Pediatric Nurses Research Articles

Psychometric evaluation of the Chinese version of the febrile convulsion knowledge scale for parents/caregivers: translation and validation study

BackgroundFever is one of the most common clinical symptoms of respiratory diseases in children. Once the child has a fever, parents and caregivers are mainly concerned that the child may have a febrile convulsion. A lack of cognitive ability not only leads to anxiety but also aggravates or delays the time of children’s medical treatment and even seriously affects the prognosis because of improper management of fever patients.Therefore, it is necessary to clarify the degree of mastery of knowledge related to febrile convulsions, implement targeted guidance and health education, and ensure that parents and caregivers receive correct and reasonable first aid treatment. The purpose of this study was to translate the Febrile Convulsion Knowledge Scale for Parents/Caregivers into Chinese and to verify its reliability and validity for Chinese parents and caregivers of children.MethodsThe Brislin traditional translation model was used to translate the Febrile Convulsion Knowledge Scale for Parents/Caregivers from English to Chinese, following authorization from the original author of the scale. This involved literal translation, back translation, and cultural adaptation. A convenience sampling method was used to select 402 parents and caregivers of children in the pediatric ward and pediatric infusion clinic of a Grade III hospital in Liaoning Province. The item analysis method was employed to assess item differentiation, while the Delphi method was used to analyze content validity. Scale reliability was evaluated through the calculation of internal consistency and test-retest reliability. Exploratory and confirmatory factor analyses were conducted to explore and verify the underlying factor structure and scale validity.ResultsThe Chinese version of the Febrile Convulsion Knowledge Scale for Parents/Caregivers consists of 3 dimensions and 8 items. The Cronbach’s alpha coefficient was 0.828, with each dimension having coefficients of 0.806, 0.720, and 0.702. The split-half reliability and test-retest reliability were 0.716 and 0.790, respectively. The Chinese version has good reliability. Exploratory factor analysis revealed that the Bartlett sphericity test was 394.52 (p < 0.001) and that the KMO value was 0.802 > 0.600, indicating suitability for factor analysis. Principal component analysis and orthogonal rotation of maximum variance were performed on the data, and items with a load greater than 0.40 within a single factor were selected for inclusion. The resulting three-factor structure explained 70.78% of the total variance. All model fitting indices were within the acceptable range, indicating the good structural validity of the Chinese version. The results of both exploratory and confirmatory factor analyses support this conclusion.ConclusionsThe Chinese version of the Febrile Convulsion Knowledge Scale for Parents/Caregivers has good reliability and validity. It can be used as a tool for clinical pediatric nurses to evaluate the knowledge of parents and caregivers of children with febrile convulsion and provide the basis for the design and implementation of targeted training plans according to the results obtained from the Chinese scale.

Effect of Feeding Methods on Respiratory Efforts in Neonate with Congenital Heart Defect

Background: Congenital heart disease (CHD) encompasses heart or blood vessel abnormalities arising during fetal development, affecting around 9 per 1,000 live births annually, totaling approximately 1.35 million infants. CHD is clinically classified as either cyanotic or acyanotic and often coincides with malnutrition and failure to thrive. Infants with CHD are at an increased risk of developing oropharyngeal dysphagia, characterized by difficulties in swallowing. Pediatric nurses play a crucial role in monitoring CHD, including respiratory rates and overall health, with particular attention to assessing nasal flaring for signs of respiratory distress as chest retractions and cyanosis. Objectives: Study aims to Assess variations in respiratory rate across different feeding methods and their impact on neonates with CHD at various time intervals. Methodology: A prospective observational study was carried out at the neonatal unit of Karbala Teaching Hospital for Children in Iraq. Fifty neonates, aged less than 28 days and diagnosed with CHD, were purposively recruited for the study. Inclusion criteria targeted neonates who were undergoing enteral feeding. Results: Analysis of records from 50 neonates revealed significant variations in respiratory rate across distinct feeding periods (p=0.027). and unveils noteworthy variations in nasal flaring throughout distinct feeding periods (p=0.001). And no significant differences in chest retraction across distinct feeding periods (p=1.000), no significant differences between breastfeeding, bottle-feeding and tube-feeding across time intervals of neonates feeding. Conclusions: Respiratory rate demonstrates significant variations across feeding periods. There are no significant differences in respiratory rates before-after feeding among breastfeeding, bottle-feeding, and tube-feeding.

Professional development in pediatric nursing: A study on the impact of educational module in legal and ethical care

The increasing complexity of legal and ethical issues in pediatric healthcare necessitates enhanced competencies among nurses. This study investigates the impact of a teaching module on the legal and ethical knowledge and practices of nurses in a pediatric tertiary care centre in South India. : A quasi-experimental, one-group pre-test and post-test design were employed over a four-week period. The participants included 60 registered nurses who were not involved in operation theaters, outpatient departments, or night shifts. A validated semi-structured questionnaire assessed the nurses' knowledge and practices before and after the intervention. The teaching module consisted of a 45-minute session that combined lecture discussions, PowerPoint presentations, and handouts. Results showed significant improvements in knowledge and practice post-intervention, with average knowledge scores increasing by 32.88% and practice scores by 41.00%. Additionally, demographic factors such as age and working experience positively correlated with knowledge and practice gains. This study underlines the effectiveness of teaching modules in closing the gap in legal and ethical training among pediatric nurses, suggesting that such educational initiatives could substantially enhance patient care and reduce legal risks.

Implementing a Pediatric Escape Room Simulation to Improve Student Learning.

Escape room simulations are an innovative teaching methodology that may be useful in addressing pediatric-specific content and clinical placement limitations of generalist nursing programs. This project studied if a pediatric escape room simulation improved students' knowledge and confidence in pediatric nursing to support the development of the pediatric nursing workforce. A pediatric escape room simulation was developed for a large Midwestern university's prelicensure nursing program. Students completed surveys to assess knowledge and confidence in pediatric nursing. Simulation quality was assessed using the Simulation Learning Effectiveness Inventory. Students' (N=37) knowledge and confidence in pediatric nursing concepts significantly increased after the simulation. Students responded positively to the simulation and recommended it be included in the undergraduate curriculum. The pediatric escape room simulation offers a promising alternative for students to gain pediatric-specific knowledge and confidence for prelicensure nursing programs in the context of limited pediatric clinical placements.

Our New Normal: Pediatric Nurse Residents' Experiences with Transition to Practice during the COVID-19 Pandemic.

This phenomenological qualitative study examined the lived experience of pediatric nurse residents' transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I'm Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents' narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic.

Knowledge, Attitudes, and Practices regarding Pain Assessment among Nurses Working at Public-Sector Pediatric Oncology Units in Pakistan

Abstract Introduction Pain in pediatric oncology patients is often undertreated due to a lack of timely assessment and inefficient communication between health care workers. Improper pain assessment is a leading cause of poorly managed pain in children. In high-income countries, pediatric oncology nurses play a key role in developmentally appropriate pain assessment measures to identify potential management strategies. However, nurses in low- and middle-income countries (LMICs) face a deficit of knowledge about pain assessment tools and management. Owing to differences in availability of resources, a disparity exists between health-related quality of life of cancer patients treated at public- and private-sector hospitals in Pakistan. Methodology The Indus Hospital and Health Network partnered with nine public-sector hospitals nationwide to improve pediatric oncology practices. Supported by the My Child Matters grant, training sessions were conducted for nurses at each public-sector pediatric oncology unit (POU) from March to December 2021. Pain assessment tools were provided. To assess retention and implementation of practices, a knowledge, attitudes, and practices questionnaire was distributed online to nurses at each POU. All responses remained anonymous. Results Fifty-four responses were recorded, 85% were female and most were between 26 and 30 years of age. Most of the participants held a diploma in nursing and were designated charge nurses with more than 6 years of experience. Forty nurses reported routinely assessing pain; the most common reason for not doing so was increased workload. Correlations were observed between routinely performing pain assessment and the number of patients per nurse, availability of formal credentialing or certifications at the institution and routinely performing pain assessment, availability of trainings focused on pain assessment and routinely performing pain assessment, and qualification of nurses and knowledge of nonpharmacological pain assessment methods. Conclusion Strategies to improve pain assessment knowledge and practices among pediatric oncology nurses in LMICs must be developed to improve patient care and clinical outcomes.

The Impact of Family-Centered Care Training: Developed Pediatric Nurses' Attitudes towards Child Care in Turkey

The Impact of Family-Centered Care Training: Developed Pediatric Nurses' Attitudes towards Child Care in Turkey

The Need for Qualitative Research in Pediatric Nursing

The Need for Qualitative Research in Pediatric Nursing

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.

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

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

Art or Artifact: Evaluating the Accuracy, Appeal, and Educational Value of AI-Generated Imagery in DALL·E 3 for Illustrating Congenital Heart Diseases.

Artificial Intelligence (AI), particularly AI-Generated Imagery, has the potential to impact medical and patient education. This research explores the use of AI-generated imagery, from text-to-images, in medical education, focusing on congenital heart diseases (CHD). Utilizing ChatGPT's DALL·E 3, the research aims to assess the accuracy and educational value of AI-created images for 20 common CHDs. In this study, we utilized DALL·E 3 to generate a comprehensive set of 110 images, comprising ten images depicting the normal human heart and five images for each of the 20 common CHDs. The generated images were evaluated by a diverse group of 33 healthcare professionals. This cohort included cardiology experts, pediatricians, non-pediatric faculty members, trainees (medical students, interns, pediatric residents), and pediatric nurses. Utilizing a structured framework, these professionals assessed each image for anatomical accuracy, the usefulness of in-picture text, its appeal to medical professionals, and the image's potential applicability in medical presentations. Each item was assessed on a Likert scale of three. The assessments produced a total of 3630 images' assessments. Most AI-generated cardiac images were rated poorly as follows: 80.8% of images were rated as anatomically incorrect or fabricated, 85.2% rated to have incorrect text labels, 78.1% rated as not usable for medical education. The nurses and medical interns were found to have a more positive perception about the AI-generated cardiac images compared to the faculty members, pediatricians, and cardiology experts. Complex congenital anomalies were found to be significantly more predicted to anatomical fabrication compared to simple cardiac anomalies. There were significant challenges identified in image generation. Based on our findings, we recommend a vigilant approach towards the use of AI-generated imagery in medical education at present, underscoring the imperative for thorough validation and the importance of collaboration across disciplines. While we advise against its immediate integration until further validations are conducted, the study advocates for future AI-models to be fine-tuned with accurate medical data, enhancing their reliability and educational utility.

Specialist nurse's health promotion work with the national childhood immunization programme: A qualitative study.

Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent childhood deaths due to disease. However, global coverage of childhood immunization has decreased throughout the world due to guardians' growing hesitancy towards immunizations. This study aims to describe how specialist nurses promote legal guardians to adhere to national childhood immunization programmes. This study had a qualitative design. Semistructured interviews with 11 specialist nurses, who were paediatric primary care nurses or nurse practitioners, were conducted. Data were analysed using qualitative content analysis. The findings, with four main categories including four subcategories, showed nurses using both local guidelines and national guidelines to promote guardians to adhere to the childhood immunization programme. The main intervention the nurses did to promote childhood immunization coverage was giving legal guardians general information about the programme. With hesitant guardians, adopting a person-centred approach towards the legal guardian improved adherence. Further research should focus on how specialist nurses can respond to guardians who decline immunization for their children, as this study identified difficulties in this area. Furthermore, research on guardians' perspectives towards childhood immunization may also help generate further effective guidance on how to promote immunization coverage among children.

Pain Management in Pediatric Patients: Evidence-Based Practices and Future Directions for Pediatric Surgical Nurses

This article provides an overview of managing pain in the pediatric population for the surgical nurse. Proper assessment of pediatric pain, newborn to age 18, is reviewed, including appropriate pain scales and self-report of pain. Pain management, including pharmacological and nonpharmacological approaches, is stated. Innovative practices such as virtual reality and educational tool kits for families are reviewed. Special considerations in the pediatric population, including undertreatment of pain in infants, preprocedural pain treatment, and postoperative pain, are included. The importance of educating, aligning expectations, and communicating among the healthcare team, patients, and families is discussed.

The Role of Pediatric Nurses During Preventable Adverse Event Disclosure: A Scoping Review.

Preventable adverse events (PAEs) occur across the healthcare spectrum; and, unfortunately, errors, adverse events, and PAEs are common in pediatric care. Historically, the role of disclosure of PAEs to patients and their families occurred between the dyad of physician and patient, with physicians assuming the responsibility of disclosure. In recent years, a trend toward a multidisciplinary team-based approach has emerged in some institutions, yet the role of pediatric nurses within the team disclosing a PAE is not fully understood. Given the unique relationship between pediatric nurses and their patients and their families, it is essential to understand does the literature tell us about the role of pediatric nurses during PAE disclosure? The Arksey and O'Malley scoping review method guided this study protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews framework guided reporting. The final sample included five articles for synthesis: none reported or described a specific role for pediatric nurses during PAE disclosure. There is a gap in the literature on the role of pediatric nurses during PAE disclosure. Two themes emerged from this review: the use of a team-based approach to disclosure, and the need to provide emotional support to the pediatric patient and their family. There is a need for additional investigation into the role of pediatric nurses as part of a team-based disclosure process and how pediatric nurses currently provide, or desire to provide, emotional support to the patient and their family.

Coping strategies and interventions to alleviate moral distress among pediatric ICU nurses: A scoping review.

Moral distress significantly affects pediatric ICU nurses, leading to nurse burnout, increased turnover and reducing patient care quality. Despite its importance, there's a notable gap in knowledge on how to manage it effectively. This review aimed to systematically identify and analyze coping strategies and interventions targeting moral distress among pediatric nurses in ICU, uncovering research gap and future studies directions. A scoping review was conducted followed framework by Levac, Colquhoun, and O'Brien and Arksey and O'Malley. Searches were performed in 11 electrical databases, like PubMed and China Biology Medicine disc, within a timeframe of the database construction to November 2023, and performed literature screening and data extraction. Sixteen articles were ultimately included. Coping strategies adopted by pediatric ICUs nurses can be categorized into adaptive and maladaptive strategies, with the latter including passive acceptance, taking leave, and drinking, while the former involve pursuing interests outside of work, reflection and philosophizing, and communication. Nine articles described and evaluated the effectiveness of interventions for moral distress, categorizing them into individual and institutional levels. Individual-level interventions include Interprofessional Perspective-Taking, the PICU Resiliency Bundle, Ethics Education/Skills, and the Center for Caring. Institutional-level interventions encompasses Comprehensive Care Round, Goals of Care Conversations, Pediatric Ethics and Communication Excellence Rounds, Nursing Ethics Council, and Medical Ethical Decision-Making, though not all were effective in alleviating moral distress. Nurses often use self-adjustment strategies for moral distress, institutional ethical support focusing on enhancing nurses' moral resilience, promoting reflective thinking and improving communication remains crucial. Various interventions for moral distress are currently available, but nurse engagement is low and their effectiveness remained to be verified. Future studies should explore what aids or hinders these interventions. There's also a need for large, multicenter trials and ongoing evaluations to create effective support systems for pediatric ICU nurses.

Advanced Practice Pediatric Oncology Nursing as Imagined or In Place in Four Lower- and Upper-Middle-Income Countries

The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered. Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized. Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture. The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation. The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations.

COMPLIANCE WITH STANDARD PRECAUTIONS AMONG PEDIATRIC NURSES IN SELECTED GOVERNMENT HOSPITALS: A CROSS-SECTIONAL STUDY

Background: Healthcare-associated infections (HAIs) are complex conditions that appear in any healthcare facility. They truly become an economic and financial burden for the family and healthcare service system, particularly in developing countries. Nurses directly provide care for patients because they can be the cause of the spread of HAIs in healthcare institutions. Thus, nurses’ compliance with standard precautions plays a critical role in HAIs prevention efforts, especially in caring for children. Objectives: to examine compliance with standard precautions among pediatric nurses and related factors. Materials and methods: A cross-sectional descriptive correlational design was used. Sample size comprised of 285 pediatric nurses at selected government hospitals who have at least 6 months of experience as a nursing professional. Nurse’s adherence to standard precautions in caring was examined by using a 4-likert questionnaire including 20 items divided into 4 subscales as use of protective devices, disposal of sharps and waste, decontamination of spills and used articles, and prevention of cross-infection. Results: The age mean of nursing participants was 31.2 years. The overall compliance score was 3.16 (SD = 0.47) with 83.2% of nurses having good compliance with standard precautions. Among subscales of compliance, nurses’ practices with decontamination of spills and used articles had the highest scores. In contrast, the use of protective devices was the lowest. Besides, the study results showed a statistically significant relationship between nurses’ attitudes regarding HAIs prevention and their compliance with standard precautions (p&lt;0.001). Meanwhile, there was no association between gender, level of education, experience in the year and standard precautions compliance. Conclusions: infection control practices with standard precautions among pediatric nurses were good. However, there were some aspects that should be improved. More related continuous training programs for nurses should be developed. Additionally, hospital administration and nurse managers should establish a system to regularly monitor and sustain compliance with infection control procedures among staff nurses as well as evaluate the suitability of HAIs prevention guidelines.

Seroprevalence of Measles (Rubeola) Antibodies in Childhood Cancer Survivors.

Background: Measles is reemerging as a public health threat, raising important questions about disease vulnerability among childhood cancer survivors. This secondary analysis assessed the seroprevalence of anti-measles immunoglobulin G (IgG) antibodies as a marker of immune status in survivors of childhood cancer and associated demographic/treatment variables. Method: Participants were childhood cancer survivors who were free of active disease, having routine blood studies drawn, and could provide documentation of having received two doses of measles, mumps, and rubella vaccine before their cancer diagnosis. Patient record review documented demographic and treatment variables. Antimeasles (rubeola) IgG antibody seroprevalence was assessed by enzyme immunoassay for vaccine-specific antibodies. Results: Of 270 survivors evaluated, 110 (42%) were female, 196 (75%) were White, and 159 (61%) were leukemia/lymphoma survivors. Of these 262, 110 (42%) had negative measles seroprevalence, suggesting loss of immunity. Conclusion: Measles antibody surveillance and the need for reimmunization for survivors of childhood cancer survivors outside the transplant setting remains controversial. Our analysis indicates that a substantial proportion of survivors lose vaccine-related immunity to measles. Pediatric oncology nurses play important roles in educating cancer survivors regarding their risk of measles infection, evaluating the need for reimmunization, correcting misinformation about vaccine safety and effectiveness, and working to optimize community herd-based immunity.

Awareness of Pediatric Nurses Regarding Drug Preparation and Administration in Gaafer bin auf Children Hospital, Sudan

Background: This study aimed to assess the awareness of nurses who care for pediatric patients related with drug preparation and administration conducted in Gaffer Bin Auf children hospital. Methods: A cross-sectional study was conducted from November to December 2015, in Gaffer Bin Auf children hospital, largest pediatric hospital in Khartoum state. The total sample size was 92 participants. The self-administered questionnaire was constructed with a total of 26 questions. For data analysis, we performed nonprobability descriptive study design. Results: The results imply that Majority of respondents aged between 20-30 years (56.5%). Approximately half of the nurses held a bachelor’s degree (52.2%), while the remainder held a diploma (47.8%). A significant proportion of nurses (83.7%) reported no prior training in drug preparation and administration. Most nurses (46.7%) had 2-5 years of clinical experience, and 69.6% worked afternoon and night shifts. Regarding drug preparation and administration, varying levels of knowledge were observed among nurses. Notable percentages of nurses demonstrated awareness in areas such as double-checking during preparation (56.5%) and using distilled water or normal saline for non-contraindicated suspension drugs (56.5%), nurse answered can avoid a mistake during Preparation by prepare medication for one individual at a time with (90.2%), most of nurses have good level of knowledge regarding to drug preparation &amp; administration practice with (65.6%). bachelor's degrees are more likely to demonstrate proficient drug preparation and administration practices compared to those with diplomas, with a significant difference of 94% (p=0.047, AOR: 0.6, 95% CI: 0.03, 1.1). This research indicating that bachelor's degree nurse graduates generally exhibit better educational preparedness for quality and safety. Additionally, participants working morning shifts are 3.4 times more likely to exhibit good drug preparation and administration practices compared to those on night shifts (p=0.011, AOR: 3.4, 95% CI: 1.3, 8.1), and 4.6 times more likely compared to those on afternoon shifts (p=0.015, AOR: 4.6, 95% CI: 1.8, 9.2). Participants with good knowledge of drug preparation and administration practices are 2.614 times more likely to exhibit proficiency compared to those with poor knowledge (p&lt;0.001, AOR: 2.614, 95% CI: 1.78, 3.90). Conclusion: The study revealed significant insights into the demographic characteristics, educational backgrounds, and practices related to drug preparation and administration among nurses. Despite a substantial portion reporting no prior training, varying levels of knowledge were evident, with most nurses demonstrating awareness in key areas such as double-checking during preparation and using appropriate solutions for suspension drugs. While there are areas for improvement, the findings suggest a solid foundation of knowledge among nurses regarding medication safety, highlighting the importance of ongoing education and fostering a culture of continuous learning within healthcare ..............

Providing optimal care in the neonatal care units in India: How Covid-19 exacerbated existing barriers.

Nearly one quarter (600,000) of all neonatal deaths worldwide per year occur in India. To reduce neonatal mortality, the Indian Ministry of Health and Family Welfare established neonatal care units, including neonatal intensive care units and specialized neonatal care units to provide immediate care at birth, resuscitation for asphyxiation, postnatal care, follow up for high-risk newborns, immunization, and referral for additional or complex healthcare services. Despite these efforts, neonatal mortality remains high, and measures taken to reduce mortality have been severely challenged by multiple problems caused by the Covid-19 pandemic. In this qualitative study, we conducted seven focus group discussions with newborn care unit nurses and pediatric residents and 35 key informant interviews with pediatricians, residents, nurses, annual equipment maintenance contractors, equipment manufacturers, and Ministry personnel in the Vidarbha region of Maharashtra between December 2019 and November 2020. The goal of the study was to understand barriers and facilitators to providing optimal care to neonates, including the challenges imposed by the Covid-19 pandemic. Covid-19 exacerbated existing barriers to providing optimal care to neonates in these newborn care units. As a result of Covid-19, we found the units were even more short-staffed than usual, with trained pediatric nurses and essential equipment diverted from newborn care to attend to patients with Covid-19. Regular training of neonatal nursing staff was also disrupted due to Covid-19, leaving many staff without the skills to provide optimate care to neonates. Infection control was also exacerbated by Covid-19. This study highlights the barriers to providing optimal care for neonates were made even more challenging during Covid-19 because of the diversion of critically important neonatal equipment and staff trained to use that equipment to Covid-19 wards. The barriers at the individual, facility, and systems levels will remain challenging as the Covid-19 pandemic continues.