Pediatric nursing
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Review Case Reports
Wish fulfillment: palliative care and end-of-life intervention.
Children with life-threatening illnesses are subjected to numerous treatments and procedures. They endure enormous physical and emotional pain as attempts are made to prolong their lives. These children require sensitive care by pediatric nurses who recognize the importance of the child's need to grow and become. ⋯ The fulfillment of the wish is a palliative care and end-of-life intervention that can ease suffering and sorrow for the child and family. It is essential to understand, however, that the child has complex emotions as the wish is fulfilled. The provision of care must, therefore, include psychological support, empowerment, and communication with the child and family to assist with life-threatening illnesses as they experience suffering within the tension of living and dying.
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Review Case Reports
An evidence-based approach for supporting parents experiencing chronic sorrow.
Chronic sorrow is defined as a normal grief response associated with an ongoing living loss that is permanent, progressive, recurring, and cyclic in nature. If a parent experiencing chronic sorrow has a support system that is inadequate or does not receive appropriate intervention for ineffective coping, it is possible that chronic sorrow can become a pathological grief state similar to depression. Nurses must recognize that chronic sorrow is a normal grief response associated with a living loss, learn to appropriately assess chronic sorrow in parents of chronically ill children, and develop ways to support parents experiencing chronic sorrow by applying evidence-based strategies to facilitate effective coping.
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Pediatric palliative nursing care, both stressful and rewarding, requires coping skills, confidence, and other attributes for successful patient care and nursing practice. Through a thorough literature review, clinical workshops, direct observations in pediatric palliative care settings, and personal nursing experience in the neonatal intensive care, pediatric intensive care, and oncology wards, this author confirmed the necessity for studies to clarify the needs of dying pediatric patients and their families, as well as the needs of nurses who provide their care. This article briefly reviews the history and current status of pediatric palliative care, describes the experiences of nurses caring for dying children, explores the impact of providing palliative care on the hospital staff, and seeks to discover possible interventions by the advanced practice nurse to influence more positive patient care and nursing staff job satisfaction and retention.
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This integrative literature review examines the long-term sensorineural hearing loss associated with cisplatin chemotherapy treatment in children with cancer. CINAHL, PsychInfo, Medline, Google Scholar, and Google databases were searched for research related to cisplatin-induced ototoxicity. The characteristics, prevalence, and underlying mechanisms of cisplatin ototoxicity are discussed. Primary care implications, including how and when to monitor the hearing of childhood cancer survivors, ways to provide family support, and education about the significance of hearing losses, and an overview of the management for hearing impairments are presented.
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This article reports an evidence-based practice project using the Iowa Model of Evidence-Based Practice to Promote Quality Care for a common nursing procedure, nasogastric tube placement verification in children. Little research exists regarding the care of nasogastric tubes in children, and traditional verification methods prevail. Auscultation of air insufflation over the abdomen is still used to check placement in many settings, despite research dating back to the 1980s questioning this approach. ⋯ Project results demonstrate a decrease (93.3% to 46.2%) in the use of auscultation and improved use of other, more reliable methods to determine nasogastric tube placement. Changing practice can be challenging. However, with persistence and re-infusion, this project provides an important example of how the evidence-based practice process leads to excellence and improves patient care.