Community Collaboration: Clinical Experiences at a Pediatric Medical Day Care.

BACKGROUND: Faculty charged with ensuring appropriate clinical experiences for prelicensure students face numerous challenges, including limited access to specialty acute care sites, particularly maternal-child, ambulatory and community settings to prepare students to care for clients outside of the hospital. METHOD: An innovative collaboration with a pediatric medical day care provided prelicensure Bachelor of Science in Nursing students exposure to nursing roles in caring for medically fragile children outside of the acute care environment. RESULTS: Providing care for children with special needs allowed students to make connections between theory and practice, explore developmental concepts, and practice specific nursing skills. Student reflection logs and feedback from the facility staff were enthusiastic and positive about the collaboration. CONCLUSION: Clinical rotations in a pediatric medical day care provided opportunities for students to care for children with medical fragilities and gain new perspectives on nursing roles in the community. [J Nurs Educ. 2023;62(7):420-422.].

A survey of role diversity among advanced practice nurses in pediatric gastroenterology.

A survey of advanced practice nurses in the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN) was conducted to assess role diversity in anticipation of sharing these results with our international colleagues at the World Congress in 2004. A single-page, 14-item survey was sent via e-mail or fax to 79 APGNN advanced practice nurses identified by their credentials (MS, PNP, FNP) in the membership database. Forty surveys were returned via e-mail or fax for an overall response rate of 51%. Most reported working full time as nurse practitioners in an outpatient gastrointestinal clinic, yet almost one third were hospital based. Additional job titles included clinical nurse specialist, researcher, and case manager or clinical coordinator. Slightly more than one half reported seeing any patients in their outpatient practice, whereas 43% saw specific populations, with constipation, gastroesophageal reflux, and abdominal pain being the most common diagnoses. Seventy percent had prescriptive privileges. Billing practices were the most diverse, with 30% always billing under their own number, 23% sometimes billing under their own number, and 40% never billing under their own number (5% not applicable). Overall, most advanced practice nurses in APGNN are pediatric nurse practitioners with a primary focus on outpatient care but also are involved in patient and family teaching, nutrition support, home care, and research. Only a few were involved with procedures, which may be surprising to our adult counterparts.

Methods to confirm feeding tube placement: application of research in practice.

Numerous published studies have demonstrated that conventional methods for documenting proper position of orally or nasally placed feeding tubes in adults are inaccurate. The few available studies done in children indicate similar inadequacies. Auscultation after insufflation of air over the stomach and other less common practices used to verify proper tube position have been shown to be ineffective in predicting correct tube position. Checking pH of aspirate has be recommended as a better method to confirm feeding tube position at the bedside. Careful review of the literature and appropriate application of research findings can lead to change in time-honored nursing practices. Although change is often difficult, a coordinated effort by nurses across organizational lines may facilitate the process.

Probiotic use in children.

Interest in nutritional supplements and functional foods has risen significantly in recent years. Many of the products that are marketed to consumers tout the benefits of probiotics for general good health and for a wide variety of conditions and situations. Although most of these products have been used safely for years, careful analysis of scientific research should be conducted before routinely recommending these products, especially for children. A basic understanding of intestinal flora, properties of probiotics, and clinical research findings is necessary for clinicians to delineate the role of probiotic agents in the pediatric population.