Incorporating Environmental Health into Pediatric Medical and Nursing Education

Pediatric medical and nursing education currently lacks the environmental health content necessary to appropriately prepare pediatric health care professionals to prevent, recognize, manage, and treat environmental-exposure–related disease. Leading health institutions have recognized the need for improvements in health professionals’ environmental health education. Parents are seeking answers about the impact of environmental toxicants on their children. Given the biologic, psychological, and social differences between children and adults, there is a need for environmental health education specific to children. The National Environmental Education and Training Foundation, in partnership with the Children’s Environmental Health Network, created two working groups, one with expertise in medical education and one with expertise in nursing education. The working groups reviewed the transition from undergraduate student to professional to assess where in those processes pediatric environmental health could be emphasized. The medical education working group recommended increasing education about children’s environmental health in the medical school curricula, in residency training, and in continuing medical education. The group also recommended the expansion of fellowship training in children’s environmental health. Similarly, the nursing working group recommended increasing children’s environmental health content at the undergraduate, graduate, and continuing nursing education levels. Working groups also identified the key medical and nursing organizations that would be important in leveraging these changes. A concerted effort to prioritize pediatric environmental health by governmental organizations and foundations is essential in providing the resources and expertise to set policy and provide the tools for teaching pediatric environmental health to health care providers

An Electronic Delphi Study to Establish Pediatric Intensive Care Nursing Research Priorities in Twenty European Countries*

OBJECTIVES:: To identify and to establish research priorities for pediatric intensive care nursing science across Europe. DESIGN:: A modified three-round electronic Delphi technique was applied. Questionnaires were translated into seven different languages. SETTING:: European PICUs. PARTICIPANTS:: The participants included pediatric intensive care clinical nurses, managers, educators, and researchers. In round 1, the qualitative responses were analyzed by content analysis and a list of research statements and domains was generated. In rounds 2 and 3, the statements were ranked on a scale of one to six (not important to most important). Mean scores and SDs were calculated for rounds 2 and 3. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Round 1 started with 90 participants, with round 3 completed by 64 (71%). The seven highest ranking statements ( 5.0 mean score) were related to end-of-life care, decision making around forgoing and sustaining treatment, prevention of pain, education and competencies for pediatric intensive care nurses, reducing healthcare-associated infections, identifying appropriate nurse staffing levels, and implementing evidence into nursing practice. Nine research domains were prioritized, and these were as follows: 1) clinical nursing care practices, 2) pain and sedation, 3) quality and safety, 4) respiratory and mechanical ventilation, 5) child- and family-centered care, 6) ethics, 7) professional issues in nursing, 8) hemodynamcis and resuscitation, and 9) trauma and neurocritical care. CONCLUSIONS:: The results of this study inform the European Society of Pediatric and Neonatal Intensive Care's nursing research agenda in the future. The results allow nurse researchers within Europe to encourage collaborative initiatives for nursing research

Influence of Stress and Nursing Leadership on Job Satisfaction of Pediatric Intensive Care Unit Nurses

BACKGROUND: High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. OBJECTIVE: To explore the influences of nurses\u27 attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. METHOD: A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses\u27 perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. RESULTS: Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients\u27 families was the most frequently cited job stressor. CONCLUSIONS: Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted

Rural Nurses\u27 Perspectives on Their Capacity to Care for Pediatric Patients in Northern and Eastern Maine

According to the 2010 U.S. census, approximately 59 million people (19%) in the United States reside in a rural area. More than fifteen percent of the nursing workforce is employed in a rural area. This creates a nurse to patient staffing ratio of 1 nurse for 117 people. This ratio demonstrates a large need for nursing personnel in the rural workforce. With a high patient to nurse ratio, rural nurses can be described to be valuable and in high demand. Rural nurses are valued for their ability to utilize different nursing specialties and care for patients all across the age spectrum. One nursing specialty that is seen often in rural settings is pediatrics. However, in the topic of rural pediatric nursing, there is little literature available. A pilot study was designed to gain an understanding of rural nurses’ perspectives on their capacity to care for a pediatric patient within their work setting in either northern or eastern Maine. This study looked at the following issues: work experience, pediatric patient population, accessibility, most observed pediatric diagnosis, pediatric social issues, academic preparedness of rural nurses, and the strengths and weaknesses of rural pediatric nursing. Nurses stated that a lack of exposure to pediatric patients and a lack of access to pediatric specialists were major weaknesses in their work settings. Overall, the nurses surveyed felt that additional training was required to continue the competency of pediatric nursing in order to accommodate the low pediatric patient census. The purpose of this thesis was to examine rural pediatric health on a community level and ignite further research studies on improving nursing and patient care within this environment

Needs Assessment for Palliative Care in Pediatric Oncology: An Integrative Literature Review

Abstract Background: Cancer is the leading cause of non-accidental death in childhood. Cancer is the primary disease for which pediatric palliative care services are utilized worldwide. Improvement in pediatric palliative care has been identified as an ongoing research priority. There are still significant gaps in current knowledge of pediatric palliative care because education has not been integrated into curriculum and clinical experiences. Objectives: The purpose of this integrative literature review aims to provide a comprehensive review of current research about the need of nursing education on palliative care for long-term care in pediatric oncology. Methods: This integrative literature review focused on articles published from 2007-2018 using CINAHL, PsycINFO, HealthSourse: Nursing, ProQuest Nursing & Allied Health Source, and PubMed. The matrix method by Judith Garrard was used to organize and synthesize the data. Findings: Six studies that integrated the need of nursing education on palliative care for long-term care in pediatric oncology were found. Conclusion: This integrative literature review has highlighted the continuing need to support nurses providing palliative care, especially in the pediatric oncology setting for long term care. This type of nursing is very emotional and can carry many difficulties, however with the appropriate support and education given to pediatric oncology nurses they would be able to provide better care to patients and their families in the long-term setting. Even, with the little research about pediatric palliative care it is discovered that the need to increase nursing education on palliative care for pediatric oncology nurses to help them gain confidence and increase their knowledge in the clinical setting is needed. Keywords: pediatric oncology, palliative care, nursing educatio

Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience., The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring boards). COG nurses facilitate delivery of protocol-based treatments for children enrolled on COG protocols, and Nursing Discipline initiatives support nursing research, professional and patient/family education, evidence-based practice, and a patient-reported outcomes resource center. The research agenda of the Nursing Discipline is enacted through a well-established nursing scholar program

Traditional Versus Objective Structured Clinical Examination on Pediatric Nursing Students’ Performance

Context: The Objective Structured Clinical Examination (OSCE) method is an effective tool for evaluating the clinical nursing skills of nursing students. OSCE is an assessment technique in which the student demonstrates their competence under a variety of simulated conditions Aim: This study aimed to compare objective structured clinical examinations versus traditional clinical examinations on pediatric nursing students' performance. Methods: A quasi-experimental research design (study and control group) was used to conduct this study. The study was conducted in the laboratory of pediatric nursing skills at the faculty of nursing, Benha University. All male and female pediatric nursing students in the 3rd year (n. =228), who were studying in the academic year 2018-2019, first semester, faculty of nursing, Benha University, was recruited. A simple random sample chose to achieve the aim of this study. The odd number was for the OSCE group and the even number for the traditional clinical examination (TCE) group. Four tools were utilized to collect data for the current study. A Structured Questionnaire Sheet, A modified Self-administered Questionnaire, Pediatric Nursing Students' Practice Observational Checklists, and Clinical Scenarios were designed to assess the pediatric nursing student OSCE exam and compare between the traditional method and OSCE method of exams. Results: The current study discovered statistically significant differences were found with a high percentage of agreement responses among pediatric nursing students for related items of OSCE method compared to those in TCE. Additionally, the results clarify a highly statistically significant difference between the studied pediatric nursing students' in TCE and OSCE total performance scores. Conclusion: Objective Structured Clinical Examination (OSCE) was opinioned as a tool for clinical evaluation. This finding appeared in pediatric nursing students' responses, which confirmed their acceptance of OSCE. The OSCE subsequently remains a more objective method of assessment than the traditional clinical forms of the exam that was previously used. OSCE can be used most effectively in undergraduate nursing curricula to assess fair practice. This type of exam provided an accurate measure of clinical skill competencies. Therefore, OSCE should be adopted as a strategy for examining clinical skills for students in all academic years. The current study recommended that Objective Structured Clinical Examination can be used as effective and meaningful assistance to fitness for practice, and OSCE should be adopted as a strategy f

Training and evaluation of professional competency in pediatric nursing

Objective: To analyze the training and evaluation of professional competency to work in the area of pediatric nursing based on the conceptions and experiences of university professors. Method: A qualitative study conducted with pediatric nursing professors from six public undergraduate courses in the state of São Paulo, Brazil. The data were collected by semi-structured interview and analyzed by the Content Analysis method. Results: Sixteen professors participated. Five main themes emerged: competency definition, attributes to act with children, advances in the training of professional competency, challenges to enable training pediatric competency, and methods and instruments for evaluating competency acquisition to work in the area of pediatric nursing. Conclusion: The findings of this study point to the importance of a balanced approach in the cognitive, psychomotor and affective dimensions in training and evaluating professional competency in pediatric nursing, as well as extending the curricular valorization of this area of knowledge and practice

Advancements of Nursing Roles in Pediatric Burn Care

Burns are a common injury for children, especially in toddlers and adolescents. Nurses are in the front line of care and possess many roles within the care of pediatric burn patients. Nursing roles in pediatric burn care can be organized into three major areas of care, including acute, rehabilitative and psychological. it is the roles that nurses carry out that make a difference in the long term quality of life in the pediatric burn patient. Goals and objectives: To address nursing roles in all three major areas of nursing care in pediatric burn care, acute care, rehabilitation care, psychosocial care, long term care and follow-up care