Clinical

Our clinical nursing articles aim to inform and educate nurse practitioners and students. This is achieved through the publication of peer-reviewed, evidence-based, relevant and topical articles.

Evaluating a nurse-led sleep support intervention to reduce melatonin prescribing in children and young people

Evaluating a nurse-led sleep support intervention to reduce melatonin prescribing in...

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.

Role of school nurses in identifying and supporting children and young people with mental health issues

Role of school nurses in identifying and supporting children and young people with...

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.

Non-biological lesbian mothers’ experiences of accessing healthcare for their children

Non-biological lesbian mothers’ experiences of accessing healthcare for their children

This group often experiences positive and negative interactions with healthcare professionals

Medication checks

A process for supporting children’s nurses after medication errors

Report on a quality improvement project aimed at improving the process of supporting nurses

Exploring support systems for nurses involved with safeguarding children

Exploring support systems for nurses involved with safeguarding children

Study found that safeguarding children work can have significant emotional effects on nurses

Parents’ perceptions of the transition of their child who is ventilator dependent from hospital to home

Perceptions of transition from hospital to home of a child who is ventilator dependent

Families can provide skilled, competent care at home to their children with support

Nurses’ underuse of non-pharmacological pain relief interventions in preterm infants

Nurses’ underuse of non-pharmacological pain relief interventions in preterm infants

Literature review identified factors contributing to nurses’ underuse of such pain relief

Family members’ perceptions of a Singing Medicine project in a children’s hospital

Family members’ perceptions of a Singing Medicine project in a children’s hospital

Children spending prolonged periods in hospital need to play and express themselves

Enhancing the care of children and young people with mental health issues

Enhancing the care of children and young people with mental health issues

Children’s nurses require education and training in mental health to provide optimal care

Frequency of injection site assessment for lipohypertrophy in children and young people with type 1 diabetes

Injection site assessment for lipohypertrophy in children with type 1 diabetes

It is vital that nurses understand the importance of injection site assessment

Does parental anxiety affect children’s pain perception during intravenous cannulation?

Children’s nurses can help parents manage anxiety to reduce the traumatic effect on children

In the child’s best interests: should life be sustained when further treatment is futile?

In the child’s best interests: should life be sustained when further treatment is...

Why you should read this article: • To understand that medical advances have meant that children with complex diseases are living longer, but in some cases prolonging treatment may be deemed futile • To understand the ethics involved in decisions about withholding or withdrawing treatment and the best interests of the child • To recognise the importance of nurturing partnerships and encouraging parents to be involved in decision-making particularly about end of life care The aim of this article is to explore the concept of medical futility and the withdrawal of care for children in intensive care units. There have been several recent cases where medical staff have considered that there was no possibility of recovery for a child, yet their clinical judgments were challenged by the parents. The private anguish of these families became public, social media heightened emotions and this was followed by political and religious intrusion. Innovations in medical treatment and technological advances raise issues for all those involved in the care of children and young people especially when decisions need to be made about end of life care. Healthcare professionals have a moral and legal obligation to determine when treatment should cease in cases where it is determined to be futile. The aim should be to work collaboratively with parents but all decisions must be made in the best interests of the child. However, medical staff and parents may have differing opinions about care decisions. In part, this may be as a result of their unique relationships with the child and different understanding of the extent to which the child is in discomfort or can endure pain.

The implementation of family-witnessed resuscitation in children and young people

Exploring the evidence for and against the practice of family-witnessed resuscitation

A position statement about predictive genetic testing among children

Genetic testing of children to predict the future risk of illness remains controversial

Development and validation of the Children’s Competence in Decision-Making Scale

Developing a tool to measure competence in the decision-making process in children aged 8-12

Withdrawal of treatment from critically ill children: legal and ethical issues

The complex issues involved in the care of children who receive life-sustaining treatment

Approaches to community-based palliative care provision by children’s hospices in the UK

Meeting the needs of children with palliative conditions and those of their families

Adolescent safeguarding: a review of the literature

Key themes are identified: adolescent life course, risk and vulnerability, and safeguarding

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