The Voice of Travel Nurses: Facilitating Effective Staffing During Pandemic and Expansion-Related Demands in a Children's Hospital.

OBJECTIVE: The aim of this study was to explore the experience and perceived value of travel nurses in a children's hospital. BACKGROUND: Children's hospitals face unique challenges related to highly specialized care requirements and workforce expansion limitations. Travel nurses can augment nurse staffing capacity during times of intense demand and may offer insights as organizations seek to strengthen work environments. METHODS: Pediatric travel nurses currently contracted at the hospital were invited to participate in a focus group or interview. Content analysis was used to summarize information and identify themes. RESULTS: From the 56 participants, 5 themes emerged. The themes were financial, flexibility, searching for healthy work environments, nursing care, and solutions. CONCLUSIONS: Hearing the voices of travel nurses may offer valuable feedback to strengthen future professional practice environments.

Novel Deployment of Pediatric Biocontainment Unit Nurses in Response to COVID-19.

ABSTRACT: Most existing biocontainment units (BCUs) in U.S. hospitals are designed to care for a limited number of patients infected with epidemiologically significant pathogens. The COVID-19 pandemic presented substantial challenges to hospital preparedness and operations because of its high incidence rate and the high risk of transmission to staff members. This article describes a novel practice innovation: a hospital-wide deployment of nurses on a trained BCU team to support hospital staff in safely caring for patients with COVID-19. Their responsibilities included assisting in the development of guidelines and providing training on safety protocols and the appropriate use of personal protective equipment. The authors show how this deployment contributed significantly to staff education and support during the pandemic.

Iatrogenic withdrawal syndrome in specialty pediatric critical care.

AIM: To describe the occurrence of opioid and benzodiazepine withdrawal symptoms in a cohort of pediatric intensive care unit (PICU) patients, the characteristics of this group, and patterns of withdrawal scoring observed during medication weaning. BACKGROUND: Patients in the PICU are a complex and vulnerable population. Opioids and benzodiazepines are routinely administered in this setting. Providers must be equipped to recognize and assess symptoms of narcotic and benzodiazepine withdrawal. METHODS: A retrospective chart review was conducted to describe all patients admitted to the medical intensive care unit who received continuous infusions of morphine and midazolam during a one-year period. Patient demographics, diagnosis, and presence of co-morbidities were abstracted. The number of days on continuous infusions was measured, along with Withdrawal Assessment Tool-1 (WAT-1) scores and documented symptoms that could be associated with withdrawal. WAT-1 scoring ranges from 0 to 12, a WAT-1 score of 3 or higher is considered to indicate clinically significant withdrawal symptoms. Descriptive statistics were utilized to summarize demographic and clinical variables. RESULTS: Among 60 cases, patient ages ranged 5 weeks to 29 years (median 3.5 years). Eighty percent of patients had a primary respiratory diagnosis and 88.3% had one or more co-morbidities. Forty-four patients (73.3%) had symptoms consistent with withdrawal. Thirty-one percent of patients had a maximum WAT-1 score between 3 and 8. The majority of patients (55%) had a history of opioid and/or benzodiazepine exposure. CONCLUSIONS: The information learned highlights the need for ongoing conversation and continued study of how best to assess and manage withdrawal syndrome in pediatric critical care environments.