Journal of pediatric nursing
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Inpatient pediatric cardiovascular patients have higher rates of cardiopulmonary arrests than other hospitalized children. Pediatric early warning scoring tools have helped to provide early identification and treatment to hospitalized children experiencing deterioration thus preventing arrests from occurring. However, the tools have rarely been used and have not been validated in the pediatric cardiac population. This paper describes the modification of a pediatric early warning scoring system for cardiovascular patients, the implementation of the tool, and its companion escalation of care algorithm on an inpatient pediatric cardiovascular unit.
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Review Comparative Study
Distraction techniques for children undergoing procedures: a critical review of pediatric research.
Pediatric patients are often subjected to procedures that can cause pain and anxiety. Although pharmacologic interventions can be used, distraction is a simple and effective technique that directs children's attention away from noxious stimuli. ⋯ Given the range of distraction techniques, the purpose of this article was to provide a critical assessment of the evidence-based literature that can inform clinical practice and future research. Recommendations include greater attention to child preferences and temperament as a means of optimizing outcomes and heightening awareness around child participation in health care decision making.
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Review Comparative Study
Optimizing the assessment of pain in children who are cognitively impaired through the quality improvement process.
Pain assessment in children with cognitive impairment (CI) is challenging. A quality improvement (QI) project involving evidence-based review of pain assessment tools, feedback from the Family Advisory Council, trialing of selected tools within clinical settings including obtaining feedback from nurses, and parents caring for nonverbal children with developmental delay was reported. ⋯ Results of postimplementation audit and challenges of staff nurse involvement in the QI process were also discussed. The 24-month-long QI process and its impact on changing practice were described in detail.
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Comparative Study
Greater saphenous vein location in a pediatric population.
The purpose of this study was to assess the accuracy of a landmark technique for cannulation of the greater saphenous vein (GSV) near the medial malleolus. We performed bedside ultrasound in a convenience sample of 100 children, ages 3 to 16 years, to evaluate the anatomy of the GSV at the ankle. Despite the proposed constancy of the landmark technique regardless of patient age, the GSV location varied significantly with increasing patient age and weight. In children less than 10 years old or weighing less than 40 kg, the traditional landmark rarely predicted the precise location of the GSV.