Pediatric Nurses Research Articles

ENHANCING NURSE-PATIENT COMMUNICATION: A COMPREHENSIVE SYSTEMATIC REVIEW OF EFFECTIVE STRATEGIES

Background: Practical communication skills are imperative in nursing to ensure patient safety and comfort. Studies reveal that nurses often fail to implement therapeutic communication fully, resulting in dissatisfaction from beginning to end patient care. Objective: This study seeks to pinpoint strategies to enhance nurses' communication proficiency with patients. Method: Employing a systematic review approach, this research delved into journals archived in the EBSCO E. Journal, Elsevier Science Direct, Pubmed, CINAHL Complete, and Google Scholar databases, alongside nursing management and leadership literature. The operational definition encapsulates the endeavors undertaken by nurses to refine communication strategies with their patients. The study was conducted across diverse clinics and hospitals, encompassing all nurses within these settings, with the research sample comprising those lacking robust communication strategies. Data was gathered through the administration of questionnaires and the utilization of observation sheets. Results: Findings underscored that training initiatives bolstered nurses' confidence in delivering comprehensive patient care. Furthermore, culturally sensitive communication skill guides proved instrumental in augmenting nurse-patient communication and patient satisfaction. Moreover, tailored therapeutic communication programs designed for pediatric nurses yielded favorable outcomes, fostering secure and healthy interactions, nurturing trust, and expediting recovery. Short workshops emerged as another effective avenue for refining nurses' communication skills. Consequently, implementing training sessions, comprehensive guides, specialized programs, and brief workshops is pivotal in elevating communication between nurses and patients.

Evidence-Based Practice in Pediatric Critical Care Nursing.

Evidence-Based Practice in Pediatric Critical Care Nursing.

Exploring Therapeutic Relational Connection in Virtual Healthcare: Insights From Nurse Practitioner Practice With Young Adults Living With Chronic Illness.

To identify the essential characteristics of therapeutic relational connection (TRC) as viewed by nurse practitioners (NPs) in the practice of their virtual visits caring for young adults living with chronic illness. This is a qualitative descriptive study of data obtained from open-ended items on an online questionnaire. The sample was recruited through an electronic listserv sent by the National Association of Pediatric Nurse Practitioners (NAPNAP) to access a national sample. Study data were collected and managed using REDCap electronic data capture tools. Data analysis was conducted through open and axial coding towards grounded theory. The 'towards grounded theory' approach adapts and evolves grounded theory principles to incorporate broader perspectives, enhancing flexibility and contextual sensitivity in the co-construction of knowledge between researcher and participants. TRC was the central phenomenon. Four themes emerged from the data including Characteristics of TRC, Behavioural Manifestations, Potential Outcomes and Environment. The transfer of skills from in-person clinic visits to the virtual setting is not synonymous. As virtual visits continue to be implemented as a mode to provide quality healthcare, identification of best practises for establishing an intentional use of TRC during virtual visits may be an essential component in the patient-provider relationship. Educational interventions can be designed to train providers to identify their current practices and ways in which they might adapt their in-person approach to the virtual visit. Identifying essential elements of TRC in virtual visits may achieve improved outcomes as an emergent healthcare delivery model for young adults with chronic illness. No patient or public contribution. Patient or public contribution was not indicated in this study as the aim was to identify the characteristics of TRC from NPs.

Effect of Mind Mapping application on Pediatric Nurses' Performance regarding Peripherally Inserted Central Catheters at Neonatal Intensive Care Unit

Effect of Mind Mapping application on Pediatric Nurses' Performance regarding Peripherally Inserted Central Catheters at Neonatal Intensive Care Unit

Call to Action: Bolstering the Diminishing Pediatric Nursing Workforce.

Pediatric workforce shortages became more apparent with coronavirus disease 2019 (COVID-19) and the rise in other viruses. Among factors affecting these shortages are undergraduate and graduate curricula that include pediatric content and clinical experiences. A narrative review was conducted to examine the state of the pediatric nursing workforce, describe curricular models in undergraduate and graduate programs, and determine the effects of these models on pediatric content and clinical experiences as well as subsequent employment in pediatric nursing. Curricula affect knowledge of pediatric content and clinical ability to practice, potentially resulting in direct care pediatric workforce shortages and subsequently the number of pediatric nurse practitioners, nurse scientists, and faculty. Research is needed on specific shortages in the pediatric workforce, standardization of required pediatric content and clinical hours, and simulation versus in-person clinical experience to prepare graduates for practice, as well as practice perspectives of new graduates' ability to practice. [J Nurs Educ. 2024;63(12):806-812.].

Guideline on the Use of Intravenous Ketamine for Procedural Sedation in the Children's Emergency Department: A Quality Improvement Project.

In pediatric emergency medicine, sedation is crucial for performing some therapeutic procedures in children. Ketamine is still not widely used, despite being the preferred agent due to its effectiveness and safety profile. Implementing a guideline for intravenous ketamine in emergencies requiring procedural sedation in children, as well as training and evaluating staff competencies in performing this procedure, are the aims of this study. Senior and mid-level physicians, including pediatric nurses working in the children's emergency department (ED), have easy access to this concise repository for carrying out this procedure safely and effectively. The main objective was to implement a policy (guideline) for sedation in the children's ED. The secondary objectives were to determine whether the introduction of this policy increased the overall satisfaction rating of procedural sedation as a service offered in the Trust, to close skillgaps among staff through targeted training, and to assess the degree of recommendation for this ongoing standard of practice, in line with the current best evidence. A retrospective review of pediatric sedation cases with fractures in the children's ED of Buckinghamshire Healthcare National Health Service (NHS) Trust was conducted between June 2022 and August 2023. Surveys were sent out to assess attitudes, sedation skills, and compliance with the Royal College of Emergency Medicine (RCEM) guidelines. A policy for pediatric sedation with intravenous ketamine was later created and put into effect. Pre- and post-intervention data were compared to assess changes in sedation competency, compliance, and confidence. Out of the 103 pediatric fracture cases reviewed, 16 were identified as needing reduction upon initial evaluation, based on the child's condition at presentation. However, only one (6%) was treated with ketamine sedation in the children's ED, whereas nine cases (56%) were reduced under general anesthesia. The remainder was treated with varying use of nitrous oxide gas (Entonox) and diamorphine. Significant progress had been made after a clinical guideline for intravenous ketamine-assisted sedation in children was put into practice. Physicians reported improved knowledge of sedation techniques, knowledge of airway control, and safety in administering ketamine sedation. The percentage of respondents supporting the guidelines increased from 61% before the intervention (nValue=11) to 94% after (nValue​=17), using various metrics. These results demonstrated how well evidence-based policies and training can improve performance, competence, and safety. The use of procedural sedation in the children's EDincreased and the need for general anesthesia was significantly reduced after a uniform pediatric ketamine sedation policy was implemented. Targeted training to address skillgaps increased employee confidence and adherence to best practices.

Parental support and influencing factors for school-age children's healthy movement behavior: a cross-sectional study

Introduction: Optimizing healthy lifestyles in children requires parental support for healthy movement behaviors. This study analyzed factors influencing parental support for school-age children's movement activities. Methods: This study employed an analytic descriptive design with a cross-sectional approach, involving a sample of 355 mothers with school-age children. The independent variables included family, child, and environmental factors, whereas the dependent variable was parental support for healthy movement behaviors, as assessed through a questionnaire. Data analysis was performed using binary logistic regression with backward elimination. Results: The factors that significantly influenced parental support for their children's engagement in light physical activities included the children's own level of participation in such activities (OR=2.52, 95% CI=0.76-6.67). Factors affecting support for moderate to vigorous activities were maternal exercise habits (OR=3.37; 95% CI=1.18-9.65), children's sports habits (OR=5.18; 95% CI=1.64-16.26), and the presence of personal gadgets (OR=0.45, 95% CI=0.23-0.86). Parental support for preventing sedentary behaviors was influenced by parental knowledge (OR=2.33; 95% CI=1.34-4.05), mother's sleep duration (OR=2.46; 95% CI=1.27-4.75), and gadgets (OR=0.55; 95% CI=0.31-0.95). Factors affecting support for adequate sleep included children's light activities (OR=3.42; 95% CI=1.27-9.23) and their ownership of personal gadgets (OR=0.44; 95% CI=0.24-0.79) Conclusions: Parental support is influenced by the knowledge and physical activity habits of both mother and child, as well as gadget use and maternal sleep patterns. Pediatric nurses can enhance this support through health education focused on promoting healthy movement behaviors within families.

Compassion fatigue and it influencing factors among pediatric nurses: a cross-sectional survey

ObjectiveThis cross-sectional survey, utilizing a convenience sampling method, was conducted to investigate compassion fatigue (CF) among pediatric nurses in Shenzhen, China. Early identification of factors influencing compassion fatigue is a critical issue that nursing managers must address urgently.MethodsA convenience sampling technique was employed, and 539 pediatric nurses from tertiary grade A hospitals in Shenzhen were assessed using the Professional Quality of Life Scale. Logistic regression analysis was subsequently conducted to identify factors influencing compassion fatigue.ResultsA total of 534 valid questionnaires were collected, yielding an effective response rate of 99.1% (534/539). The overall compassion fatigue score for the nurses was 87.83 ± 12.86 points, with the sub-scores for compassion satisfaction, job burnout, and secondary traumatic stress being 35.72 ± 7.65 points, 25.65 ± 6.44 points, and 26.45 ± 7.60 points, respectively. Among the 534 nurses, 37 showed no signs of compassion fatigue, 154 had mild CF, 169 had moderate CF, and 174 experienced severe CF. Logistic analysis revealed that gender, health status, job satisfaction, work treatment satisfaction, workload, and competitive pressure were significant factors influencing compassion fatigue.ConclusionConsidering the urban characteristics of Shenzhen and the unique nature of pediatric nursing, recognizing the inevitability of compassion fatigue in pediatric nurses, along with early identification and intervention, may be crucial for safeguarding their mental health.

Perception of Pediatric Nurses on the Use of Standardized Nursing Handover Process in Intra-Hospital Patients Transfer: Attitudes, Barriers, and Practical Challenges

Perception of Pediatric Nurses on the Use of Standardized Nursing Handover Process in Intra-Hospital Patients Transfer: Attitudes, Barriers, and Practical Challenges

Overcoming Compassion Fatigue and Burnout in Pediatric Oncology Nurses: Implementation of a Staff Well-Being Program.

Background: As frontline healthcare workers, pediatric oncology nurses are at high risk for burnout, compassion fatigue, and decreased compassion satisfaction. Research indicates that up to 60% of oncology staff experience some form of burnout. This can lead to difficulties in personal and professional relationships, decreased staff retention, and negative effects on patient safety. This evidence-based practice project evaluated the impact of a staff well-being program on pediatric oncology nurses in a 28-bed hematology-oncology unit at a children's hospital. Method: After reviewing the literature related to compassion satisfaction, compassion fatigue, burnout, and well-being, an interdisciplinary team identified best practices for implementing a staff well-being program. This program integrated the components of Code Lavender, which is an alert designed to reduce stress and provide psychological first aid, including social support and a purposeful break from the unit, with staff debriefings, or dedicated time to reflect and focus on the team's emotional response and coping strategies. Results: Nurses reported that Code Lavender met their expectations; 69% agreed or strongly agreed that it had an immediate positive impact on their well-being. The team experienced challenges in coordinating debriefings with consistency, so the process was modified to develop a format that would address the needs of those who access the well-being program. There was a marginally significant improvement in compassion satisfaction from baseline to 12 months (p = .05). Discussion: Promoting healthcare worker well-being continues to be a priority to reduce burnout and to improve compassion satisfaction. Implementation of Code Lavender and debriefings is an important step toward improving the well-being of pediatric oncology nurses.

Identifying the Needs of Paediatric-Friendly Care in Emergency Department: A Delphi Study.

To systematically analyse expert perspectives on paediatric-friendly care in the emergency department and establish specific indicators. With an increasing number of children seeking emergency care, nurses must understand the specific needs of paediatric patients and their families. A two-round modified Delphi method was used in this study. In this study, experts from clinical practice and academia assessed 56 paediatric-friendly care criteria in the emergency department. Data were collected to establish a consensus and ensure content validity. Thirty experts completed two survey rounds with response rates of 100% and 93.3%, respectively. In the initial survey, no consensus was reached for eight items. After the items were consolidated, 37 paediatric emergency-friendly care needs were identified. For each need, the item-level content validity index exceeded 0.79 for importance and feasibility. The average scale-level content validity index values were 0.95 and 0.92 for importance and feasibility. These needs were categorised into six dimensions: timely comfort (3 items), emotional care (5 items), frontline safety (11 items), emergency response (10 items), human resources support (5 items) and treatment efficiency (3 items). Paediatric emergency nurses play a vital role in caring for children, improving soft skills through compassion and training and ensuring a well-equipped, safe environment in the emergency department. This study offers valuable insights for emergency department nurses on the needs of children and their families, emphasising the importance of patient and family education, environmental considerations and the role of certified child life specialists in supporting the emergency healthcare team and ensuring appropriate paediatric care. No direct patient, service user, caregiver or public involvement existed in this study.

Pediatric nurses' fatigue descriptions in occupational injury reports: A descriptive qualitative study1.

Despite the high risks associated with occupational fatigue in healthcare, few organizations require nurses to screen and report fatigue symptoms. As a result, little is known about if and how nurses would report fatigue while on the job. To determine if hospital-based pediatric nurses reported fatigue as part of an active injury reporting method. This secondary analysis of qualitative data used a descriptive design with content analysis. Data from the parent study were collected at a U.S. pediatric hospital where nurses verbally reported on-shift injuries or near misses and pre- and post-shift health status via a digital voice recorder. Researchers used content analysis to independently code data for nurses' references to fatigue. Codes were then analyzed for patterns and themes. Approximately 30% (n = 104) of participants reported fatigue-related content. Emergent themes were Work Stressors, Individual Risk Factors, Fatigue Descriptors, Adverse Outcomes from Fatigue, Fatigue Buffers, Descriptors for Buffered Fatigue, and Favorable Outcomes from Buffered Fatigue. Fatigue descriptions align with prior literature, demonstrating the accuracy of the voice recorder data collection method. In addition, nurses expressed uncertainty about the appropriateness of reporting fatigue symptoms. Findings from this study support pediatric nurses will report fatigue, when provided an opportunity. Additional efforts are needed to better understand effective ways to improve fatigue reporting among nurses, including harnessing current technology for real-time reporting and how to change the culture around fatigue reporting.

Paediatric Nurses' Personal Accounts of Being Told Not to Disclose Information to Children With Serious Illness-An Interpretative Phenomenological Study.

To explore the experiences, and perceptions of nurses who are told to withhold clinical information from children diagnosed with serious illnesses. An interpretative qualitative phenomenological design was used for the study. Sampling was purposive and data were collected using semi-structured interviews from nurses working in a paediatric setting within the preceding 5 years. Nurse-participants described their personal experiences of withholding situations ('non-disclosure directives'). Their accounts of specific examples of situations ('personal accounts') were extracted from the interview transcripts and analysed using inductive content analysis to identify patterns and concepts within the descriptions. Data management was supported using Dedoose. Nurse-participants were interviewed face-to face and online between November 2019 and December 2020. Twenty-six Australian nurses who have cared for seriously ill children within the preceding 5 years participated in the study. Thirty-nine accounts of non-disclosure situations (personal accounts) were extracted from interview transcripts. Four types of non-disclosure were identified in the personal accounts: withholding information, temporary withholding, lying and combined withholding/lying. The inductive content analysis identified three key aspects of nurse-participants' accounts: beliefs and perceptions (about the child and parents), the nature of the experience and feelings about the experience. Moral distress occurred when nurses' actions conflicted with their moral values in response to a non-disclosure directive, particularly when asked to directly lie to children. Nurses felt disempowered by the parent's authority and the institutional hierarchy that limited their ability to participate in discussions where a non-disclosure directive was given. Nurse-participants were afforded a platform for reflection which proved valuable in allowing them to process their experiences in a non-disclosure situation. Nurses directed to withhold medical information from children should be afforded opportunities for reflection to mitigate moral distress. Nurses should be included in the planning of ethically appropriate responses to withholding directives.

A clinical review of early assessment for congenital hypothyroidism in newborns

Congenital hypothyroidism is a critical factor associated with stunting, as thyroid hormone deficiencies can impair growth starting in utero. Children with thyroid disorders, including conditions like hypoparathyroidism, often experience growth retardation due to congenital abnormalities and growth hormone deficiencies. For neonates, a lack of thyroid hormones can lead to long-term impacts, such as physical and mental disabilities, neurological disorders, and stunted growth. Early detection of congenital hypothyroidism is, therefore, essential and is typically part of newborn screening aimed at identifying congenital abnormalities. Implementing early screening protocols can diagnose and treat congenital hypothyroidism promptly, mitigating risks such as stunting and enabling better health outcomes for children. This literature review examines methods of early detection for congenital hypothyroidism across various global contexts. Three databases—PubMed, ScienceDirect, and Google Scholar—were searched using a systematic literature review approach, yielding five eligible studies with a combined study population of 920.441 newborns. These studies involved screenings for T4, TSH, 17-OHP, and G-6-PD, identifying hypothyroidism in 2.530 (27%) cases. Screening involved blood samples taken from the umbilical cord or heel within 48 to 72 hours after birth. Understanding early detection procedures for congenital hypothyroidism is essential for nurses, as it enables them to engage in early intervention and provide effective nursing care for affected infants. Early involvement can help prevent the adverse, long-term effects associated with congenital hypothyroidism, improving quality of life and supporting healthy growth trajectories for children at risk. Keywords: Congenital hypothyroidism; literature review; nursing assessment; paediatric nursing; prevention

Family-Centered Care from the Point of View of Undergraduate Nursing Students Studying in Selected Public Universities: A Cross-Sectional Study

Background: The concept of family-centered care (FCC) is central to the care model and is an essential core principle of pediatric nursing. Objectives: This study aimed to assess undergraduate nursing students' perceptions of FCC in selected government universities and examine differences in nursing students' perceptions of FCC based on gender and academic level. Methods: A cross-sectional design was used, involving 124 eligible students. Data were collected using a validated Family-Centered Care Questionnaire (FCCQ), which had a Cronbach’s alpha score of 0.90. Statistical package for social sciences (SPSS) version 25 was employed for data analysis, specifically for calculating means, standard deviations (SDs), frequencies, percentages, and conducting independent t-tests. Results: The overall mean score of perceptions was 3.35 ± 0.76. The "Family is the constant" dimension had the highest score (3.45 ± 0.91), while the "Developmental needs" dimension had the lowest score (3.26 ± 0.95). There was a significant difference in perceptions of FCC between male and female students (t = -5.291, P < 0.001) and between third- and fourth-year students (t = 7.345, P < 0.001). Conclusions: It can be concluded that undergraduate nursing students had modest perceptions of FCC, and there was a significant difference in these perceptions based on gender and academic level. This study provides valuable insight into FCC, which can inform policy design and interventions in nursing education in Jordan. An educational program is recommended to improve undergraduate nursing students' perceptions of FCC.

Australian rural emergency nurses' care of paediatric patients: A qualitative study

BackgroundRural emergency nurses (RENs) are expected to provide care to paediatric patients presenting to their facilities however, as generalist nurses, they experience challenges and feelings that are unique to the rural context. Design and methodsAn exploratory qualitative study of 13 RENs via semi structured interviews of perceptions and experiences of caring for paediatrics and self-determination of autonomous practice, motivations and connectedness in care was the approach used. FindingsInductive thematic analysis of data identified four themes with sub-themes identified within each theme. The four themes were: Caring for Children, Professional Roles, Professional Care and Connection and Professional Development. ConclusionRENs describe feeling fear, stress and anxiety when caring for sick children, particularly when known to the patient and family in their community yet will self-determine autonomous practice and use gatekeeping in certain situations of paediatric care. RENs are motivated to increase their paediatric knowledge and skills, seeking paediatric education opportunities but face barriers in attendance such as travel and costs. RENs rely on connectedness with other rural nurses, seeking paediatric nursing guidance or telehealth support, particularly when performing multiple roles or in the absence of a doctor in the ED. Practice implicationsProvision of opportunities for RENs to lead education in paediatric nursing, that is contextually appropriate and co-designed with paediatric experts is preferred. This would yield greater REN engagement and participation in paediatric education for knowledge and skill proficiency, would increase rural nurse professional development and reduce feelings of fear and anxiety when caring for paediatrics.

Academic and Employment Preferences of Nursing Students at the University of Las Palmas of Gran Canaria: A Cross-Sectional Study.

It is well known that there are differences in the academic and employment preferences of nursing students once they have completed their undergraduate studies in nursing. These preferences are largely influenced by students' affinity for certain thematic areas over others. Therefore, the objective of this study was to identify the employment and academic preferences of third- and fourth-year Nursing Degree students at the University of Las Palmas de Gran Canaria (ULPGC). A cross-sectional, descriptive observational study was conducted among nursing students across three campuses of the ULPGC (Canary Islands, Spain). An online questionnaire was used to collect various sociodemographic and academic variables, as well as preferences across ten thematic areas. Descriptive and bivariate inferential analyses were performed, along with a correlation analysis among the areas. The areas of highest preference were "Emergency Nursing", "General Nursing", and "Family and Community Nursing". The areas of lowest preference were "Other Areas (teaching, management, research)", "Mental Health and Psychiatric Nursing", and "Geriatric Nursing". Three clusters of closely correlated areas were identified: cluster 1 (Intensive and Critical Care Nursing, Emergency and Emergency Nursing and Operating Theatre and Anaesthesia Nursing), cluster 2 (Obstetric-Gynaecological Nursing-Midwifery, Paediatric Nursing and Mental Health and Psychiatric Nursing) and cluster 3 (remaining areas). A significant proportion of students expressed intentions to pursue postgraduate studies. Strategies should be implemented to enhance students' preferences in the areas of "Mental Health and Psychiatric Nursing" and "Geriatric Nursing", which are areas where there is a high demand for nurses. It is also necessary to increase their interest in research, management, and teaching. This study was not registered.

PP455 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: OPERATIONALIZATION OF A PEDIATRIC NURSE TRAINING MODULE

PP455 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: OPERATIONALIZATION OF A PEDIATRIC NURSE TRAINING MODULE

PP182 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: FACTORS ASSOCIATED WITH PEDIATRIC NURSE BURNOUT

PP182 Topic: AS16–Medical, Nursing and AHP Workforce & Education: Staff Education and Development/Equity, Diversity, Inclusion/Other: FACTORS ASSOCIATED WITH PEDIATRIC NURSE BURNOUT

Moral distress in pediatric nurses: A scoping review protocol.

Recently, moral distress in pediatric nursing has gained academic attention, yet comprehensive literature reviews on this group are scarce. This study aims to offer a detailed overview of moral distress among pediatric nurses, focusing on understanding its characteristics, prevalence, underlying causes, and consequences on the quality of patient care. Employing a scoping review approach as recommended by the Joanna Briggs Institute, this study will systematically search through PubMed, Scopus, Web of Science, APA PsycInfo, and CINAHL databases using specific search strategies. Titles, abstracts, and full texts will be independently screened by two reviewers according to the eligibility criteria. Relevant data will be extracted, categorized, and subjected to narrative synthesis to draw comprehensive insights. The anticipated findings of this study will shed light on the nature, frequency, and drivers of moral distress among pediatric nurses, along with its broader implications for healthcare practitioners, organizational practices, and patient care outcomes.