Pediatric nursing
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Parental visitation in pediatric intensive care units, induction rooms, and postanesthesia care units is still limited despite the incongruence of such policies with existing stress and social-support theories. As recently as 1994, a survey of 125 randomly selected hospitals in 10 southeastern states found that 57% restricted visits to pediatric patients in intensive care units to brief periods, 5 to 15 times per day (Whitis, 1994). Little justification can be found for these practices. ⋯ First, an understanding of the historical context of visitation policies is important. Second, efforts to dispel concerns are needed, including staff preparation. Third, a philosophical switch to family-centered care must be adopted.
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Policies of most neonatal intensive care units include teaching cardiopulmonary resuscitation (CPR) to parents or other caretakers prior to infant hospital discharge. However, little is known about CPR skills retention in this population or the outcome of parents' use of CPR. This is a study to measure CPR skills 6 months following CPR training to identify characteristics predicting successful performance and to determine if parents used CPR. ⋯ CPR skills decay is significant for caregivers of infants at high risk for cardiopulmonary arrest. Parents should be encouraged to review the steps of CPR frequently and to attend refresher classes. A significant proportion of parents of infants hospitalized in the neonatal intensive care unit are called upon to use CPR and are able to use it appropriately.
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Comparative Study
Patency of 24-gauge peripheral intermittent infusion devices: a comparison of heparin and saline flush solutions.
The purpose of this study was to compare the effectiveness of heparin and normal saline flush solutions in maintaining the patency of 24-gauge peripheral intermittent infusion devices (PIIDs). A prospective, non-randomized, sequential, blinded study design was conducted on a pediatric and a neonatal intensive care unit. The sample consisted of 134 catheters in 61 patients. ⋯ Kaplan-Meier Survival Analysis indicated that the duration of catheters flushed with heparin was significantly longer than those flushed with saline (p = .02). More catheters flushed with saline were removed because of problems (p = .027). Results of this study suggest that heparin is more effective than saline in maintaining the patency of small, 24-gauge catheters.
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Pediatric nurses from varied practice and educational backgrounds learned about research by doing a ward-based study. The aim of the study was to determine if regular assessment of children's pain would improve their pain management and postoperative progress. ⋯ Study results reinforce findings reported in the literature regarding ineffective pain management in children, and highlight a need for improved nursing practice. Clinical significance was achieved in terms of staff learning of the research process, increased awareness of pediatric pain management practices, improved ward morale, and inter-agency sharing of resources.
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Toxic ingestions (accidental or intentional) continue to occur within the pediatric population. Activated charcoal has replaced syrup of ipecac as the gastrointestinal decontamination method of choice. Activated charcoal has poor palatability and poses acceptability and administration problems with children. This article proposes innovative approaches to the administration of activated charcoal as an antidote for pediatric toxic ingestions.