Paediatric nursing
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Paracetamol and ibuprofen are safe and effective medications for reducing a fever in children and young people and they are often administered together with a view to reducing a temperature quickly. National Institute for Health and Clinical Excellence guidelines dictate that only one of these drugs should be given at a time because there is no evidence to suggest that simultaneous use is more effective. ⋯ However, the maximum dose of paracetamol was not administered. There is a need for more methodologically sound research that uses equivalent doses of both drugs.
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This article reviews the evidence for using music therapy with young people who are supported by mechanical ventilation. The author argues that music therapy is essential for developing a holistic approach focusing on the developmental level of a child or young person, as well as being an inexpensive, non-pharmacological, non-invasive therapy, with significant physiological and psychological benefits. She argues that more research is needed in this area to develop a sound evidence base on which guidelines to inform practice could be based.
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Venepuncture is one of the most feared hospital procedures for children and inadequate pain management has the potential to affect future care. Distraction has been shown to help to reduce procedural distress in children. A thematic analysis of relevant literature on distraction techniques revealed that passive distraction is more effective than active distraction during venepuncture and that the effectiveness of a particular technique depends on the attention capacity of the child and their engagement in the distraction activity.
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The use of sedation and analgesia in critically ill children is necessary for clinical management but can result in undesirable side effects such as physical dependence, tolerance and withdrawal symptoms. Weaning from sedation aims to prevent such unpleasant effects. ⋯ This variation may be the result of high workload, other external pressures, traditional ways of working or other factors. Strategies such as an easily accessible scoring flow chart, a poster display, improved staff induction or other measures could help to improve safety and quality in sedation management.
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Infants in the neonatal intensive care unit are at particular risk from clinical errors because of their fragility and vulnerability, as well as the complex nature of medication and other treatment regimes. Wrong route errors have been well documented, particularly related to enteral nutrition and medication. Published guidance for preventing such errors should inform changes in practice at the local level. ⋯ A routine revision of departmental policy resulted in a review of available evidence to inform the practice changes. Colour-coded enteral/oral syringes with a new style nasogastric tube were introduced. By promoting best practice through networking with other colleagues, staff have worked towards standardising the delivery of care in order to minimise the risk wrong route errors.