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Paediatric Unit (paediatric + unit)

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Medical Sciences	100%

Selected Abstracts

Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unit

JOURNAL OF CLINICAL NURSING, Issue 9-10 2010
Lorna Moxham
Objective., To implement and evaluate strategies suggested by general nurses to improve management of children and adolescents with mental health problems admitted to a paediatric unit of a general hospital. Background., The first phase of a study using a Participatory Action Research approach identified several concerns associated with general nurses providing care to young people with mental disorders in paediatric units of general hospitals, together with suggestions for strategies to address these issues. This paper describes the second and third phase of the Participatory Action Research study, involving the implementation and evaluation of these strategies. Design., Participatory Action Research. Methods., Actions that occurred during phase two of the Participatory Action Research study included revision and introduction of policies and procedures for mental health care in the unit, education and training sessions for paediatric nursing staff and opportunities to strengthen communication between existing mental health services. In phase three, two focus groups were conducted to explore current perceptions of mental health care delivery in the unit and evaluate change, following phase two. Results., Changes in clinical practice for paediatric mental health care were acknowledged by participants. Reflection has assisted nurses to better understand their strengths and weaknesses and to acknowledge and challenge the assumptions on which their ideas, feelings and actions about patients with mental health issues are based. Participants also recognised the existing skills and expertise they possess that are relevant to the management of young people with a mental health problem, although they continue to seek ongoing education and support in this field. Conclusions., This study demonstrates that through Participatory Action Research it is possible to enhance mental health nursing care in a rural paediatric unit. Relevance to clinical practice., Such changes have the potential to improve the experience of young people and their families whilst receiving treatment for mental health conditions in a general paediatric unit. [source]

Opportunistic immunisation of infants admitted to hospital: Are we doing enough?

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2008
Kelly-Anne Ressler
Aim: To determine the accuracy and effectiveness of opportunistic immunisation of children admitted to the paediatric unit of a large teaching hospital using retrospectively collected data. Methods: Immunisation status, documented using clinical indicator (CI) forms, of all admissions over a 1-year period was compared with that recorded by the Australian Childhood Immunisation Register. In order to determine the effectiveness of providing catch-up plans, we analysed the difference in catch-up times of the children with and without a catch-up plan on their CI form. Results: The details of 614 admissions in the study period were included. Comparing the Australian Childhood Immunisation Register with the CI for assessing immunisation status, we found that 83 of the 573 (14.5%) were incorrectly recorded, and only 25 of the 82 admissions in which the infant was overdue were identified on the ward. Children were more likely to be vaccinated within 30 days and 90 days of admission if they had been given a catch-up plan. Of the children who had not been given a catch-up plan, almost half were still overdue at 90 days. Conclusions: Admission to hospital provides opportunities for both routine and catch-up immunisation; however, for opportunistic immunisation to be effective, health service screening and immunisation documentation must be accurate. [source]

Overweight in medical paediatric inpatients: Detection and parent expectations

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2007
Karen McLean
Aims: (i) To determine prevalence and rates of detection of overweight/obesity among general paediatric inpatients. (ii) To explore parental expectations regarding detection and management of overweight/obesity during admission. Methods: This is a cross-sectional survey conducted in the Royal Children's Hospital, Melbourne, Australia. A total of 102 children aged 2,12 years admitted to a general paediatric unit at the Royal Children's Hospital and their parents participated in the survey. The main outcome measures are body mass index (BMI); documentation of weight, height and BMI in patient notes; parent description of child's weight, parent concern about child's weight, and parent opinion about detection and management of overweight. Results: Twelve of 102 children (11.7%, 95% confidence intervals 6.2%, 19.7%) were overweight or obese. All children had a documented weight, two children (2.0%) had a documented height and none had BMI documented. Seven of 12 parents of overweight children described their child's weight as healthy; five of 12 parents of overweight children were not concerned about their child's weight. Eight of 12 parents of overweight children believed all admitted children should have their BMI calculated. All parents thought the hospital should take action if a child was found to be overweight. Conclusions: Although prevalence of overweight was lower than expected, documentation of overweight did not occur for any patient in the study. Parents of overweight children with acute illnesses believed that the hospital should screen for overweight and discuss it with parents. Further studies are required to determine expectations among other patient populations. [source]

Promoting mental health care in a rural paediatric unit through participatory action research

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2009
Brenda Happell
Abstract Objective:,To explore, advance and evaluate mental health practices in a rural general paediatric unit through participatory action research. Design:,A participatory action research approach guided this study, providing an opportunity for nursing staff to become actively involved in the design, direction and outcomes of the research. Setting:,A 16-bed paediatric unit of a rural general hospital. Participants:,A purposive convenience sample of all paediatric nursing staff (n = 20; of 24 nurses). Outcome measures:,In the first phase of this study, focus groups were conducted to explore the experiences of nurses. Results:,Participants considered mental health to be a specialist discipline area and the role of the mental health nurse to be complex. They felt that their lack of training and experience with mental health issues was detrimental to the delivery of optimal patient care. There was concern about differing approaches to treatment, relationships with other mental health services and the suitability of the ward environment for young people with a mental health problem. Participants called for training by qualified mental health staff and the development of policies and clinical guidelines to facilitate their delivery of care to patients with a mental health problem in an acute medical environment. Conclusions:,There is a clear need for nursing specialities to work together to ensure that optimal care is given to patients admitted to general hospital with a mental health issue. Given the absence of accessible specialist child mental health inpatient units in regional and remote areas, upskilling paediatric nurses must be a priority. [source]

Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unit

Modelling the impact of an influenza A/H1N1 pandemic on critical care demand from early pathogenicity data: the case for sentinel reporting

ANAESTHESIA, Issue 9 2009
A. Ercole
Summary Projected critical care demand for pandemic influenza H1N1 in England was estimated in this study. The effect of varying hospital admission rates under statistical uncertainty was examined. Early in a pandemic, uncertainty in epidemiological parameters leads to a wide range of credible scenarios, with projected demand ranging from insignificant to overwhelming. However, even small changes to input assumptions make the major incident scenario increasingly likely. Before any cases are admitted to hospital, 95% confidence limit on admission rates led to a range in predicted peak critical care bed occupancy of between 0% and 37% of total critical care bed capacity, half of these cases requiring ventilatory support. For hospital admission rates above 0.25%, critical care bed availability would be exceeded. Further, only 10% of critical care beds in England are in specialist paediatric units, but best estimates suggest that 30% of patients requiring critical care will be children. Paediatric intensive care facilities are likely to be quickly exhausted and suggest that older children should be managed in adult critical care units to allow resource optimisation. Crucially this study highlights the need for sentinel reporting and real-time modelling to guide rational decision making. [source]

Birth at hospitals with co-located paediatric units for infants with correctable birth defects

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2008
Charles S. ALGERT
Objectives: To determine the percentage of liveborn infants with selected antenatally identifiable and correctable birth defects who were delivered at hospitals with co-located paediatric surgical units (co-located hospitals). Additionally, to determine the survival rates for these infants. Patients and methods: Data were from linked New South Wales hospital discharge records from 2001 to 2004. Livebirths with one of the selected defects were included if they underwent an appropriate surgical repair, or died during the first year of life. Infants with multiple lethal birth defects were excluded. Deliveries at co-located hospitals were identified, but no data on antenatal diagnosis were available. Results: The study identified 287 eligible livebirths with the selected defects. The highest rates of delivery at co-located hospitals were for gastroschisis (88%), exomphalos (71%), spina bifida (63%) and diaphragmatic hernia (61%), and the lowest for transposition of the great arteries (43%) and oesophageal atresia (40%). Mothers resident outside of metropolitan areas, where the co-located hospitals are located, had a similar rate of delivery at co-located hospitals as metropolitan women. For the non-metropolitan mothers of infants with a birth defect, this represented a 30-fold increase over the baseline delivery rate of 1.8%. Post-surgery survival rates were 87% or higher. Overall survival rates were , 86% except for infants with a diaphragmatic hernia. Conclusions: Delivery rates at co-located hospitals were high for mothers of infants with these correctable birth defects. Regionalised health care appears to work well for these pregnancies, as women living outside metropolitan areas had a similar rate of delivery at co-located hospitals to that of urban women. [source]