Enfermería y práctica basada en la evidencia / No disponible

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Uso del Emocionario en consultas de pediatría en atención primaria / Use of emotions in primary health care pediatrics visit

OBJETIVO: Conocer cómo los niños identifican y expresan sus emociones en la consulta de enfermería de Atención Primaria a partir de herramientas didácticas adaptadas. METODOLOGÍA: Este trabajo se enmarca en la metodología cualitativa utilizando como método el estudio de casos. Otras técnicas de recogida de información han sido la observación participante y entrevistas semi-estructuradas. RESULTADOS: Se ha realizado un análisis y categorización de las emociones identificadas por los niños. Las categorías en las que se han englobado las emociones son "estado de ánimo", emociones observadas ante un "suceso eventual" ocurrido en la consulta y emociones ante una "circunstancia vital". Además, hemos desarrollado tres estudios de caso prototípicos. CONCLUSIONES: El personal sanitario debe indagar en las emociones de los niños de acuerdo con el abordaje holístico de atención a la salud. Esta aproximación a la esfera emocional del niño nos ha permitido identificar emociones y conocer la relación con sus padres o hermanos o el grado de satisfacción en el colegio. El cuidado emocional favorece la relación de confianza con el personal sanitario, reduciéndose así el nivel de ansiedad que sienten los niños al acudir a las consultas programadas

OBJECTIVES: The purpose of this study is to know how children identify and express their emotions in Primary Care nursing consultation using adapted teaching tools. METHODOLOGY: This is a qualitative research, a cases study. Participating observation and semi-structured interviews have also been used in this study. RESULTS: We have analyzed and categorized the information collected through the interviews with the children. The categories we have identified are: "emotions observed in the face of an eventual event occurring in the consultation", "emotions in the face of a vital circumstance" and "state of mind". From the interviews with the children, we have developed three prototypical case studies. CONCLUSION:. Health care workers should investigate children's emotions according to the holistic approach to health care. Researching the emotional part of children has let us to know their emotions, the relationship with their parents or siblings or the degree of satisfaction in school. Emotional care could promote relationship with health care workers and reduces the anxiety children feel when they go to nursing appointments

Theoretical model of nursing care for children with obesity.

OBJECTIVES: to describe a theoretical model of nursing care for children with obesity in Primary Health Care. METHODS: Grounded Theory and the theoretical/philosophical framework of Virginia Henderson were used. The research was conducted in Family Basic Health Units and in Specialized Services in the city of Campina Grande, Paraíba, Brazil. A total of 24 participants composed four sample groups. Data were collected through semi-structured interviews, between April and October 2015, and analyzed by the constant comparison method. The analysis occurred by initial coding, construction of diagrams and memos, axial coding, selective coding and reflection on the paradigm and on the emerging theory. RESULTS: six categories emerged from the data. Nurses worrying about the care of children with obesity as a neglected area in Primary Health Care was the theoretical model. FINAL CONSIDERATIONS: the phenomenon is related to the individuality of nursing care and the need for shared responsibilities.

Missed Nursing Care in Pediatric and Neonatal Care Settings: An Integrative Review.

INTRODUCTION: Missed nursing care is required care that is delayed, incomplete, or left undone during a nurse's working shift. Missed nursing care is most often studied in adult populations; however, it may have significant consequences in pediatric and neonatal care settings. The purpose of this integrative review is to describe missed nursing care in pediatric and neonatal nursing care settings. METHODS: SCOPUS and PubMed were used in the literature search. Multiple combinations of the keywords and phrases "missed nursing care," "pediatric," "neonatal," "care left undone," or "nursing care rationing" were used for the literature search. Missed nursing care is a relatively new topic as the first article on the subject was published in 2006; therefore, inclusion criteria were set to English articles published between January 1, 2006 and October 11, 2019 that reported on missed nursing care in pediatric and neonatal inpatient care settings. RESULTS: Fourteen articles met inclusion criteria. Missed nursing care in pediatric and neonatal nursing care settings is associated with workload, patient acuity, work environment, and nurse characteristics, and is related to prolonged hospitalization of preterm infants. CLINICAL IMPLICATIONS: Providing nurses with an adequate amount of resources and tools to avoid missed nursing care will continue to improve care delivery. Missed nursing care and related patient and nurse outcomes in diverse pediatric and neonatal samples remains an area for future research.

Advances in Sports Medicine and Care of the Adolescent Athlete.

Over the past several decades there has been a dramatic change in the landscape of youth sports. This article provides an overview of sport-related injuries in the child and adolescent populations, looking at changes over the past 10 to 15 years. A closer look at frequently seen injuries, including assessment, diagnosis, and management in osteochondritis dissecans, sprains, fractures, anterior cruciate ligament, and meniscus tears, is provided. Current protocols and screening tools for this population are discussed, including preparticipation screening. The nursing implications in the clinical and community setting are identified, with ways to incorporate this information into practice.

Helping Experienced Pediatric Nurses Bridge the Gap Between Intermediate and Intensive Care.

The desire for career advancement has been identified as a cause of nurse turnover. In order to prevent nurses wanting to advance in their career from leaving the organization, a program was developed to transition nurses from pediatric acute and intermediate care to the intensive care unit. The intervention included classroom training, social support, and a formal orientation. Turnover rates are lower for participants in the program, and transitions to the intensive care unit have been successful.

Developing competencies in genetics nursing: Education intervention for perinatal and pediatric nurses.

Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an educational intervention using authentic stimulus material centered on a clinical case study of a family with a baby with Down syndrome. Quantitative and qualitative data were collected from a sample of 15 nurses and 27 students from three universities in Japan before and after completing an entry-level workshop on competency-based genetics nursing. Participants reported increased perceived genetics knowledge and clinical confidence. Despite more than 90% of the participants reporting that they understood the underlying genetics knowledge, their confidence and the ethical aspects of genetics nursing had not been promoted after the seminar. In contrast, the reflections, coded into three categories, showed they recognized families' needs for psychological support, family decision making, and protection and privacy and suggested that nurses had undergone a profound shift in understanding about these issues. Although indicating that a single seminar was insufficient, the study findings will be useful to develop educational materials on genetics for both students and nurses.

Identificar práticas de enfermagem de qualidade no ambulatório de pediatria: revisão sistemáticada literatura / dentify quality nursing practices in the pediatric outpatient care: a systematic review

Introduction: Outpatient care philosophy has been growing in the past years. Looking to the premise of pediatric healthcare, the establishing of outpatient treatment has advantage, like shortening the deep impact caused by familiar environment detachment, everyday routines and habits. This paradigm implies an adaptation of nursing care services and practices, where quality improvement should focus on continuity of care at home. Objective: to identify recommendations evidence-based of good practices to child / family nursing interventions in an outpatient setting, that allows the definition of standards / quality indicators. Methodology: A Systematic Review of Literature was performed, supported on the Cochrane Handbook orientations of studies published between 2004-2017. The research was conducted on EBSCO and PUBMED databases and resulted in 97 studies. After applying relevance tests, 80 were excluded and 17 included in the methodology critical assessment, done independently by two reviewers and based on defined criteria. At end, five articles1,2,3,4,5 were included. Results: The recommendations identified for the quality of outpatient nursing care are mainly directed to surgical situations, namely, prevention and control of infections, given the high turnover of children; use of digital strategies for preoperative preparation, avoiding anxiety and promoting early discharge, by empowering the family; telephone contact to support and ensuring continuity of care; assessment of the post-surgical condition using the Ped-PADSS checklist, ensuring the early discharge. Conclusion: The results of this study allowed us to obtain recommendations for use in nursing practice of outpatient care and enable to the consequent quality improvement of nursing care provided to child and family

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The future of pediatric nursing science.

The provision of safe and effective nursing care to children is dependent upon pediatric nurse scientists creating knowledge that guides and directs day-to-day nursing practice. Current trends demonstrating steady decreases of pediatric nurses and inadequate numbers of PhD-prepared pediatric nurse scientists put the health of our children at risk. The purposes of this paper are to (1) summarize current health care demands in pediatrics, (2) present our concern that the number of pediatric nurse scientists is inadequate to generate foundational knowledge to guide pediatric nursing practice, (3) present our perspectives on factors influencing the number of pediatric nurse scientists, and (4) recommend specific actions for nursing leaders, nursing faculty, and professional nursing organizations to increase the depth and breadth of pediatric nursing science to meet current and future pediatric care needs.

The Post-Intensive Care Syndrome in Children.

Improvements in devices and techniques used to provide life support for patients at intensive care units have reduced patient mortality. Increases in the number of survivors from a critical illness have brought long-term complications experienced during the post-intensive care period into question. The term post-intensive care syndrome (PICS) is defined as a new and deteriorating disorder in the cognitive, mental, and physical health status experienced by the survivor after intensive care unit discharge that might continue for months or even years. Opioid and sedation exposure, the severity of illnesses and injuries, dense life support interventions, length of stay in the intensive care unit, and social isolation constitute risk factors for PICS in children. These factors cause the child to experience deterioration in physical, cognitive, and psychological health domains. Such deteriorations occur on various levels and have negative effects on quality of life. The purpose of this article is to raise awareness and help pediatric nurses to develop an understanding of the condition. Increasing awareness by pediatric nurses about the magnitude and effects of complications after discharge from the intensive care unit will be the first step to protect survivors from new problems, to provide assistance for ongoing problems, and to develop follow-up strategies. PICS-related morbidities affect the majority of children discharged from PICUs. We need to understand the scope of those morbidities and develop efficient nursing interventions accordingly. It is time to expand our goal for critical and noncritical care from life-saving into improvement of functional health status and quality of life.

Theoretical model of nursing care for children with obesity / Modelo teórico de cuidado del enfermero para el niño con problemas de obesidad / Modelo teórico de cuidado do enfermeiro à criança com obesidade

ABSTRACT Objectives: to describe a theoretical model of nursing care for children with obesity in Primary Health Care. Methods: Grounded Theory and the theoretical/philosophical framework of Virginia Henderson were used. The research was conducted in Family Basic Health Units and in Specialized Services in the city of Campina Grande, Paraíba, Brazil. A total of 24 participants composed four sample groups. Data were collected through semi-structured interviews, between April and October 2015, and analyzed by the constant comparison method. The analysis occurred by initial coding, construction of diagrams and memos, axial coding, selective coding and reflection on the paradigm and on the emerging theory. Results: six categories emerged from the data. Nurses worrying about the care of children with obesity as a neglected area in Primary Health Care was the theoretical model. Final Considerations: the phenomenon is related to the individuality of nursing care and the need for shared responsibilities.

RESUMEN Objetivos: describir el modelo teórico de atención de enfermería para niños con obesidad en la Atención Primaria de Salud. Métodos: se utilizó la Teoría Basada en Datos y el marco teórico/filosófico de Virginia Henderson. La investigación se realizó en diversas Unidades Básicas de Salud Familiar y Servicios Especializados en Campina Grande, Paraíba, Brasil. Hubo 24 participantes que formaron cuatro grupos de muestra. Los datos se recogieron mediante entrevistas semiestructuradas, entre abril y octubre de 2015 y se analizaron mediante el método de comparación constante. El análisis se realizó utilizando la codificación inicial, la construcción de diagramas y memorandos, la codificación axial, selectiva y la reflexión sobre el paradigma y la teoría emergente. Resultados: de los datos surgieron seis categorías. El modelo teórico estaba constituido por el enfermero preocupado con el cuidado de niños con obesidad como área desatendida en la Atención Primaria. Consideraciones Finales: el fenómeno traspasa la individualidad de la atención del enfermero y se depara con la necesidad de una responsabilidad compartida.

RESUMO Objetivos: descrever o modelo teórico de cuidado do enfermeiro com crianças com obesidade na Atenção Básica de Saúde. Métodos: utilizou-se da Teoria Fundamentada nos Dados e na referencial teórico/filosófico de Virginia Henderson. A pesquisa foi realizada em Unidades Básicas de Saúde da Família e Serviços Especializados, em Campina Grande, Paraíba, Brasil. Com 24 participantes que formaram quatro grupos amostrais. Os dados foram coletados por meio de entrevista semiestruturada, entre abril a outubro 2015, e analisados pelo método de comparação constante. A análise realizou-se pela codificação inicial, construção de diagramas e memorandos, codificação axial, seletiva e reflexão sobre o paradigma e a teoria emergente. Resultados: seis categorias emergiram dos dados. Constitui o modelo teórico a preocupação do enfermeiro com o cuidado à criança com obesidade como área negligenciada na Atenção Básica. Considerações Finais: o fenômeno perpassa a individualidade do cuidado do enfermeiro e se depara com a necessidade de uma responsabilidade compartilhada.

The meaning of the care of hospitalized children: experiences of nursing professionals.

OBJECTIVE: to understand the meaning of the care of hospitalized children for the nursing professionals of a pediatric unit. METHOD: phenomenological study, based on the existential phenomenology of Martin Heidegger. Ten nursing professionals were interviewed with the guiding question: "What is the care of hospitalized children for you? Tell me, in detail, your experience with taking care of hospitalized children." RESULTS: the meaning of the care of hospitalized children materializes between the profession and the various ways of preoccupation. By engaging in/worrying about the ways of being of everyday life, the professionals tend to improperness when trying to mediate and level all possibilities of being. However, when they extrapolate reassurance and do not get caught up in themselves, they achieve empathy, respect, and indulgence. FINAL CONSIDERATIONS: it is necessary to reassess the teaching and practice of care, so that authentic care is offered to children and their families in the context of hospitalization.

The use of children's stories in nursing care for the child: an integrative review.

OBJECTIVE: To identify how children's stories can be used in child care. METHOD: Integrative literature review, conducted in databases between 2000 and 2018, in three languages. Full research articles were included that agreed with the following question: "How can children's stories be used in child care?". RESULTS: From the analysis of 16 selected articles, three categories emerged: The use of stories in the hospital; Specialized nursing intervention; and Stories in the educational dimension. FINAL CONSIDERATIONS: Evidence shows benefits to children, families, institutions and nursing. The use of children's stories as a care intervention can occur in different situations and settings, values; boosts bonds, reduces anxiety in children and families, encourages children's participation in care, and promotes health education. It is a low-cost and still incipient strategy in nursing.

Salidas laborales de los residentes de Pediatría. Datos del periodo 2014-2017 / Employment outcomes of residents of Paediatrics, 2014-2017 period

Introducción: dada la escasez de pediatras de nuestro sistema de salud y la necesidad de estos en Atención Primaria, donde cerca del 25% de las plazas están ocupadas por no especialistas en Pediatría, se quiso conocer el destino laboral inicial de los residentes que habían finalizado su periodo de formación en los últimos cuatro años. Metodología: se han recogido las salidas laborales de los residentes que han finalizado su periodo de rotación durante los años 2014-2017 en los hospitales españoles. La recogida se ha realizado por medio de los representantes de residentes de las comunidades autónomas y los vocales autonómicos de la Asociación de Pediatría de Atención Primaria. Resultados: se han recogido datos de las salidas laborales del 75,7% de los residentes, lo que supone conocer el destino laboral de 1263 residentes de los últimos cuatro años. La elección de Atención Primaria en el transcurso de estos años ha disminuido del 30,77 al 24,5%; igualmente han disminuido los trabajos en hospitalización o consultas hospitalarias que han descendido de un 43,8 a un 32,85%, mientras que la realización de guardias o cobertura de Urgencias ha aumentado y también ha subido el porcentaje de los que se dedican a la medicina privada. Conclusiones: el porcentaje de residentes que acude a Atención Primaria es insuficiente. El trabajo del pediatra está siendo de peor calidad, con aumento de los contratos de guardias y Urgencias. Está aumentando el porcentaje de residentes que se dirigen hacia la sanidad privada

Introduction: given the shortage of paediatricians in the Spanish health care system and the high demand for them in primary care, where approximately 25% of positions are filled by non-specialists in paediatrics, we wanted to know the initial employment destination of residents who had finished his training period in the last 4 years. Methodology: the work exits of residents who have completed their rotation period during the years 2014-2017 in Spanish hospitals have been collected. The collection was made through the representatives of residents of autonomous communities and auton mous members of the Primary Care Pediatric Association. Results: data were collected on the work exits of 75.7% of the residents, which means knowing the employment destination of 1263 residents of the last 4 years. The choice of primary care during these years has decreased from 30.77 to 24.5%, while hospitalization or hospital consultations have decreased from 43.8 to 32.85%, while the realization of guards or emergency coverage has increased and the percentage of those who dedicate themselves to private medicine has also increased. Conclusions: the percentage of residents who attend primary care is insufficient. The work of pediatrician is being of worse quality, with increased contracts of guards and emergencies. The percentage of residents heading towards private healthcare is increasing