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61.
AimThe aim of this study is to investigate nurses’ experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward.BackgroundStudent mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients.Design and methodIn this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward.ResultsMeetings with children’s destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role.ConclusionAll participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents’ and nurses’ roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country. 相似文献
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63.
《Australian critical care》2022,35(6):668-676
AimThe aim of this study was to develop an evidence-based paediatric early warning system for infants and children that takes into consideration a variety of paediatric healthcare contexts and addresses barriers to escalation of care.MethodsA three-stage intervention development framework consisted of Stage 1: evidence review, benchmarking, stakeholder (health professionals, decision-makers, and health consumers) engagement, and consultation; Stage 2: planning and coproduction by the researchers and stakeholders using action research cycles; and Stage 3: prototyping and testing.ResultsA prototype evidence-based system incorporated human factor principles, used a structured approach to patient assessment, promoted situational awareness, and included family as well as clinician concern. Family involvement in detecting changes in their child's condition was supported by posters and flyers codesigned with health consumers. Five age-specific observation and response charts included 10 weighted variables and one unweighted variable (temperature) to convey a composite early warning score. The escalation pathway was supported by a targeted communication framework (iSoBAR NOW).ConclusionThe development process resulted in an agreed uniform ESCALATION system incorporating a whole-system approach to promote critical thinking, situational awareness for the early recognition of paediatric clinical deterioration as well as timely and effective escalation of care. Incorporating family involvement was a novel component of the system. 相似文献
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66.
Joanne Embree 《Paediatrics & child health》2005,10(5):261-263
HIV infection and AIDS among children continues to be a significant problem in developing countries despite the progress that has been made in HIV prevention and AIDS treatment elsewhere during the past two decades. The reasons for this difference are complex and multifactorial. They include the higher background prevalence of infection among adults in some communities in developing countries, the slow implementation in many countries of prenatal HIV screening programs and prophylaxis which can reduce the transmission to infants during labor and delivery, the social and health consequences of not breastfeeding, and the economic realities associated with expensive diagnostic testing and antiretroviral treatment. While the world waits for an effective HIV/AIDS vaccine, to reduce the prevalence of HIV in the community, public health programs need to continue to emphasize proven methods of HIV transmission prevention among groups with a high-risk of HIV acquisition, as well as provide counselling for the general population about personal protection and the provision of compassionate care for those affected. 相似文献
67.
Rhabdoid tumour of the kidney is not common. Presentation of such a lethal tumour along with blunt abdominal trauma is even
rarer. We report such a case of Rhabdoid tumour of kidney which presented as renal trauma, and discuss the diagnostic difficulties
and rapidly fatal outcome.
Accepted: 3 February 1999 相似文献
68.
To assess the pediatric risk of mortality (PRISM) score as a prognostic scoring system in severe meningococcal disease, the
files of 53 consecutive patients admitted to a tertiary pediatric intensive care with a clinical diagnosis of meningococcal
disease and positive cultures from blood and/or cerebrospinal fluid were analysed. PRISM-score-based expected mortality was
compared with observed mortality. Expected mortality in the whole study population was 29% while observed mortality was 19%
(P < 0.05). The highest expected and observed mortality was found in septicaemic patients without (documented) meningitis, while
meningitis patients without septicaemia had the lowest mortality. All patients with a mortality risk below 18.3% (n = 29) survived whereas all those with a mortality risk of 65% or higher (n = 7) died. Of the 17 patients with a mortality risk between 18.3% and 63.9%, 14 survived and 3 died. The area under the receiver-operating
characteristic (ROC) curve was 0.94, which is at least comparable with the best-performing meningococcal-disease-specific
scoring systems.
Conclusion The PRISM score is a useful generic measure of severity of illness in meningococcal disease and can be used to determine
the effectiveness of different treatment strategies.
Received: 5 May 1999 / Accepted: 11 January 2000 相似文献
69.
Merc Pineda Javier Arpa Raquel Montero Asuncin Aracil Francisco Domínguez Marta Galvn Anna Mas Loreto Martorell Cristina Sierra Nuria Brandi Elena García-Arumí Miquel Rissech Daniel Velasco Juan A. Costa Rafael Artuch 《European journal of paediatric neurology》2008,12(6):470-475
BACKGROUND: Antioxidant therapy is a new therapeutical approach for patients with Friedreich ataxia. AIMS: To assess the effectiveness of long-term idebenone treatment in Friedreich ataxia patients. METHODS: An open-labelled prospective study. Ten paediatric patients (age range 8-18 years) and 14 adults (age range 18-46 years) with genetic diagnosis of Friedreich ataxia were treated with idebenone (5-20mg/kg/day) for 3-5 years. Neurological evolution was evaluated using the International Cooperative Ataxia Rating Scale (ICARS), and cardiological outcomes using echocardiography. RESULTS: In paediatric patients, no significant differences were observed in ICARS scores and echocardiographic measurements when comparing baseline status and after 5 years of follow-up. Concerning adult cases, ICARS scores showed a significant increase in neurological dysfunctions during 3 years of therapy (Wilcoxon test, p=0.005), while echocardiographic measurements remained unchanged. CONCLUSIONS: Our results indicate that longer-term idebenone treatment prevented progression of cardiomyopathy in both paediatric and adult patients, whereas its stabilizing effect on neurological dysfunction was present only in the paediatric population, mainly before puberty. This suggests that the age at which idebenone treatment is initiated may be an important factor in the effectiveness of the therapy. 相似文献
70.
Role of inhaled nitric oxide as a selective pulmonary vasodilator in pediatric cardiac surgical practice 总被引:3,自引:0,他引:3
Murthy KS Rao SG Prakash KS Robert C Dhinakar S Cherian KM 《Indian journal of pediatrics》1999,66(3):357-361
Our aim was to assess the role of inhaled nitric oxide (NO) therapy in post operative cases of congenital heart defects who
developed pulmonary arterial hypertensive (PAH) crisis and had no response with conventional management. From February '95
to January '97, inhaled NO therapy was used in 21 children. Age ranged from 2 months to 9 years (mean 5.6 years) and duration
of therapy ranged from 1 to 13 days. Of 21 patients, 17 responded well with 5–20 ppm while 4 did not. The preoperative mean
pulmonary systolic pressure was 88 mm Hg against mean systemic pressure of 96 mm Hg. Post operatively, their PA pressure reduced
to 62 mm Hg, with systemic pressure of 98 mm Hg. After using inhaled NO, PA pressure dropped to 24 mm Hg (mean systolic) (p<0.007),
after excluding the non responders. Of 4 non responders, two died due to irreversible pulmonary vascular disease and remaining
two died due to residual defects. The study shows that inhaled NO is a selective pulmonary vasodilator, which is useful in
postoperative PAH crisis and also reduces the transpulmonary gradient in single ventricle repair cases. It is safe and effective
for prolonged use. It is very useful in Indian perspective, when more number of cases with congenital heart defects (CHD)
alongwith severe PAH are encountered routinely. 相似文献