Nursing children and young people最新文献

Adolescent idiopathic scoliosis (AIS) is the most common spinal disorder among children and adolescents, with most cases being diagnosed around puberty. While the majority of people with AIS do not undergo treatment, a small but significant number are treated, depending on the extent of their spinal curvature. Treatment typically involves bracing, which requires substantial adherence, and/or surgery, which is invasive and permanent. Furthermore, decisions about treatment often need to be made at a critical stage of the person's development. This article examines the evidence on AIS and its treatment, synthesising the current literature and drawing from the authors' empirical work to explore the clinical outcomes of bracing and surgery, as well as the longer-term effects on people's quality of life. Drawing from this evidence, the authors provide guidance for nurses and healthcare professionals who care for people with AIS.

At certain points in nursing history, it has been necessary to make a case for children and young people to be cared for by specialist nurses educated to meet their specific needs. However, in 2018 the updated Nursing and Midwifery Council (NMC) standards of proficiency for registered nurses adopted a generic rather than field-specific approach. This article reiterates that children, young people and their families have unique needs that are best met by nurses who are trained specifically to care for them. The case is made from a historical and legal perspective, concluding with a proposal that in the best interests of children, young people and their families, the NMC should embed specific competencies for children's nurses into its standards of proficiency to future-proof this field of practice.

Managing intravenous (IV) access is a standard proficiency for UK nurses, enabling them to administer IV injections and IV infusions and to manage injection equipment and infusion pumps and devices. In this article the author describes various types of venous access devices that are commonly seen in practice and details the preparation, checking and administration of IV fluids and medicines, including some complications that may arise. The author also discusses the calculation of fluid requirements, types of IV fluids, displacement values and ongoing care of venous access devices.

Craniopagus is a rare condition in which the skulls of conjoined twins, and the neurovascular structures in their skulls, are incompletely separated. Separation surgery is complex and requires a range of skills and expertise, including from all the nursing teams involved. A multidisciplinary group of professionals in a tertiary paediatric care setting in Italy developed a comprehensive protocol for the nursing care of craniopagus twins in hospital, informed by the findings of a literature review and the expertise of its members. The protocol was applied to the management of a pair of craniopagus twins who successfully underwent separation surgery at the authors' hospital. The protocol describes the crucial role of nurses in the care of craniopagus twins and their families before, during and after separation surgery.

Acute asthma exacerbations and viral-induced wheeze are common presenting complaints on one general paediatric ward in a tertiary children's hospital in England. An inhaled beta 2 agonist, such as salbutamol, is the first-line treatment for these children and young people and they have frequent clinician reviews for salbutamol weaning before discharge. However, the informal salbutamol weaning practices used by nurses, as well as challenges in the recruitment and retention of paediatric trainee doctors, led to the development of a nurse-led salbutamol weaning pathway as a quality improvement project. Twelve nurses completed the associated nurse-led salbutamol weaning training, education and competency package and subsequently completed a questionnaire exploring their perceptions of the effect of the training package and pathway. After the training, all respondents reported feeling more confident in assessing the salbutamol requirements of children with wheeze. All of the respondents also felt that the introduction of the pathway and training would improve patient care and the confidence of children and young people, parents and carers in nurses' ability to assess children's salbutamol requirements. Time constraints were identified as a potential barrier to implementation of the pathway.