Pediatric Nursing

Includes bibliographical references.

Severe Inflammatory Syndrome in Children Testing Positive for Current or Recent COVID-19 Infection -- Pediatric Accidental Trauma: Screening and Reducing Psychological Impact -- Pediatric Home Milrinone Use While Awaiting Heart Transplant -- What Is Involved in Pediatric Heart and Liver Organ Allocation? -- Intestinal Microbiota and Child Health: A Review of the Literature -- The Communication of Palliative Care Adoption in a Pediatric Intensive Care Unit -- Perceptions of Diabetes Education Among East African Immigrant Parents -- Participation and Recruitment -- Resources and Support to Maintain the 'Essence' of Patient- and Family-Centered Care during COVID-19.

[Article Title: Severe Inflammatory Syndrome in Children Testing Positive for Current or Recent COVID-19 Infection / Judy A. Rollins, p. 109-110] Abstract: COVID 19 has resulted in a global and economic catastrophe unlike anything seen in 100 years. Until recently, we thought children were mostly spared from the disease, or if they did acquire it, cases would be mild and short-lived.;[Article Title: Pediatric Accidental Trauma: Screening and Reducing Psychological Impact / Autumn J. Lants, p. 111-114] Abstract: The recognition that children can develop post-traumatic stress disorder (PTSD) following traumatic events was not made until the third edition of the Diagnostic and Statistical Manual of Mental Disorders (Carrion & Kletter, 2012). Although the vast majority of accidently injured children experience full post-injury physical recov-ery, a significant subset experiences negative psychological sequalae, including PTSD, depression, and other anxiety disorders (Kassam-Adams et al., 2013). PTSD is the most common psychiatric disorder following traumatic events (Caffo & Belaise, 2003). Symptoms of PTSD can lead to lower health-related quality of life for up to 2 years following injury (Kassam-Adams et al., 2015). Ai-though increased rates of psychological issues post-trauma are accepted in medical literature, the number of children identified and referred to appropriate services for treatment is consistently low. This leads to long-term negative effects that have an impact on children physically, emotionally, cognitively, and developmentally.;[Article Title: Pediatric Home Milrinone Use While Awaiting Heart Transplant / Jessica DeCastro, p. 115-118] Abstract: f medically stable, the pediatric heart failure population is frequently transitioning home with inotrope support use. These patients and families are given the freedom to receive life-sustaining treatment at home while awaiting heart transplant. Through careful coordination between frontline clini-cians, nursing, home care, social work, and case management, children are able to resume school along with many other daily activities. Although this autonomy is extremely valuable and beneficial, there are various precautions that must be taken to maintain a stable medication regimen. It is crucial for caregivers to be appropriately educated regarding central venous access, medication administration, possible complications, and ongoing diligence for worsening signs of heart failure. As patients progress through treatment, they are carefully monitored to. ensure they are receiving optimal treatment regimens.;[Article Title: What Is Involved in Pediatric Heart and Liver Organ Allocation? / Adelaide Garcia, p. 119-124] Abstract: Organ transplantation began with experimentation on animals in the early 18th century. In 1954, the first successful human kidney transplant was performed on an identical twin (Andrews et al., 2017). Long-term graft survival proved to be an issue, but with the development of cyclosporine in 1983, graft survival improved significantly (Andrews et al., 2017). By 1984, the need for a national registry was clear, and the Organ Procurement and Transplantation Network (OPTN) was established to maintain a national registry for organ matching. More than 110,000 people are on the waiting list for an organ transplant, of those, 1,978 are children (1.76%) based on data provided by OPTN on March 13, 2020 (OPTN, 2020a).;[Article Title: Intestinal Microbiota and Child Health: A Review of the Literature / Mikoto Nakamichi and Dina Madi, p. 125-137] Abstract: It has been known for many years that the human body is colonized by and is a host of many different microorganisms, which are purported microbiomes. Human micro-biomes are composed of bacteria, fungi, archaea, viruses, and protozoa, and a majority of them are located in the skin, gastrointestinal tracts, respiratory tracts, and urogenital tracts (Versalovic, 2013). With the advanced genome technology and increased attention on human microbiome research over the past few decades there is a growing body of stud demonstrating that changes in number, compositional diversity, all functions of the microbiome are associated with both development of dis. eases and promotion of health in a human host (Lynch & Pedersen, 2016; Veralovic, 2013; Young, 2017). The intestinal microbiota is considered to be she most diverse and largest community of microorganisms, and is recognized as critical for physiological metabolism, immune-inflammatory responses, and disease susceptibility/ resistance of human individuals.;[Article Title: The Communication of Palliative Care Adoption in a Pediatric Intensive Care Unit / Miriam Neis, Cristianne Maria Famer Rocha, and Paulo Roberto Antonacci Carvalho, p. 128-145] Abstract: Since 1990, palliative care has been recommended by the World Health Organization as an alternative treatment for individuals with incurable and advanced diseases. It aims for a longer life with better quality and a process of dying without suffering. In the pediatric universe, palliative care is recommended in cases where no treatment can substantially change the expected disease progression or clinical condition of the child toward death. The decision-making process and communication about the adoption of Palliative Care in the Pediatric Intensive Care Unit (ICU) is a challenge for professionals because of ethical dilemmas and the emotional load this type of situation generates in the child's family and in the health team itself. A descriptive exploratory study sought to understand the development of the inter-professional team's communication processes when deciding on the adoption of Palliative Care in the Pediatric ICU, analyzing their effectiveness. Eleven family interviews were conducted, 15 questionnaires were completed by physicians, and 20 questionnaires were completed by nurses after meetings for the palliative care decision process. The study was carried out from January to November 2017 at the Pediatric ICU at the Hospital de Clínicas de Porto Alegre, Brazil. The analysis of the collected data showed that in 10 of the 14 cases observed, there was communicative effectiveness. In the four cases considered ineffective, the communication process lacked feedback techniques to check for understanding and agreement of all parties on the issues addressed. Effectiveness is not the only element to confer total adequacy in this type of communicative process. As identified by the analysis of data collected, elements such as better psychological connection, choice of milder words, demonstration of affection, and concern for the families' feelings lacked in some situations.;[Article Title: Perceptions of Diabetes Education Among East African Immigrant Parents / Kristi Klee, Karen Thomas, Deann Atkins, and Kathryn Ness, p. 146-151] Purpose: This project was initiated to evaluate clinical nurse concern that he diabetes education may not be meeting the needs of East African families. Clinical nurses noted the learning needs often exceeded the usual three days of training, and many questions remained at the time of discharge. The aim of the project was to explore the family's perceptions of the training they received and their ability to transfer the learning to home, and to use the information to improve education content. Methods: East African immigrant families who had completed diabetes education in the previous two years were approached to participate in the project. Families were interviewed using standard, open-ended questions administered with the assistance of an interpreter. Interviews were transcribed, and content was reviewed for themes. Results: Seven families native to an East African community agreed to be inter-viewed. Children were aged 3 to 16 years and had been diagnosed with type 1 diabetes mellitus over the previous two-year period. From the transcripts, eight main themes and 21 subthemes emerged. Themes included parental fear of the diagnosis of diabetes, feeling overwhelmed by the information being presented to them, and difficulty in following the concepts of carbohydrate counting and food measurement. Parents were pleased with the availability of interpreters present for class sessions, but a few felt the interpretation of the content varied between interpreters. Transition to home was challenging for many families.

Conclusion: The project involved a small population of families who provided valuable information about their perceptions of learning to manage their child's diabetes while in the hospital and the challenges experienced translating the information to their home setting. The information acquired from the interviews will be applied to diabetes education programming, starting with improving understanding of what information is most valuable at the time of initial diagnosis.;[Article Title: Participation and Recruitment / Jean Ivey, p. 152-153] Abstract: The research investigator should arrive at the knowledge of the literature and a plan to recruit participants. This is probably one of the hardest and most frustrating aspects of conducting research. People do not usually line up in excitement and agree to participate. Recruitment methods of two studies (Klee et al., 2020; Neis et al., 2020) published in this issue of Pediatric Nursing are discussed here. Those who participate or are "subjects" in research are motivated in different ways. The individual researcher and the research team must have a strategy that is appropriate for the study method and attractive in some way to the participant. Melnyk and colleagues (2019) suggest three strategies: having direct personal contact, making participation as easy as possible, and making it valuable to the person or obviously important and helpful to others. They were referring to recruitment for quantitative studies, where adequate numbers of participants are calculated to assure validity and appropriate data analysis for the study question. For studies using qualitative methods, participants may be motivated by similar ideas. In the text by Morse and colleagues (1994) on issues in qualitative research methods, there is a dialogue between several researchers, and they generate a number of possible motivations: "being given an opportunity to have a listener" (p. 298), "feeling helped" and "I've gotten to tell my story" (p. 298), and validation ("do other people feel this way?" (p. 298). Morse and colleagues (1994) assert that researchers must focus on data collection, not therapeutic goals or interventions. However, regardless of the method, at some point the investigator may have to intervene or refer if the patient's safety and wellbeing seem at risk.;[Article Title: Resources and Support to Maintain the 'Essence' of Patient- and Family-Centered Care during COVID-19 / Deborah Dokken and Elizabeth Ahmann, p. 154-155] Abstract: COVID-19 and its devastating impact is now sweeping across the United States, as well as the world. Major metropolitan areas are literally 'under siege.' Hospitals and other parts of the health care system are overwhelmed - without sufficient protective equipment for staff or even enough ventilators for patients. In the absence, often, of national guidelines, health care leaders are making decisions for their organizations and systems, and already-beleaguered frontline staff are working under new conditions. Children and youth with special health care needs (CYSHCN) and those with cancer may be at increased risk for complications from COVID-19 and are facing disruptions in care. To ensure the safety of patients and staff, some children's hospitals have restricted the presence of family members.