Background

According to report of Educational Training of Research Staff Involved in Pediatric Clinical Trials / GCP Training across multispecialty and countries, there is lack of research nurse in some regions of Europe. One of such areas is Pediatric Intensive Care in Poland.

Objectives

The aim of the study was to compare situation in EU and determine the deficits of research nurse in central Europe. It was also checked the legal support in Poland for nurses to carry out or participate in clinical trials in pediatric care.

Methods

Review of world literature included PubMed, Medline was conducted. Review of Polish legal medical and science system was conducted.

Results

In majority European Union countries research nurse is present during clinical trials. 43 % nurses are fully satisfied with the level of training received and only 9% were not. In 75 organizations from 15 countries EU research nurse are present – Poland not included due to the lack of meaningful nursing research. It may be due to the fact that in the highest reference pediatric hospital in Poland work almost 800 nurses, 100 work within the PICU, of which only one participated in the initial GCP training. Further national survey will be conducted.

Conclusion

There is lack of legal support for nurses to conduct scientific research especially in the field of pediatric anesthesiology in Poland . The international organization such as EnprEma, WHO, EC, EMA should encourage polish nurses scientific associations to conduct more research and create GCP in field of research nursing.

Background

Patient safety is the prevention of medical errors and adverse effects to patients associated with health care. Patient safety is the cornerstone of high-quality health care. In a Children’s Clinical University Hospital of Riga (BKUS) patient safety principles were implemented almost 10 years ago. Central venous access is a routine procedure performed in many departments of the hospital where the risk prevention is paramount. Central line complications during and after their insertion can cause a significant healthcare burden in cost and patient’s length of stay and quality of life.

Objectives

The aim of the study was to analyse knowledge and skills of nursing staff in central venous line care, infection prevention and safe use.

Methods

During the period from December 2017 to January 2018 a nursing stuff survey has been done. Data are summarized and analysed comparing with international practice guidelines (CDC, WHO).

Results

103 responses were collected from all departments with central line patients in the last year. The answers point to a wide variety of care.

Conclusion

The findings confirm a lack of unified care training and guidance.

There are signs of unsafe use of heparine.

The change of central line dressing rather is done too often (39%) than too less.

It puts the patient at an unnecessary risk. This leads to ineffective use of resources and materials, which is linked to increased costs and risk of infection for the patient.

At the next stage we plan to develop and implement a practical guide for care of central lines and training programme.

Background

Fear of the unknown and the unexpected is common among caregivers (i.e., the parents and relatives who provide care) of children with hydrocephalus, and the lack of adequate information should be minimized. Recently, we created and validated an education booklet in for hydrocephalus aimed to empower caregivers of children.

Objectives

Translate the Brazilian version of the booklet "Laura's diary: knowing hydrocephalus and its treatment" for the Spanish language of Spain.

Methods

Methodological study, conducted in Spain (Universidad Santiago de Compostela) and Brazil (Botucatu Medical School – UNESP). The procedure followed the steps of translation (two Brazilian translators with fluency in the Spanish language), synthesis (Spanish nurse with experience in education) and back translation (Brazilian translator and nurse with fluency in the Spanish language). Finally, convergences and discrepancies between the translated/original and the versions for the Spain context were compared.

Results

The two versions of the initial translation arrived at similar results, with few necessary adjustments in the consensus meeting between the researchers for achieving the synthesis of the translations. The two versions of the back-translation indicated that they were highly similar to the original content. The next step will be a submit to the committee of specialists for consideration.

Conclusion

Free Spanish was introduced in the form of a 21-page journal entitled, “Diario de Laura: Conociendo la hidrocefalia y su tratamiento”, to help recognize the role of nurses, minimize the negative impact of surgery, and empower families. In addition, the booklet is expected to be useful tool in future research.

Background

This abstract is a personal reflection on neonatal nursing and research experience in clinical practice at the neonatal intensive care unit.

Neonatal nurse`s perform a vital role in management of the sick infant. Considering modern neonatal unit with the extensive complex treatment options for neonates, it is relevant to implement clinical research skills to day-to-day nursing practice.

Objectives

To reflect on clinical nursing practice and research experience to determine whether neonatal nurse role is feasible to expand and assisted by adequate sources.

Methods

The information is grounded on my personal fact-based practice and presented retrospectively.

Results

During my experience as a neonatal nurse, I have cared for a variety of vulnerable babies, from extremely small preemies to term or even post term infants undergone surgery.

I enhanced my skills in the neonatal research based on secondment. I found it very interesting and I eager to learn more.

Secondment to research is a practical but it is not guaranteed. The significant impact related to my work and personal satisfaction had parental contribution.

Most of neonatal nurses are presenting unique skills as a team leader and incorporating decision-making management duty with quality improvement audits. However, shifts intensity and wide range of responsibilities with external expectation has impact on work performance.

Overcoming these challenges require adjustment in nursing education programme and salary.

Conclusion

Clinical neonatal nurse`s undertake a significant number of roles leading to contribution of delivering high standard of neonatal care to infants and families but it could be potentially overwhelming and affect the outcome.

Background

Breastfeeding brings many benefits both to mother and child’s health¹. Not only in a “somatic sense” (e.g. preventing infectious diseases), but also in regard to the mental health of those involved. However, many factors (such as maternal feelings) interfere with a successful breastfeeding initiation².

Objectives

This cross-sectional exploratory study aims to understand the maternal experience of breastfeeding onset and how psychological variables may interfere with it.

Methods

395 women, 27.7 years old (±6.7), who gave birth at University Hospital of Brasilia were interviewed within 48h to 6 days after childbirth. The parameters considered for mother's experience evaluation were: mother’s pleasantness in first attempts to breastfeed and pain during breastfeeding. The scales applied were Perceived Maternal Parenting Self-Efficacy (PMP SE), Pain Catastrophizing Scale-Parental version (PCS-P)and Edinburgh Postnatal Depression Scale (EPDS).

Results

Unpleasant breastfeeding experience shows to be positively related to how many days the pain lasts; onset of breastfeeding; search for information about pregnancy and baby caring and vaginal delivery (p<.01); and it was negatively related to highest scores at the catastrophizing scale specially in rumination and hopelessness (p<.040). Pain levels were positively correlated to longest periods in days of pain, later onset of antenatal consultations and depression (p<.050).

Conclusion

The relationship between those factors (maternal perceived self efficacy, anxious and depressive thoughts, catastrophizing behaviours) and a pleasant breastfeeding experience is not always intuitive. They need to be individually evaluated in order to elucidate when and how to intervene from the point of view of the health professional.

Background

Background: Hyperbilirubinemia is a common physiological problem in newborn. Massage is a non-invasive therapeutic technique. It does not require any special technology or equipment; can easily be carried out alongside classical medicine and can decreas side-effects.

Objectives

Objectives: To evaluate the effects of baby massage on total serum bilirubin (TSB) levels and stool,urine and breast-feeding frequency in full-term infants with hyperbilirubinemia.

Methods

This randomized controlled study was conducted 50 full-term infants with hyperbilirubinemia undergoing phototherapy. The infants were randomly allocated to two massage and control group (massage group=25, control group=25). Main variable studied were TSB, breast-feeding, stool and urine frequency which were compared in two groups.

Results

Result: In the study, the subject characteristics of the babies in the massage and control groups were similar (p> 0.05). While there was no difference between groups at the beginning of study the Total Serum Bilirubin Levels (TSB), at the end of study TSB level was lower the babies in intervention group (p<0.05). Breastfeeding, defecation and urinary frequency of the babies in the intervention group were higher than the control group (p<0.001).

Conclusion

Conclusion: The study has shown that massage therapy has a singificant effect in TSB, breast-feeding, stool and urine frequency of infants suffreing from hyperbilirubiinemia undergoing phototherapy.

Background

Hypothermia in premature infants is high despite all interventions.

Objectives

Compare the efficacy of plastic cap and cotton cap to heat loss in preterm infants at ˂32 gestation age.

Methods

This study was a randomized, controlled trial conducted in the NICU (Neonatal Intensive Care Unit) of public hospitals in Ankara, Turkey. Participants were ˂32 gestation age premature infants who randomly allocated to polyethylene cap (experimental group) or cotton cap (control group) at a 1:1 ratio. Body temperature of newborns was measured twelve times after birth (5., 10., 15., 20., 40., 40. min and 1., 2., 3., 4., 5., 6. hours).

Results

36 newborn completed the study. In the polyethylene cap group, all of temperature measurement in 1 hour after birth were significantly higher than in the control group (p<0.05). Other measurements (2., 3., 4., 5. and 6. hour) were no significant between experimental and control groups (p>0.05).

Conclusion

We are suggest that new studies with a larger sample size to be compared with a present study.The polyethylene cap is an effective barrier to the prevention of hypothermia <32 gestation prematüre infants.

Background

Preterm birth is often associated with increased parental stress, worry and anxiety, during and after admission to a Neonatal Intensive Care Unit (NICU)

Objectives

Aim of the present study was to analyse, if there is an age-dependency of parental stress after birth of a preterm neonate admitted to NICU and if there is a difference between mothers and fathers.

Methods

A prospective observational study was conducted at the NICU, Medical University of Graz, Austria. 50 mothers and 50 fathers received the PSS:NICU questionnaire within 72 hours after preterm birth of their neonate, which has been admitted to the NICU immediately after birth. This questionnaire measures parental stress via the three subscales “Looks and Behave of the Child”, “Parental Role Alteration” and “Sights and Sounds”. For analyses age of mothers and fathers were correlated to values obtained from the subscales of the PSS:NICU.

Results

47 mothers (age 30.5±5 years) and 47 fathers (age 33±6 years) were included for analyses. There was a significant increase in the stress subscale “Looks and Behave of the child” with increasing age of the mother, whereby “Parental Role Alteration” and “Sights and sounds” did not show a significant correlation with maternal age. No significant correlations of age of the father with any subscale of the PSS:NICU were observed.

Conclusion

Age-dependency of stress experience after preterm birth differs between mothers and fathers. This observation should to be taken into account when supporting mothers and fathers of preterm neonates admitted to NICU.

Background

Children are not small adults. Physically, physiologically and emotionally there are big differences in clinical symptoms as well as in vital signs and they have the right to adapted and equal health care. In adult intensive care units, material and the environment is not adapted for children. The intensive care nurse feels anxiety and stress related to lack of experience and knowledge.

Objectives

to uncover challenges adult intensive care nurses experience when caring for children in the ICU.

Methods

Eight semi-structured interviews were conducted with intensive care nurses working in two different hospitals in Mid Sweden. To analyze the data a method inspired by phenomenography was used.

Conclusion

Children’s vulnerable position in health care is clearly revealed in this study. The challenges intensive care nurses face caring for children in ICU produces fear as a result of lack of adequate experience and knowledge. In addition to fear, there is emotional involvement in the severely ill child and the child’s family, which affects on a personal level. In‑service training and a good learning environment are required. However, the teamwork and bedside care around the child promotes closer cooperation between colleagues as well as the transition of knowledge. The care environment of an ICU is not fully adapted to the complex care of a critically ill child.

Background

Newborns in NICUs experience many painful procedures. Nonpharmacological managements such as massage therapy and Kangaroo care are shown to reduce pain after procedures.

Objectives

In this study our aim was to compare the effect of oral 10% dextrose solution, 5 minutes of massage therapy and 5 minutes of Kangaroo care on NIPS scores after venipuncture in newborns.

Methods

Newborns with gestational age ≥34 weeks in NICU or rooming in with their mothers were randomly enrolled to one of three groups and a blinded investigator scored the pain using NIPS before and after the procedure.

Results

There were 27, 26 and 23 newborns in dextrose, massage and Kangaroo care, respectively. There were no statistically difference between groups in terms of gestational age, gender, birth weight, time of last feeding, feeding with mother milk/formula and venipuncture site. Pain scores were similar before and after venipuncture in groups (p> 0.05). After the procedure, infants with a score of 0-2 (no pain) included 40.7%, 46.2% and 43.5%; infants with a score of 3-4 (light- moderate pain) included 29.6%, 7.7% and 13% and infants with a score of 5-8 (severe pain) included 29.6%, 46.2% and 43.5% of the groups in dextrose, massage and Kangaroo care, respectively (p> 0.05). Although number of infants with severe pain score was lower in dextrose group, difference was statistically nonsignificant.

Conclusion

Although nonpharmacological methods were used, almost one third of the infants experienced severe pain. So our aim should be to decrease the number of invasive procedures in NICUs.