Pain management in hospitalized children: unveiling barriers from the nursing perspective.

OBJECTIVE: To understand nursing team perceptions about the barriers in pain management in the care of hospitalized children. METHOD: Descriptive-exploratory study, with a qualitative approach, conducted with eight nurses and seven nursing technicians. Data were collected at the Universidade de São Paulo University Hospital, between June and September 2022, through individual interviews, analyzed from the perspective of thematic content analysis and in the light of Symbolic Interactionism. RESULTS: The following categories emerged: 1) Knowledge translation: is pain management actuallyperformed? and 2) Reflecting changes: how to achieve the potential of pain management? Professionals have theoretical knowledge about pain management, however, they listed numerous barriers at each stage, mainly related to institutional routine, and, when reflecting on this context, they indicated the need for an institutional protocol. FINAL CONSIDERATIONS: Barriers stand out from theoretical knowledge and make pain management for hospitalized children disregarded. Knowing this context is relevant forimplementing change strategies.

Discursive analysis of nursing care toward childhood fever and its contextual differences: An ethnomethodological study.

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children.

Opportunities to Diversify the Pediatric Nursing Workforce: A Focus on Male Nurses.

INTRODUCTION: Pediatric nursing has been a profession dominated by women, but patients benefit from representation of both men and women. We describe characteristics associated with male pediatric nurses and consider potential pathways to greater male pediatric nurse workforce participation. METHOD: We used data from the 2018 National Sample Survey of Registered Nurses, a nationally representative survey of nurses that estimates characteristics of the workforce. We present summary statistics to describe demographic, work setting and work environment characteristics of male and pediatric nurse workforces. Analyses accounted for complex survey design and weighting. RESULTS: Only 7% (N = 108,752) of the pediatric registered nurse workforce and 3% (N = 779) of the pediatric nurse practitioner workforces were male. Notable demographic and educational difference exist among compared workforces. DISCUSSION: Males are significantly underrepresented in pediatric nursing. Much effort and intention need to be directed towards increasing male representation in pediatric nursing.

Investigation of the impact of paediatric hospices on the quality of care of paediatric nurses.

BACKGROUND: The establishment of paediatric hospices improves the quality of care of paediatric nurses. AIM: To examine the effect of establishing paediatric hospices on the quality of care of paediatric nurses. METHODS: Data was collected between 22 October 2022 and 25 February 2023. An online survey method was used to collect sociodemographic data and paediatric hospice data for paediatric nurses and a scale was used to determine the opinions of nurses working in the field of paediatrics. A total of 300 paediatric nurses who voluntarily participated in the collection of the research data were selected with the convenience sampling method, with written consent. SPSS 26.0 data analysis programme was used in the statistical analysis of the data obtained in the study, and Independent Sample t-test and ANOVA analysis were used in the analysis of the data. FINDINGS: Of the participating paediatric nurses, 60.9% were women, 39.1% were men, 41.1% were married, 65.9% were between the ages of 22-33, and 71.6% worked at a paediatric hospice. There was no significant difference in paediatric hospice scale scores according to sociodemographic variables such as gender, age, marital status, education level and the health institution worked by paediatric nurses (p>.05). There was a significant difference in paediatric hospice scale scores according to hospice information. It was determined that the establishment of paediatric hospices had an effect on the quality of care (p<.01). CONCLUSION: Paediatric nurses felt that the establishment of paediatric hospices would improve the quality of care of children at the end of life. It is recommended that applications and studies on the establishment and structuring of paediatric hospices should be carried out by expanding the samples, not only in the field of paediatric nursing, but also in all nursing fields.

Essential elements nurses have to address to promote a safe discharge in paediatrics: A systematic review and narrative synthesis.

AIM: The aim of the study was to synthesize the evidence on the essential elements, nurses must address when they perform therapeutic education to patients and their caregivers to promote a safe paediatric hospital-to-home discharge. DESIGN: A systematic review and narrative synthesis. METHODS: The search strategy identifies studies published between 2016 and 2023. The quality of the included studies was assessed using the Critical Appraisal Skills Programme checklists. The protocol of this review was not registered. A search of three electronic databases (PubMed, CINAHL and Web of Science) and a search in the reference lists of the included studies was conducted in February 2021 and June 2023. RESULTS: Fifteen studies met the inclusion criteria. The essential elements identified are grouped into the following topics: emergency management, physiological needs, medical device and medications management, long-term management and short-term management. Nurses have a critical role in ensuring patient safety and quality of care, and the nurses' competence makes the difference in the discharge's related outcomes. Our results can help the nursing profession implement comprehensive discharge projects. Our results support the improvement of nurse-led paediatric discharge programmes. Nurse managers can identify the grey areas of therapeutic education provided in their units and work for their improvement. Following the implementation of therapeutic education on these topics, measuring the discharge's related outcomes could be interesting. This study addresses the problem of managing a safe and efficient nurse-led discharge in a paediatric setting. It presents evidence on the essential elements to promote a safe paediatric discharge at home. These could impact nursing practice by using them to implement project and discharge pathways. We have adhered to relevant EQUATOR guidelines-PRISMA guidelines for reporting systematic review. No patients, service users, caregivers or public members were involved in this study due to its nature (systematic review).

Nurse perceptions of caring for pediatric patients with behavioral health needs on non-psychiatric units during the COVID-19 pandemic.

PURPOSE: The study examined nurses' perceptions of barriers and needs when caring for pediatric patients with behavioral health needs in inpatient non-psychiatric units during the pandemic. DESIGN AND METHODS: A quantitative descriptive comparative design was used. Members of Society of Pediatric Nurses and National Pediatric Nurse Scientist Collaborative were recruited. The survey included questions about perceived barriers and needs in caring for children with behavioral health needs in their units. RESULTS: A total of 335 nurses across the United States participated. Descriptive statistics, chi-square, and Kruskal-Wallis evaluated responses. Nurses in Southeast/Southwest regions were less fearful when caring for pediatric patients with behavioral health needs (p = .03), more often knew what to do (p = .01), and were supported by a behavioral health team with regular rounding (p = .035). Nurses in adult/pediatric hospitals were less likely to have adequate education to feel competent (p = .012). Nurses in the emergency department were less fearful (p = .02), more confident (p = .025), and more competent (p = .006). Nurses with up to two years of experience were likelier to feel assignments reflected the patient workload (p = .001) and more familiar with trauma-informed care protocols (p = .013). CONCLUSIONS: This study illustrated significant variations in competence, readiness, and attitudes among nurses across different regions, hospital types, departments, and experience levels when caring for pediatric patients with behavioral health needs. PRACTICE IMPLICATIONS: Results from this study could lead to the development of clinical practice guidelines, protocols, or policies to guide practice.

Inpatient pediatric nursing staff experiences treating psychiatric patients: A mixed methods study.

PROBLEM: A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff. METHODS: A mixed-method research study was conducted among full- and part-time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale. Surveys were followed by semistructured interviews. FINDINGS: Of the 158 staff eligible, 47 (29.7%) participated in the quantitative portion. [Correction added on 29 September 2023, after the first online publication: In the preceding sentence, the participation rate was revised from 23.5% to 29.7% in this version.] Significant differences were found between roles, with nurses experiencing lower levels of compassion satisfaction and higher levels of burnout. Role differences were seen in supervisor support and nonwork support, with nurses reporting less support from both. Supervisor support showed a significant correlational relationship with compassion satisfaction and burnout. Nonwork support showed similar correlations with compassion satisfaction and burnout. Themes that emerged from the interviews were Barriers to Care, Emotional Impact, and "Help Me Help You." CONCLUSION: Nurses may be at greater risk for compassion fatigue due to perceived inadequate support from leadership, unclear role expectations, and lack of resources.

Manejo não farmacológico da enfermagem em pacientes pediátricos com febre e hipertermia: uma revisão sistemática / Non-pharmacological nursing management of pediatric patients with fever and hyperthermia: a systematic review / Manejo de enfermería no farmacológico del paciente pediátrico con fiebre e hipertermia: una revisión sistemática

Objetivo: descrever o manejo não farmacológico do enfermeiro frente ao paciente pediátrico com febre ou hipertermia. Método: a revisão seguiu o PRISMA, contou com estudos empíricos, que abordassem o manejo não farmacológico em crianças com febre, estudos entre 2013 e 2023. As bases de dados foram Adolec, BVS, Embase, LILACS, Web of Science e a biblioteca SciELO, com os descritores "criança", "hipertermia", "febre", "enfermagem" e "enfermagem pediátrica". Resultados: selecionado 7 estudos, descrevem que o manejo não farmacológico são massoterapia, compressas, água morna e sabonete com Marshmallow. O uso de antitérmico (paracetamol) e outra medida não farmacológico foi evidenciada como efetiva. Há lacuna de protocolos para guiar os profissionais para o atendimento da criança com febre, além dos profissionais se basearem em suas crenças na assistência. Conclusão: o uso não farmacológico foi eficaz em conjunto com antitérmico. Há necessidade de outros estudos e desenvolvimento de protocolos para guiar os profissionais na assistência.

Objective: to describe the nurse's non-pharmacological management of pediatric patients with fever or hyperthermia. Method: the review followed PRISMA and included empirical studies that addressed non-pharmacological management in children with fever, studies between 2013 and 2023. The databases were Adolec, BVS, Embase, LILACS, Web of Science and the SciELO library, with the descriptors "child", "hyperthermia", "fever", "nursing" and "pediatric nursing". Results: 7 studies were selected, describing non-pharmacological management as massage therapy, compresses, warm water, and soap with Marshmallow. The use of antipyretics (paracetamol) and other non-pharmacological measures were shown to be effective. There is a lack of protocols to guide professionals in caring for children with fever, in addition to professionals relying on their beliefs in care. Conclusion:non-pharmacological use was effective in conjunction with antipyretics. There is a need for further studies and development of protocols to guide professionals in helping.

Objetivos:describir el manejo no farmacológico de la enfermera del paciente pediátrico con fiebre o hipertermia. Método: la revisión siguió PRISMA, incluyó estudios empíricos que abordaron el manejo no farmacológico en niños con fiebre, estudios entre 2013 y 2023. Las bases de datos fueron Adolec, BVS, Embase, LILACS, Web of Science y la biblioteca SciELO, con los descriptores "niño", "hipertermia", "fiebre", "enfermería" y "enfermería pediátrica". Resultados: se seleccionaron 7 estudios que describen manejo no farmacológico como terapia con masajes, compresas, agua tibia y jabón con Marshmallow. Se demostró eficaz el uso de antipiréticos (paracetamol) y otras medidas no farmacológicas. Faltan protocolos que orienten a los profesionales en el cuidado de niños con fiebre, además de que los profesionales se basen en sus creencias sobre el cuidado. Conclusión: el uso no farmacológico fue efectivo en conjunto con antipiréticos. Es necesario realizar más estudios y desarrollar protocolos que orienten a los profesionales en la prestación de asistencia.

Families' situation of caring for a child with a chronic condition: a mixed methods study / Situación de las familias en el cuidado de un hijo con una enfermedad crónica: un estudio de métodos mixtos / Situação de cuidar de uma criança com condição crônica pelas famílias: estudo de métodos mistos

ABSTRACT Objective: To analyze the meanings attributed by family members to the situation of caring for a child with a chronic condition (CCC), in the light of the Family Management Style Framework (FMSF). Method: A mixed-methods, parallel-convergent study, guided by the FMSF theoretical framework, using the conceptual component "Definition of the Situation". Fifty-three CCC families took part. Data was collected using a semi-structured interview, a questionnaire to characterize the participants and a Family Management Measure scale. Descriptive and inferential statistical analysis was carried out on the quantitative data and the qualitative data was subjected to deductive thematic analysis. Results: Family members reported a view of normality in relation to CCC, also verified by the Child's Daily Life scale. However, they indicate the repercussions of the chronic condition on the family, and that they devote more attention and time to meeting the child's care needs, which was also verified in the View of the Impact of the Condition and Management Effort scales. Conclusion: Families have a positive view of the situation of caring for CCC at home, but point out some negative effects, such as the greater time spent caring for the child.

RESUMEN Objetivo: Analizar los significados atribuidos por los familiares a la situación de cuidado de un hijo con una condición crónica (CCC), a la luz del Marco de Estilos de Gestión Familiar (FMSF). Método: Estudio de métodos mixtos, paralelo-convergente, orientado por el marco teórico del FMSF, utilizando el componente conceptual "Definición de la Situación". Participaron 53 familias CCC. Los datos se recogieron mediante una entrevista semiestructurada, un cuestionario para caracterizar a los participantes y una escala de Medida de Gestión Familiar. Se analizaron estadísticas descriptivas e inferenciales para los datos cuantitativos y los datos cualitativos se sometieron a un análisis temático deductivo.. Resultados: Los familiares relataron una visión de normalidad en relación al CCC, verificada también por la escala de Vida Cotidiana del Niño. Sin embargo, señalan las repercusiones de la condición crónica en la familia, y que dedican más atención y tiempo a la atención de las necesidades de cuidado del niño, lo que también fue verificado en las escalas Visión del Impacto de la Condición y Esfuerzo de Gestión. Conclusión: Las familias tienen una visión positiva de la situación de cuidar de CCC en casa, pero señalan algunos efectos negativos, como el mayor tiempo dedicado al cuidado del niño.

RESUMO Objetivo: Analisar os significados atribuídos por familiares a situação de cuidar de uma criança com condição crônica (CCC), à luz do Family Management Style Framework (FMSF). Método: Pesquisa de métodos mistos, do tipo paralelo convergente, orientada pelo referencial teórico FMSF, utilizando o componente conceitual "Definição da Situação". Participaram 53 famílias de CCC. Os dados foram coletados por entrevista semiestruturada, questionário de caracterização dos participantes e escala de Medida de Manejo Familiar. Realizou-se análise estatística descritiva e inferencial dos dados quantitativos e os dados qualitativos foram submetidos à análise temática do tipo dedutiva. Resultados: Familiares referem uma visão de normalidade em relação à CCC, verificada também pela escala Vida Diária da Criança. Contudo, indicam as repercussões da condição crônica na família, e que dedicam maior atenção e tempo para atender às necessidades de cuidado da criança, também verificado nas escalas de Visão do Impacto da Condição e Esforço de Manejo. Conclusão: As famílias possuem uma visão positiva da situação de cuidar das CCC no domicílio, apontando, contudo, alguns efeitos negativos, como é o caso do maior tempo despendido na atenção à criança.

Investigation of the relationship between nursing students' knowledge level of paediatric emergency practices and paediatric comfort and worry.

AIM: This study aimed to examine the relationship between nursing students' knowledge level of paediatric emergency practices and their clinical comfort and worry status. METHODS: A cross-sectional correlational design was used. Data was collected using the "Personal Information Form," "Paediatric Nursing Student Clinical Comfort and Worry Assessment Tool," and "Paediatric Emergency Practices Information Questionnaire. RESULTS: The nursing students' knowledge level of paediatric emergency practices was good (14.76 ± 2.67/2-20). Their level of worry in paediatric services was above average (14.14 ± 4.8/5-25), while their paediatric clinical comfort level was at an average level (17.61 ± 3.72/10-30). It was found that as the nursing students' knowledge level of paediatric emergency practices increased, their comfort in paediatric clinics improved (r = 0.11, p = 0.003), and their worry levels decreased (r = -0.382, p < 0.001). Variables such as knowing the emergency number to call in case of poisoning and taking the child to a health facility after an electric shock contributed to the students' clinical comfort and worry (p < 0.005). CONCLUSION: The students' worry levels in paediatric clinics were above average, while their paediatric clinical comfort levels were average. As students' knowledge of paediatric emergency practices increased, they felt more comfortable in the clinical setting and had lower worry levels. IMPLICATION OF PRACTICE: Providing nursing students with theoretical and practical training centred on paediatric emergency situations before their clinical rotations are believed to enhance their comfort in paediatric clinics.

Escaping the Silos: Utilization of a Pediatric Trauma Escape Room to Promote Interprofessional Education and Collaboration.

BACKGROUND: Millions of children are treated annually for trauma-related injuries but comprise a smaller proportion of emergency department visits than adults. As a result, emergency department teams may not have the knowledge, skills, and confidence to care for pediatric patients, and specialty teams may not interact enough as an interprofessional team to provide high-quality patient care. OBJECTIVE: The purpose of this project is to describe a novel interprofessional simulation-based education initiative to assist pediatric trauma team readiness. METHODS: An escape room was designed to provide an interactive educational environment focused on pediatric trauma education. Using an interprofessional dyad of a trauma nursing specialist and a pediatric nursing expert, the escape room was designed as a series of clues to improve pediatric skills and interprofessional collaboration between specialty teams. The escape room training was conducted (from February to March, 2023) in a large Southeastern U.S. Level II adult trauma center. RESULTS: Twenty-one registered nurses from different specialty teams participated in the simulation exercises with overwhelmingly positive feedback. Colleagues reported this was a unique way to deliver education that resulted in innovative team building and enriched collegiality between the specialty teams. CONCLUSIONS: The escape room educational format was positively received, and future events are planned across disciplines and various topics. Trauma centers with lower pediatric volumes seeking to provide engaging team-based education may use this format as a unique and innovative way to develop teams for clinical success.

The effectiveness of using interactive multimodality books in pediatric nursing in implementing Merdeka Belajar program.

OBJECTIVES: to analyzing the Effectiveness of Using Interactive Multimodality Books in Pediatric Nursing on Student Learning Outcomes in Implementing the Merdeka Belajar Program. METHODS: the research design used a quasi-experimental approach with a posttest control group design. The sample in this study was the fourth-semester nursing students of Institute of Health Science Suaka Insan Banjarmasin who received the Pediatric Nursing course, a total of 52 students. The sampling technique used is total sampling. Data analysis used the dependent t-test. RESULTS: the interactive multimodality pediatric nursing book was effective in improving the learning achievement of fourth-semester students with a significance value of 0.015 < 0.05. There is a difference in the average value of pediatric nursing courses for class A and class B, which is 3.173. CONCLUSIONS: the use of interactive multimodality books is very good for lecturers to apply in teaching to help students understand the material they are learning.

National collaborative maximizes pediatric hospital-based nurse scientist impact and resources through strategic networking.

This paper describes how a national collaborative of pediatric nurse scientists has leveraged the expertise of their membership and strategic networking to guide the development of the evolving hospital-based nurse scientist role and influence centers of nursing research. Members' narratives illustrate how their networking across the collaborative has resulted in increased clarity and understanding of the hospital-based nurse scientist role, consistency in job responsibilities and expectations, title changes that more accurately reflect the nature of the role, establishment or expansion of centers of nursing research, success in talent recruitment, diversification of center team members, reporting structure alterations, and dedicated nursing research funding mechanisms. These tangible outcomes enable pediatric nurse scientists to become more effective in their roles and transform the care of pediatric patients and their families.