Comparing two methods to obtain blood specimens from pediatric central venous catheters.

The purpose of this study was to test agreement in blood values obtained from a discard method and a push-pull method in samples from central venous catheters in pediatric patients. The discard method causes blood loss beyond what is necessary for blood testing and increases potential for infection each time the central venous catheter is entered. Twenty-eight children ranging in age from 6 months to 12 years were enrolled in the study. A research protocol was developed to pair the 2 methods of blood collection for each sample. The Bland-Altman method was used to test agreement on each blood value for each paired sample. Of the 438 pairs of measured blood values, 420 (95.9%) fell within the limits of agreement. Nurses reported no difficulty in using the push-pull technique to obtain any samples. The push-pull method of obtaining blood specimens from pediatric central venous catheters should be considered. It can eliminate blood loss through discard and can reduce infection because it reduces the number of times a catheter is entered.

Pediatric temperature measurement and child/parent/nurse preference using three temperature measurement instruments.

This study compared the tympanic thermometer with the electronic and chemical dot thermometers used at the axillary site and evaluated child, parent, and nurse preferences for method of temperature measurement. The child's (n = 146) temperature was measured using each of the three methods. Each child, parent, and nurse was asked to select a preference for device and site. Results were analyzed using the Bland-Altman method. Results showed that most of the paired readings fell within the Bland-Altman limits of agreement (LOA). When the chemical dot and tympanic temperature readings were compared with the electronic axillary reading, the tympanic thermometer was found to be in closer agreement. The chemical dot thermometer placed in the axilla consistently read higher than the electronic thermometer in the same site. Children, parents, and nurses preferred the tympanic thermometer.

The effects of infant feeding decisions on infant growth.

ISSUES AND PURPOSE: To determine the effects of feeding decisions on infant growth in the first 6 months of life. DESIGN AND METHODS: Growth measurements were collected twice during the first 6 months of infancy as part of a larger investigation of infant feeding practices (N = 52). RESULTS: Infants who received solid foods before the age of 4 to 6 months weighed less than those who received solid foods after 4 to 6 months. There were no differences in growth measurements between formula-fed and breast-fed infants, although breast-fed infants weighed more at birth. PRACTICE IMPLICATIONS: Emphasize the importance of feeding breast milk (preferably) or formula only for the first 6 months. Advise parents to withhold fruit juices until the infant is at least 6 months old.