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

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

Evaluation of a dementia awareness game for undergraduate nursing students in Northern Ireland: a Pre-/Post-Test study.

INTRODUCTION: Although it is possible to live well with dementia and many individuals with dementia lead active lives with the help of family, friends, and communities, the general impression of dementia is frequently negative. Dementia is a global health issue. Despite this, little research has been done on the effects of innovative dementia education strategies among undergraduate nursing students. The aim of this study was therefore to assess if this serious digital game, originally intended for the public, could increase knowledge about dementia in first-year nursing students. METHODS: The intervention was a digital serious game called "The Dementia Game", which was available to students throughout February 2021, to a convenience sample of first-year undergraduate nursing students (n = 560) completing a BSc Honours Nursing Degree programme in one university in Northern Ireland. The game was evaluated using a pretest-posttest design. The questionnaire comprised of a 30- item true- false Alzheimer's Disease Knowledge Scale (ADKS), which covers risk factors, assessment and diagnosis, symptoms, course, life impact, caregiving and treatment and management. Data were analysed using paired t-tests and descriptive statistics. RESULTS: Overall dementia knowledge increased significantly after playing the game. Pre-test to post-test increases were observed across a range of seven categories of dementia knowledge (life impact, risk factors, symptoms, treatment, assessment, caregiving and trajectory), with particularly large increases in knowledge of trajectory and risk factors, as shown using paired t-tests. All pre-test to post-test comparisons were significant at the p < 0.001 level. CONCLUSIONS: A short serious digital game on dementia improved first-year student's knowledge about dementia. Undergraduate students also expressed that this approach to dementia education was effective in improving their knowledge about the disease.

Exploring the voices of children and children's nurses in hospital: implications for nursing practice.

Children should have a voice in relation to all aspects of healthcare as respected and credible service users, a belief endorsed by the United Nations Convention on the Rights of the Child. The children's nurse is the healthcare professional who delivers care most frequently to children in hospital and their families, so is in an optimal position to offer valuable insight into children's experiences of being in hospital. Therefore, it is important to listen to the voices of children and children's nurses in relation to this area. This article is informed by a narrative literature review and study, undertaken by the author as part of her doctoral thesis, which explored children's experiences of staying overnight in hospital from the perspective of children and children's nurses. In this article, the author summarises the main findings from the study and considers the implications for children's nursing practice based on her reflection on these findings.

An Exploration of the Child's Experience of Staying in Hospital from the Perspectives of Children and Children's Nurses using Child-Centered Methodology.

Globally the needs of children differ to those of adults; consequently, the "voice" of children in health care delivery is paramount to its effectiveness as a service. This qualitative study aims to present a contemporary "slice" of life in four children's wards in a typical United Kingdom children's hospital in the 21st century from the perspective of the service user (child) and significant service giver (Registered Children's Nurse). Phase one of the study involved the development of a child research advisory group (CRAG) with five local primary school children (aged 10-11 years) to assist in the co-production of research questions and data collection tool for child participants - two talking cartoon characters (Sprinkle Cupcake and Ronaldo Football) via an app/iPad. In phase two (main study), hospitalized children (n = 18) and Registered Children's Nurses (n = 8) were interviewed on one occasion within their ward setting using a semi-structured approach in July 2017. The emerging broad themes (using thematic analysis), were (1) children - the child's needs, relationships, fears, and concerns, alongside (2) nurses - children's nursing, job pressures, safe and effective care. Themes were then presented as tensions in that they represent the relationship between variables where the different elements in the relationship are held in tension, such that a change in one impacts upon the other. Similarities between the children and nurse participants include issues with the environment, lack of time to care (nurse), effects of nurse-led interventions, and valued role of play. Differences are largely around the role of the parent. The development and work of the CRAG and use of "tensions" to more effectively present the complexity of the findings are unique to this study. In conclusion, this study contributes to the development of a generalized knowledge base for policy, nursing education, and clinical practice by shedding light in how the complex hospital environment can be challenging for the child and children's nurse.

Understanding the Causes of Work-Related Stress among Registered Nurses Working with Children at Home: An Integrative Literature Review.

Work-related stress in nursing is widely acknowledged. This integrative review was undertaken to systematically identify and appraise the causes of work-related stress experienced by registered nurses working with children at home. Ten studies were included, eight of which focused solely on the experiences of nurses providing palliative and end of life care at home for children. One study focused on the experiences of newly qualified nurses and one on the experiences of nurses caring for sick children at home at different stages within their care trajectory. Stress was experienced by nurses caring for children at home and identified and acknowledged within all included studies. Recurrent themes reported in the literature that contributed to work-related stress were, provision of out of hours care, challenge of developing and maintaining skills (clinical and non-clinical), ambiguity of roles and relationships (professional team and child and family), lack of resources, emotional toll, and lack of staff support. The causes of work-related stress highlighted in this review need to be proactively addressed; thus, providing an opportunity to improve the working experiences of nurses improve job satisfaction and overall wellbeing. A recommendation from this integrative review is for workplaces to identify and invest in effective strategies to prevent or reduce work-related stress.

Using Technology to Seek the Vulnerable and Marginalized Child's Voice in Hospital: Co-working with a 'Child Research Advisory Group' (CRAG).

This paper illustrates the development, value and outcome of co-working with a 'child research advisory group' (CRAG) within healthcare research. The UK qualitative study completed as part of a Doctorate in Education (EdD) primarily explored the child's experience of hospital in Northern Ireland from the perspective of the child (and children's nurse). Essentially the role of the CRAG was to co-develop simple research questions and a data collection tool which was child centered, rather than adult centered - the research tool would be used with the main study child participants aged six to 12 years old in 2017. Five primary school children, with experience of hospital from year six and seven agreed to act as a CRAG in 2016. The outcome being an innovative data collection tool which is an App featuring the choice of two talking cartoon characters who asked the co-designed research questions via an iPad. The characters are Sprinkle Cupcake and Ronaldo Football.

Updating the UK competence framework for orthopaedic and trauma nurses 2019.

The updated RCN Competence Framework for orthopaedic and trauma practitioners was published in 2019 following completion of a 2 year project undertaken by a working group of representatives from England, Northern Ireland, Scotland and Wales. Expert musculoskeletal practitioners, including an allied health professional and working across the lifespan in varying domains of orthopaedic and trauma practice, collaborated to produce a working document applicable to trauma and orthopaedic (T&O) practitioners from all NHS (UK) pay bands. The 2019 document builds on the original and subsequent versions (2005 and 2012), importing new evidence and reformatting it so that it is contemporary and easily cross referenced with the NMC Code (2018). The restructure includes an example of a learning contract demonstrating how the framework can be applied in practice, whether for self-learning, or in conjunction with the revalidation process. This paper reflects on and describes the process undertaken by the working group in the development and restructuring of the 2019 framework, including its evaluation to date and planned in the future.

The History of Children's Nursing and Its Direction Within the United Kingdom.

This article presents an account of the "evolution of children's nursing." The pertinent topic was originally developed as part of a Doctorate in Education (EdD) as it was anticipated an understanding of children's nursing would provide a more comprehensive context for a doctoral study that aims to explore the child's experience of staying in Northern Ireland's regional children's hospital from the perspectives of children and children's nurses using child-centered methodology. Northern Ireland, England, Scotland, and Wales are the 4 countries collectively known as the United Kingdom (UK). Hence the concept of "children's/pediatric nursing" was extracted and presented as a catalogue of significant events in their order of occurrence. The article also considers the future direction of children's nursing within the UK. Wider dissemination was thought pivotal to inform all registered nurses, inclusive of those caring for children in all healthcare settings.

A "Child's Rights Perspective": The "Right" of Children and Young People to Participate in Health Care Research.

As all human beings are consumers of health care provision across the life span and in receipt of care delivered by accountable health care professionals, all should have the right to be involved in shaping the future of their own health care. Rights-based participation, when applied successfully, has the potential to inform and influence the delivery of child health care, the child's experience of health care, plus children's nursing education (Coyne & Gallagher, 2011). The "right" of every child and young person to participate in research that relates to their own health care is also sustained by the author's lead position as a Senior Lecturer in Higher Education for pre-registration children's nursing in Northern Ireland and the appreciation of their voice when practicing as a registered children's nurse and ward sister. The report provides an insight into seminal work on human and child rights; the historical context of children in Western society, and the evolution of children's nursing amid the child's right to participate in shaping their own health care.

Informing pre-registration nurse education: a proposal outline on the value, methods and ethical considerations of involving children in doctoral research.

As pre-registration nurse education programmes evolve within the United Kingdom, it is imperative to involve patient/client groups within the research process, as the outcome may invoke a change in the care delivery of the registered nurse (RN). This paper focuses upon children and how children might hypothetically contribute to informing a generic nursing programme in their capacity as a rights holder and expert in their own lives. Even though their contribution and value has been debated around their capacity as research advisor, research participant and co researcher, this paper explores how the child's view of their experience of hospital and of the good nurse could be best captured. Research is a powerful vehicle that can enable their voice to equally inform UK nurse educators and policy makers so that the child's health care needs are effectively met in hospital by RN's who complete a generic programme.

The value and contribution of qualitative research to inform nurse education and policy in response to the child's experience of hospital.

The aim of this article is to consider the value of qualitative research to inform nurse education and policy for the hospitalized child and young person (CYP). The theoretical issues and tensions inherent in qualitative research with children and young people's nursing are presented in conjunction with a discussion and analysis of how the epistemological and ontological concepts underpin and guide research. It is then followed by an exploration of their influence on enabling nurses to understand the CYP's perspective, before finally leading to an analysis of the impact on the development of policy and research.

Assessing registered nurses' clinical skills in orthopaedics.

The aim of this article is to explore the views of registered nurses undertaking the new Objective Structured Clinical Examination (OSCE), incorporating an integrated preparatory skills workshop. The workshop and the OSCE were audited with particular regard to the student experience. This article describes the audit process and the results of three questionnaires: one carried out before the OSCE assessment, a second immediately after the workshop and a third four days after the assessment. The results provide an insight into the student experience.

Pain assessment tools for the child with severe learning disability.

This article aims to identify and critically review three pain assessment tools that have been recommended for use by the Royal College of Nursing (2009) in clinical practice for the child with severe learning disabilities. The tools are assessed and their application specifically to orthopaedic practice is discussed with a view to providing adequate pain relief for this group of children.

Learning to live with childhood cancer: a literature review of the parental perspective.

This article presents an analysis of literature on paternal and maternal development and resilience through the experience of having a child diagnosed, treated, and possibly die from cancer. The methods and analysis of findings from research conducted in this area are assessed, as are the data's relevance and implications for practice. The review required an in-depth search of relevant health-care databases using appropriate search terms. Findings were then culled and analysed based on the inclusion and exclusion criteria, and two papers were deemed appropriate for selection. Four contrasting themes emerged from each article. It was generally acknowledged that mothers and fathers enduring such an experience stated that changes occurred in their lives. The mothers felt a need to become tougher for their child and family, and the fathers recognized a need to focus quickly on what needed to be done to treat their child's illness. However, analytically the differences in each paper are vast. The research was conducted in Japan and the United States, where contrasting cultural and societal beliefs and influences are apparent, therefore inadvertently affecting the research findings. Furthermore, a gap in research in this area has been detected, and much more research specifically focused on this subject is required if the children's nurse is to provide evidence-based holistic care in this area on a continual basis.

Drug administration via nasogastric tube.

In 2005, the National Patient Safety Agency (NPSA) highlighted concerns about the management of nasogastric tubes following reports of unnecessary deaths because of misplaced feeding tubes in infants, children and adults. During 2006, I investigated the management of nasogastric tubes (NGTs) in children (Clarke and Richardson 2007a, 2007b). This systematic review divided primary papers into three principal themes: enteral feeding via the NGT; confirmation of NGT position and associated incidence of tube placement error; and hydration via the NGT for acute gastroenteritis in children. Findings of the review are summarised here in relation to using the nasogastric tube to administer medication to children with the aim of informing practice and improving safety.

Children's nursing education: 'the future characterised by paradoxes'.

According to Healthcare Futures 2010 (Warner et al 1998) the future for the nursing and midwifery professions will be characterised by a series of paradoxes. There will be 'a growing emphasis on prevention, yet a great demand for cure and palliation; public reliance upon professionalism within the workforce, yet greater lay assertiveness; a greater demand for technical competence and scientific rationality among nurses and midwives, yet a continuing need for traditional nursing qualities and the time to express them' (Warner et al 1998). If these projections hold true there are significant implications for nursing and midwifery education. This article provides a summary of the development of nurse education and uses the three paradoxes identified to reflect on the past and the present and explore the future of children's nursing education.