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Background: COVID-19 has unique implications for pediatric patients, and pediatric nursing students need to be adequately prepared for working with pediatric patients, their caregivers, and families. The purpose of this research was to determine the effectiveness of an innovative online COVID-19 educational module among pediatric nursing students. Methods: This study used a mixed-methods design. The sample (N = 39) consisted of prelicensure pediatric nursing students who completed a pretest, COVID-19 educational intervention, and posttest. Results: The majority of participants' scores increased after the intervention. Most participants strongly agreed that the COVID-19 educational module was effective. Unique pediatric considerations, information learned and found most helpful, and plans for application and utilization of this knowledge were revealed. Conclusions: An online COVID-19 pediatric nursing educational intervention was effective at improving participants' knowledge, confidence, and practices regarding COVID-19. [ABSTRACT FROM AUTHOR]

Since its origins, patient- and family-centered care (PFCC) has grown in size and scope. This article describes the evolution of PFCC through milestones, highlights key drivers that have influenced the growth and spread of PFCC, and discusses recommendations for the future. [ABSTRACT FROM AUTHOR]

This is Part IV in the series Nursing Power through Advocacy. Its purpose is to help advocates develop a strong voice for children's safety in relation to gun violence in schools while talking with legislators and other stakeholders. The advocate must understand the facts surrounding an issue, both positive and negative, to provide effective evidence supporting their thoughts. [ABSTRACT FROM AUTHOR]

Engagement with scientific literature is essential for health care professionals. Overcoming barriers such time constraints and lack of access to resources is possible through direct and indirect strategies. These methods are crucial for staying informed and delivering high-quality patient care. [ABSTRACT FROM AUTHOR]

Background: Pediatric medical traumatic stress (PMTS) describes a set of symptoms that commonly occur in children undergoing procedures and hospitalizations. PMTS may result in costly complications and place patients and caregivers at risk for developing post-traumatic stress (Kassam-Adams & Butler, 2017). Research suggests patient education has a lasting positive impact on PMTS (Ari, Margalit, Roth, et al., 2019). Methods: This quality improvement (QI) project implemented educational intervention on PMTS and how to provide developmentally appropriate patient education for surgical procedures. Using a pre- and post-study design, four key components were analyzed: 1) knowledge level, 2) frequency of measures taken, 3) changes in practice, and 4) barriers to implementing PMTS-sensitive care. Nurses were recruited voluntarily through email. A total of 34 emails were sent, and 11 nurses were recruited. All 11 nurses provided pre-intervention and demographic data, and eight provided post-intervention data. Data were collected via the Qualtrics® tool (2020) and analyzed using SPSS® version 27.0. This QI project qualified for exempt Institutional Review Board status. Results: Most participants (87.5%) reported their practice had improved after the intervention. A paired t test demonstrated a significant increase (p = 0.006) in selfreported knowledge level, supporting that this intervention may effectively increase staff awareness; half reported an increase in the measures they take to prevent or alleviate PMTS. Time constraints and inadequate staffing were cited as barriers. Conclusion: Staff training on patient education resulted in a significant increase in provider knowledge of PMTS. Nurses demonstrated an understanding of the role of hospitalization in PMTS and an interest in addressing this concern. Organizational support is required to sustain these interventions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to illuminate experiences of obtaining support among male adolescents with congenital heart disease and their mothers, and nurses' experiences of providing support within pediatric nursing care. Methods: This descriptive qualitative study used an inductive approach. Data were collected from interviews with six participants: two adolescents with congenital heart defects-mother dyads, and two nurses at a pediatric cardiac outpatient clinic in Sweden. Data were analyzed through content analysis. Results: Results are divided into three domains: desired support, lacking support, and undesirable support. Within these three respective domains, support is further illustrated from three categories of perspectives: adolescents, mothers, and nurses. Conclusions: Study findings show adolescents and their mothers desire support, such as family-system nursing. Nurses strive to provide support in the form of informative care like the approach based on the philosophy of pediatric familycentered care. Implications: When highlighting experiences of support from different perspectives, it is important for the provided support to be adapted to families' needs. [ABSTRACT FROM AUTHOR]

This is Part III in the series Nursing Power through Advocacy. Its purpose is to help advocates develop a strong voice for children's safety in relation to gun violence in schools while talking with legislators and other stakeholders. The advocate must understand the facts surrounding an issue, both positive and negative, to provide effective evidence supporting their thoughts. [ABSTRACT FROM AUTHOR]

Despite decades of political and legal opposition and intervention, substance use disorder continues to be a public health problem. Parental substance use deserves more attention in both adult and pediatric care settings. Pediatric care presents a key opportunity to observe the child-parent relationship and interview in a positive manner if substance use disorder in the parent(s) is suspected. [ABSTRACT FROM AUTHOR]

Aim and Background: To explore how children and adolescents perceive hope, maintain it, and use it in their lives during challenging times, specifically in the context of the COVID-19 pandemic. The pandemic presented a worldwide multifactorial impact on the mental and physical health of children and adolescents. Design and Methods: A descriptive phenomenological qualitative approach was used. Semi-structured audio-taped interviews were conducted with children (ages 8 to 12 years) and adolescents (ages 13 to 17 years) from varied settings following obtainment of written consent from parent(s) and assent from participants. Transcriptions of the audio-taped interviews were analyzed following Colaizzi's method of analysis. Lincoln and Guba's framework served as the guide for establishing trustworthiness of data and findings. Results: Forty-two interviews were conducted with 22 children and 20 adolescents at which point data saturation was obtained. Five themes representing the children's and adolescents' understanding and use of hope in their lives emerged from the data: internal light, connectedness, unique/one's own/other centered, wavering/challenged/rekindled, and a kaleidoscope of color and facets. These findings support the complex and multidimensional nature of hope in children and adolescents. Conclusions: Findings provide important data for nurses, other health care professionals, teachers, and parents to help them understand children's and adolescents' perception of hope, and how they maintained and used it within the context of the COVID-19 pandemic. Practice Implications: This study could potentially provide a basis upon which to develop hope-focused, developmentally informed interventions and programs to assist children and adolescents in cultivating, strengthening, and engaging their hope. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the status of patient safety culture among pediatric nurses in a Saudi Arabian hospital. Methods: The study employed a descriptive cross-sectional design with non-random assignment and included a convenience sample of 138 nurses who provided direct patient care across different general and specialty pediatric clinical settings. Data were collected using an anonymous, self-structured questionnaire that adopted a Survey on Patient Safety Culture™ (SOPS™). Results: The overall percentage of positive responses for the 12 patient safety culture dimensions and across 42 items was 59.2%. Furthermore, 61% of nurses reported no safety events, and 33.3% reported one to two events over the past 12 months. Conclusions: The overall percentage of positive response scores was lower than the international scores and higher than the regional benchmark scores. Clinical Relevance: Present findings should be considered by pediatric hospital management to make efforts tailored to improve the dimensions of patient safety culture in "hospital handoffs and transitions," "communication openness," and "supervisor/manager expectations and actions promoting safety." In addition, the Saudi Patient Safety Center and nursing management can use these data with a detailed understanding of the current patient safety culture in pediatric units to strengthen safe practices within health care hospitals in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Children are prescribed a complex multi-drug regimen, composed of numerous essential medications, following a liver transplantation. Several of these medications continue to be necessary for the remainder of the patient's life. Nonadherence is a major concern in this population. Strict compliance with the intricate regimen is crucial for maintenance of graft functioning. Current literature regarding the role of inpatient clinical nurses in positively influencing medication adherence, specifically with pediatric liver transplant patients, is extremely limited. Further research is needed to standardize and clarify responsibilities of the pediatric nurse in this realm. With additional resources and training, the clinical nurse can play a critical role in family-centered medication education to promote medication regimen adherence upon discharge from the hospital setting and continuing indefinitely. The clinical nurse should employ tailored, creative, and targeted teaching approaches based on the individual family's needs and child developmental stages. Systems-wide change and the need for an innovative model that allows clinical nurses to spearhead medication-regimen education in the pediatric transplant population are needed. Patients and families need extensive education and continued reinforcement on medication administration and the importance of each medication, which clinical nurses are well-suited to provide. [ABSTRACT FROM AUTHOR]

This review explores risk factors leading to adverse neurodevelopmental sequelae in patients with congenital heart disease (CHD), describes different forms of neurodevelopmental morbidity seen in school-age children and adolescents with CHD, and discusses practice implications for pediatric nurses caring for them. PubMed and Google Scholar were the primary search engines used for the literature search. One textbook chapter and 25 articles from peer-reviewed journals were selected according to relevance and recency, with a focus on studies published in 2016 or later. Data exploring negative neurodevelopmental sequelae in the domains of cognitive ability, motor function, executive functioning, and psychiatric health in pediatric patients with CHD were abstracted. Survivors of CHD may experience a variety of neurodevelopmental challenges due to abnormalities in blood flow during the fetal and neonatal period, complications in the operating room or during postoperative recovery, and biological and family-related risk factors. School-age children and adolescents with CHD may display deficits in cognitive, motor, and executive function. Higher rates of psychiatric disorders have also been identified in this population. Pediatric nurses caring for children with CHD are an integral part of the care team, helping manage various aspects of care, such as surveillance and care coordination, psychosocial care, and patientfamily education. Pediatric nurses have an important role in recognizing these challenges and providing patients with CHD the support and resources they need to attain optimal outcomes. [ABSTRACT FROM AUTHOR]

Background: The nursing profession has historically been predominated by females. This is more prevalent in pediatrics, where female health care workers, including pediatricians, outnumber their male counterparts. Nursing is generally seen as a profession of caring and service, a role normally perceived to be for females. That stereotype is further pronounced in pediatrics where the primary caregiver of the family is typically the mother. Such a stereotype is damaging to men as it discourages them from entering the profession. Purpose: To provide general knowledge and show a timeline on the impact of working as a male nurse, especially in pediatrics, and perceptions of nurses, their patients, families, and the general public. Methods: A literature review was conducted using the key words "male nurse," "men in nursing," "perceptions," and "pediatrics" in Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed. The search was limited to articles published from 2015 to 2021. Results: Male nurses and nursing students continue to be stereotyped to lack emotional intelligence and be less caring than their female counterparts. Male nurses are capable of having compassion just like their female counterparts as suggested by perceptions from nurses' patients and families. Conclusions: The shift to men entering the nursing profession has slowly been on the rise. There are efforts in recruiting men into nursing and support organizations for men entering nursing both in educational and professional institutions. However, the rise of men in pediatrics remains stagnant, with a majority of men choosing professions in adult critical care and emergency medicine. [ABSTRACT FROM AUTHOR]

Purpose: To describe the current practice of how children and their parents are informed and prepared for medical procedures at Swedish pediatric units, and to follow up on practices reported previously in 17 units. Design and Methods: A cross-sectional survey using a semi-structured questionnaire was performed in 2000, defined as Trial 1 (T1), with 58 responses, and repeated from 2017 to 2018, defined as Trial 2 (T2), with 26 responses. Potential differences between T1 and T2 were calculated with Pearson's Chi-square, and open-ended question responses were subjected to content analysis. Results: In T1, 95% of respondents reported regular preparation services and 65% reported this in T2; most practices were equal between T1 and T2. However, prior to admission, conversations with nurses (p < 0.05) and video shows on the Internet or web-based programs (p < 0.001) were more frequently reported in T2 than in T1. Additionally, written information about psychological needs at discharge (p < 0.001) and communication with nurses and physicians increased in the present study (p < 0.01). Checking the child's level of understanding was reported less in T2 (p < 0.01). Open-ended responses gave the impression that the units had ambition to inform and prepare children properly but were hindered because of time constraints, a strained staff situation, and lack of routines. Conclusions: In Swedish Pediatric Care, preparation services are emphasized; however, increased outpatient care and decreased hospital stays challenged the practice of preparation and information. The child's perspective of preparation and information needs further illumination. [ABSTRACT FROM AUTHOR]

Background: Pediatric patients are subject to numerous painful procedures during their hospitalization. These procedures can cause pain and anxiety that may be under-estimated and under-treated. Research shows that patients undergoing painful procedures receive suboptimal relief for pain and anxiety (Bice et al., 2014). Methods: A non-experimental design used retrospective chart reviews for comparison of patient care before and after implementation of a new nursing practice guideline (NPG) and order set/power plan (PP) on three inpatient units. An assessment of nursing and provider knowledge of pharmacologic and non- pharmacologic analgesia and the non-sedated procedural pain NPG/PP was completed. A nursing satisfaction survey assessed use and feasibility of the NPG. Findings: After educational implementation, nurses and providers significantly improved their knowledge of peak onset of morphine and oxycodone (p < 0.001). Nurses demonstrated significant improvement in reports of NPG utilization and knowledge of pharmacological and non-pharmacological resources (p < 0.001). Providers gained familiarity with the NPG/PP (p < 0.001). There was no evidence in the electronic health record (EHR) documentation to confirm the transfer of knowledge and compliance related to the NPG/PP. Discussion: This multidisciplinary quality improvement project improved nursing and provider knowledge of non-sedated pediatric procedural pain pharmacologic and non-pharmacologic resources in our organization. EHR documentation limitations may have contributed to the evaluation of resource application. Application to Practice: By improving knowledge of resources, we hope to increase compliance, improve pain control, and continue to evaluate their use during these short procedures. Redesign of the EHR is essential to help facilitate and evaluate NPG/PP compliance. [ABSTRACT FROM AUTHOR]

The article addresses how to determine the appropriate method, either research, evidence-based practice, or quality improvement project, that will be used in clinical inquiry in pediatric nursing. It suggests the need to identify resources offered by the employing organization. It outlines steps for exploring resources that include creation of a multidisciplinary team, exploring clinical guidelines and using the Patient/Population/Problem, Intervention, Comparison, Outcome, Time (PICOT) format.

Children with autism often engage in challenging behavior, such as physical aggression or restrictive and repetitive behavior, which interferes with the delivery of medical procedures. Although researchers have described best practices for providing services to individuals with autism within medical settings, many of these recommendations lack empirical support, mainly because it relates to overcoming challenging behavior. In contrast, applied behavior analysis offers evidence of best practices, but translation of these findings to medical settings is limited. We conducted a scoping review of the existing medical literature on best practices for treating children with autism who engage in challenging behavior within hospital settings. We also discussed how the behavior-analytic literature might contribute to best practice recommendations. [ABSTRACT FROM AUTHOR]

Purpose: La Crosse encephalitis virus (LACV) is a mosquito-borne virus that primarily affects the pediatric population. There is no available vaccination, so treatment is symptom based. Severe cases have a fatality rate of up to 1.9%, and a potential for long-term physical and neurologic sequalae. Efficacy, application, and safety of four U.S. Environmental Protection Agency (EPA)-registered mosquito repellents are reviewed in the context of mosquito-borne disease risk. Data Sources: An electronic search was conducted to locate relevant articles. Search terms included LACV, La Crosse virus, DEET, picaridin, IR3535, PMD, oil of lemon eucalyptus, mosquito repellents, encephalitis, and arbovirus. Limitations on the search were peer-reviewed, academic journals published in English between 2000 to 2020. More than 200 articles were reviewed for relevant data out of 750 articles, and 34 were used for this review. Implications: Nurses have a vital role in the prevention of disease by providing information to patients and caregivers about the risk of LACV and other mosquito-borne viruses. Risk reduction measures, including the use of EPA-registered repellents, should be recommended based on safety and efficacy evidence. Conclusion: Current literature continues to support DEET as the first-line repellent. Picaridin, IR3535, and PMD can be used as an alternative to DEET with more frequent re-application. Choice of repellents should be individualized to the situation and patient preference; however, any form of repellent is strongly recommended considering the prevalent risk of endemic mosquito-borne diseases. [ABSTRACT FROM AUTHOR]

Developing concussion assessment skills is a critical component of the school nurse's role. There is a lack of standardized concussion assessment tools for nurses in the school setting to quickly and accurately identify students who require further evaluation. The Acute Con - cussion Evaluation--Emergency Department (ACE-ED) tool is an evidence-based method of standardizing concussion assessments. A review of the literature supported the ACE-ED as a valid and reliable tool for concussion assessment. Registered nurses employed by a special education district in the suburban Midwest participated in the quality improvement project. Results showed a statistically significant increase in self-efficacy scores from preimplementation to post-implementation. This project supports the ACE-ED as a reliable, standardized concussion assessment framework for use by nurses in the school setting. Potential exists for improving nursing self-efficacy of concussion assessments when the ACE-ED tool is used in schools, thus improving time for concussion treatment in school-age children. [ABSTRACT FROM AUTHOR]

Nurses have a professional responsibility to advocate for dignified, respectful, and culturally appropriate care for all individuals. Refugees are a particularly vulnerable patient population, and each year, millions of individuals flee violence or persecution amid global unrest and a worsening climate crisis. Quality nursing care for refugees, specifically refugee children, requires a sophisticated level of cultural sensitivity and policy awareness. Nurses make up the largest health care profession and are well-positioned to collectively advocate for inclusive legislation that promotes equitable access to services for refugees. Evidence from nursing history can support policy advocacy, documenting how nurses have been on the front lines of health promotion for migrant populations in the past. This study utilized traditional historical methods with a social history framework to analyze the nursing care of immigrant children at Ellis Island hospitals from 1892 to 1924, focusing on the intersection of policy and place. Public Health Service nurses on Ellis Island learned to navigate multiple roles with potentially competing responsibilities, balancing their duty to care for immigrant patients with their obligation to protect the health of the nation. Today, legislators and health care providers appear at odds because increasingly restrictive immigration policies are often incompatible with strong public health measures that call for greater access to care for migrant communities. As the primary point of contact in refugee health, nurses can help bridge the gap between providers and lawmakers by using historical evidence to demonstrate public health policy and immigration legislation can be mutually beneficial. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses articles within the issue on topics including child growth and development, reasons infants cry, and life in the neonatal intensive care unit.

Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) are rising among today's lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adolescents, specifically, men who have sex with men (MSM) and transgender adolescents. There are numerous barriers to practicing safe sex among LGBTQ adolescents. The goal of this article is to raise awareness of the critical role nurses can play in educating this population and their parents on approaches to practicing safe sex to prevent HIV and other STIs. In addition, this article aims to encourage baccalaureate nursing education programs to incorporate LGBTQ issues in their curricula, such as providing better access to health care and prevention of HIV and other STIs for LGBTQ adolescents. Nurses have unique access to these patients, and with better understanding of how to educate and communicate with LGBTQ adolescents on the prevention of HIV and STIs, nurses can have a positive protective effect on their patients. [ABSTRACT FROM AUTHOR]

Purpose: Investigate the perceptions of fathers who have a child from birth through infancy with congenital heart disease (CHD) and determine what nurses can do to support these fathers. Method: A qualitative descriptive research design was used in this study. A semi-structured interview was conducted with 12 fathers who had a child with CHD. Fathers were asked about their thoughts and feelings regarding their child, wife, and own experiences. Results: Fathers' responses were divided into nine main categories and 27 subcategories. Since their child's birth, fathers' feelings fluctuated over time as they considered their child's disease process and future. Fathers were frustrated, fought against helplessness, and felt anxious making decisions about their child's care. They also felt pressured because they had to support their wife and try to meet other people's expectations as a husband and father. Considerations: It is necessary for nurses to understand and support not only sick children and their mothers, but also fathers who may have complicated feelings and thoughts. Because fathers of sick children do not often express their emotions, they may miss opportunities to receive effective support and care. It is also important to let those fathers know health care professionals are on their side and are trying to understand fathers' thoughts and feelings. [ABSTRACT FROM AUTHOR]

The article offers information on writing an abstract for a manuscript. Topics discussed include purpose of the abstract, characteristics of a well-written abstract, and components of the abstract for research reports. Also included are helpful hints when writing an abstract and an example of a poorly written abstract.

All-terrain vehicles (ATVs) have become increasingly popular since their introduction to the United States in the 1970s. In general, people view ATVs as an innocent source of recreation for adults and children. Most individuals are unaware that ATV riding results in significant morbidity and mortality within the pediatric population. Children younger than age 16 years represent one-third of ATV-related injuries and one-fifth of ATV-related fatalities in the United States. Additionally, injuries children suffer are often more severe than those experienced by adults. Despite ongoing prevention efforts via legislation and education, ATVs remain a significant hazard to children and adolescents. Nurses are wellpositioned to participate in the prevention of pediatric ATV trauma, and hopefully, with a better understanding of the risk factors and outcomes associated with ATV accidents, they will be inspired to join the effort to combat this safety issue. [ABSTRACT FROM AUTHOR]

A child's hospitalization affects the entire family system, with parents/caregivers reporting a myriad of stressors challenging family dynamics and coping efforts. Legacy-oriented interventions employ play- and arts-based techniques to promote collaboration and communication in families of hospitalized children and thereby foster resilience. Although offered in most children's hospitals, little is known about the impact of these interventions on pediatric patients and families, or the ways pediatric health care providers, parent/caregivers, and pediatric patients understand and describe the concept of legacy. This study explored the legacy perceptions of parents/caregivers of hospitalized children on acute or critical care units in an academic medical center. Ninety-three parents/caregivers completed a semi-structured, in-depth interview regarding their perceptions of the concept of legacy. Analysis yielded four themes: 1) legacy is a transgenerational process; 2) legacies can be actions, accomplishments, and experiences; 3) legacy can be a powerful tool for education and change; and 4) a 'good' legacy can be left in different ways. These findings together indicate that capturing and integrating a family's unique history, stories, strengths, and experiences appear to be a desirable and useful component of family-centered health care. Additionally, when considered along previous research and practice, it appears medical and psychosocial care providers should assess, recognize, and involve parent/caregivers' experiences with and understandings of legacy into legacy-oriented interventions or activities, as well as other aspects of care related to patient and family coping and functioning. [ABSTRACT FROM AUTHOR]

This three-part series provides an overview of six types of published reviews used to search, appraise, synthesize, and analyze available scientific literature on a selected topic. Part 3 discusses integrative reviews, scoping reviews, and literature reviews. [ABSTRACT FROM AUTHOR]

This three-part series provides an overview of six types of published reviews used to search, appraise, synthesize, and analyze available scientific literature on a selected topic. Part 2 discusses meta-analysis and meta-synthesis. [ABSTRACT FROM AUTHOR]

The article calls for an action to achieve environmental justice in Africa and around the world. Topics mentioned include the impact of climate crisis on the environmental and social determinants of health in Africa, the need to provide support to vulnerable countries to reduce their greenhouse gas emissions, and the importance of introducing a financial tool for loss and damage and for mitigation and adaptation.

In the article, the author discusses how to effectively support lesbian, gay, bisexual, transgender and queer (LGBTQ) patients who are experiencing mental health issues and their families. Also cited are the Trevor Project study showing that 42% of almost 35,000 LGBTQ youth ages 13-24 in the U.S. considered suicide and 75% experienced discrimination due to their sexual orientation or gender identity, and the resilience of said youth despite their predicaments.

Problem: Although mother's own milk (MOM) is the optimal source of nutrition for all infants, little is known about pediatric acute care (PAC) (pediatric inpatient units but not including general newborn or neonatal intensive care units) nurses' knowledge, attitudes, and beliefs about MOM feeding (MOMF) (feeding directly at breast or feeding expressed MOM) in the PAC setting. Eligibility Criteria: An integrative review was performed to synthesize research on MOMF knowledge, attitudes, and beliefs of PAC nurses. Criteria for inclusion were studies published in English, and with knowledge, attitudes, and beliefs of PAC nurses reported separately. Sample: Only two studies reported results specifically for PAC nurses. The studies were conducted in Australia (N = 67 nurses) and England (N = 122 nurses). Results: Overall, nurses knew the contribution of MOMF to infant health, importance of latch, and the need to seek maternal permission before offering non- MOMFs. Nurses were less knowledgeable about the differences between MOM and commercial infant formula, recommendations specific to the duration of feeding sessions, milk expression intervals, locations for milk expression, and MOMF resources for mothers. Nurses identified that hospital MOMF facilities and maternal support were poor. Conclusions: The limited research on PAC nurses' MOMF knowledge, attitudes, and beliefs suggests that PAC nurses know MOMF is important but lack knowledge about many aspects of MOMF in the PAC setting. Implications: PAC nurses' MOMF knowledge, attitudes, and beliefs merit further investigation, and programs designed to improve the knowledge, attitudes, and beliefs of PAC nurses are warranted. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to examine the reported online and health risk behaviors of adolescent cyberbullies, cyber victims, and cyberbullyvictims. Methods: This descriptive correlational study used a secondary analysis design from a larger study of high school students. The sample consisted of 464 adolescents who reported one or more experiences of cyberbullying. Results: Findings revealed significant differences (p < 0.0001) between type of bully and victim. Cyberbully-victims were more likely to report health and online risk behaviors, such as smoking, illicit drug use, having close relationships online, and sexting. Cyberbullies were likely to report viewing inappropriate material online and going on purpose to inappropriate websites. Interestingly, cyber victims also reported participation in risky behavior online, which included viewing inappropriate material online and having close relationships with people online. Discussion: Cyberbully-victims had the highest reports of health and online risk behaviors but were followed closely by their peers. Findings from this study suggest important areas of intervention with high school students who partake in aggressive behaviors. [ABSTRACT FROM AUTHOR]

There is great confusion about cannabis; terms such as marijuana, THC, CBD, and hemp are often used without a full understanding of their meanings and actions. The purpose of this article is to clarify terms related to cannabis and to provide the pediatric nurse with an objective discussion of the pros and cons of these substances. Medical cannabis is discussed, as well as many issues faced by both pediatric nurses and society related to this substance. [ABSTRACT FROM AUTHOR]

The article discusses child development in the evaluation of stress in children during the COVID-19 pandemic. Topics mentioned include the impact of COVID-19 by psychosocial development stage, signs and symptoms of stress by age, and the responsibility of the pediatric provider to examine social media use, sleep hygiene, and overall emotional wellbeing in all adolescents during and after the pandemic.

Purpose: Improvements in patient satisfaction are perpetual goals for health care organizations, and nurses are the health care providers most frequently in contact with patients and families. Understanding relationships between compassion satisfaction (CS), compassion fatigue (CF), and nurses' perceptions of their role with patient satisfaction may identify opportunities for improvement. Methods: A quality improvement survey pilot project was undertaken to establish data on the prevalence of CS and CF, as well as nurses' demographics and perceptions regarding patient satisfaction from a representative sample of hospital registered nurses from five clinical units. Descriptive statistics were used to analyze quantitative data, and for qualitative data, semantic content analysis was used. Outcomes: A total of 102 nurses voluntarily participated, and findings indicated moderate-high prevalence of CS (3.83 to 4.05) and moderate-low prevalence of CF (2.04 to 2.39) across all five pilot units without significant relationships with unit patient satisfaction ratings. Nurses (60%) perceived themselves as accountable for patient satisfaction and identified similar codes (> 75%) in open-ended responses. Conclusion: Implications for pediatric nursing were increased risk for CF, which can be mediated with proactive interventions that support nurse resiliency, and CS. Further investigation of correlations between nurse satisfaction and patient satisfaction, nursing work environment, communication, and family care in pediatrics is warranted. [ABSTRACT FROM AUTHOR]

Until recently, children have not been central in news of the COVID-19 pandemic; however, the pandemic has certainly impacted them. Recent studies suggest that both parental and children's mental health has worsened since the onset of the pandemic. These changes are most pronounced in families facing more hardship, and children already at high risk for mental health concerns are even more vulnerable as a result of the pandemic. Children's hospitals have responded in varied ways to these concerns, providing telehealth mental health visits, offering webinars on pertinent topics, and adding supportive content on their websites. This article features specific programs of Children's Mercy with hospitals in both Kansas City, MO, and Overland Park, KS, as well as several other institutions, and outlines resources for nurses to share with families. [ABSTRACT FROM AUTHOR]

Every year, thousands of people are labor- and sex-trafficked throughout the United States, generating billions of dollars. Many of these victims are children. They are included in the more than 80% of victims who seek some type of medical care during their captivity. In addition, more than 90% of the children exploited attend school daily. By seeking medical care and attending school, victims place health care personnel, especially pediatric and school nurses, in a unique position to help identify and assist them. Pediatric and school nurses both practice in settings that allow for familiarization with a child and the opportunity for private medical screenings. These opportunities allow for red flag indicators to be recognized and possible victims to be identified and/or disclose. [ABSTRACT FROM AUTHOR]

The New York City area and adjoining counties were one of the hardest hit areas in the nation with SARS-CoV-2, referred to as COVID-19. In the initial months, the impact seemed to spare those in the pediatric population; however, in March 2020, a new finding presented itself. The Centers for Disease Control and Prevention (CDC) (2020a) issued a health advisory regarding a multisystem inflammatory syndrome in children (MIS-C), formerly pediatric multisystem inflammatory syndrome, and its association with COVID-19. They noted that as of October 15, 2020, 44 states and Washington, DC, reported 1,097 cases and 20 deaths. Most pediatric cases are in children 1 to 14 years of age, and slightly more than half (56%) of reported cases were male. According to the New York State Department of Health (NYS DOH) (2020a), as of October 10, 2020, there have been 266 cases of MIS-C under investigation and two pediatric deaths, thereby making this area an epicenter of MIS-C. This article presents a broad view of the educational needs of the clinical nurse caring for the child with multi-system inflammatory syndrome. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic poses an increased threat to the mental and behavioral health of children. There is an increasing prevalence of mental health problems in children, coupled with the variability of access to mental health services and the impact of trauma and adverse childhood experiences (ACEs) on child health. The prolonged duration of the current pandemic put children at increased risk for an even higher rate of mental and behavioral health problems. Prior to the pandemic, the mental health workforce was ill equipped to care for the growing need and demand for child-specific services. As the pandemic continues to invade communities across the nation, it is vital for pediatric nurses to acknowledge COVID-19 as a major disruptor to the typical growth and development of children. The full impact of this COVID-19 pandemic on the mental health for children is uncertain. However, its impact on an already limited child-focused mental health workforce will indeed have a long-lasting impact on the health and well-being of children and their families. The socio-ecological impact of COVID-19 and its duration for those children with known mental health problems and those in whom such challenges will arise has implications for future models of care. Nurses are well-poised to both assess and intervene with mental health problems to reduce the long-term, potentially negative effect of COVID-19 on the health and well-being of children. [ABSTRACT FROM AUTHOR]

Planned pediatric surgeries stopped to prevent the spread of COVID-19, preserve beds for those who acquired the virus, and to maintain the supply of personal protective equipment (PPE) for those caring for patients as part of the COVID-19 emergency response. In children awaiting surgery, nurses' pre-operative assessments of their current state, function, and pain are critical to their positions in line for surgeries and procedures. Currently, surgery resumption depends on hospital administrators, operating room schedulers, and families' abilities to reach out. Evaluating outcomes in delayed pediatric surgeries may inform behaviors when cancelling and rescheduling surgeries in the future. As care teams re-engage with patients, pediatric surgery nurses must compel their multidisciplinary teams to maintain contact and relationships with children and their families throughout the delay. Building a nursing framework now for future emergency surgery lockdowns will make care teams more effective during the next crisis. [ABSTRACT FROM AUTHOR]

Unaccompanied children continue to immigrate to the United States from Central America and Mexico seeking asylum and often reunification with family. As this influx continues, it is the responsibility of the medical community, including pediatric nurses, to address the health needs of these vulnerable children. This article reviews current health considerations of recently detained unaccompanied children, and the impact their experiences have on their physical and mental health. [ABSTRACT FROM AUTHOR]

Problem: Neonatal sepsis is a significant cause of mortality and morbidity in the newborn. The vague clinical presentation can be a challenge to the pediatric nurse clinician, often causing a delay in diagnosis and management. Eligibility Criteria: Thirty-two articles, as well as guidelines and relevant texts, addressing late-onset neonatal sepsis and neonatal sepsis within the last 10 years were selected for review. Results: When predicting late onset sepsis in the neonate the complete blood count (CBC) with differential showed poor sensitivity and specificity; however, the white blood cells (WBC) showed a good negative predictive value (NPV), along with an I:T ratio of >0.2, strongly indicating bacteremia in a neonate. In terms of inflammatory biomarkers, C-reactive protein (CRP) and procalcitonin (PCT) showed the most promise, with good sensitivity and specificity, as well as good accessibility, when compared to interleukin 6 (IL-6) and serum amyloid A (SAA). DNA polymerase chain reaction (PCR) shows promise. Conclusions: Many sepsis treatment protocols include the CBC with differential as a main diagnostic test; however, this lacks accuracy in the neonatal population. The emergence of acute phase reactants and inflammatory biomarkers has provided additional diagnostic options in the diagnoses of neonatal sepsis. Implications: The pediatric nurse clinician should be aware of what tests are available in the clinical setting, and through the use of clinical assessment and history taking in combination with appropriate diagnostics, aim to diagnose these newborns cautiously in accordance with current practice guidelines and protocols. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to explore the optimal approach to transitioning patients with bronchopulmonary dysplasia (BPD) from the hospital to home setting. Design: A review of current literature on BPD was performed using PubMed and Scopus with the search terms bronchopulmonary dysplasia, nursing care, intensive care, outpatient management, neurodevelopmental outcomes, nutrition, respiratory therapy, and pharmacologic therapy. A total of 15 out of 32 peerreviewed journal articles published between the years 2001 and 2019 were reviewed. Types of articles included original research, reviews, and case reports. Methods: Approaches to transitioning patients with BPD from a respiratory, pharmacological, nutritional, and neurodevelopmental standpoint were compared and summarized. Conclusions: The implementation of an interprofessional care approach during discharge may have an effect on reducing readmission rates and improving overall outcomes in patients with BPD. Further research is needed to improve the understanding of the discharge and follow-up management of these patients. Practice Implications: Patients with BPD are complex and benefit from interprofessional care throughout the course of their illness, especially at times of transition. Nurses are integral members of this team of providers. Educating nurses on best practices will assist them in providing expert care to this patient population. [ABSTRACT FROM AUTHOR]

There is minimal educational material regarding heart and liver allocation guidelines for pediatric nurses. Based on the Organ Procurement Transplantation Network (OPTN) data as of March 13, 2020, there are 1,978 children waiting for solid organ transplant. The referral criteria for solid organ transplant varies greatly among organ type and leaves room for interpretation. The strict qualifications to even be considered for a solid organ transplant go far beyond the physical state of the recipient. Criteria for transplantation may include life expectancy, history of medication adherence, available social support, previously failed transplantation, financial considerations, psychological status of the patient, and developmental delay. Nurses are in a unique position to advocate for early referral, identify potential barriers to transplant, provide support during hospitalizations, educate their patients and families, and offer anticipatory guidance. To have a successful transplant, a better understanding of the complex allocation system, contraindications to transplantation, pediatric exceptions, logistics of transplantation, and factors that contribute to early and late graft loss is essential. Informed nurses are in the best position to advocate for their patients and help improve outcomes. [ABSTRACT FROM AUTHOR]

Differentiation syndrome (DS) is a life-threatening complication specific to patients with acute promyelocytic leukemia (APL) receiving all-trans retinoic acid (ATRA) or arsenic trioxide (ATO) during induction therapy. These agents have significantly improved complete remission rates and overall survival rates in pediatric patients. However, approximately one-quarter of patients receiving ATRA or ATO develop DS, which can lead to progressive cardiorespiratory distress and multiple organ failure. Early recognition and prompt initiation of systemic steroids have dramatically reduced the morbidity and mortality associated with this complication. The pediatric nurse is at the front line of patient care and plays a significant role in optimizing outcomes for these patients. [ABSTRACT FROM AUTHOR]

The article looks at several techniques for supporting siblings in pediatric health care settings. Topics mentioned include possibility for children to experience psychological growth in the face of illness and hospitalization, the impact of pediatric medical traumatic stress on patients and caregivers, and education of siblings about illness and medical events.

Nurses caring for pediatric patients with life-limiting and life-threatening conditions are often faced with the challenge of providing care to patients receiving palliative and hospice care. In some instances, patients or caregivers (such as a parent or guardian) will have had advance care planning discussions with their palliative care team that are not directly shared with the interprofessional team, including nursing staff providing direct patient care. Despite caring for chronically ill patients, nurses are often unfamiliar with the advance care planning process, and are uncertain of their role in advance care planning, how to incorporate the patient's wishes into daily nursing care, and how to assist with patient and family decision-making surrounding advance directives. Although there is substantial literature available distinguishing the differences between palliative care and hospice care, as well as the need for early palliative care consultation intervention, less information and knowledge exist about what advance directives are available in the pediatric patient population. This uncertainty coupled with a lack of knowledge in how to best navigate these difficult conversations may delay pertinent advance care planning conversations. By understanding pediatric and adolescent and young adult-focused advance directives (specifically, Five Wishes®, Voicing My CHOiCES™, and My Wishes), pediatric nurses will better understand their role in guiding and supporting patients and families, and as a result, be better prepared to assist with the advance care planning process. [ABSTRACT FROM AUTHOR]