Children's Nurses Research Articles

How to auscultate for heart sounds in infants and children.

This article provides an introduction to performing cardiac auscultation in infants and children aged 0-16 years, with the aim of improving children's nurses' knowledge and confidence in this procedure. Nurses wishing to develop competence in cardiac auscultation can use this article as a guide to complement supervised practical experience; however, it is not intended to determine an individual's competence. • Cardiac auscultation is a component of a structured cardiac assessment rather than a standalone tool. • It is important to auscultate all four main heart valve areas, listening for normal heart sounds and any additional sounds. • Several differences should be considered when auscultating heart sounds in infants and children compared with adults, including heart rate ranges and the potential need to use distraction techniques for those who are distressed. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How you think this article might help improve your practice when undertaking cardiac auscultation in infants and children. • How you could use this information to develop your own knowledge and skills before educating others on the appropriate technique and evidence base behind auscultating heart sounds in infants and children.

Research on the Application of "Internet Plus" Rehabilitation Nursing in Children with Cerebral Palsy

Abstract: Currently, cerebral palsy has emerged as a severe disease deserving significant attention. Amidst the thriving development of internet technology, the "Internet+" platform has brought new support to the medical field. This study aims to explore the application effects of "Internet+"-based rehabilitation nursing for children with cerebral palsy. A total of 60 children with cerebral palsy were randomly divided into a control group and an experimental group. The control group received conventional rehabilitation nursing, while the experimental group underwent "Internet+"-based rehabilitation nursing intervention. Comparisons were made between the two groups in terms of overall disease recovery, fine motor function, gross motor function, activities of daily living (ADL), nursing satisfaction, and quality of life. The results showed that the experimental group surpassed the control group in motor function, ADL, disease recovery efficiency, nursing satisfaction, and quality of life assessments, with statistically significant differences (P<0.05). The application of "Internet+"-based rehabilitation nursing for children with cerebral palsy can lead to more desirable overall nursing outcomes.

Developing a consensus guide to toilet training all children.

June Rogers, Independent Practitioner and Consultant, Down Syndrome UK (junerogersmbe@hotmail.com), and Davina Richardson, Children's Nurse Specialist, Bladder and Bowel UK, The Toilet Training Team, were winners of the Gold Award in the Continence Nurse of the Year category of the BJN Awards 2024.

Effects of School-Based Interventions Implemented by Nurses for Children Aged 3-6 Years: A Systematic Review of Experimental Evidence

Objectives: The 3-6 age period, which includes the pre-school, is when the child acquires essential habits, develops skills, and socializes. This systematic review was planned to examine the available evidence on the effectiveness of school-based interventions implemented by nurses and administered to preschool children. Material and Method: The systematic review used a search to identify studies published between 2015 and 2024 from PubMed, Medline, Cochrane Library, ProQuest, Science Direct, and Web of Science databases. Results: When the findings were examined, fifteen studies, including six randomized controlled trials and nine quasi-experimental studies, met the inclusion criteria. In the studies conducted, it was determined that the duration of the interventions applied only to children was between 2 and 16 sessions, the intervention periods of the studies that included parents along with children were between 8 and 30 sessions, and only 4 studies used theory or models. It was determined that the programs applied by nurses to children between the ages of 3-6 in the school environment provided children with knowledge and skills and had positive effects on the development of their physical, social, and emotional health. Conclusions: Nurses are responsible for increasing children's knowledge and skills in schools and promoting healthy lifestyles. Nurses must collaborate with parents to ensure that children's health education at home and school complement each other. The results of the studies included in the systematic review should be cautiously interpreted due to the limited number of studies and small sample size. To obtain the best evidence on the effectiveness of interventions, randomised controlled trials aiming to improve social and emotional competencies are needed to evaluate comprehensive, high-quality, and long-term effects. Systematic review registration: PROSPERO registration number was CRD42023467297

Enhancing discharge preparation for parents after complex cardiac surgery: evaluation of an e-learning resource for nurses.

Parents need to be appropriately prepared by knowledgeable healthcare professionals before going home with their infant following cardiac surgery for complex congenital heart disease (CHD). A quality improvement project was undertaken between 2018 and 2021 to equip healthcare professionals including children's cardiac nurses with the knowledge required to use the Congenital Heart Assessment Tool (CHAT) to teach parents how to monitor their infant at home. The project involved developing, implementing and evaluating an e-learning resource that included simulated scenarios captured on video. An online survey showed that users perceived the e-learning resource as having a positive effect on their understanding of complex CHD and their practice of preparing parents for discharge and home monitoring.

Impact of the Nursing and Midwifery Council (2018) future nurse: Standards of proficiency for registered nurses on children's nursing curriculum – A cross-sectional study

BackgroundStudent nurses in the United Kingdom undertake field-specific pre-registration education. The implementation of the Nursing and Midwifery Council (2018) Future nurse: Standards of proficiency for registered nurses, has raised concerns that the increasingly generic component of pre-registration programmes is not adequately preparing newly qualified children's nurses to care for children safely. ObjectiveTo investigate how the introduction of the Nursing and Midwifery Council standards in the United Kingdom has impacted the structure and field specific content of pre-registration children's nursing programmes. SettingsAn online survey completed by 54 programmes, field, or professional leads linked to 76 pre-registration children's nursing programmes. This represents 80 % of higher education institutions with Nursing and Midwifery Council approved pre-registration children's nursing programmes across all four United Kingdom countries. MethodsA survey to capture the current content and changes to curricula since the introduction of the Nursing and Midwifery Council (2018) Future nurse standards. The survey included closed-ended and open-ended questions. Closed-ended questions were statistically analysed using SPSS v.28 for Windows. Open-ended questions were thematically analysed using Quircos v.2.1. Results50 % of respondents reported changes to theoretical content. In 27 programmes (35.5 %) there was a decrease in child-specific content. Child specific teaching methods accounted for less than 30 % of the content of all programmes whereas cross-field teaching methods (Adult, Mental Health, Learning Disability and Child learners together) accounted for over 70 % of the taught content. Analysis of qualitative data identified three themes: genericism as the focus, the challenge to achieve the standards' proficiencies, and dilution of child specific content. ConclusionsThe survey responses show disparities in how United Kingdom higher education institutions have interpreted the Nursing and Midwifery Council standards highlighting academics concerns on the growing genericism within pre-registration children's nurse education nationally. These findings will inform the next stage of the project comparing the impact of greater or lesser degrees of genericism on the outcomes of the programme for newly qualified children's nurses.

Leadership in children and young people's nursing: an evolving journey.

Children and young people's (CYP) nursing leaders have experienced considerable challenges in the context of a complex health and social care system with rapidly changing organisational structures, including the establishment of integrated care systems in England on 1 July 2022. The CYP nursing lead at NHS England commissioned a review of CYP organisational structures in emerging integrated care systems across England. The review encompassed a vision for CYP services, leadership, governance structures and opportunities for progression. A proforma was used to collate data from CYP trusts, CYP standalone hospitals and children's wards in district general hospitals. Qualitative interviews were also undertaken with senior children's nurses. At the same time, the first author of this article interviewed senior children's nurses as part of a Florence Nightingale Foundation leadership scholarship. The aim was to explore how they navigated their leadership journey and understand what advice they may give to future leaders in CYP nursing. The findings in this article identify 'what good looks like' in terms of CYP nursing leadership. Six recommendations for future development and enhancement of CYP nursing leadership are outlined.

'We are pulled to the four corners': Qualitative role descriptions of advanced practice children's nurses in Malawi.

This study investigated emerging roles among specialist child health nurses (CHNs) in Malawi. Advanced nursing role development is globally advocated. Nursing role descriptions provide an evidential basis for workforce planning. Rigorously developed role descriptions are scarce worldwide, especially for Africa. Advanced nursing roles were introduced in Malawi's child health system a decade ago. We followed guidance on generating nursing role descriptions to collect and analyse qualitative data from interviews and focus groups, using qualitative content analysis. We used COREQ reporting standards. More than half (41/80) of Malawi's child health nursing workforce participated. Richly descriptive accounts of roles elicited three themes: leading and developing new services and improving existing ones; holding rare knowledge which uplifts care quality; and responsibility for developing the role. These responsibilities are experienced as a privilege and a burden, often meaning CHNs are 'pulled to the four corners'. We found evidence of remarkable achievements by Malawi's CHNs but also suggestions that they are under heavy strain. Because multi-stakeholder agreement about role content is crucial to successfully implementing advanced nursing roles, we hope the approach taken by this study, and the information generated, could be useful as part of human resources for health strategy development in other lower-resourced countries globally.

Protecting the integrity of children and young people's nursing as a distinct field of practice.

At certain points in nursing history, it has been necessary to make a case for children and young people to be cared for by specialist nurses educated to meet their specific needs. However, in 2018 the updated Nursing and Midwifery Council (NMC) standards of proficiency for registered nurses adopted a generic rather than field-specific approach. This article reiterates that children, young people and their families have unique needs that are best met by nurses who are trained specifically to care for them. The case is made from a historical and legal perspective, concluding with a proposal that in the best interests of children, young people and their families, the NMC should embed specific competencies for children's nurses into its standards of proficiency to future-proof this field of practice.

The quality of nursing care from the perspective of hospitalized school-age children

PurposeHospitalized children’s satisfaction with the care they receive is the main indicator for evaluating the way nurses should provide services and the quality of these services. The current study aimed to examine school-aged children's perceptions of nursing care quality. MethodsIn this cross-sectional study, 144 children aged 7–11 years were selected through a convenience sampling method. The data collection tool included The Child Care Quality at Hospital Questionnaire, and the personal- and family-related and disease-related factors questionnaire. Independent t-test, one-way analysis of variance, Pearson's correlation coefficient and multiple linear regression test were used for data analysis. ResultsBased on the findings, the highest score of nursing care quality was related to characteristics domain (13 ± 1.7). In addition, the children's age, father's education and history of hospitalization were related to nurses' characteristics domain; mother's education and length of hospital stay were related to nursing activities domain; and mother's education, father's occupation and length of hospital stay were related to nursing environment domain. ConclusionThe results of the present study showed that children's nurses can provide better quality care to children by paying attention to nurses' characteristics and then the scope of activities and care environment. Practice implicationsConsidering the factors affecting the nursing care quality, a conscious step should also be taken for strategic planning of care.

An exploration of managing emotional labour and maintaining professional integrity in children's hospice nursing.

Research exploring nurse-parent relationships in children's hospices is rare. To investigate how children's hospice nurses manage emotional labour and professional integrity in their long-term relationships with parents. A purposive sample of six children's nurses, from hospices across England, recorded audio diaries and participated in telephone interviews. Narratives were thematically analysed. Three overarching, cross-cutting themes were identified-purposeful positioning; balancing personability and professionalism; coping with and counterbalancing emotional labour. All themes were indicative of and/or built upon emotional intelligence constructs, such as self-awareness, self-regulation, appropriate (managed) empathy, social skills and intrinsic motivation. Innate features of children's hospice work were important for perpetuating intrinsic motivation and satisfaction. This study provided an insight into the management of emotional labour and professional integrity by experienced children's hospice nurses. The identification of emotional intelligence skills merits further exploration in this environment, as well as other children's palliative care settings.

The Management of Care, Nursing of Children Between the Ages of 6 Months and 36 Months: The Case Study of some Preschools in Vinh Phuc Province

Kindergarten education is the "foundation of foundation" of the national education system including pre-school education, general education, occupational education and university education. However, pre-school education in general and kindergarten education in particular lack in-depth theoretical and empirical research. The number of children attending kindergarten education accounts for a small percentage in pre-school education. This article focuses on researching and applying theories of educational sciences in the management of nursing and caring for kindergarten children aged from 6 months to 36 months old. The article uses review method and case study of some preschools in Vinh Phuc province. The article's findings can expand thinking about applying theories of education sciences and finding management measures to improve preschool educational quality and opportunities for children as well as the foundation for the national educational system.

Oral and dental health promotion for children's nurses.

Tooth decay remains one of the most common preventable oral health concerns in children. After birth, advice to caregivers predominantly focuses on medical health with little attention paid to dental health. Before discharge from the maternity unit and during future hospital and community appointments, opportunistic dental advice should be provided by midwives, nurses and health visitors where possible, with the aim of preventing early onset dental disease. Registering with a dentist at birth is crucial due to long NHS dental waiting lists. Simple advice on toothbrushing should be offered, including brushing twice a day with a soft toothbrush using an age-appropriate amount of fluoride toothpaste. Mothers should be provided with information on the benefits of breastfeeding for oral health alongside tailored preventive care. Appropriate advice on bottle-feeding and weaning is required, including minimising the use of added sugar, drinking from free-flow cups after six months of age, and discouraging the use of milk bottles at bedtime and in general after one year of age. Written visual summaries can be shared with parents to consolidate verbal advice on oral and dental health.

Impact of the Nursing and Midwifery Council Future Nurse Standards on children's nursing: A critical discussion

Edge et al explore the current concerns and ongoing debate around the Nursing and Midwifery Council (NMC) Future Nurse: Standards of proficiency for registered nurses (2018). This article looks at the impact of the standards on changes to pre-registration children's nursing education, exploring the impact on ensuring students are equipped with the right knowledge and skills to meet children, young people and their families' needs. Central to the discussion is the importance of hearing the voice of children and young people, and families are considered central to the ongoing discussion that is integral in shaping our future nursing workforce.

Analysis of the Effectiveness of Targeted Nursing in Children with Severe Viral Encephalitis Complicated with Respiratory Failure

Objective: To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure. Methods: From April 2021 to April 2023, 74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group (n = 37) and the reference group (n = 37). Targeted nursing was given to the target group, while general nursing was given to the reference group. Physical rehabilitation, motor scores, and lung function were compared between the groups. Results: The recovery time of limb abnormalities, convulsions, abnormal consciousness, and cranial nerve disorders in the target group was significantly better than that in the reference group (P < 0.05). The motor function, joint activity and pain, sensory function, and total score of the target group were significantly lower than those of the reference group (P < 0.05). After the intervention, lung function indicators including VC (vital capacity), FVC (forced vital capacity), and MVV (maximum voluntary ventilation) of the target group were better than those of the reference group (P < 0.05). Conclusion: Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children, speed up the recovery of motor function, and improve lung function. This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.

Central precocious puberty: assessment, diagnosis and decisions about treatment.

Precocious puberty is defined as the onset of puberty before the age of eight years in girls and before the age of nine years in boys. It is associated with negative physical health consequences in the long term and can also have negative psychosocial effects, particularly in adolescence. Central precocious puberty (CPP), which is caused by the early activation of the hypothalamic-pituitary-gonadal axis, is the more prevalent form of precocious puberty. This article explains CPP and its signs, assessment, diagnosis and treatment. It also discusses the factors to consider when deciding whether or not to treat it, stressing the importance of a shared decision-making process that children and parents should be involved in. Precocious puberty must be diagnosed and managed by specialists, but all children's nurses need a broad understanding of the condition so that they can refer children as early as possible and reassure and advise families.

Biopsychosocial pediatric nursing interventions in the adolescente diagnosed with type 1 diabetes mellitus

Type 1 Diabetes Mellitus (DM1) influences the self-perception of adolescents, their behaviour, and their integration into the social environment. The practice of Nursing Specialists in Children and Pediatric Health promotes their adaptation to the disease. The aim of the current study was to reflect on the interventions of these specialist nurses with adolescents with DM1 and their families. We performed an integrative literature review of the literature about the impact of DM1 on adolescents and the relevance of Specialist Nurses in Children and Pediatric Health in providing care to adolescents and their families. The nurse's intervention must contemplate the adolescent and macrosystem. Since diagnosis, it is crucial that the specialist nurse recognizes the adolescent's difficulties, combining technical care with constant emotional support. The nurse's intervention enables the adolescent and family to manage feelings, adjust the therapeutic regimen and integrate new routines into their daily lives.

Gaining an Empathetic Insight into Parenting: Evaluating Infant Simulator Dolls for Professional Learning.

The development of an empathetic approach when working with parents and families is fundamental to both social work and children's nursing; however, opportunities to develop this are limited. RealCare Baby infant simulator dolls were used with the aim of enabling students to gain an empathetic insight into parenting. A qualitative, evaluation study involving semistructured interviews with 10 social work and 11 children's nursing students was undertaken to evaluate experiences and views of infant simulator dolls, in relation to professional learning. Using reflexive thematic analysis of interview data, six key themes were identified: (1) positive experiences, (2) challenges, (3) impact on self, (4) empathy toward parents, (5) realism and (6) learning by reflection. All themes were evident from the participants' accounts in the context of the parenting experience. In addition to the overall positive impact on students, practical and technical challenges were also identified. However, despite these difficulties, participants valued the learning experience gained from caring for a doll and many articulated how an empathetic understanding of the parenting role was enhanced. This will potentially enable social work and children's nursing students to support parents more sensitively and empathetically.

Perceptions of Service Recipients on the Roles of Community Health Nurses in Children's Primary Care During the COVID-19 Outbreak in Northeastern Thailand

To understand the roles of community health nurses in providing services to children in primary health care units during the COVID-19 pandemic. Qualitative research was employed. Data was obtained from documents, observations, and in-depth interviews. Eighty-five key informants were recruited in the study from seven groups: public sector officers, Local Administrative Organization (LAO), community leaders, teachers in child development centers, community organizations, civil groups, and family caregivers. Data was analyzed using the content analysis method. Findings showed the roles of community health nurses in primary care units categorized into eight themes: health care provider, health educator, manager, health collaborator, health coordinator, advocator, consultant, and data collector and reporter. The research reflects the crucial roles of community health nurses in caring for children, skills, knowledge gained, and preparation and engagement of community networks during COVID-19.

Neurological observations in infants, children and young people: part two.

Neurological observations are a vital part of the assessment of infants, children and young people with a suspected or confirmed acquired brain injury (ABI). They are designed to identify neurological deterioration and inform the management of ABIs. Children's nurses may perform many of these neurological observations, including by using tools such as the AVPU scale, the Glasgow Coma Scale, pupillary response and limb assessment. This is the second of two articles that aim to encourage accuracy and consistency when performing neurological observations in infants, children and young people with a suspected or confirmed ABI to optimise their care. The article explains how to undertake various elements of a neurological assessment, how often to perform neurological observations, when to escalate concerns and why it is important to use family-centred care.