utzinger
BACKGROUND: Trained healthcare workers are an essential resource for effective health systems. However, healthcare workers' perspective on healthcare, the challenges they face to provide quality health services, and opportunities to improve motivation and providing adequate care are rarely investigated in resource-constrained settings of sub-Saharan Africa. METHODS: All reachable nurses of Abou Deia, a primarily rural district in the south-eastern part of Chad, were invited to participate...
January 8, 2018: BMC Health Services Research
Emily Stapley, Evelyn Sharples, Peter Lachman, Monica Lakhanpaul, Miranda Wolpert, Jessica Deighton
Objectives: To explore paediatric hospital staff members' perceptions of the emerging benefits and challenges of the huddle, a new safety improvement initiative, as well as the barriers and facilitators to its implementation. Design: A qualitative study was conducted using semi-structured interviews to explore staff perspectives and experiences. Setting: Situation Awareness For Everyone (SAFE), a safety improvement programme, was implemented on a sample of National Health Service (NHS) paediatric wards from September 2014 to June 2016...
December 13, 2017: International Journal for Quality in Health Care
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
Laura Farnham, Hannah Harwood, Meredith Robertson
This article explores the effect of a children's at-home nursing team, Hospital at Home (H@H), which aimed to reduce demand on acute hospital beds, support families to improve patient experience, and empower parents to care safely for their unwell children and help prevent emergency department (ED) reattendance. Data on demographics and clinical presentation of H@H and ED attendances were collected and compared. A survey measuring parents' confidence in managing their unwell children was also conducted. Of 72 patients treated by the H@H service between May and July 2016, 32 (44%) would have been admitted to hospital from the ED if the H@H service had not existed...
December 5, 2017: Nursing Children and Young People
Emily Jones, Steffan Simpson
: The Paediatric Emergency Unit at the University Hospital of Wales provides care for over 33 000 children per year. There was no provision in place to support suddenly bereaved families. Staff felt that we could improve the services provided to families who's children sadly died in the unit.The aim was to provide immediate support for the suddenly bereaved families by working in partnership with local Charity 2 Wish Upon a Star. Together we created a Standard Operating Procedure (SOP) that consisted of a checklist and pathway allowing us to refer relatives for immediate physical and emotional support...
December 2017: Emergency Medicine Journal: EMJ
Caroline Ward, Katie Knight, Mary-Rose Ballard, Georgina Keogh, Miriam Samuel, Sara Buttle, Claire Robb, Francesca Cleugh
AIMS: PATCH is a pilot acute community children's nurse led service delivering assessment and treatment for children at home who are moderately unwell and might otherwise be admitted to hospital or attend Paediatric Emergency Department (PED). Children are referred by PED or GP and followed up via telephone support and home visits depending on clinical need for duration of acute illness. METHODS: Pilot year funded by Imperial Charity. Using evaluation to build business case for sustained commissioned service...
December 2017: Emergency Medicine Journal: EMJ
Fenton O'Leary, Ioannis Pegiazoglou, Kathryn McGarvey, Ruza Novakov, Ingrid Wolfsberger, Jennifer Peat
OBJECTIVE: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. METHODS: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations. RESULTS: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations...
November 16, 2017: Emergency Medicine Australasia: EMA
Russell M Viner, Frances Blackburn, Francesca White, Randy Mannie, Tracy Parr, Sara Nelson, Claire Lemer, Anna Riddell, Mando Watson, Francesca Cleugh, Michelle Heys, Dougal S Hargreaves
OBJECTIVE: To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP). DESIGN: Observational study. PATIENTS & SETTING: Data collected prospectively on 3020 CYP 0â€"17.9 years from 6 London EDs during 14 days by 25 supernumerary clinicians. CYP with transient acute illness, exacerbation of long-term condition (LTC), complex LTC/disability and injury/trauma were considered manageable within OOHM...
October 26, 2017: Archives of Disease in Childhood
Carrie Ng, Lorraine Ng, David O Kessler
BACKGROUND: although nurses often place peripheral intravenous (IV) catheters, little is known about their perceptions regarding use of ultrasound guidance. AIM: the authors aimed to determine paediatric emergency department nurses' attitudes toward ultrasound-guided IV access techniques and assessed practice change after training. METHOD: In a cross-sectional study of nurses, they had didactic and hands-on practice sessions, using three short-axis ultrasound-guided IV access techniques on gel models...
October 26, 2017: British Journal of Nursing: BJN
Maria Clara de Magalhães-Barbosa, Jaqueline Rodrigues Robaina, Arnaldo Prata-Barbosa, Claudia de Souza Lopes
AIM: To present a systematic review on the validity of triage systems for paediatric emergency care. METHODS: Search in MEDLINE, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), Nursing Database Index (BDENF) and Spanish Health Sciences Bibliographic Index (IBECS) for articles in English, French, Portuguese or Spanish with no time limit. Validity studies of five-level triage systems for patients 0-18 years old were included...
November 2017: Emergency Medicine Journal: EMJ
Trevor Duke, Sharon Kasa Tom, Harry Poka, Henry Welch
In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries...
December 2017: Archives of Disease in Childhood
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