63 277 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
63-277 PowerPoint Presentation
Download Presentation
63-277

Loading in 2 Seconds...

play fullscreen
1 / 56

63-277 - PowerPoint PPT Presentation


  • 136 Views
  • Uploaded on

63-277. NURSING CARE OF CHILDREN & YOUTH WITH EPISODIC AND LONG-TERM HEALTH NEEDS. Introduction to 63 277. Review of course outline Review of competency performance assessments Policies Texts & Resources- DVD Clickers – class participation Clinical component 63 274.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about '63-277' - hasad-mckee


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
63 277

63-277

NURSING CARE OF

CHILDREN & YOUTH

WITH EPISODIC AND

LONG-TERM HEALTH NEEDS

introduction to 63 277
Introduction to 63 277
  • Review of course outline
  • Review of competency performance assessments
  • Policies
  • Texts & Resources- DVD
  • Clickers – class participation
  • Clinical component 63 274

63-277 Winter 2006

what is pediatrics
What Is Pediatrics ?
  • Who are the clients ?
  • What is the setting ?
  • What is nursing’s role ?

63-277 Winter 2006

pediatric nursing is
Pediatric Nursing is :
  • Practice of nursing involving the health care of children from infancy to adulthood
  • Overall goal is to promote & assist the child in maintaining optimal levels of health while recognizing the influence of the family on the child’s well being

63-277 Winter 2006

philosophy of pediatric nursing care
PHILOSOPHY of Pediatric Nursing Care
  • Focus on family- “family centered care”
  • Advocacy
  • Atraumatic therapeutic care
  • Anticipatory guidance
  • Evidence-based practice

63-277 Winter 2006

philosophy principles
Wellness the goal

Build on strengths

Everyday a new opportunity

Nature + Nurture

Child has rights

Diversity expected

Prevent injury/illness

Integrate Gr.& Dev.

Evidence-based care adapts to needs

Family is constant

Family as partners

Wholistic presence

Philosophy & Principles

63-277 Winter 2006

pediatric nursing as specialty
Pediatric Nursing As Specialty
  • Complex – multiple ages & stages
  • Anatomy & physiology different from adult
  • Growth & developmental stages
  • Full of change
  • Emphasis on anticipatory guidance, risk reduction, injury prevention

63-277 Winter 2006

changing pediatric scene
Changing Pediatric Scene
  • Partnership with families
  • Changing demographics
      • Smaller families
      • Ethnic diversity
  •   demands for adolescent care
  • Movement of care into home/community
  • Health care cost containment

63-277 Winter 2006

changes in the pediatric population
Changes in the Pediatric Population

 technology & procedures

  • More serious and complex problems
  • Fragile newborns - Survivors of premature births
  • Children with severe injuries
  • Children with disabilities who have survived
  • More frequent and lengthy stays in hospital

63-277 Winter 2006

role of pediatric nurse
Role of Pediatric Nurse

Therapeutic relationship

Family Advocacy

Caring

Disease Prevention

Health Promotion

Health Teaching

63-277 Winter 2006

role of pediatric nurse1
Role of Pediatric Nurse
  • Support/counseling
  • Restorative role
  • Coordination/collaboration
  • Ethical Decision making
  • Research
  • Health care planning

63-277 Winter 2006

ethical legal issues
Ethical-Legal Issues
  • Atraumatic care
      • Bill of rights
  • Consent for treatment
  • Age of assent (age 7)
  • Advanced directives
  • Maintaining nursing records
  • Confidentiality
  • Research with children

63-277 Winter 2006

nursing care with children families
Nursing Care with Children & Families
  • Orient to “care by family” approach
  • Increase family involvement
  • Learn interpersonal skills
    • Physical care
    • Emotional care
  • Self-awareness
  • Critical thinking - purposeful, organized, goal-directed

63-277 Winter 2006

family centered care american academy of pediatrics 2003
FAMILY-CENTERED CAREAmerican Academy of Pediatrics 2003
  • Respect for child & family
  • Recognition of effects of cultural, racial, ethnic & socioeconomic diversity on the family’s health care experience
  • Identification of and expansion of the family’s strengths
  • Support of the family’s choices related to health care

63-277 Winter 2006

family centered care cont d
Family-centered care cont’d
  • Maintenance of flexibility
  • Provision of honest, unbiased information in an affirming & useful approach
  • Assistance with emotional & other support the child & family require
  • Collaboration with families
  • Empowerment of families

63-277 Winter 2006

significance of family centered care

Significance of Family Centered Care

Family is constant in child’s life

Family supported in care giving & decision making

Expertise in own family dynamics recognized

Family strengths built on

Needs of whole family considered

Diversity among families honored & respected

Professionals enable & empower client families

Parent-professional partnership

advocacy
Advocacy
  • Intervene to prevent developmental & health problems
  • Work with families to identify needs, strengths, goals, and plans
  • Educate about available services
  • Promote children’s well-being through teaching, counseling, holistic care, collaboration

63-277 Winter 2006

therapeutic relationship
Therapeutic Relationship
  • Caring yet defined boundaries – not overinvolved
  • Empower families
    • Promote family’s control over child’s health care
    • Teach “how to” rather than “do for”
    • Decrease family dependence on health care providers
    • Separate families’ needs from own needs
  • Open communication
  • Effective advocacy
      • See [p 15 – Guidelines…]

63-277 Winter 2006

un bill of rights 1959 convention of rights 1989
UN Bill of Rights (1959) & Convention of Rights (1989)
  • Definition of a ChildA child is recognized as a person under 18, unless national laws recognize the age of majority earlier

63-277 Winter 2006

slide20
Children’s Rights
      • Freedom from discrimination
      • Conditions of freedom & dignity
      • Name & nationality
      • Adequate nutrition, housing, recreation and medical services
      • Care of parents – moral, material security
      • Protection from neglect, exploitation
      • Education
      • First to receive protection and relief
      • Be brought up in a spirit of understanding, tolerance, friendship among peoples, peace & universal brotherhood

63-277 Winter 2006

slide21
BILL OF RIGHTS for CHILDREN’S HEALTH CAREUniversity Children’s Hospital - University of California-Irvine 2006
  • To be called by name
  • To receive compassionate care in a careful, prompt& courteous manner
  • To know names of all providers caring for the child
  • To have basic needs met and usual schedules or routines honoured
  • To be kept without food or water when necessary for the shortest time possible

63-277 Winter 2006

slide22
To be unrestrained if able
  • To have parents or other important persons with the child
  • To have an interpreter for the child & family when needed
  • To object noisily if desired
  • To be educated honestly about the child’s health care
  • To be respected as a person (not being talked about unless child knows what is happening)
  • To have confidentiality respected at all times

63-277 Winter 2006

atraumatic care

Atraumatic Care

Prevent or minimize child’s separation from family

Promote a sense of control

Prevent or minimize bodily injury and pain

Prepare child for procedure or treatment

Control pain

Provide privacy

Encourage play for expression of fear or aggression

Provide choices

4. Respect cultural differences

preventing or minimizing separation
Preventing or Minimizing Separation

☺Parents present at all times

☺Accommodations provided for comfort

☺Positive attitude of collaboration by staff

☺Family encouraged to participate according to comfort levels

☺Reminder to consider parent stress level, need for sleep, nutrition & relaxation

☺Nurses must augment & complement parent role

63-277 Winter 2006

episodic care
EPISODIC CARE
  • Occasional interaction of nurse

with child and family..

  • Education part of each interaction.
  • Concerns may be developmental, growth, illness, care management or parenting needs.
  • Therapeutic relationship required
  • Best if consistent team in child-centred setting.
  • Important to plan for ATRAUMATIC CARE.

63-277 Winter 2006

special needs children long term care populations
Special Needs Children Long Term Care Populations

♦Cognitive Impairment

♦ Sensory Impairment

♦ Communication Impairment

♦ Chronic Illness

♦ Congenital disability

♦ Developmental delay

♦ Disability

♦ Handicap

♦ Impairment

♦ Technology-dependent child

63-277 Winter 2006

trends in care for child with chronic illness or disability
Trends in Care for Child with Chronic Illness or Disability
  • Developmental Focus
  • Family development
  • Family Centered Care
  • Normalization
  • Home care
  • Mainstreaming
  • Early Intervention
  • Managed care

63-277 Winter 2006

anticipatory guidance
ANTICIPATORY GUIDANCE
  • Prevention - Deal with an issue before it becomes a problem
  • Traditional
      • Information on normal growth & development
      • Nurturing childrearing practices
      • Injury prevention

63-277 Winter 2006

anticipatory guidance1
Anticipatory Guidance
  • Role of Nurse
    • Base interventions on needs identified by family
    • View family as having ability to be competent
    • Provide opportunities for family to achieve competence

63-277 Winter 2006

community health concepts
Community Health Concepts
  • Community
    • group of individuals with shared characteristics or interests who interact with each other
  • Populations
    • groups of people who live in a community
  • Target population
    • more narrowly defined groups
  • Demography
    • study of population characteristics
  • Demographic characteristics include age, gender, race ,ethnicity, socioeconomic status & education
  • Risk
    • probability of developing a disease, illness or injury

63-277 Winter 2006

nursing activities for the community
Nursing Activities for the Community
  • Needs assessment – community priorities
  • Public Health
      • Health assessment, disease surveillance, policy development
  • Health promotion
      • Perinatal care, screening clinics, parenting skills education, education on health/injury risks
  • Injury Prevention
      • Develop and implement prevention strategies

63-277 Winter 2006

community assessment
Community Assessment
  • Demographics
      • Population
      • Culture, ethnicity
      • Social class
      • Family size, types

63-277 Winter 2006

slide35
Community Systems
      • Health & social services
      • Communication
      • Recreation
      • Physical environment
      • Education
      • Safety & transportation
      • Politics & government
      • Economics

63-277 Winter 2006

mortality and morbidity
Mortality and Morbidity
  • See selected statistical document for Essex/Chatham/-Kent/Lambton

63-277 Winter 2006

vital statistics
Vital Statistics
  • Epidemiology –science of population health applied to detection of morbidity & mortality in a population
  • Mortality: number of deaths in a specific period (rate/100,000 population)
  • Infant Mortality Rate: number of deaths during 1st year of life (rate/1000 births)
  • Morbidity: prevalence of a specific illness (rate/1000)
  • New Morbidity: pediatric social illnesses e.g. poverty, abuse, violence, school failure, divorce

63-277 Winter 2006

leading health indicators for children
Perinatal inheritance

Optimal weight

Nutrition

Injury/violence

Environmental risks (pollution)

Access to health care

Substance use/abuse

Exposure to tobacco, alcohol

Sexual behaviour

Mental health

Gender

Dominant ethnic group

Family income

Home location

Education

Leading Health Indicators for Children

63-277 Winter 2006

leading causes of infant mortality
Leading Causes of Infant Mortality
  • Congenital anomalies
  • Prematurity
  • Low birth weight
  • Sudden infant death syndrome (SIDS)
  • Maternal complications in pregnancy
  • Newborn birth complications
  • Respiratory distress syndrome (RDS)
  • Infections – bacterial sepsis
  • Birth asphyxia
  • Intrauterine hypoxia

63-277 Winter 2006

leading causes of childhood mortality
Leading Causes of Childhood Mortality

After 1 year of age

  • Injuries/accidents are leading cause of death
  • Adolescence: higher risk for –
      • Injury
      • Homicide
      • Suicide
      • Cancer
      • Heart disease

63-277 Winter 2006

injuries risk factors
Sex

Temperament

Stress

Alcohol/drug use

History of previous injury

Developmental characteristics

Cognitive characteristics

Anatomic characteristics

Injuries – Risk Factors

63-277 Winter 2006

injury prevention
Injury Prevention
  • Passive strategies
      • Seat belts
      • Helmets
  • Active strategies
      • Anticipatory guidance
      • Self protection behaviours

63-277 Winter 2006

levels of prevention
Levels of Prevention
  • Primary
      • Health promotion, disease & injury prevention
  • Secondary
      • Screening & early diagnosis
  • Tertiary
      • Disease management, optimizing rehabilitation

63-277 Winter 2006

levels of prevention1
Levels of Prevention
  • Primary- focuses on health promotion & prevention of disease or injury
      • Well child clinics
      • Immunization programs
      • Safety programs-prevention of injuries
      • Nutrition programs
      • Environmental efforts
      • Sanitation
      • Community parenting classes

63-277 Winter 2006

levels of prevention2
Levels of Prevention
  • Secondary prevention- focuses on screening & early diagnosis
      • TB screening
      • Lead screening
      • Mental health counseling for stressful events ie divorce, death, disasters

Screening –purpose to detect & treat disease early in the period of pathogenesis in order to prevent the spread & progression of disease

63-277 Winter 2006

levels of prevention3
Levels of Prevention
  • Tertiary focuses on optimizing function for children with disability or chronic diseases
      • Rehabilitation
      • Disease management programs for asthma, cancer, etc
      • Special education programs

63-277 Winter 2006

best practice
Best Practice
  • Evidence-based practice & research
      • Optimize care & standards
      • Share & disseminate findings
  • Future
      • Collaborative management, ambulatory care, home care, health promotion
  • RNAO Best Practice Guidelines

63-277 Winter 2006

evidence based practice
EVIDENCE-BASED PRACTICE
  • EBP is the collection, interpretation & integration of valid, important & applicable patient-reported, nurse-observed & research derived information
  • Combines knowledge with clinical experience & intuition

63-277 Winter 2006

slide50
EBP
  • Begins with identification of the problem
  • Clinical questions are asked to allow for clear answers
  • Clinically relevant research is evaluated
  • Findings from the history & physical are analyzed
  • Specific pathophysiology is reviewed

63-277 Winter 2006

slide51
EPB
  • A care plan is developed
    • Critical appraisal of what is known & what is not known about the problem
    • Evidence is integrated with clinical expertise and patient’s unique needs
    • Interventions are initiated
    • Patient’s progress toward attainment of outcomes is evaluated

63-277 Winter 2006

bevis nursing system

INPUT

NEEDS

PROBLEMS

GOALS

DESIRES

of

Individuals

Families

Groups

THROUGHPUT

CONCEPTS – LIFE TASKS

Adaptation

(Stresses & Strains)

Maturation

TOOLS

Problem-Solving/Decision-Making

Communication

Teaching/Learning

Management/Change

Caring

OUTPUT

BEHAVIOURS

Protective

Nurturative

Generative

CLIENT SYSTEMS

Intrapersonal

Interpersonal

Community

BEVIS’ NURSING SYSTEM

ASSESSMENT DIAGNOSIS  PLANNING INTERVENTION  EVALUATION

63-277 Winter 2006

use of nursing process
Use of Nursing Process
  • Assessment
      • Physiological
          • History, examination, diagnostics
      • Developmental
          • Developmental stages & tasks
          • Client & family
      • Psychosocial
          • Culture, language, religion
          • Economics
          • Family roles, health beliefs
          • Communication

63-277 Winter 2006

nursing process cont d
Nursing Process(cont’d)
  • Diagnosis & Planning
      • NANDA
      • Parenting & family diagnoses
      • Family-centred care goals/beliefs & identified health goals
      • Collaboration – mutual identification of goals

63-277 Winter 2006

nursing process cont d1
Nursing Process(cont’d)
  • Interventions
      • creative nursing
      • interdependent nursing actions, collaboration
      • identify supports/resources, referrals
      • teaching/learning
      • ensure safety, security of child
      • care appropriate to age & development
      • caring, compassion, comfort

63-277 Winter 2006