• Title/Summary/Keyword: Nurses, Pediatric

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Pediatric Dehydration Assessment at Triage: Prospective Study on Refilling Time

  • Caruggi, Samuele;Rossi, Martina;De Giacomo, Costantino;Luini, Chiara;Ruggiero, Nicola;Salvatoni, Alessandro;Salvatore, Silvia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.278-288
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    • 2018
  • Purpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children. Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse's measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale's discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve. Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen's kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=-0.27; 95% CI, -0.47 to -0.04). The scale's discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves. Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up.

Development and Implementation of a Feeding Protocol for Infants in a Pediatric Cardiac Intensive Care Unit (소아심장외과 중환자실 장관영양 프로토콜 개발 및 효과평가)

  • Uhm, Ju-Yeon;Lee, Hyojin
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.326-335
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    • 2016
  • Purpose: It is crucial to provide adequate enteral nutrition for postoperative recovery, wound healing and normal growth in infants in pediatric cardiac ICUs. This study was done to develop a feeding protocol using the vaso-active inotropic (VAI) score and to evaluate the impact of nutritional outcomes following the new feeding protocol for infants who underwent cardiac surgery. Methods: This study consisted of three phases. First, a feeding protocol was developed based on a literature review. Second, ten experts rated the content validity. Third, a comparison study was conducted to evaluate the impact of the new feeding protocol. Data were analyzed using SPSS Version 20. Results: Twenty-nine infants were enrolled in the pre-protocol group, and 22 infants in the post-protocol group. Patients in the 2 groups were similar. Time to reach feeding goal was significantly decreased from 56.0 (27-210) hours to 28.5 (10-496) hours in the post-protocol group (Z=-4.22, p<.001). Level of enteral feeding knowledge among nurses increased significantly after implementation of the protocol. Conclusion: The feeding protocol using VAI score facilitates the achievement feeding goal to decrease feeding interruptions and help nurses in their practice. Larger studies are necessary to examine clinical outcomes following the implementation of this feeding protocol.

Is Local Anesthesia Necessary in Ketamine Sedation for Pediatric Facial Laceration Repair?: A Double-Blind, Randomized, Controlled Study (소아 안면 열상 봉합을 위한 케타민 진정시 국소 마취가 필요한가: 전향적 무작위대조, 이중맹검 연구)

  • Ko, Min Jung;Choi, Jae Hyung;Cho, Young Soon;Lee, Jung Won;Lim, Hoon;Moon, Hyung Jun
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.178-185
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    • 2014
  • Purpose: The aim of this study was to assess the clinical efficacy of combined treatment with local anesthesia and ketamine procedural sedation for pediatric facial laceration repair in the Emergency Department (ED). Methods: Patients aged 1 to 5 years receiving ketamine for facial laceration repair were prospectively enrolled in a double-blind, randomized, and controlled study at an ED. All patients were to receive intravenous ketamine (2 mg/kg). The local anesthesia group (LA group) received a local anesthetic along with ketamine, whereas the no local anesthesia group (NLA group) received only ketamine. The total time of sedation, the patients' movements and groans, adverse events, and the satisfaction ratings of physicians, nurses, and parents were recorded. Results: A total of 186 patients were randomized (NLA group: 90, LA group: 96). The total time of sedation (30.5 minutes for the NLA group, 32.6 minutes for the LA group; p=0.660), patients' groans (26 (28.9%) versus 23 (24.0%); 0.446) and movements (27 (30%) versus 35 (36.5%); p=0.350) was not affected by the addition of local anesthesia. Other adverse events were similar between the two groups. Also, the satisfaction ratings of physicians (median 4 for the NLA group versus 4 for the LA group (p=0.796)), nurses (2 versus 2.5 (p=0.400)), and parents (4 versus 4 (p=0.199)) were equivalent between the two groups. Conclusion: In this study, we found that local anesthesia was not required along with ketamine sedation for pediatric facial laceration repair.

The Educational Needs of Mothers of Nephrotic Syndrome Patients and the Degree of the Importance of Educational Activity Perceived by Nurses (신증후군 환아 어머니의 교육요구와 간호사가 인지한 교육활동의 중요도에 관한 탐색적 연구)

  • Sung Mi Hae;Jung Yun
    • Child Health Nursing Research
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    • v.3 no.2
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    • pp.169-177
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    • 1997
  • This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients and the degree of the importance of educational activity perceived by nurses who look after nephrotic syndrome patients. The study subjects were composed of 60 mothers & 63 nurses of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Mar. in 1997 to July 1997. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. The data analysis was done by SAS. t-test, and ANOVA were done to determine the effect of general characteristics of subjects on their educational needs. T-test was done to measure relations between the degree of educational needs and importance of educational activity. The results were as follows. 1. The Educational needs of mothers ranked as the highest in home care. 2. In character of mothers, the degree of education, economic state, the number of child and occupation was significant in statistically. 3. The importance of educational activity of nurses ranked the highest in diagnosis and treatment of the disease. 4. The educational needs of nephrotic syn. children' mother and importance of nurses were different in diagnosis and treatment of the disease and home care. On the basis of these results, we suggest as follows. 1. It is proposed that nurses use these results of the study actively for the educational program for Nephrotic Syndrome patients and their mothers. 2. It is suggested to make a comparative study of the degree of nurses' understanding of the importance on educational items with the instruments of this study.

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The Study on related factors of breast feeding practice (모유수유 실천 관련 요인에 관한 연구)

  • Kwon, Sook-Hee;Kim, Young-Ja;Kim, Young-Hae;Kim, In-Soon;Moon, Guil-Nam;Park, Geum-Ja;Park, Bong-Ju;Park, Soon-Og;Park, Choon-Hwa;Bae, Young-Soon;Bai, Jeung-Yee;Back, Kyoung-Seon;Song, Ae-Re
    • 모자간호학회지
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    • v.3 no.2
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    • pp.172-186
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    • 1993
  • The survey was performed on 201 cases of mothers who visited pediatric hospitals and public health clinics in Pusan and Kyeong-nam provinces from Dec. 10 to Dec. 30 of 1993. If this study, each infant weighed over 2500gm and between 2 months and 12 months old. The research was statistically analyzed according to the percentage, Pearson correlation, $x^2$-test. The result of this study were as follows ; 1. Feeding method related to the job of mother (p<0.01). 2. Feeding method related to the way of bringing up child(p<0.05). 3. Whether the mother and child shared the same room effected the feeding method (p<0.01). 4. The shape of nipple before breast feeding related to feeding method. 5. The reason for stopping breast feeding related to feeding method(p<0.01). 6. First breast feeding related to period of seperation after delivery(p<0.05). 7. Plan of breast feeding related to birth weight (p<0.05).

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Hospitalized Children and Their Nurses각 Perception of Caring (입원아동과 간호사가 지각한 돌봄에 대한 연구)

  • 김정선;김신정
    • Journal of Korean Academy of Nursing
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    • v.22 no.3
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    • pp.297-315
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    • 1992
  • Caring has been identified as the essence and unifying domin of nursing(Leininger). Many nurses believe that the art of nursing is comprised of actions that are predominantly caring in nature. Although caring has been the traditional ideology of nurses, it is only now beginning to emerge as the central construct for the development of nut sing research, theory and practice. The problem addressed by this study was to identify how hospitalized children and their nurses express the meaning of caring, how they think nurses should care for children and to describe their experiences of being cared for. The purpose was to provide theoretical understanding of caring as perceived in Korea to contribute to the development of Korean nursing knowledge. The subjects were 76 hospitalized children admitted to pediatric units in five teaching hospitals and 66 nurses who were caring for these children. In this descriptive study, data were collected from Nov 11, 1991 to Jan 30, 1992 by interviews and an open-ended questionnaire and analysed by van Kaam's method. Caring themes perceived by the children and their nurses were classified into eight categories, -helping, comfort, love, warmth(only by children), recovery from illness, health maintenance (only by nurses), presence, nurturance and responsibility. Ideal caring behaviors perceived by the children and their nurses were six categories, -to give help, provide comfort, give love, stay with, treat warmly and aid recovery. Subcategories of giving help were promptness and competence, detailed explanations and support and encouragement. Other subcategories of giving help reported only by nurses were individualizing care, recognizing needs and providing a familiar enviornment. Subcategories of maintaining comfort were making comfortable, alleviating pain ; one subcategory reported only by children was consolating. A subcategory of giving love was concern, two subcategories reported only by nurses were compassion and respect. Subcategories of staying with were playing with and touching : only nurses reported empathy, Subcategories of treating warmly were tenderness and kindness. In the experience of caring, there were 4 categories, -to give help, stay with, show concern and provide comfort. Both the hospitalized children and their nurses had experienced caring primarily from their mothers. Mothers' caring behaviors were direct, personal, basic, supportive nursing acts. On the other hand, nurses caring behaviors were task oriented skilled procedures and medically delegated acts. This study contributes understanding of the complexity of caring, more specifically the meaning and experience of caring and ideal caring behaviors. Research may be able to move into verification when instruments are developed to measure the complexity of caring beliefs, values and behaviors in Korea and other cultural settings.

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A Survey of the Nursing Interventions Performed by Neonatal Nursing Unit Nurses Using the NIC (신생아 간호단위 간호중재 분석 - 3차 개정 Nursing Intervention Classification(NIC)을 적용하여 -)

  • Oh Won-Oak;Suk Min-Hyun;Yoon Young-Mi
    • Child Health Nursing Research
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    • v.7 no.2
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    • pp.161-178
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    • 2001
  • The purpose of this study was to identify nursing interventions performed by neonatal nursing unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification(NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The new 58 nursing interventions was translated into Korean, and then modified by pannel group, which consist of clinical experts and nursing scholars and finally the 419 nursing interventions was selected. The data were collected from 112 nurses. 168 nursing interventions were performed at least monthly by 50% or more of the nurses. The high frequency of performed nursing interventions were Family domain. 37 nursing interventions were performed at least once a day. The nursing interventions receiving the highest item mean score were neonatal care, neonatal monitoring, photo-therapy; neonate, bottle feeding and temperature regulation. 56 nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the behavioral domain. The rarely used interventions were urinary bladder training, art therapy, religious addiction prevention, religious ritual enhancement and bladder irrigation. Therefore, neonatal nursing units nurses used interventions in the Physiological: basic domain most often on a daily basis and the interventions in the behavioral domain least often. These findings will help in building of a standardized language for the neonatal nursing units and enhance the quality of nursing care. Further study will be needed to classify each intervention class and nursing activity and validate NIC in pediatric care unit.

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The effects of nurses' communication styles, nurse-mother partnerships, and mothers' anxiety on coping of hospitalized children's mothers (아동병동 환아 어머니가 인지한 간호사의 의사소통유형과 간호사와의 파트너십, 불안이 대처에 미치는 영향)

  • Kim, Yonghee;Choi, Areum;Jang, Insun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.2
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    • pp.170-179
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    • 2023
  • Purpose: This descriptive study aimed to identify the contribution of nurses' communication styles, nurse-mother partnerships, and mothers' anxiety levels to the coping of mothers of hospitalized children, with the goal of establishing effective intervention strategies based on these factors. Methods: Data were collected using a structured questionnaire from July 12 to October 29, 2018. The study's participants were 200 hospitalized children's mothers in the pediatric ward of a university hospital. Results: The coping of hospitalized children's mothers showed a significant relationship with nurses' informative communication style (r=.26, p<.001), affective communication style (r=.28, p<.001), nurse-mother partnership (r=.50, p<.001), authoritative communication style (r=-.28, p<.001), and mothers' anxiety (r=-.23, p=.001). A multiple regression analysis (adjusted R2=.32) indicated that the factors affecting the mothers' coping included nurse-mother partnership (𝛽=.47, p<.001), another caregiver (yes) (𝛽=.17, p=.006), and mothers' subjective health status (very healthy) (𝛽=.15, p=.047). Conclusion: Considering that the formation of cooperative partnerships between mothers and nurses found in this study had a positive effect on the mothers' coping skills, it appears necessary to develop and implement programs for improving nurses' communication skills and ability to form partnerships, beginning from undergraduate education.

A Study of Humor as a Nursing Intervention for Hospitalized Children (입원아동을 위한 아동간호학 분야의 유머 중재에 관한 고찰)

  • Sim, In-Ok;Han, Kyung-Ja
    • Child Health Nursing Research
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    • v.12 no.1
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    • pp.114-121
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    • 2006
  • Purpose: Humor is an important part of life. Humor has many benefits as an intervention for hospitalized children. Humor is one strategy that pediatric nurses can use to help children cope with illness and hospitalizations. The purposes of the study were to 1) review the definition of humor, 2) identify methods and skills in using humor as an intervention, 3) identify the effects of humor as an intervention, and 4) suggest further research. Method: The design was a descriptive study with literature review. Previous studies were identified by searches of MEDLINE, CHNIAL, PUBMED and ProQuest. Results: Humor has positive physiological, psychological, social and communicative effects on patients and humor has a positive effect on the immune system. Conclusion: The main point identified from this study suggests that humor as a nursing intervention be developed for nurses to use with children who are hospitalized. Further research is needed to develop programs for humor as an intervention for health promotion and disease prevention in children.

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