Evidence and Practice
A discussion of subcutaneous fluid therapy in the children’s palliative care setting
Why you should read this article: • To understand the safeguarding risks young people are exposed to in the wider social context • To recognise the need for guidance on safeguarding young people • To learn how a curriculum framework could support safeguarding education in preregistration nurse education programmes Adolescence is a crucial period of transition during which young people are exposed to a range of safeguarding risks in the wider social context. However, it has been identified that the need to safeguard adolescents is less well recognised than the need to safeguard children. Furthermore, there is evidence that child development education provided as part of preregistration nurse education programmes tends to neglect adolescent development. Therefore, there is a need to adopt a life-course approach – which focuses on all stages of child development, including adolescence – and to review child development education to support future nurses in their role in safeguarding young people in practice. This article proposes a curriculum framework for adolescent safeguarding education, outlining a structure to support nurse educators when designing or reviewing preregistration nurse education programmes.
Why you should read this article: • To understand the reasons why some parents reject vaccinations for their children • To develop strategies for discussing immunisation with parents who are hesitant about vaccinating their children • To recognise how some parents become hesitant to vaccinate their children Childhood immunisations have contributed to saving millions of lives worldwide. However, a growing number of parents are declining immunisations, while other parents are choosing to delay them or opting for selective immunisations. These behaviours contribute to the reduction of herd immunity and to the possible resurgence of certain diseases. The aim of this extended literature review was to investigate factors that contribute to ‘vaccine hesitancy’ for childhood immunisation among parents. Seven qualitative studies were included in the review and examined using thematic analysis. The main themes identified were vaccine safety, effectiveness of vaccines and healthcare factors, which suggest that vaccine hesitancy is more complex than parents simply agreeing or disagreeing for their child to be immunised. A range of factors contribute to vaccine hesitancy and patients’ decisions are highly influenced by their perceived need to research information about immunisation online. Healthcare professionals involved in childhood immunisations need to be aware of these factors and behaviours that attribute to vaccine hesitancy to enhance their professional practice.
Why you should read this article • To recognise the effects of sleep deprivation on parents, children and young people • To understand the research on melatonin use in children and young people who experience sleep disturbances • To identify non-pharmacological sleep support interventions that can be implemented for those experiencing sleep deprivation Background Sleep disturbance, often arising from the way parents manage their child’s sleep, affects 40% of children and leads to increased demand on clinical services. Children and young people with significant sleep issues can be treated effectively with a supportive approach but are often prescribed the hormone melatonin because of a lack of available support services. Aim To understand the effect and clinical implications of a nurse-led sleep support clinic on melatonin prescribing in children and young people. Method A retrospective case note evaluation was undertaken of a nurse-led sleep support service delivering a bespoke programme and follow-up support to a patient group of 124 children and young people, 104 of whom had co-morbidities. Results A total of 78 (63%) patients were successfully discharged without melatonin prescriptions after a median of two face-to-face clinic visits and three telephone calls. Eleven out of 12 patients had not restarted melatonin after 12 months. Conclusion A nurse-led, non-pharmacological approach to sleep support in children and young people can provide an effective, sustainable alternative to melatonin prescribing. The authors recommend that appropriate sleep support should be administered and the response reviewed before melatonin is prescribed. Investment in sleep services to support this approach is important.
Why you should read this article • To recognise role of school nurses in mental health provision for children and young people • To identify the importance of initiating early mental health interventions in schools • To understand the importance of further education in mental health for school nurses School nurses have an important role in the provision of mental health services because of their expertise in healthcare and education. The aim of this literature review was to explore research about school nurses’ ability to identify and support children and young people in secondary education with mental health issues. A search of healthcare-related databases was undertaken using search terms such as ‘specialist community public health nurse’ (SCPHN), ‘school nurses’, ‘young people’, mental health’ and ‘adolescent mental health’ to identify relevant research. The literature review found that school nurses perform various activities for children and young people, for example promoting optimal mental health, identifying concerns and initiating early interventions. However, the literature review also suggests that unless school nurses receive further education in mental health they will be unable to develop the necessary skills required to improve outcomes for children and young people in secondary education.
This group often experiences positive and negative interactions with healthcare professionals
This article is the fourth in a series on the biological basis of child health
Why you should read this article: • To enhance your knowledge of the cardiovascular system • To increase your awareness of some of the congenital heart defects found in children and young people • To count towards revalidation as part of your 35 hours of CPD, you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) This article is the third in a series on the biological basis of child health. It outlines how the cardiovascular system develops during gestation and how congenital heart defects (CHDs) may arise in the process. The article details the pathophysiology and treatment of some of the common CHDs, including patent ductus arteriosus, atrial septal defect, ventricular septal defect and transposition of the great arteries. It explains the possible causes of CHDs and explains how these defects are detected and diagnosed. The article also provides an overview of the initial management of acutely unwell infants and children who present with a CHD. The first two articles in the series looked at cells and genetics, and embryology.
The period from fertilisation to birth is crucial in the development of an individual
An introduction to cell biology and genetics for children’s nurses
Research and advances in technology have enabled children and young people with life-limiting conditions to live longer. To maintain their well-being and quality of life many of these children usually require some form of intravenous access for treatment. Children’s nurses should have the skills and training to ensure they are competent to practise using totally implanted central venous access devices such as portacaths (ports). This article addresses the care and management of these ports in children and the wide variation in practice that exists in the UK, and makes recommendations for practice.
This article explores communication and decision-making with children and young people in healthcare. Children and young people report that healthcare professionals are good at explaining and helping them to understand what will happen to them, but that they do not feel involved in decision-making about their care or treatment. To improve communication with children and young people, they need to be involved in decision-making about their care and treatment. In partnership with children, young people and healthcare professionals Common Room Consulting, Great Ormond Street Hospital for Children NHS Foundation Trust and Health Education England have co-produced a communication model, Me first, to support decision-making with children and young people in healthcare. This article introduces the Me first model and explores how it can be applied in clinical practice.
First identified in 2015, there is no vaccine for this virus
An insight into this rare genetic disorder in which both parents are recessive gene carriers
An insight into this genetic disorder occurring in 1 in 6,000 infant males
Waardenburg syndrome is a genetic disorder that gives people a distinctive appearance
Understanding Usher syndrome which is found in approximately 10,000 people in the UK
An insight into this genetic disorder which carries a poor prognosis and is often fatal