Using cultural safety to enhance nursing care for children and young people.

People from minority groups frequently experience adversity in various aspects of their lives, including when accessing healthcare services. Culture has a significant role in all healthcare encounters between nurses, multidisciplinary teams, and children and young people and their families. This article defines culture and explains the importance of considering people's cultural values, beliefs and practices when providing care. It outlines the principles of cultural safety - an approach that incorporates ideas such as cultural awareness, sensitivity and competence - and describes how it can enhance the care of children and young people from a wide range of backgrounds.

Parents' decision-making about attending an emergency department with their child.

There is a possibility that front-line services, particularly out-of-hours services, are not accessible to some parents. The aim of this service evaluation was to gain a better understanding about visits to one emergency department (ED) in the south of England by children and their parents or carers. The specific focus was to elucidate the reasons behind frequent ED attendance and indicate a potential redesign of services. Semi-structured interviews were conducted with 13 parents. The overarching theme emerging from the transcripts was parents' complex decision-making to ensure their children's healthcare needs were addressed. Parents highlighted the absence of consistent specialist community services to support them in caring for their children at home and to act as a resource for decision-making relating to their child's care. Telephone and online information services such as NHS 111 were perceived as not always helpful. Parents were able to identify models of out-of-hours care which they saw as potentially more accessible and useful, such as the provision of a specialist paediatrician at GP surgeries. Further evaluation is necessary to make it possible to integrate parents' views and needs into service design and delivery.

Matilda the Musical: the potential value of the arts in children's nursing education.

BACKGROUND: Final-year children's nursing students evaluated the content of their course and there was strong evidence they would benefit from supplementary teaching of safeguarding before qualification. AIM: To explore the potential for the arts to enable children's nursing students to think critically and reflectively about the safeguarding of children and young people. METHOD: An action research approach was used, recruiting final-year children's nursing students in one university in the south of England. Questionnaires containing open and closed questions were used to collect data after a field trip to see Matilda the Musical, followed by discussion boards. FINDINGS: Data analysis indicated the use of the arts was a departure from traditional pedagogy, which was relished and described by the students as an interesting and exciting way of learning. Students highlighted how 'seeing' Matilda aided them later on the discussion boards to identify categories of abuse and correlate this with the effects of abuse. CONCLUSION: The use of musical theatre and discussion boards was beneficial to acquiring knowledge and bonding when delivering safeguarding teaching to final-year children's nursing students.

Considering the future direction of children's and young people's nursing.

Sonya Clark, Senior Lecturer in Children's Nursing at Queen's University Belfast, Emeritus Professor Alan Glasper, from the University of Southampton and Jim Richardson, Senior Lecturer in Children's Nursing at Kingston University and St George's, University of London, discuss the concerns of the academic community.

How professionals should communicate with children who have mental healthcare needs.

Young people with mental health needs are often cared for on children's wards by generalist children's healthcare professionals (CHCPs). Generalist CHCPs find these encounters challenging and difficult but they are viewed as an opportunity to improve the healthcare offered to these young people. The authors secured funding from Health Education South London to design and deliver interactive workshops to improve the communication skills of CHCPs with adolescents in challenging circumstances. In this article, the authors outline the design and content of the workshops and discuss how the workshops explore and challenge the attitudes the participants have that could prevent a young person from seeking support or engaging with professionals. They also describe how the workshops have improved generalist CHCPs' confidence and communication skills when talking with young people and how participants now use these encounters as an opportunity to improve healthcare for children and young people.

Ensuring cultural safety in nurse education.

Nursing courses now have a more culturally diverse mix of students and educators, and students need to consider how this influences learning and how their needs can be addressed. This article describes how the idea of "cultural safety" can promote professionally comprehensive and culturally coherent healthcare education in academic and clinical situations.

Sexual risk behavior and viremia among men who have sex with men in the HIV Outpatient Study, United States, 2007-2010.

BACKGROUND: Recent US data on unsafe sexual behaviors among viremic HIV-infected men who have sex with men (MSM) are limited. METHOD: Using data abstracted from medical records of the participants in the HIV Outpatient Study (HOPS) and a supplemental behavioral survey, we assessed the frequency of high-risk sexual practices among HIV-infected MSM in care and examined the factors associated with risky sexual practices. We also compared the frequency of unprotected anal sex (UAS) with HIV-negative or unknown serostatus partners among viremic (HIV viral load ≥400 copies per milliliter) vs virologically suppressed (HIV viral load <400 copies per milliliter) MSM. RESULTS: Among 902 HIV-infected MSM surveyed, 704 (78%) reported having sex in the past 6 months, of whom 54% reported UAS (37% insertive, 42% receptive) and 40% UAS with a male partner who was HIV-negative or of unknown serostatus (24% insertive, 31% receptive). In multivariable regression with an outcome of engaging in any UAS with a male partner who was HIV-negative or of unknown serostatus, MSM aged <50 years, who reported injection drug use risk, had ≥2 sex partners, and who disclosed their HIV status to some but not to all of their sex partners were more likely to report this practice. Among MSM who reported any UAS, 15% were viremic; frequency of the UAS did not differ between viremic and virologically suppressed MSM. CONCLUSIONS: The high frequency of UAS with HIV-negative or unknown-status partners among HIV-infected MSM in care suggests the need for targeted prevention strategies for this population.

Advanced practice nursing for enduring health needs management: a global perspective.

Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation.

Inter-rater reliability of Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale.

UNLABELLED: Children who are at risk of pressure ulcers need to be identified so that preventative measures can be taken. Most paediatric pressure ulcer risk assessment scales were developed using clinical experience, or by modifying adult scales. The Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale was developed using detailed paediatric inpatient data. AIM: To establish whether the inter-rater reliability of the Glamorgan scale was adequate for use in clinical practice. METHOD: Fifteen qualified nurses randomly selected from staff working on seven paediatric wards or units in a large tertiary referral hospital have participated in the study to date. Nurses asked permission from the children and parents in their care to collect anonymous data in the risk assessment section of the Glamorgan scale. The nurse and the researcher independently assessed the child's risk. Paired risk assessments were later compared and analysed using SPSS. RESULTS: The total risk scores ranged from 15 to 34 (high to very high risk). There was 100 per cent agreement on all items except for 'inadequate nutrition'. CONCLUSION: These preliminary data indicate that the risk assessment scale is reliable. More research on the reliability and validity of this tool with specific paediatric patient groups should be carried out, ideally comparing the performance of this tool with other published paediatric pressure ulcer risk assessment tools.

Cultural safety: an introduction.

Cultural safety is one approach to integrating cultural components into nursing care. It is based on a broad definition of culture and on nurses' analysis of their cultural selves and the impact these have on therapeutic encounters. It is the service user who judges whether the professional relationship feels culturally safe.

Pre-registration children's and young people's nurse preparation. A SWOT analysis.

An investigation was undertaken into the views of nurse educators on current approaches to preparing children's and young people's nurses in the UK. A convenience sample of lead academics in 17 child health nursing departments of British universities was contacted by email and invited to liaise with colleagues to generate lists of the strengths, weaknesses, opportunities and threats (SWOT) of the educational system. Thirteen departments provided data that were analysed and themed. Major themes included the common foundation programme, clinical skills learning, clinical placements and employment. More detailed evaluative work should be undertaken before wholesale changes are made to a relatively new curriculum.

The highs and lows of learning to be a children's nurse.

AIM: This study investigates student nurses' perceptions of the process of undergoing a programme of education leading to registration as a children's nurse. METHOD: Three groups of students (n = 14, 12 and eight) were invited to participate in a focus group using the nominal group technique to address the following questions: What has helped you in the process of becoming a children's nurse? What has hindered you in the process of becoming a children's nurse? RESULTS: The factors which helped students most in their quest to become children's nurses included: the delivery of specialist lectures from child branch nurse lecturers, having good clinical placements with mentors who want to support students, and having the support of friends and family. An important factor was the desire to become a good children's nurse and wanting to work with children. Factors which hindered students included: having unsupportive mentors who misjudge student abilities, lack of academic resources including library reading materials, too many students in each clinical area and.

Peripheral venepuncture in infants and children.

Venepuncture can be a painful and frightening experience for children. Nurses play an active role in helping them to cope with this experience and in reducing the adverse effects of venepuncture. This article explains how infants, children and their families can be supported and cared for before, during and after venepuncture.