Partner and professional support are associated with father-infant bonding: A cross-sectional analysis of mothers, midwives, and child health nurses' influence on primiparous and multiparous fathers of infants in Sweden.

OBJECTIVE: To assess if received professional and social support are associated with father-infant bonding among primiparous (first-time) and multiparous (multi-time) fathers. BACKGROUND: Early father-infant bonding predicts several positive child outcomes. However, while received professional and social support positively impacts fathers' transition into parenthood, little research has tested if these factors are associated with a stronger father-infant bond. METHODS: In total, 499 fathers (296 primiparous and 203 multiparous) of infants (aged 0-12 months) completed a cross-sectional online survey between November 2018 and March 2020. The survey included items related to socio-demographics, having a planned pregnancy, postnatal midwifery support, child health nurse support, child health center attendance, and social support. The parent-infant bonding questionnaire (PBQ) was used to assess the father-infant bond. Multiple linear regression models were estimated for the total sample and based on paternal parity. Missing data were managed through multiple imputation procedures. FINDINGS: Fathers reported fewer bonding disturbances if they received support from their partners, postnatal midwives, child health nurses, and attended more child health visits. Primiparous fathers reported fewer bonding disturbances when receiving support from their partners, postnatal midwives, and the child health nurse. However, multiparous fathers had more bonding disturbances than primiparous fathers and received less professional and partner support. CONCLUSIONS: Receiving more partner and professional support is associated with less father-infant bonding disturbances. To encourage a better father-infant bond, clinicians should invite and support all fathers, regardless of parity, as they transition to parenthood.

Impact of an Educational Program on Nurses' Performance in Providing Peripherally Inserted Central Catheter Care for Neonates.

All nurses who care for neonates with peripherally inserted central catheters require enhanced awareness of the current practice guidelines and standards. This study evaluated the impact of an educational program on nurses' performance from May 2016 to July 2017 at 4 hospitals in Tehran, Iran. The performance of 80 nurses was observed and scored 3 times before the intervention. Four weeks after the last training session, their performance was observed with the same researcher, and the checklist was completed 3 times in different working shifts. Four 35- to 45-minute training sessions were completed with a 4-week follow-up. Results of the study indicated that training courses should be held every 6 months, including permanent or periodic feedback.

Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital.

BACKGROUND: Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years. AIM: The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses. METHOD: The study was conducted at Izmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used. RESULTS: The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent. CONCLUSION: Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

Paediatric nurses' general self-efficacy, perceived organizational support and perceived professional benefits from Class A tertiary hospitals in Jilin province of China: the mediating effect of nursing practice environment.

BACKGROUND: General self-efficacy is considered one of the most influential parameters affecting the quality of clinical practice and nurses' perceived professional benefits (NPPB). Perceived organizational support (POS) is regarded as being central in understanding job-related attitudes, and it is important to enhance POS for nurses to maintain their current employment. NPPB can further reduce nurses' job burnout and turn-over intention. Many studies have explored the relationships among general self-efficacy, POS, nursing practice environment (NPE) and NPPB. However, a moderating effect of NPE has not been fully explored in nurses, especially among paediatric nurses. METHODS: A descriptive cross-sectional study was conducted from July to October 2018 with 300 paediatric nurses from 3 Class A tertiary hospitals in Jilin Province. The respondents completed the General Self-Efficacy Scale, Perceived Organizational Support Scale, Practice Environment Scale and Nurses' Perceived Professional Benefits Scale. The data were analyzed using path analysis and SPSS (version 23.0, IBM). RESULTS: General self-efficacy and POS were significantly positively associated with NPPB, which showed that the model had a good fit to the data. NPE was found to play a partial mediating role between POS and NPPB and also had a complete mediating role between general self-efficacy and NPPB. CONCLUSIONS: The results suggest that general self-efficacy indirectly influences NPPB, and POS directly and indirectly influences NPPB by NPE. Effective measures should be taken to improve nurses' practice environment in hospitals to raise nurses' enthusiasm and confidence in their work.

Experience of nurses who work with children with palliative care needs: A mixed-method systematic review.

OBJECTIVE: The importance of palliative care education for nurses has been recognized worldwide. The study aims to explore the experiences of nurses working with children with palliative care needs and to identify any related educational needs. METHODS: The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period 2000-2015. RESULTS: Finding revealed that working with children with palliative care needs is an emotionally struggling job for nurses, especially when they try to manage the transition of pediatric patients from curative to palliative care. Staffing level and time constraints comprise a major obstacle in pediatric palliative care. Focusing on invasive treatment and technology in spite of the feelings that it will not improve patients' health status intensifies the feeling of guilt and helplessness for nurses. Finally, nurses asserted the importance of receiving pediatric palliative care education, especially how to communicate with children with palliative care needs and their families. SIGNIFICANCE OF RESULTS: Further research is recommended with regard to nurses' experience in communication with children with palliative care needs. Nursing education in pediatric palliative care is significantly important, especially how to communicate with children with palliative care needs and their families.

Measuring Burnout in Pediatric Oncology Staff: Should We Be Using the Maslach Burnout Inventory?

Burnout in health service staff is a cause for concern since it has negative consequences for the individual affected, the wider organization, and patients. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) has been widely used to assess the prevalence of burnout within oncology services. The MBI-HSS is a self-report measure comprising three subscales-Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). This article reports on the first study to investigate the psychometric properties of the MBI-HSS when administered to pediatric oncology staff. Two hundred and three pediatric oncology staff recruited through seven UK Principal Treatment Centers (PTCs) and a children's cancer charity completed the MBI-HSS. The factor structure of the instrument was tested using confirmatory and exploratory factor analysis, with Rasch analysis applied to assess whether the measure meets the requirements of an interval-level scale. Cronbach alpha was used to assess internal reliability. Factor analysis did not support the traditional three-factor structure of the MBI-HSS but instead suggested seven factors. Rasch analysis and alpha coefficients indicated that while the EE and the PA subscales fulfilled the requirements of an interval-level measure for group-level diagnosis, DP did not. Further investigation revealed a "floor effect" on many DP items. Whereas the EE and PA subscales of the MBI-HSS can be used in research with pediatric oncology staff working in PTCs, there are considerable problems with the DP subscale, and researchers should be cautious in interpreting data from this subscale.

Psychometric Evaluation of a Tool for Assessment of Clinical Development in Newly Licensed Registered Nurses.

BACKGROUND AND PURPOSE: For effective evaluation of clinical development, established psychometric properties of reliability and validity are essential. The Clinical Development Assessment (CDA) tool was developed within a 12-month pediatric nurse residency program. Benner's novice-to-expert model framed the development of the CDA. METHODS: Data from 129 nurse residents and their preceptors were used to evaluate internal consistency reliability and face, content, and construct validity. Nine elements were assigned a six-point Likert scale scored as (a) unsafe, (b) novice, (c) advanced beginner, (d) competent, (e) proficient, and (f) expert. RESULTS: Moderately strong reliability was found. Using exploratory factor analysis, a single factor accounted for 68% of the variance in clinical development. Face and content validity were confirmed. CONCLUSIONS: This study identified a brief, valid, and reliable tool to evaluate clinical development in newly licensed registered nurses.

Perception, attitude, and satisfaction of paediatric physicians and nurses towards clinical practice guidelines at a university teaching hospital.

RATIONALE, AIMS, AND OBJECTIVES: To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG). METHODS: A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department. RESULTS: The response rate was 95.4%. The respondents had a positive perception and attitude towards general CPGs and specifically for the DKA-CPG; 98.7% thought CPGs were useful sources of advice, improved safety, and decreased risk, and reduced variation in practice. A total of 99.2% thought CPGs were good clinical tools, 98.3% satisfied with, had confidence in well-developed CPGs, and would recommend them to their colleagues to use, and 94.6% agreed they were cost-effective. The preferred format for CPGs was paper (46.6%) and electronic (42.9%). The DKA-CPG helped in managing patients and respondents were all satisfied and had confidence with it (100%). The rationale and objectives of the DKA-CPG were clear for 99.25%; 98.5% thought the layout was clear and well organized and user-friendly (96.2%). Compared with nurses, physicians had a higher perception towards CPGs in general (P < .05) and the DKA-CPG (P < .05). CONCLUSIONS: The paediatric doctors, and nurses have a great perception and satisfaction and positive attitude towards CPGs in general, towards the paediatric diabetic ketoacidosis CPG in particular, which in turn had a positive impact on the acceptability and implementation of the CPGs. These findings could help in sustaining a safe and high-quality health care environment through implementation of evidence-based CPGs.

Situación de la Pediatría de Atención Primaria en España en 2018 / Situation of the Primary Care Pediatrics in Spain in 2018

Introducción: la Asociación Española de Pediatría de Atención Primaria (AEPap) ha querido conocer el porcentaje de plazas de Pediatría de Atención Primaria (PAP) del sector público ocupadas por médicos no especialistas en Pediatría y sus Áreas Específicas (PAE), las condiciones laborales de las mismas y el número de profesionales que se encuentran próximos a la jubilación. Para ello, se ha realizado una encuesta entre los vocales de las asociaciones autonómicas que componen la asociación. Resultados: se han obtenido datos del 90% de las plazas de PAP. El porcentaje de plazas a nivel nacional no ocupadas por especialistas en PAE es del 25,1% (IC 95: 24,1-26,4%), habiendo mucha variabilidad entre comunidades autónomas y provincias, que va del 48,97% en las Islas Baleares al 0% en La Rioja. En relación con la edad de los profesionales, con datos obtenidos del 47,0% de las plazas, la cuarta parte tiene más de 60 años y un 40% supera los 55. En cuanto a los horarios de atención, con datos recogidos del 72,1% de las plazas, un 42,2% de los pediatras de AP trabajan exclusivamente de mañanas, un 29,9% cuatro mañanas y una tarde semanal y un 27,8% un mayor porcentaje de tardes o tardes exclusivas. Conclusiones: existe un déficit de pediatras de AP y una previsión de que este déficit aumente. Las autoridades sanitarias tienen que hacer un esfuerzo en la formación MIR y tienen que conseguir que las plazas de PAP sean más atractivas para los nuevos especialistas, favoreciendo la formación, investigación y disminuyendo el 30% de horarios de tarde exclusivas o predominantes

Introduction: the Spanish Association of Primary Care Pediatrics (AEPap) wants to know the percentage of primary care paediatrics (PAP) places in public health services occupied by non-specialists in Pediatrics and their Specific Areas (PSA), the working conditions of the same and the number of professionals who are next to retirement. For this, a survey has been carried out among the members of the autonomous associations that make up the association. Results: data of 90% of the PAP places have been obtained. The percentage of places at the national level not occupied by specialists in PSA is 25.1% (IC 95: 24,1 a 26,4%), there is a lot of variability among regions and provinces, ranging from 48.97% in the Balearic Islands to 0% in La Rioja. With data on the age obtained from 47% of the places, a quarter of the pediatricians are over 60 years old and 40% are more than 55. Regarding the hours of care, with data collected from 72,1% of the places, a 42,2% of the PAP works in the mornings, 29,9% in the morning and one evening per week and 27,8% in a higher percentage of evenings. Conclusions: there is a deficit of PAP and a forecast that this deficit will increase. The health authorities have to make an effort in the MIR training and they have to make PAP seats more attractive for new specialists, favoring training, research and decreasing 30% of exclusive or predominant evening schedules

From Patient to Provider: The Lived Experience of Pediatric Oncology Survivors Who Work as Pediatric Oncology Nurses.

There is little known about the experiences of former pediatric oncology patients that are currently working as pediatric oncology nurses. Literature reviews yielded no direct research studies involving this group of nurses. The purpose of this phenomenological study was to describe the experiences of these former oncology patients that are now oncology nurses. Eleven pediatric oncology nurses were interviewed for this study, and the following themes emerged: Awe and Awkwardness, Guilt and Gratitude, Sharing My Story, Wanting to Remember/Wanting to Forget, and Past Treatment/Current Challenges. The results of this study demonstrate the unique challenges these survivors face as they transition into their professional roles. Information about these nurses' experiences is important when considering their education and support throughout their careers.

Pediatric Nurses' Usage and Experience Toward Complementary Health Approaches.

OBJECTIVES: The usage of Complementary Health Approaches (CHA) and its popularity have been increasing among both children and pediatric nurses. The aims of this study were to (1) determine the knowledge and usage levels of pediatric nurses about CHA, (2) describe the experiences of nurses about CHA, and (3) evaluate the attitudes of nurses toward CHA. METHODS: This was multicenter study. A total of 1,450 pediatric nurses who are working at the pediatric departments of different hospitals in Turkey participated in the study between June 2013 and February 2014. Around 1,303 female and 147 male pediatric nurses, in total 1,450, were included in the study. The semi-structured questionnaire had three sections. The first section composed of 14 questions about sociodemographic characteristics. The second section contained seven questions about the nurses' professional practices with respect to CHA. The third section contained eight questions about the nurses' attitudes to CHA. RESULTS: The study revealed that 90.6% of the nurses used CHA, and primarily made use of praying (82.3%), massage (76.6%), and vitamins (60.2%), respectively. Most of the nurses used CHA for relaxation. Approximately half of the nurses did not asked the families of their CHA usage. More than half of the nurses (58.8%) stated that nurses were not responsible for informing patients about CHA. It was found that the nurses had negative experiences with CHA such as allergies, pain, and being upset. The most frequently indicated positive experience was "feeling better both physically and psychologically." CONCLUSIONS: It is extremely important that nurses have knowledge about CHA. Nurses should question parents' use of CHA and inform parents about CHA' benefits and potential risks. Considering the personal/professional experiences, it is necessary to evaluate the positive/negative effects of CHA. Research may contribute to increased awareness of the potentially important role of nurses in the delivery of CHA.

An Adaptation of the Original Fresno Test to Measure Evidence-Based Practice Competence in Pediatric Bedside Nurses.

PURPOSE: Instruments used to assess evidence-based practice (EBP) competence in nurses have been subjective, unreliable, or invalid. The Fresno test was identified as the only instrument to measure all the steps of EBP with supportive reliability and validity data. However, the items and psychometric properties of the original Fresno test are only relevant to measure EBP with medical residents. Therefore, the purpose of this paper is to describe the development of the adapted Fresno test for pediatric nurses, and provide preliminary validity and reliability data for its use with Bachelor of Science in Nursing-prepared pediatric bedside nurses. METHODS: General adaptations were made to the original instrument's case studies, item content, wording, and format to meet the needs of a pediatric nursing sample. The scoring rubric was also modified to complement changes made to the instrument. Content and face validity, and intrarater reliability of the adapted Fresno test were assessed during a mixed-methods pilot study conducted from October to December 2013 with 29 Bachelor of Science in Nursing-prepared pediatric nurses. RESULTS: Validity data provided evidence for good content and face validity. Intrarater reliability estimates were high. LINKING EVIDENCE TO ACTION: The adapted Fresno test presented here appears to be a valid and reliable assessment of EBP competence in Bachelor of Science in Nursing-prepared pediatric nurses. However, further testing of this instrument is warranted using a larger sample of pediatric nurses in diverse settings. This instrument can be a starting point for evaluating the impact of EBP competence on patient outcomes.

Percepção da equipe de enfermagem sobre a abordagem lúdica à criança hospitalizada / Percepción del equipo de enfermería sobre el enfoque lúdico al niño hospitalizado / Nursing staff perception of nursing on approach to child hospitalized lúdica

Objetivo: conhecer a percepção da equipe de enfermagem sobre a abordagem lúdica à criança hospitalizada. Metodologia: estudo qualitativo exploratório-descritivo, realizado na pediatria de um Hospital Escola do sul do Rio Grande do Sul, com oito profissionais da equipe de enfermagem. Para a coleta de dados, utilizou-se a entrevista semi-estruturada. As informações foram interpretadas por meio da análise temática de Minayo. Resultados: observou-se que a equipe de enfermagem não possui o preparo técnico-científico para utilizar a abordagem lúdica na prestação de assistência de enfermagem, visto que além de alguns desconhecerem o conceito e as técnicas aplicadas à ludoterapia, esse tema teve escasso ou nenhuma abordagem na formação acadêmica ou profissional dos entrevistados. Conclusão: faz-se necessário que tal modalidade seja inserida nos cursos de graduação e ainda que a instituições promovam o cuidado lúdico para que os profissionais possam utilizar deste instrumento do cuidado, melhorando assim a assistência prestada à criança hospitalizada

Objetivo: Conocer la percepción del equipo de enfermería sobre el enfoque lúdico para los niños hospitalizados. Metodología: estudio cualitativo exploratorio-descriptivo en pediatría en un hospital en el sur de Rio Grande do Sul. Escuela con ocho profesionales del equipo de enfermería. Para recopilar los datos, se utilizó la entrevista semiestructurada. La información fue interpretada a través de análisis temático de Minayo. Resultados: Se observó que el personal de enfermería no tiene la preparación técnica y científica para utilizar un enfoque lúdico en la prestación de cuidados de enfermería, así como algunos ignorantes del concepto y las técnicas aplicadas a la terapia de juego, este problema ha tenido poca o ninguna enfoque en la formación académica o profesional de los encuestados. Conclusión: es necesario que esta materia se integre en los cursos de grado y que las instituciones promuevan el cuidado lúdico que los profesionales pueden como una herramienta más del cuidado, con objeto de optimizar la atención a los niños hospitalizados

Objective: To know the perception of the nursing team about the playful approach to hospitalized children. Methodology: exploratory-descriptive qualitative study in Pediatrics in a hospital in southern Rio Grande do Sul School with eight nursing team professionals. To collect data, we used the semi-structured interview. The information was interpreted through thematic analysis of Minayo. Results: it was observed that the nursing staff does not have the technical and scientific preparation to use a playful approach in providing nursing care, as well as some ignorant of the concept and the techniques applied to the play therapy, this issue has had little or no approach in academic or vocational training of respondents. Conclusion: it is necessary that this mode is entered in undergraduate courses and that the institutions promote playful care that professionals can use this instrument care, there by improving the care provided to hospitalized children

A Cluster Randomised Controlled Trial of a Brief Child Health Nurse Intervention to Reduce Infant Secondhand Smoke Exposure.

Background Exposure to secondhand smoke (SHS) is a significant contributor to ill health in children. A study was undertaken to determine the effectiveness of two brief multi-strategic child health nurse delivered interventions in: decreasing the prevalence of infants exposed to SHS; decreasing the prevalence of smoking amongst parent/carers of infants and increasing the prevalence of household smoking bans. Methods This study was a 3 arm, cluster randomised controlled trial. Clusters were 39 community based well child health clinics in one local area health service. Clinics were stratified according to annual number of client appointments and then randomly assigned in a 1:1:1 ratio, (Intervention 1: Intervention 2: Control), with 13 clinics in each cluster. Parents/carers of infants in the intervention groups received a brief multi-strategic intervention from child health nurses during clinic consultations. Treatment condition 1 included computer delivered risk assessment and feedback and nurse brief advice. Treatment condition 2 included all elements of Treatment condition 1 with the addition of biochemical feedback of infant SHS exposure. Results When compared to the Control group at 12 months, no significant differences in the prevalence of infant exposure to SHS were detected from baseline to follow-up for Treatment condition 1 (OR 1.16, 95 % CI 0.73-1.85, p = 0.53) or Treatment condition 2 (OR 1.30, 95 % CI 0.88-1.92, p = 0.19) Similarly, no significant differences were detected in the proportion of parent/carers who reported that they were smokers (T1:OR 0.95, 95 % CI 0.78-1.15, p = 0.58 and T2:OR 0.97, 95 % CI 0.80-1.18, p = 0.77), or in the proportion of households reported to have a complete smoking ban (T1:OR 1.21, 95 % CI 0.89-1.64, p = 0.23 and T2:OR 1.06, 95 % CI 0.79-1.43, p = 0.68). Conclusions Further research is required to identify effective interventions that can be consistently provided by child health nurses if the potential of such settings to contribute to reductions in child SHS exposure is to be realised.

Communication During Palliative Care and End of Life: Perceptions of Experienced Pediatric Oncology Nurses.

BACKGROUND: Communication between patients, families, and healthcare providers is a central component of end-of-life care. Nurse communication during palliative care (PC) and end of life (EOL) is a phenomenon with limited research. It is unclear how the level of nursing experience influences the perspectives of nurses communicating during EOL. OBJECTIVE: The aim of this study is to describe the commonalities of experienced nurses' perceptions of communicating during PC and EOL and perceptions of barriers and facilitators to effective communication. METHODS: This study was part of a larger multisite study that used a qualitative, empirical phenomenology design and represents focus group data gathered from pediatric oncology nurses with more than 5 years of experience or who were advanced practice nurses not involved in the direct evaluation of other nurses. RESULTS: Five core themes with corresponding themes and subthemes were identified. The core themes included (a) Evolution of PC/EOL, (b) Skill of Knowing, (c) Expanded Essence of Caring, (d) Experienced Nurse as Committed Advocate, and (e) Valuing Individual Response to Grief. CONCLUSIONS: Findings reflect how the concept of experience transcended the 5 core themes and captured how experience provided nurses the know-how to fulfill the roles of communication, caring, and advocacy for children and families. IMPLICATIONS FOR PRACTICE: Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support.

Responding to families with complex needs: a national survey of child and family health nurses.

AIMS: The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. BACKGROUND: Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. DESIGN: The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. METHODS: Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. FINDINGS: Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. CONCLUSION: For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally.

[Communication with Migrant Patients and their Parents in Inpatient General Pediatric Care]. / Verständigung mit Patienten und Eltern mit Migrationshintergrund in der stationären allgemeinpädiatrischen Versorgung.

OBJECTIVES: Depending on the ethnic background of patients, the quality of communication between the parents of pediatric patients and clinicians, as well as the type and frequency of interpreter services was studied in an inpatient setting. METHODS: As part of a questionnaire-based survey, data from parents, doctors and nurses with reference to 220 pediatric patients treated in the Department of Pediatrics at the University Hospital Leipzig from February to May 2013 were analyzed; 18,2% of patients were migrants. RESULTS: No differences were found in the assessment of the quality of communication with clinic staff by migrant and non-migrant parents. Physicians as well as nurses rated the communication with migrant parents compared to non-migrant parents significantly lower. In up to 19,2% (data provided by nursing staff) and 15,3% (data provided by doctors) of the cases characterized by insufficient language skills on the part of migrant parents, interpreter services had to be procured. No professional interpreters were used. CONCLUSION: The results highlight once more the difficulties in communication between clinicians and migrant patients with insufficient language skills. More attention should be paid to the impact of the use of professional interpreters in the health care services.

Relationships Between Clinical Decision-Making Patterns and Self-Efficacy and Nursing Professionalism in Korean Pediatric Nurses.

As pediatric nurses must make decisions on a regular basis when caring for hospitalized children, clinical decision-making abilities are necessary in this profession. In the present study, we explored clinical decision-making patterns and their association with self-efficacy and nursing professionalism in pediatric nurses. We surveyed 173 pediatric nurses and analyzed the relationships between their clinical decision-making patterns and self-efficacy and nursing professionalism. Factor analysis identified 5 clinical decision-making patterns: patient-family-nurse collaborative (PNC), individual patient-oriented (IP), nurse model-oriented (NM), pattern-oriented intuitive (PI), and nursing knowledge-oriented (NK). The most frequently observed clinical decision-making pattern was the PNC. The self-efficacy and nursing professionalism were found to be higher in pediatric nurses using the IP and NM, and were lower for those using the PNC. Thus, the present results suggest that pediatric nurses' clinical decision-making patterns are influenced by nursing professionalism and self-efficacy. Therefore, intervention programs focusing on these variables might improve clinical decision-making in pediatric nurses.

Pediatric Pain Management in the Emergency Department: The Triage Nurses' Perspective.

UNLABELLED: Understanding triage nurses' perspectives of pain management is essential for timely pain care for children in the emergency department. Objectives of this study were to describe the triage pain treatment protocols used, knowledge of pain management modalities, and barriers and attitudes towards implementation of pain treatment protocols. METHODS: A paper-based survey was administered to all triage nurses at three Canadian pediatric emergency departments, between December 2011 and January 2012. RESULTS: The response rate was 86% (n=126/147). The mean respondent age was 40 years (standard deviation [SD] 9.3) with 8.6 years (SD 7.7) of triage experience. General triage emergency department (GTED) nurses rated adequacy of triage pain treatment lower than pediatric-only triage emergency department (PTED) nurses (P < .001). GTED nurses reported a longer acceptable delay between triage time and administration of analgesia than PTED nurses (P < .002). Most nurses rated more comfort with a protocol involving administration of acetaminophen (97 mm, interquartile range [IQR] 92, 99) or ibuprofen (97 mm, IQR 93, 100) than for oral morphine (67 mm, IQR 35, 94) or oxycodone (57 mm, IQR 15, 81). The top three reported barriers to triage-initiated pain protocols were monitoring capability, time, and access to medications. Willingness to implement a triage-initiated pain protocol was rated as 81 mm (IQR 71, 96). DISCUSSION: Triage nurses are willing to implement pain protocols for children in the emergency department, but differences in comfort and experience exist between PTED and GTED nurses. Provision of triage initiated pain protocols and associated education may empower nurses to improve care for children in pain in the emergency department.

Isquemia arterial aguda en pacientes pediátricos por procedimiento cardiovascular percutáneo: Incidencia, causas y evolución / Acute arterial ischemia in pediatric patients due to percutaneous cardiovascular procedure: incidence, causes and evolution", "_i": "

Introducción: La isquemia arterial aguda periférica (IAAP) es lainterrupción brusca del aporte sanguíneo a una determinada partedel organismo mediante: la obstrucción, el debilitamiento de las paredesarteriales o daño de las válvulas de las venas, teniendo comoetiología las causas de tipo orgánica y funcional. Objetivo: Determinarla incidencia y describir las causas de la isquemia arterialaguda periférica en pacientes pediátricos como consecuencia de unprocedimiento cardiovascular percutáneo. Metodología: Se realizóun estudio transversal y retrospectivo de 17 pacientes sometidos aintervencionismo, de N = 621 pacientes atendidos en los Serviciosde Hemodinámica y Cardiopediatría del Instituto Nacional de CardiologíaIgnacio Chávez, del 1 de enero de 2008 al 31 de mayo de2009. Se incluyeron pacientes de 0 a 2 años a los que les realizócateterismo cardíaco diagnóstico y terapéutico, que presentaronisquemia arterial aguda periférica. El análisis de datos se realizómediante el programa estadístico SPSS v. 17, los resultados se expresaronmediante medidas de resumen; y se utilizó la correlaciónde Spearman para el número de punciones y causas de isquemiaarterial aguda. Resultados: La muestra (n = 17) representa unaincidencia de 2.73%, predominando el sexo masculino en un 53% yafectando a los pacientes de 0 a 4 meses de edad. Las causas encontradasson el traumatismo en el 35.29%, la trombosis en el 29.41%,la embolia en el 17.64%. Existe una correlación de Spearman positivaentre número de punciones y las causas de IAAP. Conclusión:Los factores relacionados a la IAA son en su mayoría prevenibles,por lo que es necesario una adecuada detección de factores de riesgopara prevenir complicaciones vasculares periféricas.

Introduction: Acute peripheral arterial ischemia (APAI) consistsof the sudden interruption of blood supply to certain part of thehuman body through: obstruction, artery-wall weakening or veinvalveharm, being the etiology produced by organic- or functionaltypecauses. Objective: To determine the incidence of acute peripheralarterial ischemia over pediatric patients as a consequence of apercutaneous cardiovascular procedure. Methodology: A transversaland retrospective study was carried out on seventeen patientssubjected to interventionism, from N = 621 patients attendedat the Hemodynamics and Cardiopediatrics Services in the «IgnacioChávez¼ National Institute of Cardiology, from January the 1st,2008, to may 31st, 2009. The study included patients ranging from0 to 2 years old, who were practiced diagnostic and therapeuticcardiac catheterization, and presented Acute Peripheral ArterialIschemia. The data analysis was performed through the SPSS v.17 statistical program, the results were expressed by means of summarymeasurements. Spearman’s Correlation was employed forpuncture number and causes of Acute Arterial Ischemia. Results:The sample (n = 17) represents an incidence of 2.73%, prevailingthe male sex in a 53%, and affecting pediatric patients from 0 to 4months old. It was found a positive Sperman’s Correlation betweennumber of punctures and APAI causes. Conclusion: The factors relatedto APAI are mostly preventable, so proper risk-factor detectionis necessary in order to prevent peripheral vascular complications.