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.

Use of subcutaneous fluids in palliative care with children: a case study

Use of subcutaneous fluids in palliative care with children: a case study

A discussion of subcutaneous fluid therapy in the children’s palliative care setting

Designing an adolescent safeguarding curriculum framework for preregistration nurse education programmes

Designing an adolescent safeguarding curriculum framework for preregistration nurse...

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.

Immunisation

Factors contributing to parental ‘vaccine hesitancy’ for childhood immunisations

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.

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

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...

Why you should read this article: • To understand that medical advances have meant that...

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

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