Research progress of shaken baby syndrome and its preventive measures / 中国实用护理杂志

Shaken baby syndrome, also known as abusive head trauma, is one of the deadliest and most devastating forms of child abuse.This paper reviewed the risk factors, cognitive status and preventive measures of shaken baby syndrome, in order to provide reference for the prevention of shaken baby syndrome and further research on shaken baby syndrome.

Diarrea aguda, prolongada y persistente en niños y su diferencia de la diarrea crónica / Acute, prolonged and persistent diarrhea in children and its difference with chronic diarrhea

Sobre la base de 55 años de experiencia en el tratamiento de niños con diarrea aguda y la actualización de los conocimientos adquiridos en las últimas décadas en el Programa de Control de la Enfermedad Diarreica de la Organización Mundial de la Salud, se decidió revisar las definiciones de los diferentes tipos clínicos de esta entidad y su diferenciación con la diarrea crónica. Así, se aportan algunos aspectos importantes como los factores que prolongan la diarrea aguda común, el uso de antibióticos, la vacunación contra el rotavirus, el círculo vicioso diarrea-desnutrición, el uso de agentes probióticos y bioterapéuticos, el sobrecrecimiento bacteriano intestinal y la diarrea del viajero. Se concluyó que es necesario identificar precozmente la diarrea prolongada e indicar un tratamiento oportuno para evitar su progresión hacia diarrea persistente, así como el efecto negativo de esta sobre el crecimiento y desarrollo de los niños pequeños, que en ocasiones puede provocarles la muerte.

On the base of 55 years experience in the treatment of children with acute diarrhea and the updating of the knowledge acquired in the last decades in the Control Program for the Diarrheal disease of World Health Organization, it was decided to review the definitions of the different clinical types of this disorder and its differentiation with chronic diarrhea. Thus, some important aspects are offered such as the factors which prolong the common acute diarrhea, the use of antibiotics, vaccination against rotavirus, the vicious circle diarrhea-malnutrition, the use of probiotic and biotherapeutic agents, the intestinal bacterial overgrowth and the traveler's diarrhea. It was concluded that it is necessary to identify early the prolonged diarrhea and to indicate an opportune treatment to avoid its course toward persistent diarrhea, as well as its the negative effect on the growth of small children, which occasionally can cause them death

Cuidado de enfermería en una unidad de cuidado intensivo oncológico pediátrico: la importancia del perdón / Nursing care in a pediatric cancer intensive care unit: importance of forgiveness

Resumen:

Objetivos: analizar a través de una “situación de enfermería” el cuidado integral enfermero en cuidado intensivo oncológico pediátrico. Método: con base en la guía para el análisis de situaciones de enfermería desarrollada por el Grupo de Cuidado al Paciente Crónico y su Familia, de la Universidad Nacional de Colombia, se tomó una historia que sucedió en una unidad de cuidado intensivo oncológico pediátrico, para identificar en ella los componentes teórico-conceptuales del cuidado integral de enfermería.

Resultados: la “situación de enfermería” analizada refleja la visión filosófica integrativa-interactiva de la enfermería, permite analizar los conceptos que se evidencian en la práctica clínica y explorar los conocimientos que exige el cuidado integral de un paciente pediátrico con cáncer en cuidados intensivos, donde se ponen en evidencia los principios y valores profesionales e institucionales. Conclusión: la “situación de enfermería” vivida con una niña atendida en cuidado intensivo oncológico pediátrico y su familia, permite comunicar los conocimientos de cuidado que requiere una enfermera. La aplicación de una guía para reflexionar sobre la propia práctica clínica facilita el análisis y comprensión del cuidado, así como los valores y principios que lo respaldan.

Abstract:

Purpose: to analyze integral nursing care through a "nursing situation" in pediatric cancer intensive care. Methods: based on a guideline for nursing situation analysis developed by the Group for Chronic Patients and Families Care at National University of Colombia, a narrative was used in a pediatric cancer intensive care unit, in order to recognize theoretical-conceptual elements in integral nursing care. Results: this “nursing situation” reflects an integrative-interactive philosophical view of nursing and allows concepts shown in clinical practice to be analyzed. Moreover, knowledge required by integral care of pediatric cancer patients in intensive care units is explored with principles and professional and institutional values being shown.

Conclusion: a “nursing situation” in a girl being admitted in a pediatric cancer intensive care unit and her relatives allows knowledge on nursing care to be communicated. Use of a guideline to think about nursing clinical practice helps to analyze and understand both nursing care and underlying values and principles.

Objetivo: para analisar através de uma "situação de enfermagem" cuidados de enfermagem globais em oncologia pediátrica de tratamento intensivo. Método: com base na orientação para a análise de situações de enfermagem desenvolvido pelo Grupo de Assistência ao Paciente Crônico e Família da Universidade Nacional da Colômbia, uma narrativa que aconteceu em uma unidade de oncologia pediátrica de terapia intensiva foi feita para identificar que componentes teóricos conceituais de cuidados de enfermagem globais. Resultados: o "status de Enfermagem" reflete analisados integrativa visão filosófica de enfermagem interativo, para analisar os conceitos que são evidentes na prática clínica e explorar o conhecimento necessário cuidado integral aos pacientes pediátricos de câncer em cuidados intensivos, onde Eles destacam os princípios e valores profissionais e institucionais. Conclusão: "situação de Enfermagem" vivia com uma menina tratada em oncologia de terapia intensiva pediátrica e sua família, podem se comunicar conhecimento dos cuidados exigidos por uma enfermeira. Aplicando um guia para refletir sobre a prática clínica própria facilita a análise e compreensão dos cuidados, bem como os valores e princípios que a sustentam.

Intervenciones de enfermería para el cuidado del paciente pediátrico con enfermedad del reflujo gastroesofágico / Interventions of infirmary for the care of pediatric patient with disease of gastroesophageal reflux

Antecedentes: Hemos creado la guía de práctica clínica de las intervenciones de enfermería para el cuidado del paciente pediátrico con enfermedad de reflujo gastroesofágico.Métodos: Esta guía de intervención de la práctica clínica de Enfermería forma parte de los guías que integran el Catálogo General de la Práctica Clínica, la cual se instrumentó a través del programa de acción específico: Guías de desarrollo de la práctica clínica, de acuerdo con las estrategias y líneas de acción que considera el Programa Nacional de Salud. 2013-2018 Esta guía de práctica clínica guiará al profesional de la salud para que otorgue cuidados especiales a este tipo de pacientes, al mismo tiempo que se basa en el conocimiento actualizado y estandarizado que fundamenta la evidencia y la toma de decisiones que favorecen la calidad de vida del paciente con la enfermedad de reflujo gastroesofágico, disminuyendo así las complicaciones y la mortalidad súbita. Y al mismo tiempo aumentar la eficiencia del proceso de atención en la enfermería propiciando un cuidado seguro y libre de riesgos.Resultados: Se favorecerá la mejora de la eficiencia, seguridad y calidad de la atención que contribuye, por la presente, para el bienestar de la gente y de las comunidades, que es el objetivo central y la razón de ser de los servicios de salud.Conclusión: el propósito de este catálogo es establecer un estandar nacional para orientar las decisiones clínicas de guía basadas en las recomendaciones sufridas en la mejor evidencia disponible y que tiene las intervenciones dirigidas a la identificación oportuna de los signos y síntomas y complicaciones, así como intervenciones de colaboración para el tratamiento y medidas de seguridad.

Background: We created the guide of clinical practice of interventions of infirmary for the care of pediatric patient with disease of gastroesophageal reflux. Methods: This guide of clinical practice intervention of infirmary forms a part of the guides who integrate the Guides' Main Catalogue of Clinical Practice, which is orchestrated across the Specific Program of Action: Guides' Development of Clinical Practice, according to the strategies and lines of action that considers 2013-2018 National Health program. This guide of clinical practice will guide the professional of health provider to taken care this type of patients, rely on updated and standardized knowledge based on the evidence and to take decisions that affect favorably the quality of life of the patient with gastroesophageal reflux disease as well as to diminish complications, sudden mortality, increase the efficiency of the process of care in infirmary and to propitiate a sure and free care of risks.Results: it will favor the improvement of the efficiency, safety and quality of the care contributing, hereby, to the wellbeing of the people and of the communities, which it is the central aim and the reason to be of health services. Conclusion: the purpose of this catalog is to establish national modal to orientate the guide clinical decisions based on recommendations sustained in the best available evidence and having interventions directed to the opportune identification of signs and symptoms and complications as well as collaborative interventions for the treatment and safety measures.

Antecedentes: Criamos o guia da prática clínica de intervenções de enfermaria para o atendimento de pacientes pediátricos com a doença do refluxo gastroesofágico.Métodos: Este guia de intervenção prática clínica da enfermaria faz parte dos guias que integram 'principal Catalogue of Clinical Practice, que é orquestrada em todo o programa de acção específicos: Guias' as Guias de Desenvolvimento da prática clínica, de acordo com as estratégias e linhas de ação que considera 2013-2018 programa Nacional de Saúde. Este guia da prática clínica vai orientar o profissional de prestador de cuidados este tipo de pacientes, dependem de conhecimento atualizado e padronizado com base nas provas e tomar decisões que afectam favoravelmente a qualidade de vida do paciente com doença do refluxo gastroesofágico, bem de modo a diminuir as complicações, a mortalidade súbita, aumentar a eficiência do processo de atendimento em enfermaria e propiciar um atendimento seguro e livre de riscos. Resultado: ele vai favorecer a melhoria da eficiência, segurança e qualidade do contribuinte cuidado, por este meio, para o bem-estar das pessoas e das comunidades, que é o objetivo central e a razão de ser dos serviços de saúde.Conclusão: o objectivo deste catálogo é estabelecer modal nacional para orientar as decisões clínicas de orientação com base nas recomendações sustentadas na melhor evidência disponível e com intervenções dirigidas à identificação oportuna de sinais e sintomas e complicações, bem como intervenções de colaboração para o tratamento e medidas de segurança.

Dependência crônica de ventilação pulmonar mecânica na assistência pediátrica: um debate necessário para o SUS / Chronic dependence on mechanical pulmonary ventilation in pediatric care: a necessary debate for Brazil's Unified Health System

Pessoas com dependência prolongada de ventilação pulmonar mecânica necessitam de cuidados permanentes e de equipamentos, que podem alongar muito a permanência hospitalar, determinando uma dificuldade de acesso para pacientes com agravos agudos, assim como transtornos pessoais com limitação da qualidade de vida de seus familiares ou cuidadores, devido aos longos períodos de internação. Esta revisão crítica de publicações sobre dependência de ventilação pulmonar mecânica em crianças e adolescentes objetivou disponibilizar informações organizadas de modo sistemático, a fim de subsidiar o debate sobre o tema, considerando que as mudanças de perfil epidemiológico e o crescente acesso tecnológico determinam necessidades como leitos de terapia intensiva e complexa assistência domiciliar para pacientes crônicos, ainda com limites de oferta e regulação no sistema público de saúde brasileiro.

People with prolonged dependence on mechanical ventilation require permanent care and the use of equipment that can result in longer term hospital internment. This can lead to difficulty of access for patients with acute injuries, as well as personal difficulties and stress with reduced quality of life for their families or caregivers due to such longer hospital internment. This critical review of publications dealing with dependence on mechanical ventilation among children and adolescents aimed at making information organized in a systematic manner available in order to support discussion on the subject. It should be borne in mind that changes in epidemiological profile and growing technological access determine needs such as intensive therapy hospital beds and complex home care for chronic patients, which still have limits of supply and regulatory restrictions in the Brazilian public health system.

Clinical analysis of 5471 cases in a pediatric emergency observation unit / 中国小儿急救医学

Objective To evaluate the role of an emergency observation unit(OU) in pediatric care.Methods A retrospective study was conducted to evaluate the medical service of the OU for 12 months.Results During 12 months,5?471 children were admitted to the OU,which was 0.78% of all visits to the outpatient department(OD) and emergency department(ED).Of OU patients,70.9% children were discharged home and 34.6% children were discharged under 48 hours.Of OU patients,65.6% children were under 2 years old.Median length of stay was 95.7 hours.The average admission rate was 15 children per day.The patient volume per month of OU was in positive relation with the visits volume per month of OD and ED (r=0.835,P=0.001).The commonest causes for children admitted to the observation unit were pneumonia(22.2%),enteritis(13.3%) and acute upper airway infection(11.4%).Conclusion The emergency pediatric OU should be set to assess and treat young children with a variety of conditions.It is effective in relieving the problems of limited inpatient hospital bed spaces and high-volume patient visits,and helpful for limiting inappropriate hospitalization.

A Survey of the Nursing Interventions Performed by Pediatric Care Unit Nurses / 아동간호학회지

The purpose of this study was to identify nursing interventions performed by pediatric care unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification (NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The 419 nursing interventions were selected by panel group, which consist of pediatric clinical experts and nursing scholars. The data were collected 104 nurses of pediatric care unit. There were 158 nursing interventions identified as being used at least monthly 50% or more of the nurses. The 32 nursing interventions were used at least daily, indication a set of core interventions unique to pediatric care unit practice. The most frequently used nursing interventions were 'Medication administration: intravenous' & 'Medication administration: oral'. The 27 nursing interventions were rarely performed by 90% or more of the nurses. The rarely used interventions were 'Ostomy care' & 'Rectal prolaps management'. The domain received the highest mean score was Health System, followed by Physiolocal: complex, Physiolocal: Basic, Safty, Community, Family, Behavior domain. These findings will help in building of a standardized language for the pediatric care units and enhance the quality of nursing care.

A Survey of the Nursing Interventions Performed by Pediatric Care Unit Nurses / 아동간호학회지

The purpose of this study was to identify nursing interventions performed by pediatric care unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification (NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The 419 nursing interventions were selected by panel group, which consist of pediatric clinical experts and nursing scholars. The data were collected 104 nurses of pediatric care unit. There were 158 nursing interventions identified as being used at least monthly 50% or more of the nurses. The 32 nursing interventions were used at least daily, indication a set of core interventions unique to pediatric care unit practice. The most frequently used nursing interventions were 'Medication administration: intravenous' & 'Medication administration: oral'. The 27 nursing interventions were rarely performed by 90% or more of the nurses. The rarely used interventions were 'Ostomy care' & 'Rectal prolaps management'. The domain received the highest mean score was Health System, followed by Physiolocal: complex, Physiolocal: Basic, Safty, Community, Family, Behavior domain. These findings will help in building of a standardized language for the pediatric care units and enhance the quality of nursing care.