Familiarity with the clinical environment, achieved by priming, improves time to antibiotic administration in a simulated paediatric sepsis scenario: a randomised control trial.

AIM: The early administration of antibiotics in sepsis reduces mortality and improves outcomes. This randomised control trial evaluated the effect of environmental priming (EP) on healthcare student performance in a simulated paediatric sepsis scenario. METHODS: Medical and nursing students were randomised into primed and unprimed groups. Primed groups received both direct and virtual priming. Each group completed a standardised simulated sepsis scenario. Time to achieve five key clinical interventions was recorded. Mini focus groups were conducted to explore perceptions of EP. RESULTS: There were 26 primed and 26 unprimed groups. The primed students were quicker to complete all five interventions and statistically significantly quicker to achieving intravenous (IV) access (median 350 s vs 373 s, p=0.02), administering IV antibiotics (median 648 s vs 760 s, p=0.045) and seeking senior help (median 703 s vs 780 s, p=0.02). Primed students did not feel that they had gained any specific advantage from being primed. CONCLUSIONS: EP can improve clinical performance. Implications for practice include incorporating EP of key clinical areas into local induction, standardisation of resuscitation areas and regular use of in situ simulation.

Reflection on the assessment and care of a child with osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is a rare genetic condition that causes bones to become brittle and fracture. This article draws on the reflective experiences of two second-year children's nursing students on placement. It includes a case study that explores the assessment and care of a child with OI. Due to the lack of available evidence and understanding of nursing care for children with OI, the article also includes a personal reflection on clinical practice. There has been extensive development in evidence-based practice in nursing, which includes reflective practice. Reflection is an important component of nursing training and plays a part in ensuring that nurses keep their knowledge and skills up to date and gain valuable transferable skills. This article presents a reflection on nursing a child with OI along with more specific information on OI.

Treating abdominal pain in young people.

A common complaint in children, abdominal pain can be clinically challenging for healthcare professionals to diagnose and treat. Accurate assessment and thorough investigations, combined with the measurement and monitoring of vital signs, are essential to eliminate any underlying conditions. Self-reporting tools can be used to aid communication with children, who may have difficulties articulating their thoughts and feelings. This article refers to a case study to discuss the care of children who present to emergency departments (EDs) with abdominal pain. It suggests that children's nursing students can be valuable assets in busy EDs because they have the knowledge and skills required to care for young people.

Restraint in the care of children.

As a nursing student on an emergency department (ED) placement, the author of this article experienced personal and professional conflict while restraining a child during a clinical procedure. This experience should be familiar to ED nurses, many of whom, however, lack confidence in the use of restraint techniques. This article describes how nurses can acquire this confidence while understanding the practical and legal implications of restraint. The article emphasises the importance of involving children and their families or carers in therapeutic partnerships before consent to restraint is sought. It also presents three levels of holding.

Is care planning still relevant in the 21st century?

As we progress into the second decade of the 21st century, the healthcare needs of an increasingly diverse population are changing. Children's nurses must respond to these challenges by creating clear and effective plans of care in collaboration with children and their families. Legally and professionally, children's nurses are required to accurately record plans of care given to individual patients to provide a legal document demonstrating that care has been delivered (Nursing and Midwifery Council (NMC), 2008). Within this article, an overview of the nursing process and its components will be discussed, considering how this process assists in organizing and prioritizing care delivery to the child or young person and family. In addition, the support offered by a framework such as the Roper, Logan and Tierney model of nursing , in systematically assessing, planning and documenting care to meet individuals' needs, must be reinforced and its application practiced. Subsequently, the use and contribution of such processes and frameworks to the organization and delivery of care will be examined within the context of a clinically-based scenario, which has helped to explore students' knowledge and skills in the second year of a 3-year undergraduate programme. The authors firmly believe that care planning skills are fundamental to safeguarding vulnerable children, their families and, indeed, the nursing profession in this current challenging socioeconomic environment.

Incidence of group C human rotavirus in central Australia and sequence variation of the VP7 and VP4 genes.

Human group C rotavirus was identified in central Australia in each of eight years over a 16-year period between 1982 and 1997. Cases occurred either sporadically but over a relatively short period of time or as clustered outbreaks. These are the only reports of human group C rotavirus in Australia other than that of a single case reported approximately 1,800 km away in 1982. The electrophoretic genome profiles of isolates were identical for all those identified within the same year but different between those identified in different years. The VP7 genes of four isolates identified in four different years over a 7-year period between 1987 and 1993, and the VP4 genes of two of these isolates showed relatively little variation in genome and deduced amino acid sequence upon comparison of the equivalent genes between isolates. The sequences were also very similar to those from the corresponding genes from most of the human group C rotavirus isolates from other countries. This continues the observation of a high degree of gene sequence conservation among human group C rotaviruses worldwide.