3. CURRENT ATRENDS IN PEDIATRIC
AND PEDIATRIC NURSING
FAMILY CENTERED CARE
HIGHTECHNOLOGY CARE AND IMPROVEMENT
IN DIAGNOSISANTTREATMENT
EVIDENCE BASED PRACTICE
PRIMARY NURSING
PREVENTIVE CARE
CONTINUUM OF CARE
ATRAUMATIC CENTRE
COST CONTAINMENT
CASE MANAGEMENT
DEVELOPEMNT IN ADOLESCENT MEDICINE
4. FAMILY CENTERED CARE
FAMILY CENTERED CARE is to recognize the
family as the constant in a child’s life ,while
the service systems and personnel within
those systems fluctuate.
It covers 2 concepts-
1. Enabling
2. empowerment
5. ENABLING:
In this process of all the family members are
helped by the professionals to create the
opportunities and means to utilize their
present abilities and acquire new skills that
are necessary to provide care to their ailing
children
6. EMPOWERING
It helps to foster the strengths of family
members to cope up and withstand stress
related to sickness of their children.
7. FAMILY CENTERED CARE
The goal of care is to minimize the
manifestations of the illness and maximize
the child’s cognitive, physical, and
psychosocial potential
8. NURSES RESPONSIBILITIES
The nurse recognize family as an essential
part of child’s care and illness experience and
acknowledge and respect the family feelings
in caring for both within and outside the
hospital
The nurse may suggest parenting classes to
increase their knowledge base and promote
empowerment
In the absence of child’s family she is
supposed to maintain daily routine of child as
established by family
9. ATRAUMATIC CARE
It is provision of therapeutic care in settings ,
by personnel, and through the interventions
that eliminate or minimize the psychologic
and physical distress experienced by children
and their families in the health care system .
10. PURPOSES
Prevent or minimize the child’s separation
from the family
Promote a sense of control
Prevent or minimize the bodily injury and
pain
11. CASE MANAGEMENT
Case management has developed as an
approach to coordinated care and control costs.
Nurses as Case managers have responsibility and
accountability for a particular group of patients
and use a system of critical paths derived from
standard of care.
12. BENEFITS
Improved patient and family satisfaction
Decreased fragmentation of care
Ability to describe and measure outcomes for
a homogenous group of patient became
apparent
13. PRIMARY NURSING
It is system for the distribution of nursing care
in which care of one child is managed for the
entire 24-hour day by one nurse who directs
and coordinates nurses and other personnel;
schedules all tests, procedures, and daily
activities for that patient; and cares for that
patient personally when on duty
14. PREVENTIVE CARE
Efforts to improve the health and to reduce
the costs have led to an increased emphasis
on preventive care.
Anticipatory guidance is vital during each
health contact with children and their
families; education of family includes
everything from keeping their home safe to
prevent illness.
15. CONTINUUM OF CARE
In order to provide care more efficiently,
nursing care of children now encompasses a
continuum of care that extends from acute
care setting such as hospitals to outpatient
setting such as rehabilitative units,
community care settings, homes and schools.
For example: after an acute hospital stay, a
child may be able to complete
therapy at home.
16. HIGH TECHNOLOGY CARE AND
IMPROVEMENT IN DIAGNOSIS
AND TREATMENT
Advancement in the medical field has created
the care of children technologically versatile.
The nurse also needs to be technologically
competent enough to meet the nursing care
needs of children
The advancement in the diagnosis
technology has made detection of many
disorders even in the fetal period
18. SURFACTANT THERAPY
The surfactant therapy is the most important
clinical advance in neonatal intensive care. It is
useful both for prevention and treatment of
RDS.
Surfactant: it is a lipoprotein which decreases
the surface tension of distal airways
maintaining adequate functional residual
capacity during expiration.
For example-
Survanta,Infasurf,Corosurf,Exosurf
19. CPAP
Infants with hyaline membrane disease are
handicapped by reduced lung compliance
and alveolar collapse during expiration.
Administration of oxygen under positive
pressure prevents alveolar collapse and
ensure gas exchange throughout the
respiratory cycle.
20. IMCI
TheWHO strategy of IMCI has been adapted.
The Indian version of the program, integrated
management of neonatal and childhood
illnesses, incorporates additional elements of
new born care.
The implementation strategy incorporates
home visiting to provide health preventive and
promotive care to newborn babies and infants.
21. Goals of IMNCI-
a) Focus on most common causes of mortality.
b) Nutritional assessment of all sick infants and
children.
c) Homecare for newborns like exclusive breast
feeding, preventing hypothermia etc.
d) The implementation of various preventive
health care services to newborn and infants
22. COLOR CODEDAMNAGEMENT:
PINK classification-child needs in patient
care.
YELLOW classification-child needs specific
treatment provide it at home(antibiotics).
GREEN classification-child needs no
medicine ,advise home care.
23. EVIDENCE BASED PRACTICE
STEPS IN EVIDENCE BASED PRACTICE-
a) FRAME QUESTIONS
b) SEARCH FOR EVIDENCES
c) ASSESS EVIDENCES
d) MAKE DECISIONS
e) EVALUATE PERFORMANCES
24. It provides a systematic approach to enable nurses
to effectively use the best solutions related to
nursing practice
Nursing focuses is on illness aspect of care the
human response during disease and therapy
Quality improvements measures and throwing
outdated management tools are essential to
improve nursing practice.This is possible with
the help of EBP
25. DEVELOPMENT IN ADOLOSCENT
MEDICINE
The world is witnessing the flooding of new
technology as well as medication in the
market.
Everyday new medications are coming into
existence that is available for the client; the
nurse will continually have to keep up with
the new additions
26. COST CONTAINMENT
With passage of time there is a continuous
trend of hike in price of drugs due to inflation
and other global factors.
The nurses face a challenge of cost
containment without to sacrificing quality
care
27. FOCUS FROM TREATMENT OF
DISEASE TO PROMOTION OF
HEALTH
SHIFT FROM FOCUS ON
Disease centered care Child centered care within the family system
Starting care for the woman after she became pregnant Health education and anticipated guidance on planned
parenthood and guarding the maternal health before
conception
Only caring to the sick children in the hospital The participation in the prevention of illness, health
promotion activities and follow up of children with chronic
illness at home.
Caring of the physical condition of the child in isolation Comprehensive care of child to strengthen the competence
of the family
Not allowing the parent to be with the child in the hospital and
rigid visiting hours
Ensuring that children must have one parent stay with them
in the hospital and participate in care. Flexible visting hours
in the children wards.
Illness oriented Health promotion oriented
Providing routinized care Quality care in terms of play, recreation etc.
Traditional practice Evidence based practice.
28. CHANGING ROLE OF PEDIATRIC
NURSE
Primary role
Secondary role