Pediatric nursing
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Unintentional injury is the leading cause of death and disability in children 14 years and under. The National SAFE KIDS Campaign, a nationwide organization aimed at education and prevention of unintentional injury, recently released its 10-year report that describes areas of success, areas in need of improvement, and goals for the future. The full 61-page report is worthy of reading and referencing for all those involved with children and their health care. Highlights of the report are summarized below.
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Seat belts and child safety seats can provide effective protection against serious and fatal injuries, but motor vehicle crashes (MVCs) remain a leading cause of death and injury among infants and children. Recent fatalities associated with air bags have intensified awareness of pediatric occupant car safety issues. A review of pediatric literature from 1989 to 1997 summarizes studies on the correct use, incorrect use, and non-use of child safety restraint devices; injuries patterns to children as occupants in MVCs; transporting children with special needs; lethal air bag injuries; and injury prevention educational programs.
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Infrared tympanic thermometry (ITT) is increasingly used as a convenient, noninvasive assessment method for febrile children. However, the accuracy of ITT for children has been questioned, particularly in relation to specificity and sensitivity. This study was designed to (a) determine the correlation and extent of agreement between rectal temperature (RT) readings obtained by electronic thermometer and ear-based temperature readings obtained by ITT, and (b) determine the accuracy of detecting fever in children under 6 years of age. ⋯ Sensitivity, specificity, positive predictive value, and negative predictive value are unacceptably low and the number of children with fever who would be missed by screening with a tympanic thermometer is unacceptable. Findings of this study do not support the use of tympanic thermometers to detect fever in children under 6 years of age.
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This study examined children's and adolescents' perceptions of the descriptors hurt, ache, and pain. Nonhospitalized subjects (N = 198) between 8 and 19 years of age from three schools rated the levels of intensity associated with each of the descriptors on a word-graphic rating scale and matched each to one of three drawings depicting painful experiences. ⋯ Significant preferences for matching descriptors to painful experiences was not demonstrated except for the word ache. These findings indicate that children and adolescents associate similar levels of intensity with pain, hurt, and ache but associate different experiences with each.
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Randomized Controlled Trial Clinical Trial
The COPE program: a strategy to improve outcomes of critically ill young children and their parents.
Critically ill young children and their parents are subjected to multiple stressors during hospitalization, which may predispose them to short- and long-term negative outcomes. Nurses who care for children who are critically ill and their families during and following their intensive care unit stay must be knowledgeable of the impact of a child's critical illness on the family and factors influencing adjustment to the stressful experience. Knowledge of these issues is essential in planning effective intervention strategies to enhance coping outcomes in this population. This article (a) discusses how young children and their parents are affected by critical illness; (b) outlines major sources of stress for families; (c) identifies factors influencing coping outcomes; and (d) describes the COPE program, a newly devised early intervention program for critically ill young children and their parents.