Paediatric nurses' experiences of success and failure in first-time peripheral intravenous catheter insertion: A qualitative study.

PURPOSE: To explore in-depth the thoughts, anxiety factors, and experiences of paediatric nurses regarding the success and failure of first-time peripheral intravenous catheter insertion. DESIGN AND METHODS: The study employed a qualitative research method using the phenomenology design. Face-to-face semi-structured in-depth interviews were conducted with nurses (N = 12) working in the paediatric service and neonatal intensive care unit of a teaching and research hospital. The transcripts were analysed using a phenomenological approach and an inductive process. RESULTS: Four themes were identified: Peripheral Intravenous Catheter Insertion, Experience of Success on the First Attempt, Experience of Failure on the First Attempt, and Proposed Solutions. Nurses felt a sense of happiness when they successfully inserted a peripheral intravenous catheter on their first attempt in paediatric patients. Conversely, they experienced emotions such as sadness, worry, stress, and anxiety when they failed and had to make repeated attempts. CONCLUSION: Unsuccessful peripheral intravenous catheter insertions cause distress and anxiety for nurses, patients, and parents alike. Therefore, nurses' experiences of peripheral intravenous catheter insertions in healthcare settings should not be ignored and require improvement. IMPLICATIONS FOR CLINICAL PRACTICE: Unsuccessful peripheral intravenous catheter insertions affect children, parents, and nurses negatively, thus reducing the success rate of repeated peripheral intravenous catheter insertions. Therefore, it is advisable for nurses conducting paediatric peripheral intravenous catheterisations to undergo periodic training. A specialised intervention team should be established for cases of initial failure, and a mentoring system between seasoned and new nurses is recommended.

Moral Distress and Its Relating Factors Among Pediatric Emergency Department Nurses: A Cross-Sectional Study.

OBJECTIVES: Emergency services are patient circulation units that require chaos, trauma, and high tension. It was aimed to determine the moral distress levels of pediatric nurses in pediatric emergency and emergency departments and relevant factors. METHODS: This study is a descriptive and cross-sectional study. It consists of 255 nurses with their data. The Participant Information Form and the Moral Distress Scale-Revised for Pediatric Nurses (MDS-R) were used to collect data. RESULTS: In the study, the mean score of MDS-R frequency was found to be 27.36 ± 13.16, the mean score of MDS-R intensity to be 37.65 ± 17.53, and the mean total score of MDS-R to be 58.96 ± 39.40. It was determined that 93.7% of the nurses received training on moral distress, and education level was effective on moral distress levels of the nurses. The nurses working in the pediatric emergency service had higher moral distress levels than the nurses serving pediatric patients in the emergency department ( P(total MDS-R) = 0.02, P(frequency of MDS-R) = 0.008). Job satisfaction ( P(total MDS-R) = 0.003, P(frequency of MDS-R) < 0.001, P(intensity of MDS-R) < 0.001) and frequency of thinking about changing working unit ( P(frequency of MDS-R) = 0.02, P(intensity of MDS-R) = 0.01) were found to be effective on the level of moral distress. It was determined that the type of emergency service, the working time in the emergency service, and the level of job satisfaction significantly affected the total moral distress scores of the nurses ( P < 0.001, R2 = 0.09). CONCLUSIONS: It was found in the study that nurses had low levels of moral distress; however, many factors relevant to working conditions were associated with moral distress. The pediatric emergency service nurses were determined to experience a higher moral distress compared with the emergency department nurses serving pediatric patients.

Pediatric nursing students' self-efficacy regarding medication administration and clinical comfort and worry: A pre-posttest comparative study of nurse mentoring versus peer mentoring.

AIM: This study aimed to examine the effect of mentoring practice by graduate nursing students and clinical nurses on students' self-efficacy in pediatric medication administration, clinical comfort and worry levels of students taking pediatric nursing courses. BACKGROUND: Children are a highly sensitive group against medication administration errors. Improving the self-efficacy of student nurses who will work with this group toward medication administration is essential. Mentoring programs can increase students' skills and self-efficacy by reducing their stress levels during clinical practice. DESIGN: The research is a two-group pretest-posttest randomized controlled experimental research design. SETTINGS: The study was conducted in the pediatric units of a training and research hospital located in the Western Black Sea region of Turkey between October 1, 2022 and December 30, 2022, as part of the clinical practice of the Pediatric Nursing course in the fall semester of 2022-2023. PARTICIPANTS: The study sample consisted of 143 students (peer mentoring group=73, nurse mentoring group=70) who were 3rd-year students taking the pediatric nursing course. METHODS: Participant information form, Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSCNS) and Pediatric Nursing Students Clinical Comfort and Worry Tool (PNSCCWT) were administered to the students before the clinical practice. Then, the groups received mentoring practice in the clinical practice area for 14 weeks. At the end of the practice, MASSCNS and PNSCCWT were administered to the students again. RESULTS: The groups were homogeneously distributed when compared according to descriptive characteristics (p > 0.05). The self-efficacy scores of the students in both groups after clinical practice were significantly different from those before clinical practice (tnurse=-4.724, pnurse=0.000 <0.05; tpeer=-3.742, ppeer=0.001 <0.05). CONCLUSIONS: This study's results indicate that nurse mentoring and peer mentoring effectively increase nursing students' self-efficacy during pediatric clinical practice. While nurse mentors decreased students' worry, peer mentors increased students' clinical comfort levels.

The relationship between the nutritional literacy level and heart health attitudes of adolescents.

PURPOSE: It was aimed to evaluate the effect of adolescents' nutritional literacy level on their heart health attitudes. METHODS: This is a descriptive and cross-sectional study. Data from 416 adolescents were obtained in the study. The Adolescent Nutrition Literacy Scale (ANLS) and the Cardiovascular Health Behavior Scale for Children (CHBSC) were completed by participants. The adolescents' demographic information, lifestyle, and diet habits were collected. The results were analyzed using descriptive statistics and multivariable regression. RESULTS: The participants' mean scores of the ANLS and the CHBSC were as 68.30 ± 8.68 and 67.55 ± 8.45, respectively. It was determined that 88.7% of the adolescents had moderate attitudes towards heart health and that there was a weak and negative correlation between the ANLS and CHBSC scores (r = -0,207; p < 0.001). It was determined that there was a statistically significant difference in ANLS and CHBSC scores in terms of gender, Body Mass Index (BMI), fast food consumption frequency, what they primarily pay attention to in food, weekly exercise frequency, the amount of daily water consumption, general health status and reading the label of packaged products (p < 0.05). It was determined that exercising, general state of health, BMI, consumption of fast food, and reading the label of packaged products were key predictors of CHBSC scores. Additionally, exercising, consumption of fast food, and reading the label of packaged products were identified as key predictors of ANLS scores. CONCLUSIONS: Our analysis suggests that higher levels of nutritional literacy are related to more positive attitudes towards heart health in adolescents. Additionally, our analysis identifies key predictors of both nutrition literacy and heart health behaviors. PRACTICE IMPLICATIONS: School health nurses should consider the variables influencing these parameters to improve attitudes towards nutritional literacy and heart health in adolescents.

Effect of Intravenous Infiltration Management Program on Peripheral Intravenous Catheter Success and Infiltration in Hospitalized Infants.

BACKGROUND: Peripheral intravenous catheter (PIVC) insertion is the most frequently used method for intravenous (IV) treatment in pediatric patients. PURPOSE: The aim of this study was to determine the effect of the Intravenous Infiltration Management Program on the success of PIVC insertion and infiltration in infants. METHODS: The study was carried out using a quasi-experimental design with pretest-posttest control groups and included 750 PIVC procedures for 218 infants between 28 days and 12 months of age. RESULTS: The program decreased the number of PIVC insertions per patient, although it was not statistically significant (P = .076) and had an impact on the success of the PIVC attempt (P < .001), first PIVC attempt (P < .001), PIVC dwell time, and early detection of infiltration (P < .001). CONCLUSION: The program is effective in the success of the PIVC insertion process and early detection of infiltration.