Development and testing of the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain.

The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS) is a modification of Ferrell and McCaffery's Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS) (1997). The survey was modified for use with pediatric nurses. Following these modifications, five national content experts in pain management rated the relevance of the items to establish content validity. Using data from 12 subjects, test-retest reliability of the tool was found to be r = 0.67, indicating an acceptable level of stability. The Cronbach's alpha was 0.72 from the responses of 247 pediatric nurses working in a large children's hospital and 0.77 using the responses from 88 members of a pediatric nursing specialty organization, indicating an acceptable level of internal consistency. In keeping with the new standards from the Joint Commission on Accreditation of Health Care Organization (JCAHO), it is recommended that the PNKAS be used to evaluate pediatric nurses' competency in pain management.

Pediatric nurses' knowledge and attitudes survey regarding pain.

PURPOSE: The purpose of this study is to determine pediatric nurses' current attitudes and knowledge regarding pain. METHOD: The Pediatric Nurses' Knowledge and Attitudes Regarding Pain Survey was completed by a convenience sample of 274 nurses at a large children's medical center. RESULTS: Sixty-six percent of the questions were answered correctly. Nurses with their master's degree scored significantly higher (75%). Hematology/oncology nurses (76%), nurses from the intensive care unit (71%), and emergency room nurses (70%) scored significantly higher than nurses from other patient care units. CONCLUSIONS: Pain management knowledge deficiencies were identified, including assessment; pharmacologic management with opioids, nonopioids, and adjuvant medications; risks of addiction; risks of respiratory depression; nonpharmacologic pain interventions; and the treatment of procedural pain, surgical pain, and cancer pain.

Clinical impact of preoperative respiratory syncytial virus testing.

The purpose of this study was to determine if preoperative assessment (i.e., physical examination and history review) of pediatric patients can predict positive test results for respiratory syncytial virus (RSV) infection, surgery cancellations, and adverse anesthetic outcomes. Approximately 400 pediatric patients were identified for the study from infection control statistics and classified by RSV test result and surgery cancellation status into three groups for analyses. Researchers analyzed retrospective chart data of preoperative histories and physical findings using one way analysis of variance to compare age among the groups and Fisher's exact test to compare patient characteristics and signs and symptoms of illness. The results show that active RSV infection cannot be predicted by history and physical findings alone. In addition, patients who had a history of pulmonary disease and who were wheezing at the time of their examinations were more likely to have their surgeries cancelled, independent of positive test results for RSV infection.

Evaluating children's literature as a source for patient education.

Children's literature can be used to educate patients about illness, surgery, and hospitalization. However, nurses must evaluate popular literature for developmental appropriateness and content accuracy. Developmental considerations for selecting appropriate children's literature as patient education material include cognitive abilities, language development, and children's literary preferences. Content accuracy is judged based on current practice. Twenty-three children's books addressing surgery and hospitalization were reviewed by the senior author. A seven-step process was utilized to determine the appropriateness of each piece of children's literature reviewed. Based on the review, four common content inaccuracies were identified: (a) the depiction of nurses and their roles, (b) parental visitation policies, (c) preoperative preparation requirements, and (d) the depiction of inpatient surgeries that are currently performed on an outpatient basis. Only four of the 23 books reviewed were recommended to prepare children for surgery in the authors' community. The process of reviewing a book is demonstrated using the example of Curious George Goes to the Hospital.

Developmental effects on the adolescent of a temporary ileostomy.

Adolescence is an exciting time of transition, as the child breaks away from a dependent role and establishes an independent adult identity. Adolescents vacillate between dependence and independence as they meet the daily challenges of growing up. The adolescent with a chronic illness, however, may find dependence thrust upon him or her by physical condition and health care needs. This article describes how a temporary ileostomy can interfere with the adolescent's ability to master developmental tasks. Initial findings from semistructured interviews of four teenage boys provide evidence of the effects of a temporary ileostomy on an adolescent's psychosocial development.