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2.
Crit Care Nurse ; 39(4): e1-e7, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31371373

RESUMO

BACKGROUND: Pulmonary hypertension is a rare, life-threatening disease with limited therapeutic options and no definitive cure. Continuous intravenous prostacyclin therapy is indicated for treatment of severe disease. These medications have a narrow therapeutic index and a brief half-life; therefore, administration errors can be lethal. OBJECTIVE: To reduce medication errors through an inpatient program to improve, standardize, and disseminate continuous intravenous prostacyclin therapy practice guidelines. METHODS: Data were collected from the electronic safety reporting system of a single hospital to determine the number and types of continuous intravenous prostacyclin therapy errors that were reported over an 8-year period. A clinical database and hospital pharmacy records were used to determine the number of days on which hospitalized pediatric patients received the therapy. INTERVENTIONS: A nursing-directed quality improvement initiative to enhance the safety of continuous intravenous prostacyclin therapy for pediatric patients was begun in January 2009. Efforts to improve safety fell into 4 domains: policy, process, education, and hospital-wide safety initiatives. RESULTS: The number of therapy errors per 1000 patient days fell from 19.28 in 2009 to 5.95 in 2016. Chi-square analysis was used to compare the result for 2009 with that for each subsequent year, with P values of .66, .35, .16, .09, .03, .12, and .25 found for 2010 through 2016, respectively. CONCLUSIONS: The trend in reduction of continuous intravenous prostacyclin therapy errors suggests that proactive processes to standardize its administration, emphasizing both policy and education, reduce medication errors and increase patient safety.


Assuntos
Enfermagem de Cuidados Críticos/normas , Epoprostenol/administração & dosagem , Hipertensão Pulmonar/tratamento farmacológico , Infusões Intravenosas/normas , Erros de Medicação/prevenção & controle , Enfermagem Pediátrica/normas , Gestão da Segurança/normas , Adolescente , Criança , Pré-Escolar , Enfermagem de Cuidados Críticos/educação , Currículo , Educação Continuada em Enfermagem , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , Erros de Medicação/estatística & dados numéricos , Erros de Medicação/tendências , Enfermagem Pediátrica/educação , Guias de Prática Clínica como Assunto , Gestão da Segurança/tendências , Estados Unidos
3.
Crit Care Nurse ; 39(3): 59-66, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154332

RESUMO

Pain management and sedation strategies have become more complex in recent years, with accompanying documented increases in morbidity and mortality. Consequently, various government agencies and professional associations have issued requirements or recommendations designed to ensure optimal and safe pain management in different populations. The pediatric nurse must understand the rationale behind these guidelines, which pain and sedation assessment tools are valid and reliable, how and when to use these tools, and the purpose and limitations of each tool. This article summarizes the recent recommendations, identifies valid and reliable pediatric pain and sedation assessment tools, and describes the appropriate use of these tools to provide safe and high-quality patient care.


Assuntos
Sedação Consciente/normas , Hipnóticos e Sedativos/administração & dosagem , Manejo da Dor/métodos , Enfermagem Pediátrica/normas , Guias de Prática Clínica como Assunto , Criança , Pré-Escolar , Sedação Consciente/métodos , Educação Continuada em Enfermagem , Feminino , Humanos , Masculino , Dor/tratamento farmacológico , Pediatria , Reprodutibilidade dos Testes , Estados Unidos
4.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31209160

RESUMO

The American Academy of Pediatrics has created recommendations for health appraisal and preparation of young people before participation in day, resident, or family camps and to guide health and safety practices at camp. These recommendations are intended for parents and families, primary health care providers, and camp administration and health center staff. Although camps have diverse environments, there are general guidelines that apply to all situations and specific recommendations that are appropriate under special conditions. This policy statement has been reviewed and is supported by the American Camp Association and Association of Camp Nursing.


Assuntos
Acampamento , Saúde da Criança , Segurança , Acampamento/psicologia , Acampamento/normas , Criança , Saúde da Criança/normas , Humanos , Poder Familiar , Enfermagem Pediátrica/normas , Pediatria/normas , Atenção Primária à Saúde , Papel Profissional , Segurança/normas
5.
Creat Nurs ; 25(2): 103-112, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31085662

RESUMO

Despite recent emergence of information about treatment of medical trauma in children, the literature remains sparse regarding prevention of medical trauma. Health-care professionals are in an ideal position to educate about and advocate for ways to prevent the far-reaching consequences of medical trauma, yet policies remain which at times contribute to the problem. This article presents practical approaches intended to reduce the likelihood of medical trauma in children receiving serial casting for treatment of progressive infantile scoliosis (PIS). The majority of the suggestions apply not only to children being treated for PIS, but to children receiving medical treatment for many conditions. The article also provides suggestions for parents who are enduring the stress of their child undergoing repeated surgeries and hospital stays. The authors interviewed a variety of experts in the field and draw on their own experiences as clinical social workers specializing in the treatment of post-traumatic stress disorder and developmental trauma in children.


Assuntos
Moldes Cirúrgicos , Enfermagem Pediátrica/normas , Guias de Prática Clínica como Assunto , Escoliose/enfermagem , Escoliose/psicologia , Estresse Fisiológico , Estresse Psicológico/prevenção & controle , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
6.
Rev Bras Enferm ; 72(suppl 1): 41-48, 2019 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30942343

RESUMO

OBJECTIVE: To know the aspects involved in the production of subjectivity and autonomy of nursing professionals working in Pediatric Units. METHOD: An exploratory and descriptive study, with a qualitative approach, performed with users, professionals and nursing managers, totaling 44 participants. Data collection took place in the pediatric hospitalization units of two University Hospitals through semi-structured interviews, organized and treated by Nvivo 10 software and then submitted to content analysis. RESULTS: The production of subjectivity and autonomy in nursing workers involves both the conditions of the work environment as the relation of the nursing team, the relation of hierarchy and the profile of the professional that works in the Pediatric Unit. FINAL CONSIDERATIONS: The valorization path of the nursing profession emerges, whose knowledge and competence in the area of work contribute to the construction of autonomous subjectivities.


Assuntos
Eficiência , Recursos Humanos de Enfermagem no Hospital/psicologia , Autonomia Profissional , Adulto , Feminino , Humanos , Entrevistas como Assunto/métodos , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/normas , Enfermagem Pediátrica/normas , Pesquisa Qualitativa , Local de Trabalho/psicologia , Local de Trabalho/normas
7.
Am J Hosp Palliat Care ; 36(11): 959-966, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31014075

RESUMO

Palliative care services are beneficial for pediatric neurology patients with chronic, life-limiting illnesses. However, timely referral to palliative care may be impeded due to an inability to identify appropriate patients. The aim of this pilot case-control study was to test a quantitative measure for identifying patients with unmet palliative care needs to facilitate appropriate referrals. First, a random subset of pediatric neurology patients were screened for number of hospital admissions, emergency center visits, and problems on the problem list. Screening results led to the hypothesis that having six or more hospital admissions in one year indicated unmet palliative care needs. Next, hospital admissions in the past year were counted for all patients admitted to the neurology service during a six-month period. Patients with six or more admissions as well as age- and gender-matched controls were assessed for unmet palliative care needs. In hospitalized pediatric neurology patients, having six or more admissions in the preceding year did not predict unmet palliative care needs. While this pilot study did not find a quantitative measure that identifies patients needing a palliative care consultation, the negative finding highlights an important distinction between unmet social needs that interfere with care and unmet palliative care needs. Further, the method of screening patients used in this study was simple to implement and provides a framework for future studies.


Assuntos
Doença Crônica/enfermagem , Diagnóstico Precoce , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/normas , Doenças do Sistema Nervoso/enfermagem , Enfermagem Pediátrica/normas , Guias de Prática Clínica como Assunto , Adolescente , Criança , Feminino , Humanos , Masculino , Projetos Piloto
8.
Rev Bras Enferm ; 72(2): 494-504, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017215

RESUMO

OBJECTIVE: to analyze the attributes, antecedents and consequences of the concept a "good nurse" in the context of Pediatrics. METHOD: concept analysis study based on Rodgers' evolutionary method. Theoretical stage consisted of searching for articles in the CINAHL, Embase and Pubmed databases and a practical stage of semi-structured interviews with pediatric nurses. The final analysis unified the two stages by categories of antecedents, attributes and consequences of the concept. RESULTS: 20 articles and 10 interviews were analyzed revealing as antecedents aspects related to education, scientific development and ethical-moral skills and values. Responsibility, compassion, honesty and advocacy stand out as attributes of the "good nurse." The consequences describe implications for children and families, as well as for professionals. FINAL CONSIDERATION: the analysis of the concept of the "good nurse" allowed us to clarify fundamental aspects for the execution of good practices, establishing parameters for investment in professional development programs.


Assuntos
Formação de Conceito , Enfermeiras e Enfermeiros/normas , Enfermagem Pediátrica/normas , Humanos
9.
Rev Bras Enferm ; 72(2): 531-540, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017219

RESUMO

OBJECTIVE: to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. METHOD: integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017. RESULTS: we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care. FINAL CONSIDERATION: we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.


Assuntos
Cuidados de Enfermagem/métodos , Cuidados Paliativos/métodos , Prática Clínica Baseada em Evidências/métodos , Humanos , Cuidados de Enfermagem/normas , Enfermagem Oncológica/métodos , Enfermagem Oncológica/normas , Cuidados Paliativos/normas , Enfermagem Pediátrica/métodos , Enfermagem Pediátrica/normas
10.
J Nurs Care Qual ; 34(4): 370-375, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30889080

RESUMO

BACKGROUND: As the level of acuity of pediatric hospital admissions continues to increase, additional pressure is being placed on hospital resources and the nursing workforce. LOCAL PROBLEM: Currently, there is no formalized approach to care for high-acuity patients on our pediatric inpatient unit. METHODS: We used a qualitative descriptive design, guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behaviour (COM-B) model, to conduct focus groups and interviews with clinicians and administrators to identify potential barriers and enablers to implementing a high-dependency care (HDC) model. An HDC model focuses on the relationship between adequate nursing staff resources and patient acuity to improve patient health outcomes. RESULTS: Participants identified the need for clear guidelines and supportive physical structures to facilitate HDC implementation. Anticipated benefits included enhanced nursing confidence and family-centered care. CONCLUSIONS: Study findings highlight multilevel factors to consider prior to implementing an HDC model on a pediatric inpatient unit.


Assuntos
Gestão de Mudança , Hospitais Pediátricos , Ciência da Implementação , Assistência Centrada no Paciente/normas , Enfermagem Pediátrica/normas , Índice de Gravidade de Doença , Criança , Grupos Focais , Humanos , Pacientes Internados , Entrevistas como Assunto , Modelos de Enfermagem , Motivação , Pesquisa Qualitativa
11.
Rev Esc Enferm USP ; 53: e03454, 2019 Mar 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30843927

RESUMO

OBJECTIVE: To analyze the training and evaluation of professional competency to work in the area of pediatric nursing based on the conceptions and experiences of university professors. METHOD: A qualitative study conducted with pediatric nursing professors from six public undergraduate courses in the state of São Paulo, Brazil. The data were collected by semi-structured interview and analyzed by the Content Analysis method. RESULTS: Sixteen professors participated. Five main themes emerged: competency definition, attributes to act with children, advances in the training of professional competency, challenges to enable training pediatric competency, and methods and instruments for evaluating competency acquisition to work in the area of pediatric nursing. CONCLUSION: The findings of this study point to the importance of a balanced approach in the cognitive, psychomotor and affective dimensions in training and evaluating professional competency in pediatric nursing, as well as extending the curricular valorization of this area of knowledge and practice.


Assuntos
Competência Clínica , Educação em Enfermagem/métodos , Docentes de Enfermagem , Enfermagem Pediátrica/educação , Adulto , Brasil , Currículo , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Enfermagem Pediátrica/normas , Estudantes de Enfermagem
14.
Pediatr Blood Cancer ; 66(6): e27663, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30786168

RESUMO

BACKGROUND: In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low- and lower-middle income countries (L/LMIC). We conducted an international survey in 2016-2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions. PROCEDURE: Data from a cross-sectional web-based survey completed by nurses representing 54 countries were analyzed (N = 101). Responses were clustered by relevance to each standard and compared according to the 2017 World Bank-defined country income classification (CIC) of hospitals. RESULTS: CIC and nurse-to-patient ratios in inpatient wards were strongly associated (P < 0.0001). Nurses in L/LMIC prepared chemotherapy more often (P < 0.0001) yet were less likely to have access to personal protective equipment such as nitrile gloves (P = 0.0007) and fluid-resistant gowns (P = 0.011) than nurses in high-resource settings. Nurses in L/LMIC were excluded more often from physician/caregiver meetings to discuss treatment options (P = 0.04) and at the time of diagnosis (P = 0.002). Key educational topics were missing from nursing orientation programs across all CICs. An association between CIC and the availability of written policies (P = 0.009) was found. CONCLUSIONS: CIC and the ability to conform to pediatric oncology baseline nursing standards were significantly associated in numerous elements of the baseline standards, a likely contributor to suboptimal patient outcomes in L/LMIC. To achieve the goal of high-quality cancer care for children worldwide, nursing disparities must be addressed.


Assuntos
Disparidades em Assistência à Saúde/normas , Renda/estatística & dados numéricos , Neoplasias/enfermagem , Enfermagem Oncológica/normas , Enfermagem Pediátrica/normas , Qualidade da Assistência à Saúde/normas , Padrão de Cuidado , Estudos Transversais , Países em Desenvolvimento , Humanos , Agências Internacionais , Prognóstico , Inquéritos e Questionários
15.
J Pediatr Nurs ; 44: 9-15, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30683286

RESUMO

The interrater reliability of the Braden Q skin risk assessment scale has never been reported. The purpose of the study was to assess the interrater reliability among pediatric Skin Champion (SC) nurses with the use of the Braden and Braden Q scales. The pilot study included 16 paired SC nurses. Each pair of nurses attempted to assess 8 patients using the Braden and Braden Q scales. However, patient care requirements at the time of the study assessments limited the number slightly. The actual number of assessments with the Braden scale was n = 52 and the Braden Q was n = 63. The Intra-class Correlation Coefficient (ICC) for the Braden scale was 0.894, 95% confidence interval (CI) (0.823, 0.938), which is excellent agreement. The ICC for the Braden Q was 0.726, 95% CI (0.585, 0.824), which is fair to good agreement. Among the six subcategories on the Braden scale, mobility and activity had higher agreement scores among the SC nurses. Among the seven subcategories on the Braden Q scale, mobility and sensory perception had higher agreement scores. Nutrition and friction/shear subcategories on both scales had the lowest agreement scores. Subcategories with the lowest agreement usually have the greatest measurement error. Possible sources of error include unclear definitions of scoring criteria, different clinical data pulled from different locations in the chart. Error can be reduced by clarifying the subcategory definitions and standardizing the data used for the assessment and the location of each data point in the EMR. A high interrater agreement is the goal because it provides confidence that the scale is used reliably to identify high risk patients who require additional care to prevent harmful events.


Assuntos
Avaliação em Enfermagem/métodos , Enfermagem Pediátrica/normas , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Adulto , Criança , Estudos de Coortes , Feminino , Hospitais Pediátricos , Humanos , Masculino , Variações Dependentes do Observador , Enfermagem Pediátrica/tendências , Projetos Piloto , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Gestão da Qualidade Total , Resultado do Tratamento
16.
Nurse Educ Pract ; 34: 85-89, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30476728

RESUMO

Safeguarding children teaching is a required component in all pre-registration nursing curricula. A structured approach to this teaching as part of preparation for registration as a children's nurse was developed jointly by the Course Leader and the Designated Nurse for Safeguarding Children. This approach aims to equip children's nurses with the necessary theoretical knowledge and practical skills needed for safe practice. A key element in this curriculum is simulation, where students must assess injuries on manikins, select and complete appropriate documentation, and perform a nursing handover. Simulation has recognised value in nurse education but its use in safeguarding children teaching for student children's nurses has not previously been widely reported. This small-scale qualitative study explored the student experience and the impact of simulation teaching in the development of relevant knowledge and the core safeguarding skill set of observation, interpretation, documentation and communication. The methodology for this small, qualitative study was triangulated, comprising observation of the simulation teaching and two sets of semi-structured interviews. The resultant data was investigated using thematic analysis. The outcome of the study suggested that students were able to transfer learning from the simulation into clinical practice, and that simulation as an approach to safeguarding children teaching resonated with the students' preferred learning style and merits further consideration and evaluation.


Assuntos
Competência Clínica/normas , Enfermeiras Pediátricas/educação , Enfermagem Pediátrica/normas , Estudantes de Enfermagem/psicologia , Atitude do Pessoal de Saúde , Estudos de Coortes , Bacharelado em Enfermagem/métodos , Humanos , Simulação de Paciente , Enfermagem Pediátrica/educação , Pesquisa Qualitativa , Treinamento por Simulação/métodos
17.
Nurs Ethics ; 26(3): 663-673, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-28766394

RESUMO

BACKGROUND: Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses. AIM/OBJECTIVES: This study was conducted to evaluate moral distress among nurses in selected pediatric hospitals in Tehran, Iran. RESEARCH DESIGN: This cross-sectional study was conducted on eligible nurses who were selected through proportional stratified sampling and who completed demographic characteristics and the pediatric version of Moral Distress Scale-Revised questionnaires. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, and Pearson correlation coefficient. PARTICIPANTS AND RESEARCH CONTEXT: In total, 195 pediatric nurses working at three selected children's specialized university hospitals in Tehran participated in this study. ETHICAL CONSIDERATIONS: This study was evaluated and approved by the institutional review board of Tehran University of Medical Sciences. FINDINGS: The mean and standard deviation of total score of moral distress was 106.41 ± 61.64 within a range of 10-257. Also, the difference between the mean score of moral distress of the group who had not quitted their position and those who have quit in the past was statistically significant (p = 0.043). The situation that was associated with the highest moral distress was "observing medical students performing painful procedures on patients just to gain some skill." Total score of moral distress was significantly higher among male nurses (p = 0.014), while nurses with a master's degree experienced just a higher intensity of moral distress compared to those who had a bachelor's degree (p = 0.006). CONCLUSION: Since many pediatric nurses clearly face moral distress while taking care of children, it is necessary to consider measures for preventing or decreasing situations that would lead to this distress.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Enfermagem Pediátrica/normas , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Atitude do Pessoal de Saúde , Esgotamento Profissional/etiologia , Esgotamento Profissional/psicologia , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Enfermagem Pediátrica/métodos , Psicometria/instrumentação , Psicometria/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Carga de Trabalho/psicologia , Carga de Trabalho/normas , Local de Trabalho/psicologia , Local de Trabalho/normas
19.
West J Emerg Med ; 21(1): 134-140, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31913833

RESUMO

INTRODUCTION: The World Health Organization recently recognized the importance of emergency and trauma care in reducing morbidity and mortality. Training programs are essential to improving emergency care in low-resource settings; however, a paucity of comprehensive curricula focusing specifically on pediatric emergency medicine (PEM) currently exists. The African Federation for Emergency Medicine (AFEM) developed a PEM curriculum that was pilot-tested in a non-randomized, controlled study to evaluate its effectiveness in nurses working in a public Tanzanian referral hospital. METHODS: Fifteen nurses were recruited to participate in a two-and-a-half-day curriculum of lectures, skill sessions, and simulation scenarios covering nine topics; they were matched with controls. Both groups completed pre- and post-training assessments of their knowledge (multiple-choice test), self-efficacy (Likert surveys), and behavior. Changes in behavior were assessed using a binary checklist of critical actions during observations of live pediatric resuscitations. RESULTS: Participant-rated pre-training self-efficacy and knowledge test scores were similar in both control and intervention groups. However, post-training, self-efficacy ratings in the intervention group increased by a median of 11.5 points (interquartile range [IQR]: 6-16) while unchanged in the control group. Knowledge test scores also increased by a median of three points (IQR: 0-4) in the nurses who received the training while the control group's results did not differ in the two periods. A total of 1192 pediatric resuscitation cases were observed post-training, with the intervention group demonstrating higher rates of performance of three of 27 critical actions. CONCLUSION: This pilot study of the AFEM PEM curriculum for nurses has shown it to be an effective tool in knowledge acquisition and improved self-efficacy of pediatric emergencies. Further evaluation will be needed to assess whether it is currently effective in changing nurse behavior and patient outcomes or whether curricular modifications are needed.


Assuntos
Currículo , Medicina de Emergência Pediátrica/educação , Enfermagem Pediátrica/educação , Estudos de Casos e Controles , Criança , Competência Clínica/normas , Serviços Médicos de Emergência/normas , Hospitais Públicos , Humanos , Enfermeiras Pediátricas/educação , Enfermeiras Pediátricas/normas , Medicina de Emergência Pediátrica/normas , Enfermagem Pediátrica/normas , Projetos Piloto , Encaminhamento e Consulta , Ressuscitação/educação , Ressuscitação/normas , Inquéritos e Questionários , Tanzânia
20.
Crit Care Nurse ; 38(5): 44-56, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30275063

RESUMO

Pediatric cardiac failure is a significant problem that may be caused by cardiomyopathy, myocarditis, or congenital defects that cannot be surgically repaired. Long-term mechanical circulatory support (LTMCS) devices provide hemodynamic support for patients in heart failure as a bridge to heart transplant and, sometimes, cardiac recovery or destination therapy. Critical care nurses must have a comprehensive understanding of LTMCS device function and keen assessment skills to detect signs of impaired perfusion and device failure. Nurses should anticipate postoperative interventions, prevent adverse events, and be prepared to respond during emergencies. Patient care should be family centered and nurses must strive to maximize patients' quality of life throughout device implantation. This article provides a basic guide to caring for pediatric patients receiving LTMCS, including specific information regarding 4 devices that are often used for pediatric heart failure: Berlin Heart EXCOR, SynCardia Total Artificial Heart, HeartWare HVAD, and HeartMate II.


Assuntos
Oxigenação por Membrana Extracorpórea/educação , Oxigenação por Membrana Extracorpórea/instrumentação , Insuficiência Cardíaca/enfermagem , Coração Auxiliar , Enfermagem Pediátrica/educação , Enfermagem Pediátrica/normas , Guias de Prática Clínica como Assunto , Adulto , Criança , Pré-Escolar , Educação Continuada em Enfermagem , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/educação
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