PEDIATRICS ARTICLE

Article No.1 December 2011

Hygiene Behaviour Latest Trend in Medication Administration Infection- Control Measures Patient and Parent Education Read Inside!!!

Ongtangco, Antonette M.

BSN IV A

Table of Contents
Hygiene Behaviour . 4 Latest Trend in Medication Administration . 5 Infection- Control Measures . 5 Patient and Parent Education 6

A nurse will always give us hope, an angel with a stethoscope.

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Nurses Can Really Do

Nursing is a healthcare profession focused on the care of individuals, families, and communities to attain, maintain, or recover optimal patients health and quality of life. As defined by Virginia Henderson, The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible. Nurses work in a large variety of specialties where they work independently and as part of a healthcare team. Nurses play a significant role in improving and maintaining patients condition through proper assessment, individual plans of care, implementation, evaluation of patients present health condition and more importantly, increasing patients and relatives knowledge through dissemination of information and provision of health teachings. In the college years, every student nurse undergo self awareness activity in their psychiatric nursing subject that makes him or her to be aware with his or her strengths as well as weaknesses and steps that he or she could take in order to make use all of his or her capabilities in order to be an effective health team member. It enables the student nurses to answer questions such as: Where do I see myself five, ten or twenty years after? Will this field of nursing favours professional growth for me? Will this satisfy my interest and gist in life? Aside from self satisfaction, will this job be financially rewarding? This activity is indeed important in assessing future nurses field of nursing specialty in the near future. The different fields in nursing include public health nursing or community health nursing, private duty or special duty nursing, nursing education, military nursing, school nursing, clinic nursing, industrial or occupational health nursing, and also hospital or institutional nursing. A nurse in a hospital or institutional nursing encompasses wider scope of patient care in the sense that it provides individual patient care in the area in which he or she was designated. Pediatric nursing is an excellent career for those registered nurses who love kids and do not mind hard work as the day of a pediatric nurse can be hectic, working with patients that range from newborns to teenagers. No two days are ever the same, really. The work involved in pediatric nursing is very different from any other types of nursing. Because the patients are young, they need special care. A nurse with a quick smile, endless patience, and a friendly personality can make the experience of staying in a hospital a lot less scary for kids. Pediatric nurses are more able to easily relate to worried parents and other family members. Pediatric nursing holds greater responsibility in providing patient care- being an effective healthcare provider for them is really selflattering.

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In this day and age, clients coming into the hospital are much sicker and therapies are more complex and invasive and as a pediatric nurse, we have to be sure we are providing patient care, therapies and other procedures in the most effective and safest way possible, says David Davis, RN, MN, Director for Medical- Surgical Services at Childrens Hospital Los Angeles. Patient safety has become more complex as the healthcare environment is more complex. With growing nursing education, researches and higher technologies, nurses from corner to corner of the globe are speaking up and working with hospitals to improve pediatric patient care and safety. Seemingly small modifications in areas such as (1) Hygiene behaviour, (2) Proper medication administration, (3) Infection control measures, and (4) Patient and parent education are proving change is possible and essential.

Hygiene Behaviour
Hygiene behaviour is one of the most important factors in patients overall state of health and wellness. It has an impact on individual sense of being well. Oral health care must be the essential in hospitalized patient yet it may be the greatest unmet health need of hospitalized children anywhere even though oral health is recognized as being an essential part of overall health as stated by Gorbova et. al., (2004), it has too often been overlooked and neglected. Many diseases have been associated with oral hygiene behaviour. Poor dental and oral health or oral infection, especially periodontitis, can lead to more a severe illnesses including mouth pain, inability to chew and eat, abscess and soft tissue infection, and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia and may cause a delay in children developmental milestone that leads to diminished self-esteem or impaired school performance. Pediatric nurses are in a unique position to contribute to the health of their patients and should take advantage of the opportunity to provide quality oral health care aimed at health promotion for all children, including those who are hospitalized. A comprehensive oral health care program for hospitalized children includes assessment, oral hygiene, and education. Oral health care for children, especially to those who are critically ill or otherwise, should be an integral part of hospital nursing care. Proper education through performance, demonstration and instruction to the patient or to his or her relatives about proper oral hygiene could only be a simple procedure for the nurse yet, gives a huge benefits. In the clinical area, for example, a patient who has been diagnosed with rheumatic heart disease or those who are place with oral tube feeding must receive a regular oral hygiene to prevent the development of secondary problems such as infections as well as those patients who are immunocompromised or immunosupressed especially those who are taking immunosuppressive drugs in the case of asthma, pneumonia and other- related diseases as they are more susceptible in developing secondary diseases which could affect their mental, physical growth and in more severe cases can lead to death.

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Latest Trend in Medication Administration

When administering medications to patients, before it must be administered, the pediatric nurse must follow the Golden Rules or Rights accordingly as a standard operating procedure. The rights include the right drug to be administred, right patient, right dose, right route, right time, right client assessment or drug history, right documentation, right client education, right to refuse as well as the right to be checked and monitored about potential drug to drug of drug to food interactions. Giving medications of any forms to the patient is a very vital function of a pediatric nurse. A simple error in any of the rules in giving administration to patient can lead to a serious or potentially life- threatening effect to patient who will receive it. To take action with this kind of problem, in California, at Childrens Hospital Los Angeles, patientsafety experts decided to analyze the process of medication administration to identify sources of error. As they followed nurses, the experts found nurses sometimes were interrupted as many as 50 times as they moved from the medication room through the final step of administering the medication. To correct the problem, the hospital instituted a new program in the fall known as Medicus Interruptus. In this new system, nurses wear a bright yellow sash that drapes across their shoulders and hips whenever they are starting the process of medication administration. When this sash is on, physicians, nurses and family members know or aware that the nurse should not be interrupted. Now doctors will stop and say they will come back later because they see I am wearing the sash, says Erin Schmidt RN, BSN, a Medical- Surgical at CHLA. Weve seen a huge decrease in interruptions. Its not pretty to wear it, but its becoming a part of our hospital culture just to promote the patients safety. This new innovated system is not yet implemented here in the Philippine setting especially in the government hospitals but errorfree medication administration must always be observed and be done ethically by the nurses. Nurses must individually check the physicians order and must be aware observant and knowledgeable about the possible reactions or side effects to the patient and manage them appropriately.

Infection Control Measures

When doing procedures to the patient such as parenteral injections, wound dressings, central line dressing, and other basic procedures, it is important for the nurses to apply the basic principles ideally in wherever institution they are belong. Although some changes require longer time to fully apply into practice, healthcare providers sometimes simply need to revisit an existing procedure. Basically, hand washing techniques. There are required times when performing hand washing. That is, it should be performed before and after doing the procedure and every patient to patient contact.
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This technique does not necessarily mean that there would be a 100 percent elimination of development of possible secondary diseases or problem because but, it could help in reducing the number of the existing problem. To attest, a study made at Childrens Hospital of Philadelphia, the cardiac ICU was selected to pilot a project aimed at reducing the number of central line-associated bloodstream infections. Every healthcare member was given a task in the study that had been conducted. One of those healthcare members was Alleyne, a quality coordinator of her unit. She was given a task with improving handwashing techniques among the staff. Rather than nagging co-workers who were not washing their hands at the required times, she tried a different approach. According from her, if she catches people doing the ideal thing, she would give a positive impact, instead. It inspired people to do better. It is better to be the one to lead rather than just writing out a policy. The results of these changes have beenimpressive. After the first year, the number of infections decreased 50% in the cardiac ICU. The second year, the number dropped by an additional 30%. The policy was implemented throughout the hospital, and hospital wide. In addition to improving patient safety, Alleyne is pleased that these new policies are saving money for the hospital. Lately, the hospital also standardized the practice of changing the central line dressing, and contraptions and other equipments which could be a vector for the development of secondary problems. Anyone can inspire other people in improving the working environment-with commitment and teamwork, they are able to overcome any problems.

Patient and Parent Education

Provision of health education and health teachings to patient is a fundamental yet integral part in rendering effective patient care. Increasing the patient and relatives knowledge about the patients condition can give a positive impact to patients health. For example, when a pediatric nurse are stressing-out discharge plans to the relatives of a patient, from birth to 1 year, it is important to keep the hands of their childs clean because at this age, putting their hands into their mouth can satisfy their developmental needs. Provide reading materials during their hospitalization as one of their diversional activities and prevent the boredom in the hospital. Providing things that can make them feel secure as well as emphasizing to the relatives the importance or proper introduction of health care team to their child rather than frightening them that if they are not cooperative, they will be punished by them and will inject them with large needles and it is really painful. This fictitious information can lead to misapprehension of the child to healthcare member and make them be uncooperative. It is also important to educate them about the safety and security as these ages are very curious and inquisitive which make them be more physically active and sometimes try unnecessary movement which make them vulnerable to physical harm and injury. Educating the relatives about the patients condition and the side effects or any untoward reactions of the procedures or medications is very helpful. For example when the patient was prescribed drugs that give an adverse reaction can help them to determine when to report the symptoms and withhold the drugs as advised by the physician. This simple health teaching can save the patient life especially in emergency situation.
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Nurturing or nourishing as a short definition of nursing holds an enormous impact to patients health. During the school years, every student nurses was given their opportunity to think and choose about what fields in nursing according to what they think they are well- versed. Caring for a pediatric patient is a challenging role for a nurse because their frame of mind can sometimes be unpredictable. Being friendly and bringing longer tolerance to them can help the nurse to build a harmonious relationship and can develop the conviction of a nurse so that he or she can render patient care effectively and efficiently. The growing trend in the field of nursing continuously innovate the existing nursing practice. Researches and studies have been developed through the years with the aims of delivering the best nursing care to the patient and in regaining or maintaining their wellness. It has been identified in the previous studies that small modifications in the existing nursing care bestow a great positive impact on patients health. Be just the first to act and lead in improving the environment. Take the chance as the opportunity for gaining benefits between you as learning and sense of self- growth and your patient as a beneficiary of a quality patient care. Keep in mind that we, as nurses really do great things to patients health.

The attitude or belief of a nurse of just rendering care to the patient is not good enough. Instead, we, near future nurses should render quality patient care and be their advocate that will enable them to improve their state of health or their faster recovery as well as to promote their sense of well- being.....

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Remarks:

Grade:
References:
Alleyne, Felicia (March 2011). Registered Nurse in the Cardiac Care Center at Childrens Hospital of Philadelphia, United States of America. Gorbova & John (2004) U.S. Department of Health and Human Services [USDHHS] Schmidt, Erin (2011). Medical- Surgical at Childrens Hospital at Los Angeles, California.

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