Nursing children and young people最新文献

Childhood arrhythmias are relatively rare but can present with a wide range of symptoms, depending on the type of arrhythmia, the child's age and the presence of underlying cardiac conditions. This article provides an overview of the most common childhood arrhythmias, exploring diagnostic methods and outlining treatment options. It also highlights key 'red flag' symptoms requiring urgent referral and the role of nurses in assessment, management, education and long-term support of affected children and their families. Understanding arrhythmias, recognising when to escalate care and delivering age-appropriate information are essential for improving outcomes and ensuring safe, effective nursing care.

Witnessing traumatic events such as the death and dying of patients without adequate support can have a negative effect on patient care and clinician well-being. This qualitative literature review aimed to explore and identify the coping mechanisms used by nurses who care for children who are dying or have died. Understanding these mechanisms is essential to inform clinical practice, reduce psychological strain and improve the quality of care. Coping mechanisms were categorised into three main themes: organisational, adaptive and maladaptive. Maladaptive strategies, despite their negative psychological consequences, were the most frequently reported, particularly in high-stress environments such as paediatric intensive care units. This pattern may reflect environmental or cultural factors that limit the use of more adaptive strategies. Further UK-based primary research is required to assess the effectiveness of these mechanisms and ensure their relevance to the NHS and children's nursing practice.

Background: Neonatal umbilical cord infection is a significant contributor to neonatal sepsis, a leading cause of newborn mortality, particularly in sub-Saharan Africa and southern Asia. The World Health Organization recommends the use of 7.1% chlorhexidine digluconate gel for newborn umbilical cord care to reduce infection risks. In Ghana, this recommendation has been adopted by the Ministry of Health. However, uptake and adherence to this recommendation are inconsistent.

Aim: To explore nurses' perspectives on the factors influencing the use of chlorhexidine gel in newborn umbilical cord care in a tertiary referral hospital in Ghana.

Method: A qualitative, exploratory, descriptive design was adopted using purposive sampling to recruit 15 nurses with at least six months' experience in neonatal care. Semi-structured, face-to-face interviews were conducted and data were analysed using content analysis to identify the main themes and subthemes.

Findings: Two main themes and seven subthemes emerged from the analysis. While participants showed good awareness of chlorhexidine gel, there were inconsistencies in their knowledge of its application, largely due to inadequate training. Maternal socioeconomic status and cultural beliefs influenced adherence to use of the gel, with some mothers opting to use traditional substances such as herbal preparations, cow dung and toothpaste instead. Low maternal health literacy and affordability concerns further affected the uptake of chlorhexidine gel. Participants identified the need for structured training programmes and policy interventions to enhance the uptake of chlorhexidine gel.

Conclusion: Limited knowledge among healthcare providers, maternal socioeconomic barriers, cultural influences and misconceptions about chlorhexidine gel hinder its widespread adoption for newborn umbilical cord care. Addressing these challenges requires targeted training for nurses, culturally sensitive maternal education and policy interventions such as cost waivers for chlorhexidine gel to promote equitable access. Furthermore, research comparing the effectiveness of the gel versus its aqueous form is recommended to improve acceptance and use in Ghana.

Measles is a highly infectious, notifiable, viral disease that is commonly contracted in childhood and associated with a characteristic rash. Most children and young people who contract measles make a full recovery, but measles infection is associated with rare but serious complications in vulnerable groups, such young infants, immunocompromised individuals and pregnant women. Vaccination is the most effective way to prevent measles infection, but uptake of the measles, mumps and rubella (MMR) vaccine in the UK has fallen short of the vaccine coverage required to provide herd immunity and prevent measles outbreaks. Consequently, there has been an increase in confirmed measles infections across the UK in recent years. This article provides a brief history of the epidemiology of measles and the MMR vaccine. It also discusses the signs and symptoms of the infection and its management, including the public health measures required. The authors consider how children's nurses can enhance uptake of the MMR vaccine through health promotion discussions with parents and carers using motivational interviewing techniques.

Children's nurses aim to keep children and young people safe and ensure that they are offered high-quality, accessible services and support when needed. However, it is estimated that one in ten children in the UK will experience neglect at some point during their childhood. With reference to the literature, this article critically analyses the complex barriers to effective safeguarding practice that contribute to medical neglect. These include suboptimal communication, not keeping the child at the focus of care, not being professionally curious and not attempting to understand the child's lived experience. The article explains the statutory guidance on safeguarding and the importance of using appropriate tools and safeguarding supervision in supporting nurses to work with vulnerable families. Nurses can improve the lives of children and young people in their care by adopting creative, holistic approaches to concerns raised, while not jeopardising the therapeutic relationship and losing open, honest access and communication between the family and nurse. The author explores the idea that a shift from attempting to control the child and family, and instead working collaboratively with them, can help reduce the incidence of medical neglect.

Transgender people have reported negative experiences of healthcare service provision, often due to a lack of awareness and education among staff. The challenges experienced by transgender people when accessing healthcare are likely to be even more pronounced for children and young people with gender dysphoria. Nurses working in children's settings are well placed to create a care environment where children and young people with gender dysphoria feel safe, acknowledged and respected. However, currently there is no mandatory requirement or standardised approach in relation to education and training on transgender health, so some healthcare professionals may lack the foundational knowledge needed to provide gender-inclusive care. This article highlights the urgent need for comprehensive mandatory preregistration education and post-registration training in transgender health to foster inclusive and respectful care for children and young people with gender dysphoria.

Background: Nasogastric tube insertion (NGTI) is one of the most uncomfortable medical procedures. Discomfort, pain and distress in children undergoing NGTI remain significant challenges and there is limited research into effective comfort strategies for this patient group.

Aim: To investigate the challenges and complexities of NGTI in children under the age of ten years and develop recommendations on mitigating procedural distress and trauma by examining the beliefs, attitudes and experiences of healthcare professionals and parents.

Method: A qualitative research methodology was used involving guided discussions with two focus groups of seven and nine participants, respectively. Data analysis was performed using inductive latent content analysis.

Findings: NGTI commonly caused distress to all involved - children, parents and healthcare professionals. There was a lack of consensus and consistency in NGTI practices and a range of contextual barriers to improving the care of children undergoing the procedure. Four guiding principles for improving NGTI practice emerged: critically questioning the necessity and timing of NGTI; taking the time to develop and apply an individually tailored approach; ensuring child-friendly conditions and working as a team to implement comfort strategies; and conducting post-procedure team debriefing and reflection.

Conclusion: There is a need for a holistic approach to NGTI that includes dialogue between all involved, the development of evidence-based guidelines and comprehensive training in technical delivery and comfort strategies.

Background: Neonatal pain is often overlooked in healthcare settings, with misconceptions about pain perception in neonates contributing to inadequate management and potential long-term neurodevelopmental consequences.

Aim: To explore nurses' perspectives on neonatal pain management in Ghana.

Method: A qualitative, exploratory study was conducted using purposive sampling to select participants from the children's department of a quasi-government (public-private partnership) hospital in Ghana. Ten registered nurses participated in face-to-face interviews. Data were analysed using thematic analysis.

Findings: Four main themes emerged: nurses' knowledge and recognition of neonatal pain; neonatal pain management practices; nurses' attitudes towards the management of neonatal pain; and barriers to neonatal pain management. While some nurses recognised behavioural indicators of pain, inconsistent use of validated assessment tools and reluctance to use pharmacological interventions were reported.

Conclusion: Findings highlight the need for targeted training, use of standardised assessment tools and evidence-based protocols. Strengthening nurses' knowledge and skills is vital to improving neonatal pain care in Ghanaian healthcare settings.

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.

Children with overweight or obesity are at risk of experiencing perioperative complications during general anaesthesia (GA). At Guy's and St Thomas' NHS Foundation Trust in London, children who require dental surgery under GA are placed on a waiting list for the Dental Day Surgery Unit (DDSU) or the Evelina London Children's Hospital (ELCH), which has inpatient beds and a paediatric intensive care unit, depending on their body mass index (BMI) and centile thresholds. The waiting list for the ELCH is longer than for the DDSU. This article discusses the results of a retrospective audit which involved analysis of the BMI of 300 children (aged ≤16 years) on the waiting lists for both sites (DDSU n =250; ELCH n =50). The aims were to identify those who were overweight or very overweight, calculate how much weight loss would be required for some of those allocated to the ELCH to be treated instead at the DDSU and to achieve a healthy weight, and to compare obesity prevalence with national data. The results identified 57 (19%) of the 300 patients as very overweight or overweight. A total of 24 (48%) patients on the ELCH waiting list ( n =50) were identified as very overweight or overweight. For seven (29%) of these 24 patients, the amount of weight loss required to be treated at the DDSU ranged between 19.5kg and 0.9kg and the amount of weight loss required to attain a healthy weight ranged between 28.5kg and 11.5 kg. The prevalence of obesity among the audit cohort was lower than national obesity prevalence rates for children.