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Witkowska MI, Janhunen K, Sak-Dankosky N, Kvist T. Parents' perceptions of patient safety in paediatric hospital care-A mixed-methods systematic review. J Adv Nurs 2024. [PMID: 39118473 DOI: 10.1111/jan.16361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/06/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024]
Abstract
AIM(S) To identify and summarize evidence on paediatric patient safety in a hospital setting from parents' point of view. DESIGN A mixed-methods systematic review. PROSPERO ID ID number CRD42023453626. DATA SOURCES PubMed, Scopus, ScienceDirect, the Cochrane Library and the Wiley database were searched in July 2023. REVIEW METHODS Two researchers independently applied eligibility criteria, selected studies and conducted a quality appraisal. Data-based convergent synthesis and thematic content analysis were employed. RESULTS Twelve studies were included: eight qualitative research studies, two cross-sectional studies, one non-randomized experimental study and one mixed-methods study. The results were grouped into two themes-parental perceptions of inclusion in paediatric patient safety and parental perceptions of exclusion from paediatric patient safety-and comprised seven main subthemes: comfort in communication, parental engagement, communication difficulties, withdrawal from activity, uncertainty about available information and threats to patient safety. CONCLUSIONS Parents are willing to be engaged in care but require support from healthcare professionals, as they are often anxious about the condition of their children and actions they believe might be helpful. They need to be treated as valuable partners and be engaged in communication and decision processes. IMPACT The development and implementation of interventions involving parents in ensuring the safety of hospitalized paediatric patients should be of the utmost priority to healthcare organizations, as the common theme throughout the included studies was the need for improved communication with and recognition of parents as allies. REPORTING METHOD The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Maria I Witkowska
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katja Janhunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Zerpe AS, Ramklint M, Nowinski D, Öster C. Parental satisfaction with hospital care for children with non-syndromic craniosynostosis: A mixed-method study. J Pediatr Nurs 2024; 77:e465-e473. [PMID: 38762423 DOI: 10.1016/j.pedn.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE The study aims to investigate factors influencing parents' satisfaction with hospital care for children with craniosynostosis during hospitalization for surgery. DESIGN AND METHODS A mixed-methods study with a convergent, parallel design was used. Ninety-five parents responded to the Swedish Pyramid Questionnaire for Treatment, a 25-item questionnaire with six quality domains. In addition, 20 parents were interviewed about their experiences. Frequencies were calculated, and content analysis was used to analyze free-text comments and transcribed interviews. RESULTS Parents' assessment of the overall quality of care was high (mean 87%, range 10-100%). They were most satisfied in the domain staff attitudes and less satisfied with information routines and participation. Content analysis of the interviews gave two overarching themes: Factors that parents experienced as facilitating good quality of care and Factors that parents experienced as impeding good quality of care. CONCLUSIONS Parents were generally satisfied with the care provided, and interviews captured parents´ views on important factors. Staff attitudes affected parents' perception of quality of care. PRACTICAL IMPLICATIONS Clear information and dialogue as well as making parents feel they are part of their child's team can result in higher satisfaction, and allowing families to stay together in the hospital can ease the hospitalization experience. Using a theoretical model can help in suggesting relevant caring actions based on parents' reported care experiences.
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Affiliation(s)
- Anna Stenson Zerpe
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University Hospital, Entrance 85, S-75185, Uppsala, Sweden.
| | - Mia Ramklint
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, Entrance 10, S-75185, Uppsala, Sweden
| | - Daniel Nowinski
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University Hospital, Entrance 85, S-75185, Uppsala, Sweden
| | - Caisa Öster
- Department of Medical Sciences, Psychiatry, Uppsala University Hospital, Entrance 10, S-75185, Uppsala, Sweden
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Harlow AB, Ledbetter L, Brandon DH. Parental presence, participation, and engagement in paediatric hospital care: A conceptual delineation. J Adv Nurs 2024; 80:2758-2771. [PMID: 38037504 DOI: 10.1111/jan.15996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
AIM To delineate between the concepts of parental presence, participation, and engagement in paediatric hospital care. DESIGN The concepts' uses in the literature were analysed to determine attributes, influences, and relationships. METHODS Delineations of each concept are established and conceptual definitions are proposed following Morses' methods. DATA SOURCES MEDLINE (PubMed); CINAHL, PsycINFO, Sociology Source Ultimate (EBSCOhost); Embase, Scopus (Elsevier); Google Scholar. Search dates October 2021, February 2023. RESULTS Multinational publications dated 1991-2023 revealed these concepts represent a range of parental behaviours, beliefs, and actions, which are not always perceptible to nurses, but which are important in family-integrated care delivery. Parental presence is the state of a parent being physically and/or emotionally with their child. Parental participation reflects parents' performing caregiving activities with or without nurses. Parental engagement is a parents' state of emotional involvement in their child's health and the ways they act on their child's behalf. CONCLUSION These concepts' manifestations are important to parental role attainment but may be inadequately understood and considered by healthcare providers. IMPLICATIONS Nurses have influence over parents' parental presence, participation, and engagement in their child's care but need support from healthcare institutions to ensure equitable family-integrated care delivery. IMPACT Problem: Lack of clear definition among these concepts results in incomplete and at times inequitable family-integrated care delivery. FINDINGS Parental presence is an antecedent to parental participation, and parental presence and participation are elements of parental engagement. The concepts interact to influence one another. IMPACT Hospitalized children, their families, nurses, and researchers will benefit through a better understanding of the concepts' attributes, interactions, and implications for enhanced family-integrated care delivery.
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Affiliation(s)
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Debra H Brandon
- Duke University School of Nursing, Durham, North Carolina, USA
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Park J, Jeon H, Choi EK. Digital health intervention on patient safety for children and parents: A scoping review. J Adv Nurs 2024; 80:1750-1760. [PMID: 37950382 DOI: 10.1111/jan.15954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore digital health interventions on patient safety for children and their parents. DESIGN A scoping review. METHODS The PCC 'Participants, Concepts, and Contexts' guided the selection of studies that focused on children under 19 years of age or their parents, patient safety interventions for children, and digital health technology for patient safety interventions. This study was conducted using the Arksey and O'Malley framework's five steps. We reported the review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. DATA SOURCES PubMed, CINAHL, Embase, Web of Science, and Cochrane were searched for articles published up to November 2022. RESULTS A total of 13 articles were included and categorized according to the following criteria to describe the results: intervention characteristics, type of digital technology, and outcome characteristics. Regarding intervention characteristics, we identified two categories, prevention and risk management. Additionally, we identified four types of digital technology, mobile applications, web-based technologies, computer kiosks and electronic health records. Finally, in studies focussing on child safety, parental safety behaviours were used to assess injury risk or detect changes related to prevention. CONCLUSION Patient safety interventions provided through appropriate digital technologies should be developed to enhance continuum of care for children from hospitalization to home after discharge. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Digital health interventions can bolster the role of healthcare providers in patient safety in and out of hospitals, thus improving children's safety and quality of care. IMPACT What problem did the study address? Although the various advantages of digital health technology have been demonstrated, the potential role of digital technology in patient safety interventions for children has not been explored. What were the main finding? Preventive patient safety interventions and risk management for children have been developed. Where and on whom will the research have an impact? Digital health interventions on patient safety can improve children's safety and quality of care by promoting non-face-to-face engagement of children and parents after discharge and expanding healthcare providers' roles. TRIAL AND PROTOCOL REGISTRATION Registered on the Open Science Framework (https://osf.io/dkvst). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jisu Park
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Heejung Jeon
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute College of Nursing, Yonsei University, Seoul, South Korea
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Bašković M, Markanović M, Ivanović S, Boričević Z, Alavuk Kundović S, Pogorelić Z. Risk Factors Leading to Overnight Stays in Pediatric Surgical Outpatients. CHILDREN (BASEL, SWITZERLAND) 2024; 11:382. [PMID: 38671599 PMCID: PMC11049595 DOI: 10.3390/children11040382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/12/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Same-day surgery implies patient discharge on the same day after the surgery. The main aim of the research was to determine which predisposing factors lead to children treated with same-day surgery not being able to be discharged on the same day. METHODS For the purposes of this research, the electronic records of patients in the hospital information system were reviewed retrospectively. The search included patients who were surgically treated through the Day Surgery Unit at the Children's Hospital Zagreb with various diagnoses from 1 January 2021 to 31 December 2023. The target group consisted of patients who could not be discharged on the same day (n = 68), while for the purposes of the control group (n = 68), patients were randomly selected, comparable by age and gender, who were discharged from the hospital on the same day in accordance with the principles of same-day surgery. RESULTS In relation to the parameters of interest between the groups, statistically significant differences were observed in the type of general anesthesia (p = 0.027), the use of analgesics (p = 0.016), the time of entering the operating room (p = 0.000), the time of leaving the operating room (p < 0.0001) and the duration of surgery (76.81 ± 37.21 min vs. 46.51 ± 22.46 min, p < 0.0001). When explanatory variables were included in the regression model, they explained 38% of the variability in the dependent variable. Only the variable "duration of surgery" provided significant information to explain the variability in the dependent variable (p = 0.004). CONCLUSIONS Although the duration of surgery was imposed as the main predictor of hospitalization after same-day surgery, and considering the extremely small number of studies on the mentioned topic, especially in the pediatric population, further, preferably multicenter research on the mentioned topic is needed.
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Affiliation(s)
- Marko Bašković
- Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia; (M.B.)
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
| | - Martina Markanović
- Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia; (M.B.)
- Day Surgery Unit, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia
| | - Sanja Ivanović
- Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia; (M.B.)
- Day Surgery Unit, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia
| | - Zrinka Boričević
- Department of Surgery, General Hospital Karlovac, Ulica Andrije Štampara 3, 47000 Karlovac, Croatia
| | - Sandra Alavuk Kundović
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10000 Zagreb, Croatia
| | - Zenon Pogorelić
- Department of Pediatric Surgery, University Hospital of Split, Spinčićeva Ulica 1, 21000 Split, Croatia
- Department of Surgery, School of Medicine, University of Split, Šoltanska Ulica 2a, 21000 Split, Croatia
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Kerimaa H, Hakala M, Haapea M, Serlo W, Pölkki T. The preparation of children for day surgery from the parent's viewpoint: A mixed methods study. Nurs Open 2024; 11:e2121. [PMID: 38436537 PMCID: PMC10910610 DOI: 10.1002/nop2.2121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 01/13/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
AIM The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint. DESIGN Empirical Research Mixed Method. METHODS The research applied a mixed-methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2-6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi-structured interviews were conducted with 15 parents to better understand their experiences. RESULTS According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective.
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Affiliation(s)
- Heli Kerimaa
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | - Mervi Hakala
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Oulu University HospitalOuluFinland
| | - Marianne Haapea
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Research Service UnitOulu University HospitalOuluFinland
| | | | - Tarja Pölkki
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Oulu University HospitalOuluFinland
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Kilic U, Büyük Tural E, Oruc MA, Aydın Avci I. The effect of VR headsets used during burn dressing in children on satisfaction and anxiety level of their parents. J Pediatr Nurs 2024; 75:e152-e158. [PMID: 38233321 DOI: 10.1016/j.pedn.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
PURPOSE The aim of this study was to determine the effect of virtual reality used during burn dressing in children on the satisfaction and anxiety levels of their parents. METHODS The study, which was designed as a prospective randomized controlled trial, was carried out with the parents of children aged 5-10 years who visited the only burns unit of a hospital in the northern region of Turkiye between 5 July 2021 and 1 April 2022 for dressing. There were a total of 52 participants in the study, 26 in the control and 26 in the intervention group. RESULTS The mean age of the children was 7.31 ± 1.81 years in the intervention group and 7.08 ± 1.72 in the control group. After the dressing was applied to the children, the mean anxiety score of the parents of the children was found to be 0.09 ± 0.28 in the intervention group and 0.64 ± 0.53 in the control group. The mean nursing care satisfaction score of the parents in the intervention group was found to be 4.70 ± 0.50 while it was 2.80 ± 0.26 in the control group. CONCLUSIONS In the study, while the anxiety levels of the ones in the intervention group decreased after the dressing, their satisfaction levels with nursing care were found higher than the control group. PRACTICE IMPLICATIONS Nursing interventions that would reduce the pain and anxiety experienced by children during medical procedures are also effective in reducing the anxiety of parents, and therefore, they should be included in distraction efforts with their children.
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Affiliation(s)
- Ummuhan Kilic
- R&D and Projects Specialist, Samsun Provincial Health Directorate, Adalet Mah, 100. Yıl Blv, No:232, 55060 Ilkadim, Samsun, Turkey
| | - Esra Büyük Tural
- Department of Child Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey.
| | - Muhammet Ali Oruc
- Department of Family Medicine, Samsun University, Provincial Health Director, Samsun Provincial Health Directorate, Adalet Mah, 100. Yıl Blv, No:232, 55060 Ilkadim, Samsun, Turkey
| | - Ilknur Aydın Avci
- Department of Public Health and Diseases Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Kurupelit Campus, 55200 Atakum, Samsun, Turkey.
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Ventura Expósito L, Arreciado Marañón A, Gomà Tous M, Ferrerons Sánchez M, Zuriguel-Pérez E. Nurses' views on the presence of family members during invasive procedures in hospitalised children: A questionnaire survey. J Clin Nurs 2024. [PMID: 38323664 DOI: 10.1111/jocn.17062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/08/2024]
Abstract
AIMS AND OBJECTIVES (I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient-and family-centred care model. BACKGROUND Family presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence. DESIGN Observational, descriptive, cross-sectional study. METHODS Study population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire. RESULTS A total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions. CONCLUSIONS The results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills. RELEVANCE TO CLINICAL PRACTICE The data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient-and family-centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears.
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Affiliation(s)
- Laia Ventura Expósito
- Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona. Cerdanyola del Vallès, Barcelona, Spain
- Vall Hebron Barcelona University Hospital (HUVH), Barcelona, Spain
- Multidisciplinary Nursing Research Group, Vall d' Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonia Arreciado Marañón
- Department of Nursing, Faculty of Medicine, Cerdanyola del Vallès, Campus Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Barcelona, Spain
| | | | - Mercè Ferrerons Sánchez
- Vall Hebron Barcelona University Hospital (HUVH), Barcelona, Spain
- Multidisciplinary Nursing Research Group, Vall d' Hebron Research Institute (VHIR), Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, Vall d' Hebron Research Institute (VHIR), Barcelona, Spain
- Department of Knowledge Management and Evaluation, Vall d'Hebron University Hospital, Barcelona, Spain
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Agúndez Reigosa B, Cabrera López IM, Sánchez Marcos E, Galán-Olleros M, Sánchez Olivier M, Calleja Gero L, Jiménez García R. Hospital at Home Program for the Treatment of Pediatric Osteoarticular Infections. Hosp Pediatr 2024; 14:75-83. [PMID: 38186289 DOI: 10.1542/hpeds.2023-007265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
OBJECTIVES Hospital at home (HAH) replaces acute inpatient hospital care for selected patients by providing care in their homes. We sought to describe the characteristics, management, and complications of patients with osteoarticular infections (OAIs) treated in an HAH program and its economic impact. METHODS We conducted a retrospective observational study evaluating an HAH program in a pediatric hospital in Spain, describing the characteristics of patients with confirmed OAIs requiring intravenous antibiotic therapy admitted to this program between January 2019 and December 2022. The program operates as a virtual ward with possible daily visits by physicians and nurses and 24/7 telephone contact. RESULTS A total of 88 patients (median age, 4.1 years; interquartile range [IQR], 1.7-10.6) with OIAs were admitted to the HAH program. Osteomyelitis (57%) and septic arthritis (29%) were the most frequent infections. Cefuroxime (42%) and cefazolin (39%) were the most frequently prescribed antibiotics. Caregiver self-administration was performed in 99%, allowing multiple daily doses of antimicrobial therapy, 80% by peripheral line. Thirteen patients (15%) had drug-related adverse events, only 3 requiring drug modification. Two patients (2%) were readmitted during HAH, and 1 was readmitted within 30 days of HAH discharge. The median HAH stay was 7 days (IQR, 4-8.75). For osteomyelitis, hospital days lowered from 8.5 days (IQR, 4.5-12) to 4 days (IQR, 3-7) after HAH implementation (P = .005) with 68% per-patient estimated cost savings. CONCLUSIONS HAH treatment of OAIs is effective and cost-efficient. Patient support by medical and nursing staff, adequate family training, and regular communication are essential to ensure safe home admission.
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Affiliation(s)
| | | | | | | | - Monica Sánchez Olivier
- Hospital at Home Program, Department of Pediatrics
- Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Lourdes Calleja Gero
- Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Raquel Jiménez García
- Hospital at Home Program, Department of Pediatrics
- Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Palomares González L, Hernández Caravaca I, Gómez García CI, Sánchez-Solís de Querol M. A presença dos pais durante procedimentos pediátricos invasivos: depende de quê? Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6101.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumo Objetivo: o atendimento centrado na família durante procedimentos invasivos tem sido endossado por muitas organizações profissionais de saúde. O objetivo deste estudo foi avaliar as atitudes dos profissionais de saúde em relação à presença dos pais durante o procedimento invasivo realizado em seus filhos. Método: os prestadores de serviços de saúde pediátricos (divididos em categorias profissionais e faixa etária) de um dos maiores hospitais da Espanha foram solicitados a preencher um questionário e escrever comentários de texto livre. Resultados: a pesquisa foi respondida por 227 pessoas. A maioria (72%) dos participantes, em suas respostas, relatou que os pais algumas vezes estão presentes durante as intervenções, embora houvesse diferenças entre as categorias profissionais a esse respeito. Os procedimentos em que os pais estavam presentes eram aqueles considerados “menos invasivos” (96% dos casos), enquanto apenas 4% estavam presentes naqueles considerados “mais invasivos”. Quanto mais velho o profissional, a presença dos pais foi considerada menos necessária. Conclusão: as atitudes em relação à presença dos pais durante o procedimento pediátrico invasivo são influenciadas pela categoria profissional, a idade do prestador de serviço de saúde e a invasividade do procedimento.
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Palomares González L, Hernández Caravaca I, Gómez García CI, Sánchez-Solís de Querol M. Presencia de los padres durante procedimientos pediátricos invasivos: ¿De qué depende? Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6101.3827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Resumen Objetivo: la atención centrada en la familia durante procedimientos invasivos ha sido respaldada por muchas organizaciones profesionales dedicadas al cuidado de la salud. El objetivo de este estudio fue evaluar las actitudes de los profesionales de la salud con respecto a la presencia de los padres durante los procedimientos invasivos realizados en niños. Método: a los prestadores de atención médica en Pediatría (divididos en categorías profesionales y rangos de edad) de uno de los hospitales más importantes de España se les solicitó que respondieran un cuestionario y redactaran comentarios de texto libre. Resultados: un total de 227 profesionales respondieron la encuesta. En sus respuestas, la mayoría (72%) de los participantes informó que, en ocasiones, los padres están presentes durante las intervenciones, aunque se registraron diferencias entre las distintas categorías profesionales al respecto. Los procedimientos en los que los padres estuvieron presentes se consideraron como “menos invasivos” (96% de los casos), mientras que solamente el 4% estuvo presente en los considerados “más invasivos”. A mayor edad de los profesionales, menos necesaria se consideró la presencia de los padres. Conclusión: las actitudes con respecto a la presencia de los padres durante procedimientos pediátricos invasivos se vieron influenciadas por la categoría profesional, la edad del prestador de salud y la invasividad de los procedimientos.
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Ceylan SS, Turan T. Investigation of predictor factors of the nursing students attitudes toward parents' participation in care. J Pediatr Nurs 2023; 73:e503-e508. [PMID: 37884404 DOI: 10.1016/j.pedn.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE A positive attitude toward family-centered care practices should be developed in undergraduate education. This study aimed to investigate nursing students' attitudes toward parental participation in child patient care and the factors that influence it. DESIGN AND METHODS This study was a descriptive cross-sectional study. The study data were collected from the nursing department of a university located in the west of Turkey. The study was conducted with 260 nursing students. The descriptive Features Form, Family-Centered Care Practices Form, and Parental Participation Attitude Scale were used in data collection. RESULTS The students' average parental participation attitude in care scores was at a moderate level. It has been determined that gender, hospitalization experience, education on family-centered care, and support from instructors in family-centered care practices had a positive effect on the student's attitudes toward parental participation in care (p < 0.05). The regression analysis showed gender and family-centered care education as predictors of student' attitudes toward parent participation in care. CONCLUSIONS It was found that students' attitudes toward parental participation in the care of child patients were at an indecision level and not at the desired grade, and it was affected by gender, hospitalization experience, education, and instructor support. PRACTICE IMPLICATIONS The development of family-centered care practices should begin in nursing education. It is recommended that detailed attention be given to topics related to family-centered care in nursing education, and seminars be organized on this subject. Thus, nursing students can both develop a positive attitude toward family-centered care and learn to work together with the family.
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Affiliation(s)
- Sibel Serap Ceylan
- Department of Pediatric Nursing, Pamukkale University Faculty of Health Sciences, Denizli,Türkiye.
| | - Türkan Turan
- Department of Pediatric Nursing, Pamukkale University Faculty of Health Sciences, Denizli,Türkiye.
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Signorelli C, Robertson EG, Valentin C, Alchin JE, Treadgold C. A Review of Creative Play Interventions to Improve Children's Hospital Experience and Wellbeing. Hosp Pediatr 2023; 13:e355-e364. [PMID: 37830155 DOI: 10.1542/hpeds.2022-006994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
CONTEXT Being in the hospital can be stressful for children and caregivers. Evidence-based play interventions to reduce this stress, such as play therapy or Child Life services, have been introduced in hospitals globally, with growing awareness of potential benefits. OBJECTIVES To evaluate the impact of nonmedical/illness-specific creative or play-based programs in hospital settings on children's (<18 years) and their caregivers' hospital experiences, wellbeing, and other health outcomes. DATA SOURCES PubMed, CINAHL, Google Scholar. METHODS We conducted a systematic review of original articles published since 2011, screening 2701 de-duplicated articles. RESULTS We identified 25 eligible articles, representing 1629 children (57% male), 422 caregivers, and 128 health professionals. Included studies most commonly evaluated professional children's entertainers (n = 8 studies), music therapy (n = 4), unstructured play (n = 3), and humanoid/animal robots (n = 3). Most studies evaluated the impact on the child's level of anxiety (n = 14/25), mostly supporting a reduction (n = 13/14 studies). Several studies provided evidence for a reduction in children's pain (n = 4/6), and negative emotional/behavioral outcomes (eg, sadness, anger, irritability; n = 5/6 studies). There was mixed evidence for the impact of the included interventions on physiologic outcomes (eg, systolic pressure, heart frequency; n = 3/5 studies) and fatigue (n = 1/2 studies). Evidence on caregiver outcomes and the impact on health care services was limited. CONCLUSIONS The findings of our review generally supported the value of play-based interventions on children's' wellbeing while in the hospital, particularly reducing anxiety and pain. Further evaluation of their impact on caregivers' outcomes and the health care system is needed.
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Affiliation(s)
- Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
| | - Eden G Robertson
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
- Starlight Children's Foundation, Naremburn, NSW, Australia
| | - Chelsea Valentin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Joseph E Alchin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
| | - Claire Treadgold
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
- Starlight Children's Foundation, Naremburn, NSW, Australia
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Barbosa GM, Weber A, Garcia APRF, Toledo VP. Experience of hospitalization of the family with children and adolescents in psychological distress. Rev Esc Enferm USP 2023; 57:e20220457. [PMID: 37930233 PMCID: PMC10615362 DOI: 10.1590/1980-220x-reeusp-2022-0457en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 09/03/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To learn about the experience of families of children and adolescents in psychological distress facing hospitalization in a psychiatric inpatient unit of a general university hospital. METHOD This is a qualitative phenomenological-social study, with data collection carried out from February to March 2022 through open interviews, analyzed using Alfred Schutz's framework with the construction of categories of meaning. RESULTS Based on the analysis of eight interviews, it was possible to understand changes in the families' way of life, impacts on their routine, work, and social relationships. Their expectations were about the recovery of mental health and autonomy. CONCLUSION This study allowed us to understand the experience of families faced with the hospitalization of children and adolescents in psychological distress and understand their members' needs. The need for implementation of care spaces that incorporate the relationship between the multidisciplinary team and the family is highlighted.
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Affiliation(s)
| | - Aldair Weber
- Universidade Estadual de Campinas, Faculdade de Enfermagem,
Campinas, SP, Brazil
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Palomaa AK, Hakala M, Pölkki T. Parents' perceptions of their child's pain assessment in hospital care: A cross-sectional study. J Pediatr Nurs 2023; 71:79-87. [PMID: 37030017 DOI: 10.1016/j.pedn.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE A prerequisite for successful pain management is identifying the pain and assessing its intensity. The aim of this study was to describe parents' perceptions of their child's pain assessment in hospital care. DESIGN AND METHODS This study was a descriptive cross-sectional study. A questionnaire was completed by parents (n = 261) whose child was hospitalized in one of the pediatric units (n = 6) of the University Hospital in Finland. Quantitative data were analyzed using statistical methods; open-ended data were analyzed using inductive content analysis. RESULTS Parents reported that their children experienced moderate (36%) to severe pain (42%) during hospitalization. The most intense pain experienced by the children was associated with needle-related procedures (41%). A large proportion of parents (83%) were involved in their child's pain assessment. Parents were satisfied with their child's pain assessment but perceived some shortcomings. Parents hoped that a variety of methods would be used to assess their child's pain and that the parents' and child's views on pain would be taken into account. CONCLUSIONS Most children experience moderate to severe pain during hospitalization. Parents are often involved in pain assessment but are rarely instructed to use pain scales. PRACTICE IMPLICATIONS Child's pain should be assessed regularly and frequently enough. It is important that the child and parents are involved in shared decision-making about pain assessment and treatment, and they have opportunities to ask questions. Guidance should be offered to parents about the use of pain assessment scales.
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Affiliation(s)
- Anna-Kaija Palomaa
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu, University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland.
| | - Mervi Hakala
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu, University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
| | - Tarja Pölkki
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu, University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
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Sundal H. Home-like care: Collaboration between parents and nurses in everyday situations when children are hospitalized. J Child Health Care 2023:13674935221149778. [PMID: 36606622 DOI: 10.1177/13674935221149778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
When children are hospitalized, parents and nurses need to collaborate. This study aims to investigate how parents and nurses experience collaborating and sharing responsibilities and tasks when providing home-like care for hospitalized children in everyday situations. This qualitative study used a hermeneutic phenomenological approach with observations and interviews and was conducted in a general medical pediatric unit. Twelve parents of eleven hospitalized children between the ages of 1 and 6 years with various medical diagnoses and seventeen nurses who cared for those children participated in the study. Parents and nurses collaborated and shared responsibilities and tasks to provide home-like care for hospitalized children in everyday situations by making mealtimes seem familiar, maintaining customary sleeping patterns, adapting washing and dressing routines, and facilitating play and activity. Parents and nurses collaborated to maintain a familiar rhythm in an unfamiliar environment to enhance the children's well-being. The nurses' degree of involvement in the children's everyday situations varied from little to moderate to strong, with parents assuming the main responsibilities. Nurses' involvement in children's everyday situations was variable, depending on the complexity of the situations.
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Affiliation(s)
- Hildegunn Sundal
- Faculty of Health Sciences and Social Care, 5562Molde University College, Molde, Norway
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Palomares González L, Hernández Caravaca I, Gómez García CI, Sánchez-Solís de Querol M. Parental presence during invasive pediatric procedures: what does it depend on? Rev Lat Am Enfermagem 2023; 31:e3828. [PMID: 36888793 PMCID: PMC9991004 DOI: 10.1590/1518-8345.6101.3828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/29/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE family-centered care during invasive procedures has been endorsed by many professional health care organizations. The aim of this study was to evaluate the health professionals' attitudes towards parental presence during their child's invasive procedure. METHOD pediatric healthcare providers (divided in professional categories and range of ages) from one of the Spain's largest hospitals were asked to complete a questionnaire and write free-text comments. RESULTS 227 responded the survey. Most (72%) participants, in their answers, reported that parents are sometimes present during interventions, although there were differences between professional categories in this respect. The procedures in which the parents were present were those considered "less invasive" (96% of cases), while only 4% were present in those considered "more invasive". The older the professional, the less necessary parental presence was considered. CONCLUSION the attitudes towards parental presence during pediatric invasive procedure are influenced by the professional category, the age of the healthcare provider and the invasiveness of the procedure.
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Affiliation(s)
- Laura Palomares González
- Virgen de la Arrixaca University Children's Hospital, Department of Neonatal ICU, El Palmar, Murcia, Spain
| | - Iván Hernández Caravaca
- University of Alicante, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante, Comunidad Valenciana, Spain
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Santos ACPDO, Camargo CLD, Vargas MADO, Conceição MMD, Whitaker MCO, Maciel RCM, Baptista SCO, Santo MRDE. Perception of family members and health professionals about institutional violence against hospitalized children. Rev Gaucha Enferm 2022; 43:e20210244. [PMID: 36043646 DOI: 10.1590/1983-1447.2022.20210244.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the perception of family members and health professionals about institutional violence against hospitalized children. METHODS Qualitative, exploratory-descriptive study, used approximations with Foucault's thinking, carried out in a pediatric unit of a large hospital in Salvador - Bahia. 10 mothers and 39 health professionals participated. Data collection took place between November/2018 and October/2019 through semi-structured interviews. Data content analysis was performed with the help of the NVIVO12 software. The study, approved by Ethics Committee, complied with resolution 466/2012. RESULTS The Institutional Violence was understood by the participants evidenced in three categories: abusive care practices; problems in the relationships between professionals, child and family; precariousness of the hospital structure. CONCLUSION The perception of family members and health professionals about the presence of Institutional Violence in children's hospital care demonstrates the need to establish actions in their confrontation to ensure the dignity of the child during hospitalization.
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Affiliation(s)
| | | | | | | | | | - Rochelle Cíntia Militão Maciel
- Universidade Federal da Bahia (UFBA), Complexo Hospitalar Universitário Professor Edgard Santos. Salvador, Bahia, Brasil
| | | | - Marisa Reis do Espírito Santo
- Universidade Federal da Bahia (UFBA), Complexo Hospitalar Universitário Professor Edgard Santos. Salvador, Bahia, Brasil
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Santos ACPDO, Camargo CLD, Vargas MADO, Conceição MMD, Whitaker MCO, Maciel RCM, Baptista SCO, Santo MRDE. Percepção de familiares e profissionais de saúde sobre a violência institucional à criança hospitalizada. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210244.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Compreender a percepção de familiares e profissionais de saúde sobre a Violência Institucional à criança hospitalizada. Método: Estudo qualitativo, exploratório-descritivo, de aproximações com o pensamento foucaultiano, realizado em unidade pediátrica de hospital de grande porte em Salvador/Bahia. Participaram 10 mães e 39 profissionais de saúde. A coleta de dados ocorreu entre novembro/2018 e outubro/2019 através de entrevista semiestruturada. Foi realizada análise de conteúdo dos dados, com auxílio do software NVIVO12. O estudo foi aprovado por um comitê de ética e respeitou a Resolução 466/2012. Resultados: A Violência Institucional foi compreendida pelos participantes como: práticas de cuidado abusivas; problemas nas relações entre profissionais, criança e família; precarização da estrutura hospitalar. Conclusão: A percepção de familiares e profissionais de saúde sobre a presença da Violência Institucional no cuidado hospitalar infantil demonstra a necessidade de estabelecer ações para o seu enfrentamento para assegurar a dignidade da criança durante a hospitalização.
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