Nursing children and young people最新文献

A lumbar puncture may be performed for various reasons, but is commonly used to facilitate the diagnosis of central nervous system infections in infants and children. It involves inserting a needle into the lower spine to obtain cerebrospinal fluid, which is then sent for testing in a laboratory. The results of the tests, together with a clinical assessment of a patient, can guide the effective treatment of infections and reduce the risk of neurological conditions. This article outlines some of the reasons why lumbar punctures are performed, discusses the practical aspects of the procedure and explains how nurses can effectively support the child and their family, while also assisting the practitioner undertaking the procedure.

Many children admitted to paediatric intensive care units (PICUs) present with unmet dental health needs or develop these during their admission. It is important to maintain good oral health because suboptimal oral hygiene is linked to various dental and medical conditions, with intubated patients being at risk of developing hospital-acquired pneumonia. This article outlines the role of PICU nurses in identifying children's dental health needs by undertaking oral assessments when each child is admitted to the unit and by implementing national initiatives and guidelines on oral health. The article also details the findings of a service evaluation in the PICU at Evelina London Children's Hospital, England, which demonstrated the importance of maintaining good oral hygiene and the benefit of opportunistic dental treatment while children are admitted to the unit.

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.

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.

Children and young people's (CYP) nursing leaders have experienced considerable challenges in the context of a complex health and social care system with rapidly changing organisational structures, including the establishment of integrated care systems in England on 1 July 2022. The CYP nursing lead at NHS England commissioned a review of CYP organisational structures in emerging integrated care systems across England. The review encompassed a vision for CYP services, leadership, governance structures and opportunities for progression. A proforma was used to collate data from CYP trusts, CYP standalone hospitals and children's wards in district general hospitals. Qualitative interviews were also undertaken with senior children's nurses. At the same time, the first author of this article interviewed senior children's nurses as part of a Florence Nightingale Foundation leadership scholarship. The aim was to explore how they navigated their leadership journey and understand what advice they may give to future leaders in CYP nursing. The findings in this article identify 'what good looks like' in terms of CYP nursing leadership. Six recommendations for future development and enhancement of CYP nursing leadership are outlined.