Pediatric nursing
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Few bibliometric studies have been done of the nursing literature; however, much can be learned about nursing and specialty areas of clinical practice by examining the articles published in nursing journals. The purposes of this study were to describe the extent of research, clinical, and evidence-based practice articles published in maternal/child nursing journals and the information sources used to develop that literature. ⋯ Research publications were cited most frequently including research studies published in medical journals (n=687, 26.7% of all the cited documents), followed by research studies published in nursing journals (n=371, 14.4%) and journals in other disciplines. The maternal/child nursing journals examined in this study are disseminating research findings to nurses for use in clinical practice.
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Sedation is commonly performed in children in the emergency department. However, little is known about adverse events that may occur after discharge. This study was conducted to evaluate adverse effects occurring after discharge in children following sedation in the emergency department. ⋯ Children experience minor adverse effects from sedation after discharge from the emergency department. Anticipatory guidance about these adverse effects should be given to parents and caregivers prior to discharge.
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Nurses' knowledge and attitudes about pain affect their ability to manage patients' pain. A mechanism was sought to evaluate nursing competency in pain management at eight pediatric hospitals. Several pain survey tools were reviewed, considering the patient population around which they were designed, the basis for survey content, and format. ⋯ The tool was modified for applicability to the nurses caring for pediatric populations that do not include oncology. Revisions were made with the concurrence of Manworren to assure that neither the content being tested, nor the integrity of the tool, was affected. Stability of the modified tool (PNKAS-Shriners Version 2002) was verified by retesting 6-8 weeks after initial survey.
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To improve care of children who die in acute care settings there is a need to develop a clearer understanding of the barriers to provision of palliative care. The purpose of this study was to describe the experiences and views of health care providers in giving care to children who have undergone intensive therapies for life-threatening illnesses. A qualitative, descriptive design was conducted in the intensive care nursery, pediatric intensive care unit, and pediatric blood and marrow transplant unit at a southeastern US medical center. ⋯ Three challenges in employing palliative care to acutely ill infants and children were identified: (a) finding the true dying point, (b) making the transition to palliative care, and (c) turning care over to an outside palliative care team at a critical juncture of caring. Professional issues in providing palliative care included inadequate preparation and, especially for nurses, the crossing of professional boundaries. An integrated model of palliative care is needed that is initiated at diagnosis and allows for the bidirectional transitioning across the illness and treatment trajectories.