ABSTRACT
Objective To identify the core interventions preliminarily performed by pediatric nurses for hospitalized children. Methods Based on Nursing Interventions Classification (NIC), the data of survey related to the factors of representation and frequency derived from the definition of Core Nursing Interventions were collected from 59 pediatric senior nurses above the 3rd clinical ladder, working in one of Shanghai university affiliated and tertiary children hospitals. The data was analyzed by L type of Metric Diagram. The intervention with product of two factors above 12 was selected as the core intervention. Results A total of 109 interventions were selected as core interventions on pediatric nursing from 497 interventions of NIC. The top 3 domains in quantity of interventions were physiological complex domain (36 items), physiological basic domain (26 items) and health system domain (19 items). The domain with the highest score (16.79 ± 3.42) was safety domain, followed by physiological complex domain (16.19 ± 2.98), while domain with the lowest score (13.62±2.05) was family domain. Conclusions The initial and systematic pediatric nursing core interventions were identified based on NIC and definition of core intervention. Part of core interventions reflects the characteristics of pediatric nursing practice, but more is requested to reflect the pediatric-specific care related to family-center and age-appropriated concepts. Some of inefficient interventions remind nursing administers further reflect thinking, especially on human resource management.
ABSTRACT
Objective To evaluate and compare the predictive validity of the Braden Q and Braden pressure ulcer risk assessment scales in the acute pediatric patients, and explore the cutoff score of the scales. Methods We adopted the prospective cohort study design.The settings included three PICU of three different children's hospitals. Two nurses were appointed as the data collectors, and they were in charge of both the scoring and the skin assessment separately. Results We collected 145 samples. There were 9 patients who developed the pressure ulcers, and the incidence rate was 6.2%. The cutoff score of Braden Q and Braden scale was 17 and 14. The AUC of the ROC curve of the two scales was 0.481 and 0.398. Conclusions The Braden Q scale is more suitable for the pediatric patients. Further study is neededed to improve the scale.
ABSTRACT
Objective To explore nurses' experiences of ethics dilemma and coping strategies involed in caring dying patients. Methods Interviews were conducted with 25 nurses from four different levels of hospitals in Shanghai. Results The ethical dilemmas that participants encountered with were derived from different standpoint and ethics decision-making between "relieve pain" and "extend life span","life value" and "insufficient medical resources","agent execution for patients' rights of being informed consent" and"medical intervention rights". Nurses' coping strategies included patiently communicating with family members to achieve agreement,failing to change family's decision then passively accepting it by self-adjustment,and following hospital rules and regulation or relying on team decision-making. Conclusion The study analyzed and discussed the reasons behind ethical dilemmas,as well as providing some suggestions on how to improve the coping abilities for nurse staffs. It can provide reference and basis for ethical decision-making.