Nursing children and young people最新文献

Over the past decade there has been a drive towards prevention of type 1 diabetes (T1D), which has led to the development of screening programmes to identify individuals with early-stage disease. In the same period, clinical trials have been taking place on the use of immunotherapy in preventing T1D progression. These developments in screening and immunotherapy require care pathways that provide monitoring, information and support to children and young people with early-stage type 1 diabetes and their families. This article provides an overview of the developments in screening and immunotherapy and considers the implications for children and young people and their families and for the healthcare professionals involved in their care.

The traditional patient-clinician relationship is changing as young people and their families often now turn to the internet and social media for health information, treatment advice and support. Much of that content, however, is unregulated, unverified and inaccurate, which leads to the dissemination of health misinformation. Healthcare professionals working with young people with eczema and their families need to understand why young people turn to social media for health information, identify trends in online misinformation about eczema, and provide alternative, trustworthy sources of information. This article discusses particular areas of online misinformation about eczema as well as dermatology content on specific social media platforms. It also reports the views of young people on the youth panel of the charity Eczema Outreach Support about different social media platforms.

Homeostasis can be described as the dynamic process within an organism designed to maintain a relatively constant internal environment that is conducive to the optimal functioning of cells, enzymes and organs. To regulate physiological variables, homeostasis relies on mechanisms called negative and positive feedback loops. However, certain factors can disrupt homeostatic processes, leading to dysregulation and disease. This article provides an overview of homeostasis, including negative and positive feedback loops and dysregulation. The authors use a fictional case study - an adolescent girl with type 1 diabetes who develops diabetic ketoacidosis - to illustrate the adverse effects of homeostatic dysregulation and demonstrate the relevance of understanding homeostasis in children's nursing.

The 0-19 looked after children (LAC) team in Doncaster, England, is a well-established service that has developed over time to identify and address the health needs of looked after children and young people and care leavers. Its aims are to improve outcomes for these children and young people by offering a holistic approach to assessing their health and well-being. The principle of having a dedicated nurse specialist for LAC following each child or young person throughout their care journey enables a trusting relationship to be established and the voice of the child or young person to be heard. This article reports on several developments in the Doncaster LAC team, including a local pilot of joint nurse and GP initial health assessments and participation in a national pilot of mental health assessments.

Rationale and key points: Respiratory auscultation involves listening to and interpreting sounds from within the chest. Undertaking respiratory auscultation effectively requires appropriate equipment, knowledge of physiology and pathophysiology and experience in listening to and interpreting breath sounds. Nurses undertaking this procedure must ensure they have the knowledge and skills to do so and work within the limits of their competence. This article provides a step-by-step guide that explains how to undertake respiratory auscultation with infants and children aged 0-16 years. • Respiratory auscultation is an essential procedure for informing differential diagnoses and assessing the trajectory of a child's illness and response to treatment. • In children with structurally normal, healthy lungs and a regular breathing pattern, the respiratory sound should be relatively quiet, with regular movement of air along the trachea and bronchioles, in and out of the lungs. • Any breath sounds heard in unexpected areas requires further investigation, while a complete absence of breath sounds must be treated as a clinical emergency and assistance from the medical team must be sought immediately. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking respiratory auscultation with infants and children. • How you could use this information to educate nursing students or your colleagues on the procedure for undertaking respiratory auscultation with infants and children.

Climate change is an ever-increasing threat that is having significant detrimental effects on the planet and people's health and well-being. This article explores these effects and examines the environmental impact of different types of inhalers, demonstrating the vast difference between certain types. It also discusses how children's nurses can implement inhaler changes in children and young people effectively, using change management theory and recognised change tools as a guide. With reference to the latest research and studies, the author demonstrates how making inhaler changes can significantly reduce their impact on the environment, thereby protecting the lives of children today and future generations.

Children and young people with diabetes mellitus and their families often develop expertise in managing their condition independently, but their autonomy to manage it is often removed during hospital admissions. Insulin is a high-risk medicine and insulin errors can lead to serious or life-threatening events. Allowing children and their parents or carers to self-manage their diabetes and self-administer insulin while in hospital is likely to improve patient safety. In 2022-2023, the paediatric diabetes team at Southampton Children's Hospital, England, developed and implemented a diabetes self-management policy for children and young people on insulin therapy who are admitted as inpatients. The new policy provides a robust decision-making tool for healthcare professionals and gives children and young people and their parents the opportunity to self-manage during hospital stays, if they are deemed competent and it is considered safe to do so. It is anticipated that the policy will facilitate communication between families and staff, improve patient experience and promote safe and effective diabetes management on the wards.

Sepsis in children has been defined as a clinical syndrome resulting from a dysregulated immune response to infection. Several publications have highlighted the need for education for healthcare professionals on the recognition and management of sepsis to improve patient care and reduce the risk of morbidity and mortality. This article offers information, tools and resources for children's nurses to promote a multidisciplinary team approach to assessing children and young people with suspected sepsis and escalating care where appropriate. It uses a case study to illustrate the challenges that may be encountered in diagnosing sepsis and providing effective care.

Background: Nasogastric tube (NGT) feeding under physical restraint is a clinical intervention that may be required when a child or young person is medically unstable secondary to restrictive eating.

Aim: To explore the experiences of parents when their child receives NGT feeding under physical restraint and understand the effects of this on them.

Method: This is a secondary analysis of data from two previous studies on NGT feeding under physical restraint - one in mental health wards and one in children's wards - in which semi-structured interviews had been conducted with patients, staff and parents. For this secondary analysis, the authors thematically analysed 31 transcripts of interviews with parents.

Findings: Parents reported a range of emotions which could be conflicting in nature, notably relief and shame. In both studies, parents understood the necessity of NGT feeding under physical restraint but experienced the intervention as traumatic. They expressed empathy for staff facilitating the restraint. In the children's wards study, some parents described conflict and damaged relationships with staff, and three parents had participated in physically restraining their child for NGT feeding.

Conclusion: Nursing staff should be aware that NGT feeding under physical restraint is distressing for parents. Adopting a trauma-informed framework may help to mitigate the traumatic effects on parents and, in turn, on their child.

Medical procedure-induced anxiety in children can have short- and long-term negative effects. Research shows that children's anxiety can be affected by non-pharmacological interventions and adults' behaviours in a complex manner. This article presents a scoping review of the literature on non-pharmacological interventions to manage medical procedure-induced anxiety in children. Based on this review, the authors propose a framework comprising six strategies for effective non-pharmacological management of medical procedure-induced anxiety in children. A real-life, and anonymised, example is used to illustrate this framework in practice.