Pediatric Nurses Research Articles

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.

"While Everyone Else was Doing Sports, I Used to Sit on the Sidelines." How Do Adolescents Manage Their Asthma?: A Qualitative Study.

Effective asthma management is a necessity for the control and optimal outcomes of the condition. A number of factors may either facilitate or act as barriers to the management of asthma in adolescents. The objective of this study was to assess the feelings, thoughts, and behaviors of adolescents diagnosed with asthma regarding the management of their condition. This exploratory qualitative study was conducted using semi-structured, in-depth interviews with 12 adolescents aged 12-18 years who were followed up with a diagnosis of asthma at a university hospital pediatric allergy clinic between October 15 October 2023, and December 15 December 2023. The study was written using the COREQ checklist. Three main themes were identified in this study: (1) facilitators, (2) barriers, and (3) information. Adolescents reported that they needed more information about medication use and asthma disease to manage asthma. Asthma control ability, positive beliefs, and supportive relationships were facilitators of asthma management. However, poor asthma control, negative beliefs, lack of support, poor communication, and asthma-related stigma were identified as barriers to asthma self-management. Adolescents had information needs in asthma management. This study highlights that barriers to asthma self-management in adolescents are much greater than the facilitators. For adolescents to manage their asthma well, their information needs must be met. Therefore, pediatric nurses should prepare individualized training to meet the specific needs of adolescents.

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

Background/Objectives: 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). Methods: 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. Results: 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. Conclusions: 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.

Effects of nurse's knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management in South Korea: a descriptive study.

This study aimed to identify the effects of nurse's knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management and provide the primary data necessary for the efficient intravenous injection management of hospitalized children. This study was a descriptive study design with 141 nurses who perform pediatric intravenous therapy care at eight hospitals in the S, C, D, and S regions. Data were collected from September 1, 2023, to September 30, 2023. Nursing performance of pediatric intravenous injection management was significantly positively correlated with knowledge (r=.44, p<.001) and self-efficacy (r=.19, p=.022). Nurses' knowledge (β=.42, p<.001) and self-efficacy (β=.22, p=.004) of pediatric intravenous injection management and care were identified as significant predictors of nursing performance thereof, with these two factors explaining 21.9% of the variance. This study found that knowledge and self-efficacy of pediatric intravenous injection management are significant predictors of the practice of intravenous care among pediatric nurses. Therefore, considering these factors, education and intervention programs should be developed to enhance pediatric nurses' knowledge and self-efficacy regarding intravenous injection management.

The influencing factors of pediatric nurses' perception of patient safety culture and partnership with patients' parents on patient safety nursing activities in South Korea: a descriptive study.

This study aimed to identify the effects of pediatric nurses' perception of patient safety culture and their partnership with patients' parents on pediatric patient safety nursing activities. This descriptive study was conducted over a two-month period, from October to November 2022, utilizing self-reported questionnaires. The study included 165 nurses, each having at least 6 months of working experience in wards where children were admitted. These nurses were selected from 13 pediatric specialty hospitals, general hospitals, and university hospitals across seven regions. The data analysis was performed using the SPSS/WIN 26.0 program (IBM Corp.) for descriptive statistics, t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. The average scores for awareness of patient safety culture, partnership with patients' parents, and pediatric patient safety nursing activities were 3.37±0.41, 3.94±0.41, and 4.50±0.38, out of 5 points respectively. The factors influencing pediatric patient safety nursing activities were identified as a partnership with patients' parents (β=.41, p<.001). Among hospital-related characteristics, safety management committee (β=.16, p=.029) and safety management regulations (β=.17, p=.016) were also analyzed as factors influencing patient safety nursing activities. These factors accounted for 29.2% of the explanatory power for pediatric patient safety nursing activities. Based on the above study results, we found that to promote safe nursing activities for pediatric patients, developing and implementing training programs that enhance partnerships with patient's parents was imperative, and establishing work regulations and a safety management committee to systematically manage safety management tasks was deemed important.

Knowledge, Attitudes, and Perceptions of Quebec Nurses Relating to Climate Change in the Context of Their Practice with Children Aged 0 to 5 Years: A Cross-Sectional Descriptive Study.

Reducing children's vulnerability to climate change (CC) depends firstly on parents having the ability to adapt. The purpose of this study was to describe knowledge, attitudes, and perceptions of nurses in support of parents' ability to adapt to CC to protect the physical and psychosocial health of 0-5 year olds. A cross-sectional descriptive study was used. A total of 127 pediatric nurses from the province of Quebec completed an online questionnaire documenting nurses' knowledge, attitudes, and perceptions about CC. A third of nurses have little or no knowledge of the health risks of CC for children, even though they consider it to be a major issue for children. Nurses perceive that parents don't generally consider their children to be among the most vulnerable to CC, trivialize their effects on their children's health, have little knowledge of the effects of CC mainly on their children's psychosocial health, know little about the means to use to protect them, and more readily seek help from family and friends to ensure their children's protection. Nurses affirm that they are responsible for discussing the health effects of CC with parents, introduce measures to reduce their effects, possess little knowledge and few skills for reducing their effects, and feel unprepared to deal with their effects in their practice. Greater access to training on CC-related concepts is needed to increase nurses' knowledge. Nurses' perceptions must be validated with parents to promote optimal protection of children from CC.

Virtual Children’s Hospital for Learning Pediatric Nursing

Abstract Background In the context of a funded Erasmus+ program, a platform of a Virtual Children’s Hospital for Learning Pediatric Nursing - VLPN is being developed. The education of nurses working with children, adolescents and families, needs to include specialized knowledge, skills, attitudes and behaviors that will empower them to provide optimal and high-quality care. The virtual platform enables the improvement of pediatric nursing competences of the nursing students through interactive and self-paced activities and content. Objectives 1. To develop an immersive and interactive virtual reality learning environment (VRLE), a virtual children’s hospital and new teaching and learning methods and practices, utilizing virtual reality and simulation in teaching. 2. To promote the international collaboration of students and lecturers through the VRLE Results The results are preliminary. 1. The VRLE includes educational materials developed to be integrated in the pediatric nursing studies, easy to access and use by the students and teachers with innovative self-pace learning material i.e. videos, 3D-models, interactive tests. Digital patients can react to the provided care with speech, movement, facial expressions and gestures, something that is not possible with the manikins in the Labs. 2. Nursing students and lecturers from different countries can participate in joint remote seminars or workshops in the VRLE, sharing and comparing their country and culture-specific differences and similarities in the nursing practices. VRLE and digital materials enables synchronous and asynchronous learning. Conclusions VRLE is highly conducive to clinical and procedure-focused training by enabling simulation. VR methods offer nursing students the opportunity to practice skills in a safe and risk-free environment in an immersive way. It can be accessed by multiple students, teachers or nurses at the same time from different locations in different countries. Key messages • New innovative VRLE enhances nursing students’ knowledge and skills that are needed when working with sick children and their families. • International collaboration, interaction and mobilization are enabled by using a virtual platform instead of traveling, thus strengthening the co-operation in European higher educational institutes.

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

Mindfulness Exercises Reduce Acute Physiologic Stress Among Female Clinicians.

Approximately 50% of clinicians experience excessive emotional, physical, and mental stress, with repercussions across the entire medical system. Mindfulness exercises may mitigate this excessive stress. Heart rate variability (HRV) is an objective stress measure that can quantify which mindfulness exercises provide the greatest stress reduction. To define the impact of specific mindfulness exercises on HRV, a surrogate for physiologic stress, and the relationship between physiologic (HRV) and subjective stress measured by the State-Trait Anxiety Inventory during a one-day mindfulness workshop. This was a prospective observational pilot study performed at a quaternary children's hospital with diverse subspecialists of pediatric nurses, nurse practitioners, and physicians. Our primary outcome measure was change in HRV from baseline during three mindfulness exercises. The grounding, deep breathing, and body scan exercises all produced statistically significant changes in HRV among our 13 female participants. The body scan exercise produced statistically significant changes in all studied HRV parameters compared with baseline. We observed significant increases in Root Mean Square of Successive Differences between normal heartbeats (p = 0.026), high frequency (p ≤ 0.001), and the parasympathetic nervous system index (p ≤ 0.001) reflecting increased parasympathetic tone (e.g., relaxation), whereas sd 2/sd 1 ratio (p ≤ 0.001) and the stress index (p = 0.004) were decreased reflecting sympathetic withdrawal (e.g., decreased stress). Subjective stress decreased after 1-day mindfulness training (44.6 to 27.2) (p < 0.001). Individuals with the largest decrease in subjective stress also had the most improvement in HRV during the body scan exercise. Clinician stress levels (HRV) improved after participating in grounding, deep breathing, and body scan meditations, which may highlight their importance as stress reduction tools for clinicians. Monitoring of HRV during mindfulness exercises may provide deeper understanding of which specific exercises produce the greatest physiologic stress reduction for individual participants and the trend of these changes over time.

Evaluation of the psychometric properties of the Turkish version of the Skin-to-Skin Contact Scale for nurses.

Skin-to-skin contact is the practice with the highest level of evidence that increases the growth, development, and healing rate of the newborn. Neonatal nurses are also the best practitioners of skin-to-skin contact. This study examined the psychometric properties of the Turkish version of the Skin-to-Skin Contact Scale for nurses. This descriptive, correlational, and cross-sectional study was carried out with 226 neonatal and pediatric nurses between July 2022 and July 2023. The data were collected using an online questionnaire, including a descriptive information form and a skin-to-skin contact scale for nurses. Data were analyzed by explanatory and confirmatory factor analysis, Cronbach's alpha, and item-total score analysis. It was determined that the scale consisted of 20 items and four sub-dimensions and that those four sub-dimensions explained 53.01% of the total variance. All factor loads were higher than 0.30 in the explanatory and confirmatory factor analyses. All the fit indices were higher than 0.80, and the Root Mean Square Error of Approximation (RMSEA) was less than 0.080 in the confirmatory factor analysis. Cronbach's alpha was determined to be 0.89 for the total scale and greater than 0.70 for all sub-dimensions. The Skin-to-Skin Contact Scale for nurses was determined to be a valid and reliable measurement tool for Turkish nurses. It is recommended that the scale be used regularly in clinics to determine nurses' attitudes towards skin-to-skin contact.

The effect of social support and parental monitoring on glycaemic control in adolescents with type 1 diabetes mellitus.

Glycaemic control is a crucial aspect of managing type 1 diabetes mellitus (T1DM). Strict glycaemic control has been proven to reduce the long-term complications of the disease. The aim of this study was to investigate the effect of parental involvement in diabetes care and social support on glycaemic control in adolescents with T1DM. In this cross-sectional study, 94 adolescents and their parents admitted to a university hospital between January and July 2023 were included in the study. The Multidimensional Scale of Perceived Social Support (PMDC-R) and Parental Monitoring Scale (MSPSS) in Diabetes Care of Adolescents with T1DM were used as data collection tools. Females constituted 63.8% of the adolescents who participated in the study and the glycaemic control of females was significantly lower than males (p < 0.05). The mean HbA1c of the adolescents was 8.65 + 1.57. In the study, PMDC-R and MSPSS scores of adolescents with good and poor glycaemic control were compared. The PMDC-R of the good control group were statistically significantly higher than the poor control group (p < 0.05), but there was no significant difference between the MSPSS scores. Parental supervision plays a protective role in adolescents, and glycaemic control is better as parental supervision increases. Paediatric nurses should collaborate with parents in diabetes management. This approach may help adolescents to be more successful in diabetes management.

Validity and reliability of the Endotracheal Suction Assessment Tool© in adult ICU patients: A methodological study

BackgroundNovice nurses often find endotracheal suctioning signs unfamiliar. The Endotracheal Suction Assessment Tool© (ESAT©) aids pediatric nurses in suctioning but lacks an adult equivalent. A valid and reliable ESAT© for assessing intensive care unit patients’ suction needs across different populations is necessary. AimTo test the validity and reliability of the ESAT© in adult ICU patients. MethodsThis methodological study assessed suction needs in patients at a tertiary adult ICU of a university hospital. Two independent observers used the ESAT© to determine suction needs. Data from 106 suction procedures were collected using a patient characteristics form, the ESAT©, and a suction monitoring form. The ESAT© includes eight respiratory and ventilation parameters and seven clinical consideration parameters. Hemodynamic and respiratory parameters were measured before, and one and five minutes after suction. Linguistic validity, content validity, and pilot testing were conducted. Interobserver agreement was evaluated, and psychometric evaluation was done using content validity index (CVI) and intraclass correlation coefficient (ICC). Data were analyzed with paired samples t-test and ANOVA. ResultsItem CVI ranged from 0.80 to 1.00, and scale CVI was 0.96. Inter-item correlation and ICC for inter-rater reliability were both 0.933 (95 % CI = 0.903–0.954, p < 0.001 for ICC). Cohen’s Kappa coefficients ranged from 0.690 to 1.000 (p < 0.001), indicating high consistency between raters for all tool items. All scale items showed near-perfect agreement except SpO2, which showed substantial agreement. ConclusionThe S-CVI was good, indicating near-perfect agreement among raters. ESAT© is highly reliable and valid for determining suction needs in adult intensive care patients. Implications for PracticeThe ESAT© aids autonomous decision-making for suctioning needs. Originally for novice pediatric nurses, the ESAT© was adapted for adult intensive care nurses. The ESAT© is valid and reliable for adult intensive care patients.

Paediatric Emergency Nurses' Perception of Medication Errors: A Qualitative Study.

To explore paediatric emergency nurses' perceptions of medication administration errors. A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant's consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan. The participants' discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered.