Education on childrens complex care needs in general nursing curricula in Europe: An inductive content analysis

Are pediatric practicum experiences a beneficial component of registered nurse education programs? Nursing students and new graduates weigh in: A qualitative descriptive research study

BACKGROUND

In Canada, the British Columbia College of Nurses and Midwives requires baccalaureate registered nurse education programs to deliver a generalist curriculum meeting entry-level competencies. To fulfill this requirement, nursing programs ensure the provision of practice opportunities for hands-on experience with patients of all ages through practicum. Current literature suggests the limited availability of clinical placement opportunities in pediatric settings. This may reduce the opportunity for nursing students to become acquainted with the unique needs of infants, children, and adolescents as part of their nursing education.

AIM

This study aimed to explore students' and new graduates' experiences of acute and community pediatric clinical practicum as part of their British Columbia nursing education program.

SETTINGS, PARTICIPANTS, AND METHODS

This study utilized a qualitative descriptive approach. Fifteen online semi-structured interviews were conducted with thirteen undergraduate nursing students and two recent graduates. Participants in this study were distributed across the province of British Columbia, representing the North, the Interior, and the Lower Mainland. Data were analyzed using thematic analysis.

RESULTS

The key themes of relational practice and exposure to lived experiences (and their related subthemes) are explored in detail. Both themes encapsulate the importance that nursing students ascribe to the pediatric practicum experience as part of their nursing education.

CONCLUSION

The result of this study deduced that the pediatric practicum experience provided nursing students with learning opportunities they may not get elsewhere such as: building relationships with children, adolescents, and their families within the context of care and developing awareness of the lived experiences of health and illness with each patient encounters. This unique perspective of nursing students may prove valuable for the planning and delivery of clinical learning in nursing education programs.

Is nurse staffing associated with critical deterioration events on acute and critical care pediatric wards? A literature review

Pediatric and neonatal patients admitted to acute and critical care wards may experience critical deterioration events that may lead to unexpected deaths if unrecognized and untreated promptly. Adequate levels and skill-mix of nurse staffing are essential for the quality of patient monitoring and response to deteriorating patients. Insufficient staffing may have an impact on the occurrence of missed care and consequently on critical deterioration events, increasing the risk of mortality and failure-to-rescue. To review the literature to explore the association between nurse staffing levels or skill-mix and pediatric and neonatal critical deterioration events, such as mortality, pediatric intensive care unit (PICU)/neonatal intensive care unit (NICU) unplanned admissions, cardiac arrests, and failure-to-rescue. A structured narrative literature review was performed. Pubmed, Cinhal, and Web of Science were searched from January 2010 to September 2022. Four independent reviewers conducted the study screening and data extraction. The quality of the studies included was evaluated using the Joanna Briggs Institute critical appraisal tools. Out of a total of 2319 studies, 15 met the inclusion criteria. A total of seven studies were performed in PICU, six in NICU, and two in general pediatric wards. Nurse staffing measures and outcomes definitions used were heterogeneous. Most studies suggested nursing skill-mix, increased working experience, or higher nursing degrees were associated with increased survival in PICU. Decreased nursing staffing levels were associated with increased mortality in NICU and mechanically ventilated patients in PICU.

CONCLUSION

Evidence on the association of nurse staffing and critical deterioration events in PICU and NICU is limited, while there is no evidence reported for pediatric wards. Future research is needed to determine adequate levels of nurse/patient ratios and proportion of registered nurses in the skill-mix for pediatric acute and critical care nursing to improve outcomes on in-patient wards.

WHAT IS KNOWN

• Adult nursing skill-mix, staffing ratios, and level of education are associated with patient mortality and failure to rescue. • In children, nurse staffing levels are associated with clinical outcomes.

WHAT IS NEW

• Evidence on the association of nurse staffing levels or skill-mix with pediatric or neonatal mortality is limited. • There is some evidence regarding the association of nursing work experience, certification, higher level degree with in-hospital survival in PICU.

A Gap Between Children's Rights and Curricular Content in Health, Social Care, and Teacher Education Programs: An Exploratory Cross-Sectional Study

INTRODUCTION

Exposure to child maltreatment is a social and public health challenge that will require interprofessional collaboration to overcome. Evidence indicates that professional students in health, social care, and teacher education programs receive inadequate training in recognizing and responding to child maltreatment. The aims are to 1) assess the extent to which these students found that their uniprofessional education and a large-scale interprofessional learning (IPL) course had taught them about children in general, children's rights, and vulnerable/at-risk children; and 2) explore differences in student responses according to age and educational background.

METHODS

A cross-sectional study. Students (n=2811) completed questionnaires prior to or after IPL courses held in 2019 and 2020 (hybrid case-based, small-group, on-campus courses targeting children, young people, and their families as end users).

FINDINGS

The majority (>90%) agreed that it was important to learn about child-related topics. Only 4.3% disagreed that it was important to learn about vulnerable/at-risk children. Health and social care students enhanced their insight into all the child-related topics (p<0.001) after the IPL course. Teacher education and child welfare students reported decreased insight into children in general (p<0.001 in 2019 and p=0.008 in 2020) but increased insight into vulnerable/at-risk children in 2020 (p=0.001). According to stratified analyses, there was a significantly increased insight into all child-related topics among physiotherapy and Mensendieck physiotherapy students (p<0.001), decreased insight into children in general among teacher education students (p<0.02), and increased insight into vulnerable/at-risk children among teacher education students (p ≤ 0.001) in both 2019 and 2020. Age was of minor importance. The response rates ranged from 16.0% to 36.0%.

CONCLUSION

After the IPL course, the health and social care students significantly enhanced their insight into child-related topics, whereas the students in teacher education and child welfare gained increased insight into vulnerable/at-risk children.