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Practice Protocol (practice + protocol)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Utilization of the Ottawa Ankle Rules by Nurses in a Pediatric Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 2 2002
Anna Karpas MD
Objectives: To determine the ability of pediatric emergency department (ED) nurses to accurately apply the Ottawa Ankle Rules (OAR) and to evaluate whether the rate of negative ankle radiographs can be reduced by incorporating the OAR into an existing collaborative practice protocol (CPP). Methods: The authors' ED currently uses a CPP in which patients with ankle pain, swelling, deformity, or decreased range of motion on primary nursing assessment undergo radiography prior to physician evaluation. A cross-sectional study was conducted between June and November 2000. Patients aged 5-19 years with an ankle injury who met at least one of the CPP criteria were eligible for enrollment. The OAR were applied by the primary nurse after initial assessment. Ankle radiographs were ordered for all enrolled patients. The interobserver variability between nurses was evaluated on a random sample. Results: One hundred ninety subjects were enrolled in the study. The OAR were correctly interpreted by nurses in 98.4% of subjects. Agreement on the interobserver reliability sample was 100%. Of the 185 subjects, 31 (16.8%) had positive radiographs. Positive OAR results were noted in 30 of 31 subjects with positive radiographs. The sensitivity of the OAR was 97% (95% CI = 0.82 to 0.99) with a specificity of 25% (95% CI = 0.18 to 032). Use of the OAR would have reduced the radiography rate by 21%. Conclusions: Trained nurses can accurately apply and interpret the OAR. The incorporation of the OAR into the nursing assessment of children with acute ankle injuries may reduce the number of radiographs ordered. [source]

R3 Increasing the awareness of the role of the dental team in child protection

INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2006
A. M. CAIRNS
Aims:, Construction and delivery of a multiagency child protection (CP) course for the dental team in five health board areas; increase knowledge of the signs of physical child abuse (CA); increase likelihood of referral when concerned; aid development of individual practice protocols; increase familiarity with local referral protocols and procedures. Method:, A 3-hour course was designed and delivered in five health board areas by two paediatric dentists and a member of the local CP team. The course content included: orofacial signs of CA; role of the dental team in CP; and local referral procedures and protocols. Questionnaires concerning the above topics were distributed to the course participants immediately prior to the start, and 1 month after the course. Results:, A total of 117 members of the dental team completed the first questionnaire and 65 the second. Knowledge of the signs and symptoms of CA improved from 68.5% to 81%. Prior to and following the course: 58.9% and 40.6% reported that a fear of consequences to the child would influence the decision to report (P = 0.019); 79.5% and 38.5% were concerned that their lack of knowledge would negatively influence the decision to report (P < 0.001); 19.4% and 38.9% had a practice protocol (P < 0.001); 17.3% and 48.4% had seen their local guidelines (P < 0.001). Conclusions:, The course achieved increased: knowledge of the signs of CA; likelihood to refer due to reduction in fear of consequences to child and increased knowledge of both indicators of CA and referral procedures; dental practice protocols; familiarity with local procedures and protocols. [source]

Utilizing an Oral Sucrose Solution to Minimize Neonatal Pain

JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2005
Debbie Gearner Thompson
issues and purpose.,To present an evidence-based practice protocol for oral sucrose administration to minimize neonatal procedural pain. conclusion.,Examination of published research may provide additional modalities to expand an established pediatric pain-management program. practical implications.,The extensive research evaluating oral sucrose supports its inclusion in a pediatric pain-management program. A thorough implementation plan will allow new modalities to be included to optimize procedural pain relief for hospitalized neonates with minimal staff resistance and improved patient outcomes. [source]