Pediatric Care Setting Research Articles

Impact of an Adult Congenital Heart Disease Order Set in a Pediatric Cardiac Intensive Care Unit.

Background: Patients with congenital heart disease (CHD) are increasingly surviving to adulthood. Given their age- and condition-specific needs, the optimal postoperative setting for these patients is not yet determined. This study aims to evaluate the utility of an adult-specific order set in improving clinical outcomes for these patients in a pediatric cardiovascular intensive care unit (ICU). Methods: Adults with CHD (ACHD) admitted to the cardiovascular ICU following cardiac surgery at a pediatric tertiary care center were identified for a retrospective cohort study. Health care delivery metrics and clinical outcomes of participants who received the adult-specific order set were compared with control patients admitted prior to the intervention. Categorical outcomes were compared using the χ2 test of independence or Fisher exact test, and continuous outcomes were assessed using the t test. Results: A total of 130 ACHD patients received the intervention, with no significant differences observed in clinical outcomes when compared with 89 controls. While there was additionally no reduction in hospital-related mortality (2.3% vs 7.8%, RR 0.3; P = .1), clinician ordering behaviors were better aligned with best-practices following the intervention. Among patients with moderate or greater anatomic complexity, a post hoc analysis demonstrated reduced in-hospital mortality from those who received the adult order set. Conclusions: The implementation of an adult-specific order set in a pediatric care setting did not improve clinical outcomes for all ACHD patients. Patients with moderate and greater anatomic complexity did see a mortality benefit, suggestive that targeted electronic tools may most benefit those who have the highest risk.

Exploring the Impact of Medical Complexity on Nursing Complexity of Care in Paediatric Patients: A Retrospective Observational Study.

To explore the impact of medical complexity, defined by the number of chronic conditions, on the complexity of care, as described by the frequency of nursing diagnoses (NDs) and nursing actions (NAs), in paediatric patients. Retrospective observational study. This study was conducted in an Italian university hospital and involved the analysis of electronic health records for neonatal and paediatric patients who were consecutively admitted from January to December 2022. The sample was classified into three categories-non-chronic, single chronic and multimorbid patients-according to their clinical profiles. NDs recorded within the first 24 h from patient hospital admission and NAs performed throughout the hospital stay were counted for each group. Distinct variations in the prevalence and patterns of NDs and NAs were observed across different levels of medical complexity. A significant moderate positive correlation between the number of NDs and NAs was found. However, the frequency of NDs did not directly correlate with the number of chronic conditions. Conversely, a weak but significant negative correlation was identified between the quantity of NAs and the number of chronic conditions. While the frequency of NDs showed a stable but decreasing trend as the number of chronic conditions increased, a higher number of chronic conditions were associated with a lower quantity of NAs. We discovered a notable variation in the complexity of care across varying levels of medical complexity in paediatric patients. Our findings suggest that the complexity of care does not necessarily correspond to the degree of medical complexity. The observed negative relationship between the number of chronic conditions and the quantity of NAs underscores the need for further research to explore this unexpected finding and its implications for clinical practice. Without the adoption of standardised nursing terminologies, such as nursing diagnoses (NDs) and nursing actions (NAs), assessing the complexity of care in paediatric settings can be challenging. Integrating clinical nursing information systems that incorporate standardised NDs and NAs into electronic health records is crucial for accurately documenting and analysing the complexity of care and its relationship with medical complexity. In paediatric patients, the frequency of nursing diagnoses (NDs) at hospital admission is significantly associated with the quantity of nursing actions (NAs) delivered during hospitalisation. However, there is no correlation between the frequency of NDs and medical complexity, as defined by the number of chronic disorders. Specifically, the frequency of NDs decreases with increasing medical complexity, while the quantity of NAs is negatively associated with the number of chronic disorders. This indicates that the complexity of care cannot be inferred solely from medical complexity, and additional factors need to be explored. These findings enhance understanding of how complexity of care relates to medical complexity in paediatric patients. Insights into the prevalence and patterns of NDs and NAs can benefit nurses, managers, researchers and policymakers by informing clinical and organisational decision-making to ensure high-quality care. The study adhered to the RECORD Statement. Patients, service users, caregivers or public members were not directly involved in the design, conduct, analysis and interpretation of data or in writing this paper. Patients contributed only to data collection.

Bridging the Gap: Assessing Nephrology Transition Practices in Pediatric and Adult Care Settings

Bridging the Gap: Assessing Nephrology Transition Practices in Pediatric and Adult Care Settings

Determining infection prevention staffing needs for the pediatric ambulatory and procedural care setting.

Recent analyses suggest thatexisting infection preventionist (IP) staffing ratios do not reflect the scope of institutional needsafter accounting for complexity and non-inpatient locations. We sought to determine the current IP staffing level required to address the complexity and scope of our pediatric ambulatory and procedural operations. This needs assessment was adapted from previous analyses by Bartles et al (2018). We surveyed IPs covering ambulatory/procedural locations regarding clinical complexity indicators and estimated hours per week spent engaged in IP activities. The reported hours were used to calculate total IP hours per week and associated full-time equivalents (FTEs). Half (118/237) of surveyed locations/services reported at least 1 complexity indicator, while nearly 9% (21/237) reported 3 or more complexity indicators. IPs spent 181.0h/wk focused on ambulatory/procedural locations, equating to 4.5 FTEs. Infection prevention and control leadership used these findings to successfully add 4 IP FTEs to the department. These FTEs will allow increased ambulatory/procedural IP support, improved regulatory readiness, and increased quality improvement initiatives. Assessing the complexity and scope of pediatric ambulatory/procedural locations can be a valuable tool for (1) advocating for overall IP staffing increases at a system level and(2) determining the distribution of IP time and resources in such locations.

Heart rate to identify non-febrile children with dehydration and acute kidney injury in emergency department: a prospective validation study

We previously developed and retrospectively validated the estimated percentage of heart rate variation (EHRV) as a predictor of the composite outcome of ≥ 5% dehydration and/or acute kidney injury (AKI) in non-febrile children. The current study aimed to prospectively validate EHRV as a predictor for dehydration or AKI in a different cohort of children attending the Pediatric Emergency Department. From July 2022 to August 2023, 256 pediatric patients aged 0–18 years attending the Pediatric Emergency Department were enrolled. EHRV was calculated as follows: [(HR at admission − 50th percentile of HR for age and sex)/HR at admission] × 100. Dehydration was categorized as < 5% or ≥ 5% fluid deficit. AKI was defined according to KDIGO creatinine criteria. Statistical analyses included receiver-operating characteristic (ROC) curves and logistic regression analysis. Among enrolled patients, 52 had ≥ 5% dehydration, 50 had AKI, and 16 had both conditions. EHRV demonstrated significant predictive ability for both ≥ 5% dehydration (AUROC = 0.71; 95% confidence interval (CI), 0.63–0.78; p < 0.001) and AKI (AUROC = 0.78; 95% CI, 0.71–0.84; p < 0.001). An EHRV > 24.5% was associated with an increased odds ratio (OR), adjusted for confounders, of ≥ 5% dehydration (OR = 3.5; 95% CI, 1.6–8.0; p = 0.003) and AKI (OR = 3.4; 95% CI, 1.6–7.3; p = 0.002). The sensitivity and specificity of this cut-off were 34% and 83% for ≥ 5% dehydration and 36% and 84% for AKI, respectively.Conclusions: This study prospectively validates the clinical utility of EHRV in predicting dehydration and AKI in a pediatric emergency care setting. An EHRV > 24.5% could serve as a marker for suspecting dehydration or AKI. Further validation across diverse patient populations and settings is needed. What is Known:• An increased heart rate (HR) is a readily detectable sign of dehydration in children.• In a retrospective validation cohort, an estimated HR variation (EHRV) greater than 24.5% compared to the 50th percentile of HR was predictive of ≥ 5% dehydration and/or acute kidney injury (AKI) in non-febrile patients.What is New:• We prospectively validated the clinical utility of EHRV in predicting dehydration and AKI in a pediatric emergency care setting.• We confirmed that an EHRV greater than 24.5% is associated with increased odds of ≥ 5% dehydration and AKI.

A Review on the Impact of Bedside Echocardiography in Managing Critically Ill Children in the Pediatric Intensive Care Unit.

Over the past three decades, a variety of non-invasive hemodynamic devices have been developed. However, none of the existing methods, such as transthoracic echocardiography, esophageal Doppler ultrasound, plethysmography, thoracic impedancemetry, or sublingual capnography, fully embody the ideal characteristics of reliability, reproducibility, rapid response, ease of use, comprehensive safety, affordability, and continuous monitoring capacity. Among these, echocardiography stands out as a particularly effective approach, meeting many of these criteria due to its widespread availability, relative ease of use, and critical role in detecting anatomical abnormalities and basic changes in myocardial function. It is frequently used in pediatric intensive care units to assess the structure and function of the heart muscle.The effectiveness of echocardiography in pediatric critical care is also constrained by the need for high-quality imaging and accurate interpretation. Currently, there is a notable lack of literature on the application of echocardiography in pediatric critical care. This study seeks to evaluate the existing scientific evidence regarding the effectiveness of echocardiography as a tool for monitoring hemodynamics in pediatric critical care settings.

Perspectives on the Practice of Collaborative Care: Topical Themes and Future Directions From the Lens of a Collaborative Care Child Psychiatrist.

The increasing shortage of psychiatrists in the workforce is a well-documented and alarming trend. In light of this workforce shortage, psychiatrists bear a professional and ethical responsibility to identify strategies to increase access to mental health treatment and thereby reduce the impact of the psychiatrist shortage on patients and on the greater health system. One such strategy is the collaborative care model (CoCM), which has demonstrated efficacy in the mental health treatment of both pediatric and adult populations. In this article, the CoCM is presented as one effective strategy to address the behavioral workforce shortage. Current themes observed from the clinical practice of psychiatric collaborative care in a pediatric collaborative care setting are discussed with contemplation of future directions.

The barriers and challenges of using health information technology in medication administration process for pediatrics and neonates: A qualitative study.

Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision-making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country. Semi-structured face-to-face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi's seven-step approach. The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: "inappropriate management approaches" with two sub-categories ("Managers' reluctance to adopt new technology", "lack of adequate budget for hardware resources"), and "resistance to change" with two sub-categories ("A desire to use conventional (traditional) approaches in care","cultural issues and impracticality of providing some specialized technology services"). The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved "effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers" interest in using new technology. The present findings can guide the development of more effective and user-friendly HIT systems in pediatric and neonatal care settings.

Collecting Sociodemographic Data in Pediatric Emergency Research: A Working Group Consensus.

Understanding and addressing health care disparities relies on collecting and reporting accurate data in clinical care and research. Data regarding a child's race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic characteristics are important to ensure equity in research practices and reported outcomes. Disparities are known to exist across these sociodemographic categories. More consistent, accurate data collection could improve understanding of study results and inform approaches to resolve disparities in child health. However, published guidance on standardized collection of these data in children is limited, and given the evolving nature of sociocultural identities, requires frequent updates. The Pediatric Emergency Care Applied Research Network, a multi-institutional network dedicated to pediatric emergency research, developed a Health Disparities Working Group in 2021 to support and advance equitable pediatric emergency research. The working group, which includes clinicians involved in pediatric emergency medical care and researchers with expertise in pediatric disparities and the conduct of pediatric research, prioritized creating a guide for approaches to collecting race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic data during the conduct of research in pediatric emergency care settings. Our aims with this guide are to summarize existing barriers to sociodemographic data collection in pediatric emergency research, highlight approaches to support the consistent and reproducible collection of these data, and provide rationale for suggested approaches. These approaches may help investigators collect data through a process that is inclusive, consistent across studies, and better informs efforts to reduce disparities in child health.

PICNIC Unconference: Growing a community of practice for psychological professionals working in paediatric and neonatal critical care

In September 2023, 58 psychological professionals from across the UK and Republic of Ireland convened for an ‘Unconference’ event in Birmingham to strengthen their developing community of practice in paediatric and neonatal critical care settings. This article describes the origins, purpose, format, content and evaluation of the Unconference, providing a map for groups to follow when organising such events in the future including helpful routes to take and pitfalls to avoid.

NURS-22. NAVIGATING DISPARITIES: COMPREHENSIVE CARE AND ACCESS TO CLINICAL TRIALS FOR ADOLESCENTS AND YOUNG ADULTS WITH CENTRAL NERVOUS SYSTEM TUMORS

Abstract BACKGROUND Central nervous system (CNS) tumors are one of the most common causes of cancer-related death in the adolescent and young adult (AYA) age group. Despite being a prevalent cancer diagnosis, adolescents and young adults continue to be underrepresented in clinical trials. Literature review shows a notable lack of research focused on clinical care, reproductive health, and psychosocial aspects specific to this population. The longstanding issue of low AYA participation in clinical trials persists across various cancer types, with a particular scarcity of data regarding CNS tumors. Notably, the lack of participation in clinical trials has been associated with worse survival outcomes and increase in frequency and severity of treatment-related toxicity, emphasizing the critical impact of this issue on patients’ overall morbidity and mortality. The literature underscores the under-representation of AYAs with CNS tumors in neuro-oncology trials.. METHODS This talk will review challenges faced by adolescents and young adults (AYAs) diagnosed with central nervous system (CNS) tumors.We will discuss the necessity for molecular profiling in the diagnostic workup of CNS patients to delineate tumor biology and guide treatment plans, including clinical trial access. To address the insufficient understanding of best practices for this group, there is a crucial call for expanding access to clinical trials. We will explore barriers to clinical trial access and provide case examples of successful and unsuccessful work with AYA patients with CNS tumors with ideas to improve access. Finally, we will discuss the holistic care of AYAs with CNS tumors through a multidisciplinary approach, incorporating expertise in neuro-oncology, oncofertility, palliative care, and psychosocial aspects within both pediatric and adult care settings RESULTS N/A CONCLUSIONS By the end of this presentation, pediatric RNs and APPs will have an understanding of the differences in caring for this unique population of patients including benefits of enrolling adolescents and young adults with CNS tumors in clinical trials.

Trends in C reactive protein testing: a retrospective cohort study in paediatric ambulatory care settings

ObjectivesThis study aims to investigate C reactive protein (CRP) testing practices in paediatric ambulatory care across British primary care and accident and emergency (A&E) departments.Design, setting, participantsThis retrospective cohort study...

Risk Factors for Deterioration Events in the Pediatric Acute Care Setting.

Rapid response system (RRS) activations resulting in emergency transfers (ETs) and codes outside the ICU are associated with increased mortality and length of stay. We aimed to evaluate the patient and care team characteristics of RRS activations resulting in ETs and codes outside the ICU (together classified as "deterioration events") versus those that did not result in a deterioration event. For each RRS activation at our institution from 2019 to 2021, data were gathered on patient demographics and medical diagnoses, care team and treatment factors, and ICU transfer. Descriptive statistics, bivariate analyses, and multivariable logistic regression using a backward elimination model selection method were performed to assess potential risk factors for deterioration events. Over the 3-year period, 1765 RRS activations were identified. Fifty-three (3%) activations were deemed acute care codes, 64 (4%) were noncode ETs, 921 (52%) resulted in nonemergent transfers to an ICU, and 727 (41%) patients remained in an acute care unit. In a multivariable model, any complex chronic condition (adjusted odds ratio, 6.26; 95% confidence interval, 2.83-16.60) and hematology/oncology service (adjusted odds ratio, 2.19; 95% confidence interval, 1.28-3.74) were independent risk factors for a deterioration event. Patients with medical complexity and patients on the hematology/oncology service had a higher risk of deterioration events than other patients with RRS activations. Further analyzing how our hospital evaluates and treats these specific patient populations is critical as we develop targeted interventions to reduce deterioration events.

Paediatric Activity Anomaly Detection using CNN-XGBoost for Early Intervention and Patient Safety

The development of a robust anomaly detection system capable of distinguishing between normal and abnormal activities in paediatric care settings is of paramount importance for early intervention and patient safety. This endeavor presents substantial challenges due to the unique characteristics of paediatric activities, making it necessary to employ a combination of Convolutional Neural Networks (CNNs) and XGBoost to effectively address these complexities. The initial step involves the assembly of a meticulously annotated dataset comprising video sequences encompassing a broad spectrum of paediatric activities, both normal and abnormal, with a strong emphasis on diversity and representativeness. This dataset is subjected to rigorous preprocessing to ensure consistency and quality. This research employs a Kalman filter as a pre-processing step. This filter helps to reduce noise and enhance the quality of the video data. By smoothing and stabilizing the trajectories of objects or subjects within the video frames, the Kalman filter provides a cleaner input for subsequent stages of the process. CNN employed for feature extraction from video frames, capturing both spatial and temporal cues. To account for the temporal dimension inherent in video data, by ensuring that the model can capture nuanced patterns in paediatric activities. The accuracy of the proposed method is 88%. The extracted features or sequences are input into an XGBoost classifier, designed as a binary classification task to differentiate between normal and abnormal activities. Robust model evaluation is conducted on validation and test datasets using appropriate performance metrics, with continuous feedback loops established with healthcare professionals and caregivers to fine-tune and optimize the model's performance.

Utilization of the Keeping Hope Possible Toolkit with parents of children with life limiting and life threatening illnesses during the COVID-19 pandemic: Exploring pediatric nurses and allied healthcare provider opinions

BackgroundFor families with children diagnosed with complex illnesses, the COVID-19 pandemic added many challenges. In order to mitigate inevitable disruptions in pediatric care settings, caregivers may need added supports and resources. The Keeping Hope Possible (KHP) Toolkit is a self-administered intervention intended to enhance caregiving experiences of parents with a child with multiple needs. However, little is known about effectively disseminating the Toolkit. Purpose and methodsA qualitative, thematic analysis was conducted to explore the opinions and perceptions of pediatric nurses and allied healthcare providers (HCPs) in relation to the dissemination and use of the KHP Toolkit for use by families with complex medical needs. Structured interview data were analyzed from a sample of seven pediatric HCPs working in various care settings in one Canadian province. FindingsFive themes were developed including: Recognising Importance of the KHP Toolkit; Needing Support and Direction; Implementation and Use of the KHP Toolkit; Realizing Important Considerations for Success; and, Emphasizing Connection through Isolated Times. DiscussionParticipants recognized the importance of the KHP Toolkit for parents and extended family in a variety of settings to encourage self-care, daily structure, and connectedness. Thus, pediatric nurses' awareness and openness to the initial dissemination of the Toolkit is essential, and a subsequent interprofessional team approach will ensure consistent reminders and support for families. Application to practiceCareful assessment of family readiness for learning about and using the KHP Toolkit is essential, along with an interprofessional approach to consistent inquiry and support at each family encounter.

Guarding the Vulnerable: Perceptions of Security and Workplace Violence in Pediatric and Gynecological Care Settings of Karachi

Background: Violence in the workplace against medical professionals is a serious problem, especially in developing nations like Pakistan. The purpose of this study was to evaluate the opinions of medical professionals regarding Karachi's current hospital security protocols and pinpoint opportunities for enhancement.&#x0D; Methods: A cross-sectional survey of 414 healthcare providers from public and private hospitals in Karachi, Pakistan was undertaken. The participants' sociodemographic characteristics, encounters with workplace violence, evaluations of hospital security measures, and recommendations for enhancement were all encompassed in the questionnaire. The data were analysed utilising descriptive statistics, chi-square tests, and multinomial logistic regression.&#x0D; Results: A significant proportion of the participants expressed discontentment with security standards, citing insufficient staffing (71.7%), absence of monitoring systems (72.7%), and inadequate access control guidelines (64.7%). A greater frequency of reported workplace violence was substantially correlated with overall dissatisfaction with security (82.3% vs. 58.1%, p &lt; 0.001). The results of multinomial logistic regression showed that being a nurse (OR = 1.73, 95% CI: 1.12-2.68) and being dissatisfied with security measures (OR = 3.21, 95% CI: 1.87-5.52) were independent risk factors for workplace violence. Increasing security staff, improving surveillance systems, and fortifying access control protocols were among the recommendations for improvement.&#x0D; Conclusions: Improved hospital security measures are essential to address workplace violence against healthcare providers in Karachi. Implementing the recommended strategies can create a safer work environment and enhance the quality of patient care.&#x0D; Keywords: Workplace violence, healthcare providers, hospital security, Karachi, Pakistan, perceptions.

Clinician and parent views on urine collection in precontinent children in the UK: a qualitative interview study

ObjectiveTo explore the experiences of healthcare professionals (HCPs) and parents of urine collection methods, to identify barriers to successful sampling and what could improve the process.DesignQualitative research, using individual semistructured...

Determination, categorization, and hierarchy of content for a pediatric emergency medicine curriculum designed for emergency medicine residents.

Currently, the Accreditation Council of Graduate Medical Education requires time-based pediatric experiences for emergency medicine (EM) residents in both pediatric emergency medicine (PEM) and critical care settings. The American Board of Emergency Medicine has published the Model of the Clinical Practice of Emergency Medicine, which is a list of content an EM resident should learn. However, this list is large and without prioritization and therefore can be difficult to incorporate into time-limited curricula. The primary objective of this study was to develop comprehensive categorization of PEM content using an EM lens. The second objective was to suggest a prioritization for the EM learner of the enumerated PEM elements. We first assembled a comprehensive list of PEM concepts, diagnoses, and procedures that might be taught to EM residents. We then convened focus groups composed of key stakeholders to help formulate content and concept themes important for EM resident training. Once the themes were identified, we divided the list of PEM topics into appropriate themes and then carried out a second round of focus groups expanded to include more diverse expert input for prioritizing the elements of the comprehensive list within each theme. We prioritized 168 important PEM concepts from previous standards and emerging PEM literature among 10 identified themes: the pediatric normal, the bottom-line boil-it-down approach, common presentations, high-acuity pediatric cases and procedures, differences between children and adults, same between children and adults, red flags, infrequency of caring for a child compared with an adult, keep breadth but promote self-directed depth, and triage and disposition. Based on input from stakeholders in EM resident education, we identified key themes within PEM education and created a framework for the hierarchical categorization of PEM content for within an EM residency.

How to follow the guidelines, when the appropriate fluid is missing?

Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April-May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey. Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known: • Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. • Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New: • Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East.Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country. • Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution.

HOLISTIC ORAL CARE FOR CRITICALLY ILL CHILDREN: KNOWLEDGE AND PRACTICES OF INTENSIVE CARE UNIT NURSES

Objective: This research aims to assess the knowledge, perceptions, practices, and education of pediatric critical care nurses regarding oral care for critically ill children. The study addresses the existing gap in evidence-based oral care in this population and emphasizes the importance of understanding these factors for the development of effective oral hygiene practices in pediatric critical care settings. Methods: A descriptive cross-sectional study was conducted between October 2022 and March 2023 in Babylon Governorate. Four hospitals located in Hillah City, Babylon Province, were selected as the study sites. The sample included nurses working in specific critical care units within these hospitals, with a total of 170 nursing personnel participating. Data collection involved the distribution of questionnaires to the nurses, and statistical analysis was performed using SPSS software. The study obtained the necessary administrative and ethical approvals for data collection. Results: The sample consisted of 170 intensive care unit nurses, selected through stratified sampling based on gender (105 female and 65 male). Recruitment for the study commenced in February 2023. The mean score for oral health knowledge was moderate (2.14), However, the oral care practice score was good (2.02). No significant differences were observed in comprehensive mouth care scores based on age and educational qualification. Nevertheless, a significant difference was found in the mean score for complete oral care between male and female nurses (18.37 vs. 17.85, p = 0.021). Moreover, knowledge and practice scores varied significantly based on years of experience. Conclusions: This study provides valuable insights into the knowledge, perceptions, and practices of intensive care unit nurses regarding oral care. Implementation of standardized oral care protocols, along with adequate resources and support, can contribute to enhancing comprehensive mouth care in intensive care units.