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Paediatric Departments (paediatric + department)
Selected AbstractsSupport needs of children's nurses involved in child protection casesJOURNAL OF NURSING MANAGEMENT, Issue 6 2009VICKI ROWSE MA Aim, This qualitative study explored the experiences of nurses working in a hospital paediatric department, who had direct involvement in child protection cases, to discover their support needs and suggest developments in training and support. Background, The study was inspired by an awareness of increasing anxiety amongst nurses involved in child protection cases. Method, A phenomenological approach was used with fifteen nurses during semi-structured interviews, which were taped, transcribed and analysed thematically. Results, Involvement in child protection has a lasting impact; nurses need procedural information from a knowledgeable supporter during a case; and, they need individualized support. The personal qualities of the Named Nurse for Safeguarding Children were crucial. Conclusions, Involvement in child protection cases has lasting effects for individuals. The emotions generated can lead to interagency and inter-professional communication difficulties and affect the future management of child protection by individuals. Seeking support can be hampered by individuals' fear of ridicule or of making a mistake. Implications for nursing management, This study has implications for the training of children's nurses in child protection procedures, and the provision of appropriate effective support for individuals. The long-term effects of involvement are previously unreported by nurses. [source] Early severe weight loss in newborns after discharge from regular nurseriesACTA PAEDIATRICA, Issue 5 2010E Tjora Abstract Aims:, To study incidence and risk factors of early neonatal dehydration in a Norwegian population based cohort. Methods:, Term neonates admitted to a paediatric department during 2002,2008 with a weight loss , 12% within three weeks of age were identified retrospectively through review of medical records. For each patient a sex-matched control group of two full-term infants was selected to assess risk factors for dehydration. Results:, A total of 38 of 37 321 infants (1.0,) were admitted at a median age of 6 (interquartile range 5,12) days, and the admission rate increased during the study period (p for trend = 0.008). Simultaneously, mean nursery stay decreased from 3.5 to 2.7 days (p = 0.022). Mean weight loss was 15.0% of birth weight and 17 of 29 (58.6%) had serum sodium above 145 mmol/L. The only significant difference between patients and controls was that mothers of patients were older (32.3 ± 5.0 vs. 29.4 ± 5.4 years, p = 0.005). Conclusion:, Short nursery stay may be a risk factor for dehydration in newborn infants. [source] Community-acquired pneumonia (CAP) in children in Oslo, NorwayACTA PAEDIATRICA, Issue 2 2009Anita C Senstad Abstract Aim: To investigate the epidemiology and clinical characteristics of community acquired pneumonia (CAP) in children before the introduction of the 7-valent pneumococcal vaccine in the national vaccination programme. Methods: For the period 21 May 2003 to 20 May 2005 hospitalization rates for pneumonia in children were obtained from retrospective studies of medical journals. Pneumonia was also studied prospectively in children less than sixteen years old referred to Ullevål University Hospital (Oslo) in the same time period. Results: The overall observed hospitalization rate of pneumonia was 14.7/10 000 (95% CI: 12.2,17.1), for children under five it was 32.8/10 000 (95% CI: 26.8,38.8), and for children under two 42.1/10 000 (95% CI: 32.0,52.3). In the clinical study 123 children, of whom 59% (73) were boys, met the inclusion criteria and were enrolled. Only 2.4% (3) had pneumonia complicated with pleural effusion and in general few complications were observed. No patients required assisted ventilation, and none were transferred to the intensive care unit. Penicillin was effective as treatment for pneumonia. Conclusion: Pneumonia, seen in a paediatric department in Oslo, is a common but benign disease. Penicillin is effective as treatment for pneumonia in Norwegian children. [source] Characterizing violence in health care in British ColumbiaJOURNAL OF ADVANCED NURSING, Issue 8 2009Rakel N. Kling Abstract Title.,Characterizing violence in health care in British Columbia. Background., The high rate of violence in the healthcare sector supports the need for greater surveillance efforts. Aim., The purpose of this study was to use a province-wide workplace incident reporting system to calculate rates and identify risk factors for violence in the British Columbia healthcare industry by occupational groups, including nursing. Methods., Data were extracted for a 1-year period (2004,2005) from the Workplace Health Indicator Tracking and Evaluation database for all employee reports of violence incidents for four of the six British Columbia health authorities. Risk factors for violence were identified through comparisons of incident rates (number of incidents/100,000 worked hours) by work characteristics, including nursing occupations and work units, and by regression models adjusted for demographic factors. Results., Across health authorities, three groups at particularly high risk for violence were identified: very small healthcare facilities [rate ratios (RR) = 6·58, 95% CI =3·49, 12·41], the care aide occupation (RR = 10·05, 95% CI = 6·72, 15·05), and paediatric departments in acute care hospitals (RR = 2·22, 95% CI = 1·05, 4·67). Conclusions., The three high-risk groups warrant targeted prevention or intervention efforts be implemented. The identification of high-risk groups supports the importance of a province-wide surveillance system for public health planning. [source] Technology-dependent children in the community: definitions, numbers and costs,CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2001C Glendinning Summary Objectives To assess available data on the numbers of technology-dependent children living at home in the UK and estimate the costs of caring for them. Design Data were obtained from all known secondary sources, including surveys of children with specific conditions known to specialist paediatric departments and the database of applicants to the Family Fund Trust. The costs of all services received by three hypothetical exemplar ,case study' children were calculated. Results All existing sources of data have some shortcomings. Taking these shortcomings into account, it is estimated that there may be up to 6000 technology-dependent children living at home. They appear to be disproportionately young and may be distributed unevenly between different regions of the UK. The total service costs of caring for each child will vary according to the types of technologies involved and local patterns of services, but may be as high as £150 000 a year. Conclusions Because of the very high costs of services, routine information on the numbers of technology-dependent children discharged home is urgently needed. This should include details of the duration of technology dependence and the local area to which the child is discharged. New opportunities for joint service planning and purchasing should improve the co-ordination of services for these children. [source] Socio-economic characteristics in children with coeliac diseaseACTA PAEDIATRICA, Issue 1 2005J. F. Ludvigsson Abstract Aim: To study the relationship between socio-economic factors and coeliac disease. Methods: This study was part of a prospective cohort study of 16,286 children born from 1 October 1997,1 October 1999 (the ABIS study; All Babies in Southeast Sweden). Eight paediatric departments recorded all children with coeliac disease in southeast Sweden. Coeliac disease was confirmed through biopsy. Socio-economic characteristics (maternal employment, civil status, whether parents were born in Sweden, parental education, place of living before pregnancy and during pregnancy, crowded living), infant sex, previous siblings, parental age and maternal alcohol consumption during pregnancy were analysed using logistic regression. All data, except for those related to diagnosis of coeliac disease, were obtained through a questionnaire distributed at birth. Results: Coeliac disease in the offspring was less common among mothers who had worked <3 mo during pregnancy (odds ratio, OR=0.29; 95% CI: 0.09,0.94; p=0.039). This risk decrease remained after adjustment for confounders (adjusted OR=0.28; 95% CI: 0.09,0.92; p=0.035). No other socio-economic factor was related to coeliac disease. Conclusion: This study indicates that most socio-economic factors are probably of little importance to the development of coeliac disease. [source] Audit of antibiotic prescribing in two governmental teaching hospitals in IndonesiaCLINICAL MICROBIOLOGY AND INFECTION, Issue 7 2008U. Hadi Abstract This article estimates the magnitude and quality of antibiotic prescribing in Indonesian hospitals and aims to identify demographic, socio-economic, disease-related and healthcare-related determinants of use. An audit on antibiotic use of patients hospitalized for 5 days or more was conducted in two teaching hospitals (A and B) in Java. Data were collected by review of records on the day of discharge. The method was validated through concurrent data collection in Hospital A. Multivariate logistic regression analysis was performed to determine variables to explain antibiotic prescribing. Prescriptions were assessed by three reviewers using standardized criteria. A high proportion (84%) of 999 patients (499 in Hospital A and 500 in Hospital B) received an antibiotic. Prescriptions could be categorized as therapeutic (53%) or prophylactic (15%), but for 32% the indication was unclear. Aminopenicillins accounted for 54%, and cephalosporins (mostly third generation) for 17%. The average level of antibiotic use amounted to 39 DDD/100 patient-days. Validation revealed that 30% of the volume could be underestimated due to incompleteness of the records. Predictors of antibiotic use were diagnosis of infection, stay in surgical or paediatric departments, low-cost nursing care, and urban residence. Only 21% of prescriptions were considered to be definitely appropriate; 15% were inappropriate regarding choice, dosage or duration, and 42% of prescriptions, many for surgical prophylaxis and fever without diagnosis of infection, were deemed to be unnecessary. Agreement among assessors was low (kappa coefficients 0.13,0.14). Despite methodological limitations, recommendations could be made to address the need for improving diagnosis, treatment and drug delivery processes in this setting. [source] | ||||||||||