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Background: Mongolian government has set improvement of clinical proficiency of nursing students as one of its priorities. Nursing professionals have the sentinel role in providing healthcare services in rural areas. Outcome-based education (OBE) offers a promising pedagogical approach to actively mentally engage students to strengthen their clinical proficiencies. We implemented a pilot project with the objective of comparing students' clinical performance under OBE with our traditional didactic techniques. Methods: The researchers implemented a non-equivalent two-armed quasi-experimental post-test-only' design approach study. The intervention arm (n = 34) received OBE pediatric training, while the control arm (n = 32) received the traditional pedagogical pediatric nursing training. Each arm of the study completed 16 hours of theory, 32 hours of clinical skills practice and 32 hours of seminars in pediatric nursing care. Data were collected using a five-section instrument, Demographic, Competency Inventory, Nursing Students' Satisfaction, Course Experience, and Objective Structured Clinical Examination. Performance and knowledge proficiencies were evaluated by applying the two-sided independent T-test. The distributions of categorical variables were assessed by Fisher's exact test or chi-squared test of significance. Results: The intervention arm had higher mean score value in the competency inventory (X¯ = 238.70, SD = ± 23.07) compared to the control arm (X¯ = 222.11, SD = ± 39.94) (P = 0.04); similarly, the mean value for nursing students' satisfaction was higher for the intervention arm (X¯ = 117.87, SD = ± 15.94) compared to the control group (X¯ = 109.76, SD = ± 16.94) (P = 0.049). Additionally, the difference in the mean value for course experience questionnaire between the intervention arm (X¯ = 125.33, SD = ± 19.30) and the control arm (X¯ = 110.41, SD = ± 11.28) was statistically significant (P = 0.0001). Finally, the intervention arm had a higher mean value (X¯ = 85.40, SD = ± 6.11) for objective structural clinical examination compared to the control arm (X¯ = 81.56, SD = ± 7.01) (P = 0.023). Conclusion: OBE pedagogical approach offers promising benefits to improving nursing students' clinical competencies; additionally, the OBE approach seems to increase students' satisfactions with their clinical curriculum. [ABSTRACT FROM AUTHOR]

Aim: To develop a nurse‐led model of analgesia to manage post‐operative pain in the surgical neonate. Design: A four‐round e‐Delphi study was conducted from March to December 2022. Methods: An e‐Delphi method was used seeking a consensus of 70% or greater. Fifty‐one experts were invited to join the panel. Members consisted of multi‐disciplinary healthcare professionals who work in areas associated with neonatal care. In round 1, 49 statements relative to neonatal pain assessment and management were distributed to the panel. Panel members were asked to rate their level of agreeance on a Likert scale from 1 to 5 (1 = strongly disagree to 5 = strongly agree). Ratings equal to or greater than 4 represented agreement, 3 indicated uncertainty and 2 or less disagreement with the proposed statement. An opportunity for free‐text responses after each statement was provided. This iterative process continued for three rounds. In the fourth and final round, the completed model of neonatal nurse‐controlled analgesia was presented along with a further opportunity to provide feedback on the final version. Results: Four rounds of statements and voting were required to reach consensus on a model of neonatal nurse‐controlled analgesia. The model consists of criteria for use, over‐arching guidelines and three separate pathways based on an individual baby's pain assessment scores, need for pain relieving interventions and time‐lapsed post‐surgical procedure. Conclusion: A comprehensive model of neonatal nurse‐controlled analgesia, applicable to the Australasian context, was developed in collaboration with a group of neonatal experts. Impact: This study provides a multi‐modal family‐integrated model to manage neonatal post‐operative pain. By providing nurses with increased autonomy to assess and manage acute pain, this model has the potential to not only provide a more responsive and individualized approach to alleviate discomfort, but highlights the integral role of parent partnerships in the neonatal intensive care. Reporting Method: This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies. Patient or Public Contribution: No patient or public contribution was utilized for this study. [ABSTRACT FROM AUTHOR]

As cases of type 1 diabetes mellitus (T1DM) increase, so do their impact on sibling relationships. This literature review of four databases from 2010 to 2024 discusses findings from five studies and the themes that emerged: education needs and family functioning. Improvements in family- centered care and education are needed for siblings of children with T1DM. [ABSTRACT FROM AUTHOR]

Introduction: Limited evidence exists regarding medication administration errors (MAEs) on general paediatric wards or associated risk factors exists. Objective: The aim of this study was to identify nurse, medication, and work-environment factors associated with MAEs among paediatric inpatients. Methods: This was a prospective, direct observational study of 298 nurses in a paediatric referral hospital in Sydney, Australia. Trained observers recorded details of 5137 doses prepared and administered to 1530 children between 07:00 h and 22:00 h on weekdays and weekends. Observation data were compared with medication charts to identify errors. Clinical errors, potential severity and actual harm were assessed. Nurse characteristics (e.g. age, sex, experience), medication type (route, high-risk medications, use of solvent/diluent), and work variables (e.g. time of administration, weekday/weekend, use of an electronic medication management system [eMM], presence of a parent/carer) were collected. Multivariable models assessed MAE risk factors for any error, errors by route, potentially serious errors, and errors involving high-risk medication or causing actual harm. Results: Errors occurred in 37.0% (n = 1899; 95% confidence interval [CI] 35.7–38.3) of administrations, 25.8% (n = 489; 95% CI 23.8–27.9) of which were rated as potentially serious. Intravenous infusions and injections had high error rates (64.7% [n = 514], 95% CI 61.3–68.0; and 77.4% [n = 188], 95% CI 71.7–82.2, respectively). For intravenous injections, 59.7% (95% CI 53.4–65.6) had potentially serious errors. No nurse characteristics were associated with MAEs. Intravenous route, early morning and weekend administrations, patient age ≥ 11 years, oral medications requiring solvents/diluents and eMM use were all significant risk factors. MAEs causing actual harm were 45% lower using an eMM compared with paper charts. Conclusion: Medication error prevention strategies should target intravenous administrations and not neglect older children in hospital. Attention to nurses' work environments, including improved design and integration of medication technologies, is warranted. [ABSTRACT FROM AUTHOR]

Background: Postoperative delirium (POD) represents a prevalent and noteworthy complication in the context of pediatric surgical interventions. In recent times, a hypothesis has emerged positing that cerebral ischemia and regional cerebral oxygen desaturation might serve as potential catalysts in the pathogenesis of POD. The primary aim of this study was to methodically examine the potential relationship between POD and regional cerebral oxygen saturation (rSO2) and to assess the predictive and evaluative utility of rSO2 in the context of POD. Methods: This prospective observational study was conducted at the Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China, spanning the period from November 2020 to March 2021. The research cohort comprised children undergoing surgical procedures within this clinical setting. To measure rSO2 dynamics, cerebral near-infrared spectroscopy (NIRS) was used to monitor rSO2 levels both before and after surgery. In addition, POD was assessed in the paediatric patients according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. The analysis of the association between the rSO2 index and the incidence of POD was carried out through the application of either the independent samples t-test or the nonparametric rank-sum test. To ascertain the threshold value of the adjusted rSO2 index for predictive and evaluative purposes regarding POD in the pediatric population, the Receiver Operating Characteristics (ROC) curve was employed. Results: A total of 211 cases were included in this study, of which 61 (28.9%) developed POD. Participants suffering delirium had lower preoperative rSO2mean, lower preoperative rSO2min, and lower postoperative rSO2min, higher ∆rSO2mean, higher amount of ∆rSO2mean, lower ∆rSO2min (P < 0.05). Preoperative rSO2mean (AUC = 0.716, 95%CI 0.642–0.790), ∆rSO2mean (AUC = 0.694, 95%CI 0.614–0.774), amount of ∆rSO2mean (AUC = 0.649, 95%CI 0.564–0.734), preoperative rSO2min (AUC = 0.702, 96%CI 0.628–0.777), postoperative rSO2min (AUC = 0.717, 95%CI 0.647–0.787), and ∆rSO2min (AUC = 0.714, 95%CI 0.638–0.790) performed well in sensitivity and specificity, and the best threshold were 62.05%, 1.27%, 2.41%, 55.68%, 57.36%, 1.29%. Conclusions: There is a close relationship between pediatric POD and rSO2. rSO2 could be used as an effective predictor of pediatric POD. It might be helpful to measure rSO2 with NIRS for early recognizing POD and making it possible for early intervention. Key points: 1. Pediatric postoperative delirium is closely related to rSO2. 2. Incorporating rSO2 monitoring into pediatric perioperative nursing plans and procedures could be effective, especially in younger children. 3. Further investigation can focus on different approaches to optimize perioperative cerebral oxygenation. 4. This study provides a new idea for the prediction, identification and evaluation of postoperative delirium in children, and helps to improve the objectivity, accuracy and effectiveness of evaluation. [ABSTRACT FROM AUTHOR]

Background: Painful procedures are common in the hospital setting. Limited research has been conducted on the use and effectiveness of patient/caregiver-selected techniques to help manage pain during procedures. This study explored the effect of using a Comfort Menu tool for needlestick procedures on patients' and/or caregivers' perceptions and experience of pain, and nurses' perceptions of its benefits and ease of use. Methods: This randomized correlational study included the Wong-Baker FACES® Pain Rating Scale, the FLACC Behavioral Pain Assessment Scale, and two postprocedural surveys. Participants included 100 hospitalized children aged 0 to 18 years and/or their caregivers (50 in the experimental group provided with the Comfort Menu and 50 members in the control group provided with standard care), and 47 nurses. Results: A significant difference was found between the experimental and control groups (p = 0.0100), with those in the experimental group reporting less severe pain than control group participants. All patients and/or caregivers indicated the Comfort Menu was easy to use; 98.04% reported it made being part of their or their child's care better, and 96.08% reported it reduced their or their child's perception of pain. All 47 nurses responded favorably to the use of the Comfort Menu. Conclusion: Using the Comfort Menu improved patient and family involvement, pain perception, and the procedure experience. Findings suggest the Comfort Menu should be part of the standard pain management protocol as hospitals seek better ways to manage pain and to provide patient-and-family centered care. [ABSTRACT FROM AUTHOR]

The article announces the launch of "Bridging the GAP: Empowering Neonatal Nurses in Drug Development for Neonates," a series by the Critical Path Institute (C-Path) and the National Association of Neonatal Nurses (NANN) aimed at empowering neonatal nurses in research and improving outcomes for neonates.

Pediatric nurses are key members in providing health care to children. Emotional intelligence plays an important role in healthcare and healthcare education, and higher emotional intelligence is associated with more compassionate and empathetic patient care, higher knowledge and skills, and better teamwork. This research is a predictive correlation study which was conducted in 2022 on 236 nurses working in pediatric wards. In this study, SPSS22 and AMOS26 and path analysis statistical method were used for data analysis. The results of this study showed that the professional quality of life with caring behaviors in nurses working in pediatric ward (β = 0.339, p <.001) and the professional quality of life with emotional intelligence in nurses working in pediatric ward (β = 0.175 , p =.002) and emotional intelligence correlated with care behaviors in nurses working in the pediatric ward (β = 0.306, p =.001). The ability to explain the final model is 18%. The results of this study showed that having a higher professional quality of life in pediatric nurses, in addition to being effective on the mental health of nurses, can also affect caring behaviors. Pediatric nurses with a higher level of compassion satisfaction and less burnout can have empathic behaviors and more effective communication with the child and its parents as a whole unit of care and provide more humanistic care that is required to care for a sick child. [ABSTRACT FROM AUTHOR]

Background: Emphasizing the crucial significance of maintaining a national nursing workforce well-prepared with the necessary knowledge, skills, and abilities to respond effectively is the growing frequency of natural and environmental disasters, coupled with public health emergencies such as the COVID-19 pandemic. So, the study aimed to explore pediatric nurses' preparedness to monkeypox outbreak, and their stress during this outbreak in Egypt. Methods: A cross-sectional study was conducted on a 416 nurses direct care for children at selected governmental hospitals in Egypt. Demographic form, Questionnaire for Infectious Disease Outbreak Readiness & Preparedness, factors affecting nurses' preparedness, and the generalized anxiety disorders scale-7 were the tools of the study. Results: (81.5%) of studied nurses had unsatisfactory level of preparedness to monkeypox outbreak. (96.4%) and (95.4%) of them were affected their preparedness by high workload and inconsistent income with the of risk of infection factors. Also, (57.2%) of them had high stress level. Conclusions: The study revealed the importance of ensuring adequate supplies of PPE are available and provided, and protocols must be implemented to ensure availability in case of an outbreak. Moreover, nurse staffing levels and workload distribution should be regularly reviewed to create reasonable nurse-patient ratios. [ABSTRACT FROM AUTHOR]

Background and Aim: The Manchester Triage System (MTS) is a clinical risk management tool used to attribute priority in emergency departments. In pediatric acute care, triage systems are associated with more subjective evaluations as they often depend on caregivers' perceptions. This study aims to study the relationship between MTS and clinical outcomes. Methods: We analyzed every visit to the Pediatric Emergency Department (PED) between august 2018 and February 2021. The exposure group was defined as a red or orange priority and a compound outcome of hospitalization, transfer to tertiary care hospital or death was assessed. Results: We obtained 63.897 admissions, of which 52,5% corresponded to male patients and 80,6% were admitted by the parents' initiative. Green priority (49,9%) was the most frequent, followed by yellow (42,0%), orange (7,6%), blue (0,4%) and red (0,1%). The incidence rate of the studied outcome was 17,8% in the exposure group and 3,1% in the other patients, with an attributable risk of 14,7%. 7 patients must be triaged with red or orange priority so that one additional case of the outcome is verified. The main used flowchart was "Child that doesn't feel well" (20,3%). Conclusion: The priority attributed by the MTS has some association with the patient's outcome. The low number needed to harm can be due to a useful application of the system and may reflect the deleterious effect that a bad clinical first impression may pose in the prognosis. [ABSTRACT FROM AUTHOR]

Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to explore the experience and perceived value of travel nurses in a children's hospital. BACKGROUND: Children's hospitals face unique challenges related to highly specialized care requirements and workforce expansion limitations. Travel nurses can augment nurse staffing capacity during times of intense demand and may offer insights as organizations seek to strengthen work environments. METHODS: Pediatric travel nurses currently contracted at the hospital were invited to participate in a focus group or interview. Content analysis was used to summarize information and identify themes. RESULTS: From the 56 participants, 5 themes emerged. The themes were financial, flexibility, searching for healthy work environments, nursing care, and solutions. CONCLUSIONS: Hearing the voices of travel nurses may offer valuable feedback to strengthen future professional practice environments. [ABSTRACT FROM AUTHOR]

Aims: Missed nursing care (MNC) significantly affects patient safety and quality of care. It is a widely used concept that has been studied in different settings, but research in paediatric care is quite limited. Therefore, this descriptive cross‐sectional study aimed to report the prevalence, patterns, correlates, factors and predictors of MNC in paediatric care units in two central European countries. Design: A cross‐sectional comparative study. Methods: Data collection was carried out between June and November 2021 using the MISSCARE Survey‐Pediatric. The study included 441 registered nurses working in paediatric care units in the Czech Republic and Slovakia. Data were analysed using descriptive and inferential statistics in the SPSS 25.0 statistical program. Results: Almost all nurses, 92.7% of nurses missed at least one nursing activity during the last shift. The most missed care activity in both countries was the promotion of neuroevolutionary development, and the most prominent reasons were labour resources. MNC was weakly but significantly correlated with nurse experience in the current position and was predicted by the country, nurse education and overtime hours (p ≤.05). Differences in prevalence of MNC and reasons for MNC were identified based on several variables (p ≤.05). Conclusion: The assessment of MNC in paediatric settings is often a neglected area, although the prevalence in this study was moderate. Implications for the Profession and/or Patient Care: Nurse staff shortages, as a global problem, have many impacts on patient outcomes in the delivery of nursing care. However, there are also many factors that can reduce the prevalence of MNC. More research should focus on a closer examination of these factors that involve hospital and nurse variables. Reporting Method: The study was carried out according to the STROBE checklist and the RANCARE guideline. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Paediatric Clinical Care Pathways (CCPs) are developed for specific health conditions or patient populations and are designed to standardise care across different healthcare settings, including hospitals, clinics, and outpatient settings. These care pathways outline the clinical guidelines for diagnosis, treatment, and follow-up of specific medical conditions. They provide a framework for the delivery of care based on the best available evidence and tailored to each patient's individual needs. This overview is aimed at identifying the available evidence for the effective use of CCPs in paediatric patients with Lower Respiratory Tract Infection (LRTI). It reviews the nature of CCPs of LRTI, their benefits, strategies to implement them, steps involved in development of CCPs and the disease condition in paediatric population for whom the CCPs are used so far. The article also gives an account of limitations of using CCPs. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Background: Children in hospital experience significant pain, either inherent with their pathology, or caused by diagnostic/therapeutic procedures. Little is known about pediatric pain practices in sub‐Saharan Africa. This survey aimed to gain insight into current pain management practices among specialist physician anesthetists in four sub‐Saharan African countries. Methods: A survey was sent to 365 specialist physician anesthetists in Nigeria, South Africa, Uganda and Zambia. Content analysis included descriptive information about the respondents and their work environment. Thematic analysis considered resources available for pediatric pain management, personal and institutional pain practices. Results: One hundred and sixty‐six responses were received (response rate 45.5%), with data from 141 analyzed; Nigeria (27), South Africa (52), Uganda (41) and Zambia (21). Most respondents (71.83%) worked at tertiary/national referral hospitals. The majority of respondents (130/141, 91.55%) had received teaching in pediatric pain management. Good availability was reported for simple analgesia, opioids, ketamine, and local anesthetics. Just over half always/often had access to nurses trained in pediatric care, and infusion pumps for continuous drug delivery. Catheters for regional anesthesia techniques and for patient‐controlled analgesia were largely unavailable. Two thirds (94/141, 66.67%) did not have an institutional pediatric pain management guideline, but good pharmacological pain management practices were reported, in line with World Health Organization recommendations. Eighty‐eight respondents (62.41%) indicated that they felt appropriate pain control in children was always/often achieved in their setting. Conclusion: This survey provides insight into pediatric pain practices in these four countries. Good availability of a variety of analgesics, positive pain prescription practices, and utilization of some non‐pharmacological pain management strategies are encouraging, and suggest that achieving good pain control despite limited resources is attainable. Areas for improvement include the development of institutional guidelines, routine utilization of pain assessment tools, and access to regional anesthesia and other advanced pain management techniques. [ABSTRACT FROM AUTHOR]

The Société Internationale d’Oncologie Pédiatrique [International Society of Paediatric Oncology] (SIOP), founded in 1969, aims to improve the lives of children and adolescents with cancer through global collaboration, education, training, research and advocacy. The annual congress provides the opportunity to share late-breaking research, clinical experiences and debate, with experts worldwide. SIOP’s six Continental Branches represent their constituent members in North America, Oceania, Latin America, Africa, Europe and Asia and bring best practices and recent research findings of value to their specific patient populations. In 1990, the SIOP Board of Directors addressed the formerly predominantly European/North American society transforming into a global association by establishing a scholarship program to bring low- and middle-income country (LMIC) paediatric oncologists and nurses to SIOP meetings. A major achievement was SIOP’s acceptance as a World Health Organisation (WHO) non-state actor in official relations in 2018, joining 220 non-governmental organisations, international business associations and philanthropic foundations with this privilege. SIOP supports advocacy with WHO member states and civil society to highlight the specific needs of cancer in this age-group through key programs especially supporting the WHO Global Initiative for Childhood Cancer. Sustained improvement in childhood cancer outcomes has paralleled the integration of research with care; thus, SIOP launched a Programme for Advancing Research Capacity for funding selected clinical trial groups in LMICs. SIOP supports south-south partnerships, and the principles elegantly expressed in SIOP Africa’s checklist for co-branding projects, that include the prioritisation of local needs, cultivation of local expertise and commitment to equitable partnerships. SIOP now counts approximately 3,000 members from over 128 countries; 39% are from more than 60 LMICs. SIOP members have multidisciplinary expertise on all aspects of childhood cancer care working in collaboration with key stakeholders including governments, civil society organisations and funders to improve the lives of children/adolescents with cancer everywhere in all ways. [ABSTRACT FROM AUTHOR]

Objective Our objective is to describe the implications, anticipated and perceived, by providers in a level-IV neonatal intensive care unit (NICU) with immediate patient access to inpatient notes and test results in the wake of the 21st Century Cures Act (CCA). Study Design Using a mixed-method approach in February 2021, a preimplementation survey of neonatologists, neonatal fellows, nurse practitioners, and neonatal nurses reported their perspectives on the new 21st CCA and how they anticipated that it would change their practices, and the experience of families in the NICU. In the follow-up to implementation, a postsurvey was completed by staff reporting their experiences in July 2021. Thematic analysis was performed. Results In the preimplementation survey, staff reported the greatest perceived benefits of the changes to be an increase in families' ability to be part of the care team and prepare questions, and faster discussion of results by the care team. Also, staff's highest concerns were that family members may incorrectly interpret results delivered electronically without the context provided by the care team and be overwhelmed by the amount of information available. In the postimplementation survey, staff reported that the Act had less impact on their practice than they had anticipated preimplementation. Conclusion To maximize benefits and limit burdens to families and staff, care teams should consider a thoughtful approach to information sharing with family members in compliance with the 21st CCA. Key Points The impact of the 21 CCA on the NICU has not been studied. NICU staff have significant concerns related to the release of results to families. This study highlights the need to set expectations and provide family-centered care. [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]

Anaphylaxis is a vital systemic allergic reaction. A rapid diagnosis of anaphylaxis is lifesaving. In most cases, nurses are the first to encounter and intervene in anaphylaxis. Therefore, they have a vital responsibility in such cases. The aim of this study is to create a questionnaire and evaluate the anaphylaxis knowledge levels of pediatric nurses. This is a descriptive type of study. The study took place in Turkey. 80 pediatric nurses who work in pediatric intensive care, neonatal intensive care, child service, and pediatric emergency service participated in the study. The sociodemographic data collection form and the anaphylaxis knowledge level assessment form was used for the study. ANOVA and t-test are used to evaluate the data. The average anaphylaxis knowledge score of the pediatric nurses was found 12.61 ± 2.61, therefore it's moderate. The reliability of the questionnaire was high. Knowledge levels were moderately sufficient in diagnoses and insufficient in treatment and follow-up. Considering how critical anaphylaxis is, the moderately sufficient and insufficient knowledge levels are not substantial and should be increased advancedly. The questionnaire created for this study can be used in future studies. Health institutions should plan training regarding anaphylaxis and recompose anaphylaxis training in general, elaborate treatment and follow-up, and assess pediatric nurses' knowledge periodically. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of partnership nursing among nurses when caring for children and young people with long‐term conditions, and their families. Background: Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision‐making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing. Design: A qualitative systematic review followed Joanna Briggs Institute meta‐aggregation approach and has been reported according to PRISMA guidelines. Methods: A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre‐determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted. Findings: A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision‐making principles to deliver individualised care. Conclusion: Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three‐way triadic partnership may aid therapeutic relationships and shared decision‐making. Implications for clinical practice: Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision‐making. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization declared that medication errors are the third largest global patient safety challenge. The medication administration stage is a common and susceptible stage for medical errors to occur. Objective: To explore the factors contributing to medication administration errors specifically in pediatric care units as perceived by nurses in a Jordanian hospital. Methods: A qualitative descriptive study was conducted involving face-to-face audio-recorded interviews with 9 nurses in a tertiary hospital located in the north of Jordan. A convenience sampling technique was used to select the participants of our study. Data were collected between October 2022 and November 2022. The data were analyzed using inductive thematic analysis. Results: Four themes emerged affecting medication administration errors in pediatric care units. These were environmental, staff, parents and patient, and medication-related factors. Conclusion: The findings of this study raise awareness of the most frequent sources of medication errors in a Jordanian hospital. Holding training and supervision to raise awareness among nurses and the availability of equipment and supplies could improve medication safety practices. [ABSTRACT FROM AUTHOR]

Background: Premature neonates often experience feeding difficulties during their hospital stay, and evidence‐based interventions have been shown to improve feeding outcomes. Aim: This study investigated whether an infant‐cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding in neonates in a neonatal intensive care unit. Study Design: A quality improvement study with a pre, during and post intervention test design. All premature neonates admitted to the unit were eligible. The feeding programme included a four‐month nurse training module and nurse coaching. Results: A hundred and twenty‐five nurses or nurse assistants attended the programme and 706 neonates were included. The median time to independent oral feeding (IOF) was 40, 36 and 37 days, respectively, for pre, during and post intervention. The reduction in time to IOF observed during the post‐intervention period compared with the baseline period was significant (HR = 1.32, CI 95%: 1.01–1.74). No difference was noted in the length of hospital stay between the three study periods. Conclusions: An infant‐cue based nurse educational feeding bundle can promote earlier achievement of IOF in preterm neonates. Relevance to Clinical Practice: This quality improvement study demonstrates the impact that a nurse‐driven intervention in neonatal care can have on improving practice. Feeding interventions involve the early introduction of oral feeding, non‐nutritive sucking (NNS), and oral motor stimulation, and should be individualized for each neonate. These individualized feeding interventions applied by all nurses and assistant nurses, can facilitate the achievement of earlier independent oral feeding in preterm infants and should be included in neonatal critical care nurse education programs. [ABSTRACT FROM AUTHOR]

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic deeply affected the lives of children and young people; studies report adverse effects on mental, physical, and social well-being. However, the impact of the pandemic on obesity care for children received little attention. The aim of this study was to gain insight into the challenges youth healthcare nurses experienced and to describe implications for future obesity care and policy. We conducted interviews, participant observations, and a group session with youth healthcare nurses during the pandemic in Amsterdam, the Netherlands. Youth healthcare nurses reported a deterioration in the problems of children and young people who were already in the highest classification for pediatric obesity, such as increased weight gain, mental health problems, and socio-economic problems. The nurses experienced immense challenges while trying to provide obesity care, such as a decrease in face-to-face contact with youth and their families, as well as loss of continuity of care. It is important to reconnect with these families, invest in a trusted relationship with youth receiving obesity care, and prioritize available and accessible obesity care for those who need it the most. [ABSTRACT FROM AUTHOR]

This study aimed to assess the accuracy of liquid drug dose measurements made by caregivers and explore the factors influencing these measurements. Caregivers (n = 176) of children aged less than 8 years, who were treated at the pediatric clinic of a university hospital in Turkey between July and October 2019, were eligible to participate in this study. The caregivers' ability to accurately measure a 2.5-mL dose of medication was observed using standardized measurement instruments, including 15-mL and 30-mL dosing cups, a 3-mL dropper, a 5-mL dose spoon, and a 5-mL oral syringe. A comparison was made with the reference weight determined for the 2.5-mL dose to calculate the margin of error. A dose of ± 20% of the reference value was considered a clinically significant error. The chi-square test was used to examine differences in dose error rates concerning individual characteristics. Caregivers exhibited a dosing error rate exceeding 20%. Specifically, 43% of the errors occurred when using 15-mL cups, 37% with 30-mL cups, 22% with 3-mL droppers, 4.5% with 5-mL spoons, and 4% with 5-mL syringes. In cases where errors were under 20%, the rates were as follows: 1.1% with 15-mL cups, 2.8% with 30-mL cups, 19% with 3-mL droppers, 3.4% with 5-mL spoons, and 4% with 5-mL syringes. The dosing errors were not affected by the role and health literacy level of caregivers, regardless of the type of dosing tool they used (all p values > 0.05). The study found that oral syringes and dosing spoons had the lowest error rates, whereas dosing cups had the highest error rates. Conclusion: Healthcare providers in family health centers and pediatric clinics should educate caregivers about proper drug administration with oral syringes and dosing spoons, even if dosing cups are included. What is Known: • Dose calculation errors and incorrect measurement tools are the leading factors causing errors. • Liquid medicine bottles are still often accompanied by dosing cups as measuring instruments. • Both the American Academy of Pediatrics (AAP) and the U.S. Food and Drug Administration (FDA) recommend that parents use standard measuring instruments such as oral syringes, droppers, and measuring spoons instead of kitchen spoons for administering the correct dose to children. What is New: • The measuring tool with the maximum errors was the dosing cup, whereas oral syringes and dosing spoons were more accurate. • Individual administering medication at home and the health literacy level had no effect on the accuracy of dose measurement. • Pediatric nurses, in particular, should incorporate safe liquid medication measurement tools into parental education. [ABSTRACT FROM AUTHOR]

Introduction: With improved survival in pediatric solid organ transplantation (SOT) care has focused on optimizing functional, developmental, and psychosocial outcomes, roles often supported by Allied Health and Nursing professionals (AHNP). However, there is a scarcity of research examining frameworks of clinical practice. Methods: The International Pediatric Transplant Association AHNP Committee developed and disseminated an online survey to transplant centers as a quality improvement project to explore AHNP practice issues. Participant responses were characterized using descriptive statistics, and free‐text comments were thematically analyzed. Responses were compared across professional groups; Group 1: Advanced Practice Providers, Group 2: Nursing, Group 3: Allied Health. Results: The survey was completed by 119 AHNP from across the globe, with responses predominantly (78%) from North America. Half of respondents had been working in pediatric transplant for 11+ years. Two‐thirds of respondents were formally funded to provide transplant care; however, of these not funded, over half (57%) were allied health, compared to just 6% of advance practice providers. Advanced practice/nursing groups typically provided care to one organ program, with allied health providing care for multiple organ programs. Resource constraints were barriers to practice across all groups and countries. Conclusion: In this preliminary survey exploring AHNP roles, professionals provided a range of specialized clinical care. Challenges to practice were funding and breadth of care, highlighting the need for additional resources, alongside the development of clinical practice guidelines for defining, and supporting the role of AHNP within pediatric SOT. Professional organizations, such as IPTA, can offer professional advocacy. [ABSTRACT FROM AUTHOR]

Objective. To test the hypothesis that PROMPT reduces permanent brachial plexus palsy and perineal tears. Design. A prospective/retrospective cohort study. Setting. Hanover Medical School, Germany. Population/Sample. A self-selected population. Methods. The training period is from November 9th, 2017, until December 31st, 2019; control: January 1st, 2004, until November 8th, 2017. Main Outcome Measures. Shoulder dystocia, nonpermanent and permanent brachial plexus injuries (BPIs), perineal tears III°/IV°, manual manoeuvres, and asphyxia. Results. There was a total of 22,640 births, and shoulder dystocia increased from 48/18,031 (0.27%) to 23/4,609 (0.50%) ((p = 0.017), OR: 1.88, 95% CI: (1.14; 3.09)), whereas BPIs decreased from 7/48 (14.6%) to 1/23 (4.3%) (p = 0.261). There was 1/7 (14.2%) of permanent BPI before and 0/1 (0%) case after. Perinatal asphyxia increased from 3/48 (6.3%) to 4/23 (17.4%) (p = 0.23). However, adverse outcomes after one year were zero. McRoberts' manoeuvre increased from 37/48 (77.1%) to 23/23 (100%) ((p = 0.013), OR: 1.62, 95% CI: (1.33; 1.98)), and internal rotation manoeuvres and manual extraction of the posterior arm from 6/48 (12.5%) to 5/23 (21.7%) (p = 0.319). Episiotomies decreased from 5,267/18,031 (29.2%) to 836/4,609 (18.1%) ((p < 0.001), OR: 0.54, 95% CI: (0.49, 0.58)), whereas perineal tears III°/IV° associated with shoulder dystocia increased from 1/48 (2.1%) to 1/23 (4.8%) (p = 0.546). Vaginal operative deliveries remained constant (6.5% vs. 7%). Conclusions. PROMPT significantly improves the management of shoulder dystocia and decreases permanent brachial plexus injuries but not perineal tears III°/IV°. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has significantly affected nursing, as nurses are crucial in providing healthcare services. Understanding the factors influencing nurse retention is essential for maintaining a strong and long‐lasting workforce because nurse retention is becoming increasingly complex. This study aimed to investigate the influence of professional identity and job satisfaction on the intention to remain employed while also evaluating the levels of professional identity, job satisfaction, and intention to stay among paediatric nurses amidst the COVID‐19 pandemic. This correlational and descriptive study included a stratified sample of 257 paediatric nurses and was guided by the STROBE checklist. Data were collected through valid and reliable questionnaires, which included a nurses' professional identity scale, job satisfaction survey, intention to stay scale, and a demographic questionnaire. Data collection was conducted from January to April 2022. The study was approved by the ethical research committee at the Nursing Faculty – Mansoura University, ensuring adherence to the Helsinki Declaration. The paediatric nurses reported elevated professional identity, moderate job satisfaction, and moderate intention to stay employed with mean scores of 80.35 ± 13.22, 113.70 ± 19.58, and 8.40 ± 3.55, respectively. Multiple regression explained 13.0% of the variation in paediatric nurses' intention to remain employed (F = 18.50, p < 0.001). Professional identity positively correlated with the intention to stay (β = 2.69, p = 0.008). Job satisfaction also had a positive relationship with the intention to stay (β = 3.49, p < 0.001). Healthcare managers should focus on professional identity strategies such as supportive work environments, growth opportunities, and valuing paediatric nurses' contributions. Implementing interventions such as fair compensation, support, and rewards can enhance paediatric nurses' retention and quality of patient care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of the different types and causes of acquired brain injuries (ABIs) in infants, children and young people • To increase your understanding of the pathophysiology of ABIs and associated complications • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Caring for infants, children and young people with an acquired brain injury (ABI) can be challenging due to their developing brain and reliance on parents and caregivers. It is essential that children's nurses are able to perform effective neurological observations, because these can identify deterioration and inform the management of patients with an ABI. This is the first of two articles that aim to encourage accuracy and consistency when undertaking neurological observations in infants, children and young people with an ABI to optimise their care. This first article details the pathophysiology, types and causes of ABIs and explains the potential complications that can occur following such injuries. [ABSTRACT FROM AUTHOR]

The COVID-19 and Children with Medical Complexity (CMC) Extension for Community Healthcare Outcomes (ECHO) was developed as a "just in time" learning format to respond to the vast number of challenges faced by health care clinicians, public health professionals, and families/caregivers of CMC during the coronavirus disease 2019 (COVID-19) pandemic. A unique aspect of the ECHO was the meaningful integration of family leaders who participated as faculty, learners, case study presenters, and guest lecturers. Another distinguishing feature of this ECHO was its inclusion within a Collaborative Improvement and Innovation Network. A mixed methods analysis found that the COVID-19 and CMC ECHO was associated with significant gains in knowledge and confidence in caring for CMC and their families during the COVID-19 pandemic. This article provides an overview of the results of the COVID-19 and CMC ECHO and provides recommendations related to utilizing the ECHO model as a rapid response mechanism for systems improvement, clinical practice improvement, and education during a public health emergency. [ABSTRACT FROM AUTHOR]

Background: The establishment of paediatric hospices improves the quality of care of paediatric nurses. Aim: To examine the effect of establishing paediatric hospices on the quality of care of paediatric nurses. Methods: Data was collected between 22 October 2022 and 25 February 2023. An online survey method was used to collect sociodemographic data and paediatric hospice data for paediatric nurses and a scale was used to determine the opinions of nurses working in the field of paediatrics. A total of 300 paediatric nurses who voluntarily participated in the collection of the research data were selected with the convenience sampling method, with written consent. SPSS 26.0 data analysis programme was used in the statistical analysis of the data obtained in the study, and Independent Sample t-test and ANOVA analysis were used in the analysis of the data. Findings: Of the participating paediatric nurses, 60.9% were women, 39.1% were men, 41.1% were married, 65.9% were between the ages of 22–33, and 71.6% worked at a paediatric hospice. There was no significant difference in paediatric hospice scale scores according to sociodemographic variables such as gender, age, marital status, education level and the health institution worked by paediatric nurses (p>.05). There was a significant difference in paediatric hospice scale scores according to hospice information. It was determined that the establishment of paediatric hospices had an effect on the quality of care (p<.01). Conclusion: Paediatric nurses felt that the establishment of paediatric hospices would improve the quality of care of children at the end of life. It is recommended that applications and studies on the establishment and structuring of paediatric hospices should be carried out by expanding the samples, not only in the field of paediatric nursing, but also in all nursing fields. [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]

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of 'narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. [ABSTRACT FROM AUTHOR]

Objective: The Glasgow Coma Scale (GCS) is widely used to objectively describe the extent of patients' impaired consciousness. However, there are known variations in scoring GCS both in adults and children which may impact patient management. The aim of this audit was to assess the application of GCS by medical and nursing staff in pediatric medical patients. Subject and Methods: An online questionnaire was distributed amongst doctors and nurses working in the Department of Child and Adolescent Health at Mater Dei Hospital in Malta. The participants assigned GCS for 8 case scenarios involving children of different ages with varying levels of consciousness. Results were analyzed by calculating percentage agreement and by Cronbach's alpha. Results: Sixty-six participants were studied, with a response rate of 52%. Performance was poor overall, with Cronbach alpha 0.53. Correlation was better at the upper and lower ends of the scale and the worst performance was for verbal response. Only respondents with 5–10 years of experience achieved acceptable consistency in the application of the GCS (Cronbach alpha 0.78). Conclusion: There is considerable variation in application of GCS in pediatric patients, highlighting the need for education and training to improve consistency for this commonly used neurological assessment tool. [ABSTRACT FROM AUTHOR]

Purpose: A model was hypothesised by integrating two theoretical models: the compassion satisfaction‐compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work‐related variables during the COVID‐19 pandemic. Background: Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety. Methods: A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work‐related variables. Compassion satisfaction ‐ compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist. Results: The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work‐related variables (co‐workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life. Conclusion: The Compassion satisfaction ‐ compassion fatigue ‐Empowerment integrated model allows for assessing the different paths in the relationship between work‐related variables and burnout. Relevance to clinical practice: These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID‐19 pandemic. These strategies should focus on enhancing co‐workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence. [ABSTRACT FROM AUTHOR]

Objective: Pain is associated with most invasive interventions in childhood and considered as an unpleasant condition; thus, it should be relieved. This study aimed at investigating the effect of two different non-pharmacological pain-relief methods on reducing the pain and anxiety associated with intramuscular (IM) injection in children. Methods: This study was a prospective experimental randomized controlled trial. The sample of the study comprised 150 children aged 7 to 12 years who were brought to the pediatric injection room in a university hospital and had IM injection. The children were randomized into the Shotblocker (n=50), cold application (n=50) and control (n=50) groups. Results: The children in the control group felt pain more than did the children in the ShotBlocker and cold application groups. The difference was statistically significant. Assessment of the anxiety level during the IM injection demonstrated that the children in the control group experienced anxiety statistically significantly more than did the children in the ShotBlocker group. Conclusion: The children in the ShotBlocker and cold application groups experienced pain less than did the children in the control group during the IM injection. When compared to the Cold Application method, ShotBlocker method is more effective in reducing IM injection-related pain and fear. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, numerous studies have shown the high prevalence of occupational stress (OS) of health workers, affecting the quality of health care provided. To date, there is no study regarding OS of emergency care pediatric nurses working in Greece. This study aimed to examine the pediatric nurses' OS working in tertiary public hospitals in Greece. In this cross-sectional study, a total of 104 pediatric nurses were recruited randomly from summer 2020 to summer 2021. The Expanded Nursing Stress Scale (ENSS), which consists of 59 items grouped into nine categories, was used to assess nurses OS. The overall OS mean score was 141.04 (SD = 33.48), indicating mild stress. Among nine categories, pediatric nurses were more stressed about patients and families (mean = 22.83, SD = 5.71), as well as death and dying (mean = 19.33, SD = 5.22), whereas they were less stressed about discrimination (mean = 4.21, SD = 4.09) and problems with peer support (mean = 12.11, SD = 4.58). Sex, age, and shifts did not correlate with OS. Borderline correlation was present between age and inadequate emotional preparation for less experienced nurses (p = 0.047), while higher educated pediatric nurses were more stressed because of workload than lower educated pediatric nurses (p = 0.044). Greek pediatric nurses sufferedmild OS during the COVID-19 pandemic. There is a great need for further research and implementation of supportive sustainable programs aimed to the minimization of OS and the optimization of health care provided during and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background and aim: Pediatric Intensive Care Units (PICUs) are clinical settings where patient loss is frequently experienced. A sense of professional grief and posttraumatic growth in nurses who have experienced patient loss has a significant impact on psychological and physical health, work satisfaction, turnover rates, as well as on personal and professional relations, and employee loyalty. The aim of this study was to investigate grief and posttraumatic growth in PICU nurses and to examine related factors. Methods: The study is of cross-sectional design and was conducted with 200 nurses who were working in 87 PICU's around Turkey during the period March 30 - June 30, 2021. Data were collected with a Descriptive Information Form, the Texas Revised Inventory of Grief (TRIG), the Posttraumatic Growth Inventory (PTGI), and an open-ended question asking for suggestions as to how nurses can cope with loss. Online questionnaires were used in the data collection. Descriptive statistics, the student t-test, one-way analysis of variance, and post-hoc tests were employed in the analysis of the data. Results: The nurses' mean scores were 49.425 ± 10.868 on TRIG and 61.450 ± 24.934 on PTGI. A negative weak correlation was found between the intensity of the nurses' grief and their posttraumatic growth (r = 0.144, p = 0.041). Receiving training on dealing with a patient's terminal stage (t=-2.688, p = 0.001), feeling comfortable about providing the patient's care (t = 2.624, p = 0.009) and providing the family with emotional support during patient care (t = 1.979, p = 0.049), and the presence of supporting health professionals reduced levels of grief (t = 2.797, p = 0.000). Being a woman (t = 3.299, p = 0.001), willingness to work in the unit (t=-3.219, p = 0.002), and being given enough time to accept the loss (t = 3.986, p = 0.000) were correlated with higher levels of posttraumatic growth. The nurses most commonly wanted more time allotted to recuperate after a loss (n = 35) and professional support (n = 22). Conclusions: Nurses experience a moderate sense of grief after a patient's loss. As levels of grief decrease, posttraumatic growth increases. Healthcare administrators and future researchers can benefit from these findings when planning supportive interventions to help nurses cope with their feelings of grief and achieve posttraumatic growth. Strengths and limitations: A limitation of the study is that it was conducted only with nurses who were Association members. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) are often too noisy, exceeding 70–80 dBA, which can have negative effects on staff. The corresponding recommendation of the World Health Organization (average sound pressure level below 35 dBA) is often not achieved. To date there is a lack of intervention studies examining the extent to which unit-based noise management in ICUs contributes to a reduction in noise exposure for the staff. The study therefore aims to provide answers to 1) how unit-based noise management sustainably reduces the subjective noise exposure among staff, and 2) how this intervention affects other noise-related topics. Methods: We performed a monocentric prospective longitudinal study with three measurement points in a German university hospital in three ICUs. We collected data from different healthcare professionals and other professional groups between October 2021 and August 2022 using an online questionnaire. Data were analyzed using descriptive and inference statistics. Results: A total of n = 179 participants took part in the surveys. The majority of participants were nurses or pediatric nurses. Most participants worked more than 75% full-time equivalent. Staff on the three ICUs reported high levels of noise exposure. No significant changes in noise exposure over time were observed. Participants were already aware of the topic and believed that a behavior change could positively influence the noise environment. Conclusions: This study provides an initial insight into how a unit-based noise management could contribute to a reduction in the subjective noise exposure among staff in ICUs. The results of this study highlight the importance of this topic. Future studies should aim to research aspects of adherence and their facilitators or barriers, which promote the sustained implementation of noise-reducing measures by staff. Trial registration: German Clinical Trials Register (DRKS): DRKS00025835; Date of registration: 12.08.2021. [ABSTRACT FROM AUTHOR]

Background: Resilience, an individual's ability to cope with and recover from stressors, is supported by contextually specific factors. Factors in the work environment may support or hinder nurses' resilience to the specific stressors present in pediatric nursing, an understudied population. Objective: We aimed to explore the contextual factors in the work environment of pediatric nurses with varying levels of resilience, including social support, the work environment, and opportunities for coping from an individual approach. Methods: This study is a secondary mixed-methods analysis using ordinal logistic regression and a meta-matrix of survey responses and semi-structured interview transcripts from 30 pediatric nurses. Results: 5 themes, 3 supporting and 2 hindering resilience, emerged from the interviews. Nurses described their resilience as supported by sharing the burden, support from administration, and taking a break. Participants described resilience as hindered when they found it challenging to provide quality nursing care and when they felt unappreciated or undervalued. No theme significantly changed the odds of having higher resilience. Conclusions: Our findings suggest that nurses recognize resources and conditions within their work environment as influencing their resilience. However, workplace resources and conditions are only one contributor to pediatric nurse resilience. Encouraging breaks and informal opportunities for nurses to support each other may support resilience in pediatric nurses. In addition, nursing leaders can support pediatric nurse resilience by regularly spending time connecting with nurses. Finally, health care organizations should consider how changes in the work environment may hinder nurse resilience by adding stress or changing access to supportive factors. [ABSTRACT FROM AUTHOR]

Effective communication in end‐of‐life care for pediatric cancer patients is crucial. Yet, limited research focuses on the communication experiences of pediatric oncology nurses during this period. This study aims to investigate the communication experiences and needs of these nurses with children and their families during the end‐of‐life period. A qualitative study design with photo voice methodology was followed. The research was conducted with 16 pediatric oncology nurses working in the pediatric oncology wards of a university hospital between January and May 2023. Data were collected the "Characteristic Information Form", "Semi‐Structured Interview Form", and photovoice methodology. Data were analyzed through reflexive thematic analysis. Most of the nurses are at the undergraduate level, and their working experience in pediatric oncology wards ranges from 4 months to 17 years. Seven main themes emerged: Optimistic Communication‐Interaction, Mindfulness, Active Coping, Behavioral Actions, Death Uncertainty Dilemma, Interpersonal and Environmental Factors, and Discrepancy between Ideals and Reality. The study sheds light on the importance of pediatric oncology nurses' ideals versus realities upstream approach in communicating with end‐of‐life children and their families, empowering pediatric oncology nurses on the journey to ideal end‐of‐life care. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to determine pediatric nurses' knowledge of autism spectrum disorders (ASD). Methods. We conducted a population-based online survey of 273 pediatric nurses in eastern Saudi Arabia using convenience sampling method. Perceived knowledge was assessed using the knowledge of childhood autism among Health Professionals Questionnaire (KCAHW) that was translated into Arabic. We used multivariate regression analysis to determine the influence of demographic factors on the perceived knowledge. Using Pearson's correlation analysis, we assessed the correlation between the outcome variables and the predictor variables. Results. ASD knowledge is generally higher among pediatric nurses with higher academic qualifications (r = 0.29, p < 0.001). They scored higher on general knowledge (M = 21.5, SD = 5.7) and lower on signs and symptoms (M = 15.2, SD = 4.3), diagnosis (M = 13.8, SD = 3.9), and management of ASD (M = 12.4, SD = 4.1). A significant correlation was found between mean KCAHW and age (r = 0.12, p = 0.029), sex (r = 0.18, p = 0.003), years of experience (r = 0.25, p < 0.001), education level (r = 0.34, p < 0.001), and hospital type (r = 0.21, p = 0.001). Predictors of knowledge and understanding were level of education (β = 0.23, p = 0.001), formal training (β = 0.16, p = 0.012), and years of experience (β = 0.19, p = 0.005). The majority could not define ASD or recognize early signs and symptoms or associated comorbidities. Lack of social and emotional reciprocity and impaired language development have been reported, as well as the perception of ASD as a neurodevelopmental disorder. Conclusion. Higher academic qualifications are associated with high general knowledge of ASD; however, nurses in this cohort performed poorly in ASD sign and symptom recognition, diagnosis, and management. [ABSTRACT FROM AUTHOR]

Purpose: To provide a general understanding and framework of action for pediatric nurses to quickly identify anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE) in their patients, direct them to proper treatment, and promote high-quality, evidence-based nursing care. Design: A review of current literature on pediatric ANMDARE was performed with PubMed, EBSCO Host, and CINAHL databases using the search terms anti-N-methyl-D-aspartate receptor encephalitis, pediatrics or children, early recognition, diagnosis, nurse, or nursing. Out of 65 journal articles published between the years 2005 and 2022, 52 were reviewed, including original research, systematic reviews, literature reviews, and case reports. Methods: Synthesized publications regarding clinical signs and symptoms, diagnosis, treatment, and outcomes of ANMDARE in pediatric patients. Conclusions: ANMDARE is a complex autoimmune encephalitis that commonly presents in pediatric patients as behavioral changes, psychological disturbances, dyskinesias, and seizure activity. Incidence of ANMDARE in pediatric patients has risen over the past 15 years, yet ANMDARE is not familiar to many pediatric nurses from a clinical, pathological, or treatment standpoint. Proper recognition of ANMDARE and treatment via immunotherapy are crucial for positive clinical outcomes and potential reversal for full recovery, highlighting the need for improved nursing education on the disease. [ABSTRACT FROM AUTHOR]

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18‐item questionnaire was administered to final‐year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self‐evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to understand the Neonatal Intensive Care Unit (NICU) healthcare providers' (HCPs) experiences and needs during their own past, present and desired pregnancies. It has been reported that HCPs' personal and professional lives are mutually interconnected. Given the NICU HCPs' knowledge of the risks and potential adverse outcomes of newborns admitted to the NICU, their pregnancy experience may be more challenging than that of the general population. However, to date, these aspects are still little studied. Design: A qualitative descriptive study design was adopted. Methods: Semi‐structured interviews were conducted between January and April 2021 in a single third‐level NICU in northeastern Italy. Transcripts were analysed using inductive content analysis. Findings are reported according to the COREQ guidelines. Results: Nineteen HCPs participated in this study. Participants included 12 nurses, 6 medical doctors, and 1 paediatric physical therapist. All participants reported that their professional knowledge and experience influenced their pregnancy‐related experiences, emotions and behaviours. Some participants employed adaptive coping strategies, while others were likely to experience post‐traumatic stress reactions. The narratives of the men and women were similar. Three themes were identified: 'Feeling different'; 'Influence of work experience on decision‐making'; 'Coping with difficulties'. Conclusion: To reduce the potential impact of NICU HCPs' work experience on pregnancy, family functioning and infant health, management of parental emotions should be considered for this population. Impact: Hospital managers could prevent the potential distress of vulnerable NICU healthcare workers during pregnancy by tailoring interventions aimed at supporting them in becoming aware and making sense of their work experiences or sensitizing individual psychological support. Moreover, university students should be offered self‐help strategies to face potential dual role conflicts in their future careers. Patient and Public Involvement: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective To investigate the mechanism of psychological capital and perceived organizational support in the influence of workplace violence on pediatric nurses’ burnout. Methods By convenience sampling method, 417 pediatric nurses in a tertiary children’s hospital in Shanxi Province were surveyed with the questionnaires from April to May 2022, including the Workplace Violence Scale, the Psychological Capital Scale, the Perceived Organizational Support Scale, and the Occupational Burnout Scale. Differences in job burnout among pediatric nurses with different demographic characteristics were compared. Pearson correlation analysis was performed to examine the correlations among the scores of each scale. The Bootstrap method was used to verify the mediating effects between variables. Results The prevalence of job burnout among these pediatric nurses was 66.91% (279/417). Statistically significant differences in job burnout scores were found among pediatric nurses with different ages, marital statuses, employment types, average daily working hours, average monthly incomes, and working departments (P < 0.05). The pediatric nurses aged 31 -40 years, married, informally employed, working in the emergency department, having longer average daily working hours, and earning lower average monthly incomes had higher levels of job burnout. Workplace violence was negatively correlated with psychological capital (r = - 0.269, P < 0.01) and perceived organizational support (r = - 0.303, P < 0.01), and positively correlated with job burnout (r = 0.418, P < 0.01). Psychological capital (r = - 0.543, P < 0.01) and perceived organizational support (r = - 0.543, P < 0.01) were negatively correlated with job burnout, while psychological capital was positively correlated with perceived organizational support (r = 0.488, P < 0.01). Mediation effect analysis showed that the indirect effects of perceived organizational support and psychological capital as single mediators and as chained mediators were significant, with the mediating effect values of 0.095, 0.044, and 0.043 accounting for 22.51%, 10.42%, and 10.18% of the total effect, respectively. Conclusions Pediatric nurses had a high level of job burnout. Workplace violence affected job burnout through the mediating roles of psychological capital and perceived organizational support, as well as their chained mediating effect. Hospital administrators should improve pediatric nurses’ psychological capital and perceived organizational support to alleviate the impact of workplace violence on job burnout. [ABSTRACT FROM AUTHOR]

The care given to newborns immediately within the first few hours of birth is critical for their survival. The neonatal period transitional period, immediately after birth, and it is critical for their survival and existence. Essential newborn care is one of the significant strategies for neonatal survival, especially immediately after delivery. Pediatric Nurses are the key healthcare providers who care for neonates immediately after birth. Aim of the study was to assess Nurse's Knowledge Associated with the Routine Essential Newborn Care after birth in Baghdad City. A descriptive design was utilized for this study. The setting The study was carried out at Al-Elwiya Maternity Teaching and the Private Nursing Home Hospitals in Baghdad city. Sample: A purposive sample consisted of 60 participants (Pediatric/midwives nurses) according to inclusion criteria. Tools: The questionnaire was constructed and developed and include two parts: the first part includes A structured Nurses demographic characteristics Sheet, and the second part includes for nurses' knowledge about immediate of the newborn care. Results: The results of the present study indicated that 45 (75.0%) of nurses had fair knowledge and (10%) had good knowledge, only (15.0%) of them had poor knowledge. Conclusion: According to the findings of the present study, the study concluded that only 10 % of nurses has good knowledge of routine essential newborn care after birth. And the socio-demographic characteristics of nurses' have no effect on their knowledge, exception of years of experience working in the delivery room which has a significant effect on the level of pediatric/midwives nurses' knowledge. Recommendation: Replication of the study on large samples of pediatric/midwives nurses nurses. Also, Education program for pediatric/midwives nurses about immediate newborn care to improve their knowledge and practice. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the nurses' practices regarding drug administration before the intervention program, to evaluate the nurses' practices regarding drug administration after the program (post-test-1-2), To predict whether there is an effect of some demographic characteristics on nurses' practices in pediatric intensive care. Material: the study implemented during the period from September 14, 2022, to December 15, 2022. A Quazy-experimental design was used, with one group test - re-test method (pre and post-test 1 and post-test 2) for the studied sample. An instrument was developed for the study. A non-probability sample (purposive) includes all male and female nurses working in the pediatric intensive care unit / pediatric surgery center in Nineveh Governorate, whose number is (23). Result: The average age of the nurses was 28 ± 4.80 years, (52.2%) of their ages ranged between (25-29) years. The nurses' practice was poor (average 30.26 ± 8.86) in the pre-test period and good practice (average 45.30 ± 9.87) in the first post-test with a p-value (0.05). Conclusions: The study came to the conclusion that the intervention program improved nurses' poor practices regarding post-operative care of infants with tracheoesophageal fistula into good practices and had a significant impact on how nurses administered postoperative medication. [ABSTRACT FROM AUTHOR]