Paediatric nursing
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Central venous catheters (CVCs) are an essential tool in paediatric intensive care, providing a means to monitor patient haemodynamics and to administer fluids, nutrition, blood products and medications. Because multiple factors contribute to the high risk of catheter related infection, a multi-strategy approach is required to prevent such infections. Using contemporary literature and clinical audit findings a 'care bundle' was created for use within the PICU at Birmingham Children's Hospital. This care bundle groups together best practices in order to prevent catheter related bloodstream infection.
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Nursing continues to extend its practice base as the acuity of children in general wards often with complex illnesses and treatment increases. There is a need for ongoing development of the physical assessment skills of nurses who care for children and young people in order to facilitate early recognition of clinical problems. ⋯ The skill of auscultation adds another dimension that augments the respiratory assessment repertoire of the nurse. This article builds on the palpation skills presented in February issue and provides a practical step-by-step introduction to auscultation.
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Review Case Reports
Intestinal transplantation in children: a new challenge for nursing.
Small bowel transplantation is a recent innovation and thus a relatively new area of nursing practice. There is a lack of literature on the nursing care of children whose only hope of long-term survival is small bowel transplantation. The aim of this article is to raise awareness about intestinal transplantation in children using a case study to highlight the main nursing implications including: multidisciplinary team working, monitoring fluid balance, caring for immunosuppressed patients, monitoring for acute rejection and discharge preparation of the child and family.
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Nasojejunal delivery of enteral feeds is a safe and effective alternative to parenteral nutrition in critically ill children in whom intra-gastric feeding is usually poorly tolerated. A guideline for bedside placement of nasojejunal tubes (NJTs) was developed by a mulit-disciplinary group. An audit of practice was carried out following implementation of the guideline. ⋯ The audit also demonstrated that 26 out of 27 nurses and doctors reported they found the guidelines easy or very easy to follow. Reducing variations in practice through the use of guidelines increases the frequency of jejunal feeding. This benefits critically ill patients by improving tolerance of enteral feeding for better nutritional outcomes.