Trends in umbilical cord care: Scientific evidence for practice

To provide an increasing body of knowledge related to umbilical cord care, a literature review was conducted to study the evolution of umbilical cord care, to evaluate the scientific evidence used to guide practice changes, and to make recommendations for current practice. Historically, there has been a wide range of inconsistent practices related to umbilical cord care that have included a variety of cleansing agents and techniques. The findings of this literature review indicate that the current standard of umbilical cord care may be based on historic practices and traditions rather than scientific investigation and justification. There appears to be little support for continued alcohol use. Yet, insufficient evidence is available to support an immediate change in the standard of care from topical antimicrobial treatment of the umbilical cord to natural healing. Further research is recommended to evaluate natural healing and to establish evidence-based recommendations for practice.     

Adolescent Perceptions of Relevant Social Problems

PROBLEM: Social problems can be a significant stressor for adolescents. Disturbed youth often experience negative outcomes to social problems, solve problems poorly, and display distortions in reasoning about social problems. METHODS: A series of focus groups was conducted with adolescents (N = 36), and the data was analyzed inductively. Activities to increase the rigor of the study data (establishing credibility, trustworthiness, and transparency) were incorporated into the phenomenological research design. FINDINGS: Five social problem themes with critical attributes were perceived to be relevant to teenagers in today's society. CONCLUSIONS: Adolescents' social problems shift in response to a changing society. Findings from this study can be used to help target assessments and treatment plans when working with disturbed youth.     

Nurse Practitioners' Use of Nursing Diagnoses

"Where are We Now?" is an occasional feature in Nursing Diagnosis. The column focuses on current issues and trends related to nursing diagnosis development, implementation, and evaluation.     

Catchers in the Rye: Treatment Foster Parents as a System of Care

PROBLEM: Similar to the children in J. D. Salinger's novel, The Catcher in the Rye, youth in foster care face the specter of "going over the cliff." METHODS: The empirical basis for "treatment foster care" is reviewed, concluding that treatment foster care is both a clinically and cost-effective form of community-based treatment. FINDINGS: Treatment foster parents prevent the fall of foster youth into the chasm of school failure, involvement with juvenile justice, and dependent living as adults. CONCLUSION: Treatment foster care is an evidence-based approach that is less restrictive and offers troubled youth an opportunity to engage and grow within a family setting.