Pediatric nursing
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The Joint Commission requires pediatric hospitals to implement fall prevention programs and evaluate the efficacy of such programs. The Humpty Dumpty Falls Scale (HDFS), a seven-item assessment scale used to document age, gender, diagnosis, cognitive impairments, environmental factors, response to surgery/sedation, and medication usage, is one of several instruments developed to assess fall risk in pediatric patients. ⋯ Using the HDFS cut-off score of 12 and above to indicate a high risk for falls in these children yields a high false-positive rate. Investigators and staff at pediatric specialty hospitals need to continue their pursuit of valid instruments and tools that contribute to fall reduction.
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Traumatic brain injuries (TBIs) in childhood, especially those related to participation in sports and recreation activities, are receiving increased public awareness. Research is beginning to show that even mild TBIs (mTBIs) may not be mild at all, and could have serious long-term effects on the health, behavior, and cognitive abilities of children. With the development of the Centers for Disease Control and Prevention's TBI tools for professionals, a more evidenced and systematic way is available to help recognize and manage mTBI. New research on predictor values showing that symptoms may not be the best way to assess the severity of mTBI will help to change how mTBIs are managed in the future.
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In 2007, The Joint Commission began requiring health care organizations to develop and implement a standardized approach to clinical handoff. The goal is to improve patient safety across the health care continuum. While accurate and complete handoff communication is essential in all areas of patient care, it is of critical importance where patients require the most complex care, such as in the emergency department. ⋯ Eight nurses of varying levels of practice who work a variety of shifts participated to explore the clinical handoff process in the emergency department of a pediatric teaching hospital. Perceptions and beliefs regarding the process of clinical handoff (who is involved, what variations exist, where they occur) and barriers to the clinical handoff process were explored. Recurring themes included provider-directed handoff, interruptions--impediment to care, and envisioning the ideal process.