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INTRODUCTION TO
PAEDIATRIC NURSING
Mrs Deepa P
Assistant Professor
Government College of Nursing
TD Medical College
Alappuzha,Kerala,India
PAEDIATRICS
Pedia
Means
Child
A perfect gift
PAEDIATRICSPAEDIATRICS
 IatrikeIatrike means treatmentmeans treatment
 IcsIcs means branch of sciencemeans branch of science
Differences between Adult and PaediatricDifferences between Adult and Paediatric
NursingNursing
Treating a child is not like treating a miniature adult.
 Anatomical differences- body size
differences
 Maturational changes- Body systems
 Physiological- lack of reserves
 Congenital defects & genetic
variances
 Developmental issue CommunicationCommunication
barriersbarriers
 Legal issues
 Emotional DifferencesEmotional Differences
 Procedures
DEFINITION-
PAEDIATRICS
 Branch of medical science that deals withBranch of medical science that deals with
the care of children from conception tothe care of children from conception to
adolescence in health and illness.It isadolescence in health and illness.It is
concerned with preventive,promotive,concerned with preventive,promotive,
curative and rehabilitative care ofcurative and rehabilitative care of
children.children.
FATHER OFFATHER OF
PAEDIATRICS- DrPAEDIATRICS- Dr
Abraham JacobiAbraham Jacobi
Paediatric NursingPaediatric Nursing
• The specialised area of nursing practice
concerning the care of children during
wellness and illness. It includes
preventive, promotive, curative and
rehabilitative care of children
Pediatric NursingPediatric Nursing
• All round development of the body mind and
spirit of the growing individual.
Paediatric NursingPaediatric Nursing
• Involves in giving assistance ,care and
support to the growing and developing
children to achieve their individual
potential for functioning with fullest
capacity.
Paediatric NursingPaediatric Nursing
 Nursing of infants and childrenNursing of infants and children
is consistent with the definitionis consistent with the definition
of nursing as “the diagnosis andof nursing as “the diagnosis and
treatment of human responsestreatment of human responses
to actual or potential healthto actual or potential health
problems”.(Wong)problems”.(Wong)
Lilian Wald 1893 –the founder of visiting nursing in the U.S.,
begins teaching a home class on nursing for Lower East Side of
New york women after a trying time at an orphanage where
children were maltreated
GoalsGoals
 To provideTo provide skilful intelligent need
based comprehensive care to theto the
children inchildren in health and illnesshealth and illness
Goals contdGoals contd
 ToTo interpret the basic needs of
children to theirto their parents and family
members and to guide them in child careand to guide them in child care
Goals contdGoals contd
 ToTo promote Growth and
Development of children towardsof children towards
optimum state of health forfor
functioning at the peak of their capacity infunctioning at the peak of their capacity in
future.future.
Goals contdGoals contd
 ToTo prevent disease and alleviate
suffering in children.in children.
GoalsGoals
 Care to childrenCare to children
GoalsGoals
 Interpret needsInterpret needs
GoalsGoals
 Prevent diseasePrevent disease
and alleviateand alleviate
sufferingsuffering
GoalsGoals
 Promote growthPromote growth
and developmentand development
Qualities of a Paediatric NurseQualities of a Paediatric Nurse
PRINCIPLES- CHN
PRINCIPLES CHN
1. In Nursing Practice
• Concerned with the well being
of the child
• Developmental needs are
integrated in Nursing care
• Nursing care is delivered to
the family child unit
CONTD
• Nursing practice provides a
unifying feature for the
integration of theory into
nursing practice.
• An interdisciplinary approach is
used to plan and provide care.
Attention is paid to the ethical,
legal and moral dilemmas
present in the provision of
health care.
PRINCIPLES CHN
2. Related to Child
• Each child is a unique person and
family member with needs and
concerns that are unique that are
increased and complicated during
illness and hospitalisation.
• Growth and Development are
functions of genetic endowment and
an environment which provides a
meaningful experience.
CONTD
• The child’s coping response to
illness or hospitalisation is a
function of his developmental
capabilities, threats, challenges,
frustration, gratification.
• Anticipatory guidance techniques
help the child master the potentially
traumatic experience of illness and
hospitalisation
PRINCIPLES CHN
3. Related to the Family
• The integrity of family is supported during
illness/ hospitalisation
• The family’s culture and religious beliefs
are supported during illness and health
• The family’s style of coping with stress is
strengthened during illness and health.
Principles CHN
Family Centered Care
FAMILY
An institution where individuals
related through biology or enduring
commitments and representing
similar or different generations and
genders, participate in roles involving
mutual socialization, nurturance and
emotional commitment (Lerner,
Sparks and McCubbin)
Key Elements of Family
Centered Care
Family is the constant
Facilitate Family professional
collaboration
Care of an individual child
Program development and
Implementation
Policy formation
Family Centered Care contd…
Exchanging complete and unbiased
information
Honors the cultural diversity- ethnic
social racial economic educational
and geographic diversity.
Recognizing and respecting different
methods of coping and supporting
(developmental educational environmental
emotional and financial support).
Family Centered Care contd…
Family to family support-networking
Ensuring Services and support
systems - flexible, accessible and
comprehensive.
Appreciating families as families and
children as children.
Family Centered Care-
Concepts
Enabling
Enable families by creating opportunities
and means for all family members to
display their current abilities and
competencies to acquire new ones.
Empowering
Interact such that families maintain or
acquire a sense of control over their
lives and acknowledge positive changes.
Atraumatic Care
“FIRST DO NO HARM”
Atraumatic Care
Provision of therapeutic care in
settings, by personnel and through
the use of interventions that
eliminate or minimize the
psychologic and physical distress
experienced by children and their
families in the health care system.
Therapeutic care
Prevention
Diagnosis
Treatment
Palliation of acute and chronic
conditions
Settings
Home
Hospital
Health care setting
Personnel
Anyone directly involved in providing
therapeutic care
Interventions
• Psycho logic
Preparing for procedures
• Physical
Preparing space or room for the
family
Psychologic Distress
Anxiety
Fear
Anger
Disappointment
Sadness
Shame
Guilt
Physical Distress
Sleeplessness
Immobilisation
3 Principles3 Principles
• Prevent or minimise child’s separation
from family.
• Promote a sense of control.
• Prevent or minimise bodily injury and pain.
ExamplesExamples
• Fostering parent child relation ship
• Preparing for unfamiliar procedure
• Controlling pain
• Allowing child privacy
• Providing play activities
• Providing choices
• Respecting cultural differences
Case Management
Best possible care with minimal costs
Prevent duplication of Nursing care
Roles
• Primary care giver
Roles
• Health educator
Roles
• Nurse counselor
Roles
• Social worker
Roles
• Team co ordinator
Roles
• Manager
Roles
• Child care advocate
Roles
• Recreationist
Roles
• Consultant
Roles
• Researcher
TRENDS IN CHN
TRENDS IN CHN
 Expanded role of Paediatric Nurse
 Family centred care
 Child initiated care
 Nursing Process Approach
 Inter disciplinary approach
 Rooming in approach
 Minimal hospital stay policy
 Intensive care Unit
Expanded roles of Paediatric
Nurse
 Paediatric nurse practitioner/Nurse specialist
 Paediatric nurse clinician- oncology,
neonatology, community
 Child and family advocate
 Paediatric Nurse collaborator/Co ordinator
 Paediatric nurse researcher
 Paediatric nurse educator
 Paediatric nurse Administrator
 Primary Paediatric nurse
 Community Paediatric nurse
TRENDS IN CHN contd
• Child Guidance clinic
• Child Development Centres
• Development of Genetic engineering and
Molecular biology
• Computer technology in Paediatric
Nursing
• Comprehensive care of children
FUTURE TRENDS
 Prevention and promotion
 Home care
 Community care
 Cost containment
 Increasing Accountability
 Increased dedication
 Leadership
 Research
ISSUES IN CHILD HEALTHISSUES IN CHILD HEALTH
NURSINGNURSING
Ethical IssuesEthical Issues
 Withdrawing and with holdingWithdrawing and with holding
life supportlife support
 Ideal observer theoryIdeal observer theory
 OmniscienceOmniscience
 Omni percipienceOmni percipience
 DisinterestDisinterest
 Dis passionDis passion
 ConsistencyConsistency
Legal IssuesLegal Issues
• Informed consentInformed consent
• Standard of care and QualityStandard of care and Quality
assuranceassurance
• Short staffing and staff floatingShort staffing and staff floating
Conceptual IssuesConceptual Issues
 AutonomyAutonomy
 CompetenceCompetence
 BeneficenceBeneficence
 PaternalismPaternalism
 Truth tellingTruth telling
 ConfidentialityConfidentiality
 Conflict of InterestConflict of Interest
Cultural IssuesCultural Issues
 Aware of the cultural beliefs andAware of the cultural beliefs and
interactive stylesinteractive styles
 Assess the effect of them on aAssess the effect of them on a
particular child and familyparticular child and family
Social IssuesSocial Issues
Broken familiesBroken families
Co habitationCo habitation
AdoptionAdoption
Disturbed home situationsDisturbed home situations
AIDS in childrenAIDS in children
Handicapped children- physical,Handicapped children- physical,
mental or socialmental or social
Social Issues contd.Social Issues contd.
 Prevention of handicappedPrevention of handicapped
1.1. Genetic counsellingGenetic counselling
2.2. Identification and early treatment of highIdentification and early treatment of high
risk grouprisk group
3.3. ImmunisationImmunisation
4.4. Proper nutrition of mothers and childrenProper nutrition of mothers and children
5.5. Health care of pregnant mothersHealth care of pregnant mothers
Social Issues contd.
Child abuse
Child labour
Child marriage
Infanticide
Genetic Issues
 Insemination with artificial donor
 Surrogate mothering
 Antenatal detection of abnormalities and
MTP
Research IssuesResearch Issues
• Right to privacy
• Right to informed consent
• Truth in experimentation
• Confidentiality
Declaration of
the Rights of the Child
 All children have the right to what follows, no
matter what their race, colour, sex, language,
religion, political or other opinion, or where they
were born or who they were born to.
 You have the special right to grow up and to
develop physically and spiritually in a healthy
and normal way, free and with dignity.
 You have a right to a name and to be a member of
a country.
 You have a right to special care and protection
and to good food, housing and medical services.
contdcontd
 You have the right to special care if
handicapped in any way.
 You have the right to love and
understanding, preferably from parents and
family, but from the government where
these cannot help.
 You have the right to go to school for free,
to play, and to have an equal chance to
develop yourself and to learn to be
responsible and useful.
Your parents have special responsibilities
for your education and guidance.
contdcontd
 You have the right always to be among the
first to get help.
 You have the right to be protected against
cruel acts or exploitation, e.g. you shall not
be obliged to do work which hinders your
development both physically and mentally.
You should not work before a minimum age
and never when that would hinder your
health, and your moral and physical
development.
 You should be taught peace, understanding,

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Introduction to Paediatric Nursing

  • 1. INTRODUCTION TO PAEDIATRIC NURSING Mrs Deepa P Assistant Professor Government College of Nursing TD Medical College Alappuzha,Kerala,India
  • 3. PAEDIATRICSPAEDIATRICS  IatrikeIatrike means treatmentmeans treatment  IcsIcs means branch of sciencemeans branch of science
  • 4. Differences between Adult and PaediatricDifferences between Adult and Paediatric NursingNursing Treating a child is not like treating a miniature adult.  Anatomical differences- body size differences  Maturational changes- Body systems  Physiological- lack of reserves  Congenital defects & genetic variances  Developmental issue CommunicationCommunication barriersbarriers  Legal issues  Emotional DifferencesEmotional Differences  Procedures
  • 5. DEFINITION- PAEDIATRICS  Branch of medical science that deals withBranch of medical science that deals with the care of children from conception tothe care of children from conception to adolescence in health and illness.It isadolescence in health and illness.It is concerned with preventive,promotive,concerned with preventive,promotive, curative and rehabilitative care ofcurative and rehabilitative care of children.children.
  • 6. FATHER OFFATHER OF PAEDIATRICS- DrPAEDIATRICS- Dr Abraham JacobiAbraham Jacobi
  • 7. Paediatric NursingPaediatric Nursing • The specialised area of nursing practice concerning the care of children during wellness and illness. It includes preventive, promotive, curative and rehabilitative care of children
  • 8. Pediatric NursingPediatric Nursing • All round development of the body mind and spirit of the growing individual.
  • 9. Paediatric NursingPaediatric Nursing • Involves in giving assistance ,care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity.
  • 10. Paediatric NursingPaediatric Nursing  Nursing of infants and childrenNursing of infants and children is consistent with the definitionis consistent with the definition of nursing as “the diagnosis andof nursing as “the diagnosis and treatment of human responsestreatment of human responses to actual or potential healthto actual or potential health problems”.(Wong)problems”.(Wong)
  • 11. Lilian Wald 1893 –the founder of visiting nursing in the U.S., begins teaching a home class on nursing for Lower East Side of New york women after a trying time at an orphanage where children were maltreated
  • 12. GoalsGoals  To provideTo provide skilful intelligent need based comprehensive care to theto the children inchildren in health and illnesshealth and illness
  • 13. Goals contdGoals contd  ToTo interpret the basic needs of children to theirto their parents and family members and to guide them in child careand to guide them in child care
  • 14. Goals contdGoals contd  ToTo promote Growth and Development of children towardsof children towards optimum state of health forfor functioning at the peak of their capacity infunctioning at the peak of their capacity in future.future.
  • 15. Goals contdGoals contd  ToTo prevent disease and alleviate suffering in children.in children.
  • 16. GoalsGoals  Care to childrenCare to children
  • 18. GoalsGoals  Prevent diseasePrevent disease and alleviateand alleviate sufferingsuffering
  • 19. GoalsGoals  Promote growthPromote growth and developmentand development
  • 20. Qualities of a Paediatric NurseQualities of a Paediatric Nurse
  • 22. PRINCIPLES CHN 1. In Nursing Practice • Concerned with the well being of the child • Developmental needs are integrated in Nursing care • Nursing care is delivered to the family child unit
  • 23. CONTD • Nursing practice provides a unifying feature for the integration of theory into nursing practice. • An interdisciplinary approach is used to plan and provide care. Attention is paid to the ethical, legal and moral dilemmas present in the provision of health care.
  • 24. PRINCIPLES CHN 2. Related to Child • Each child is a unique person and family member with needs and concerns that are unique that are increased and complicated during illness and hospitalisation. • Growth and Development are functions of genetic endowment and an environment which provides a meaningful experience.
  • 25. CONTD • The child’s coping response to illness or hospitalisation is a function of his developmental capabilities, threats, challenges, frustration, gratification. • Anticipatory guidance techniques help the child master the potentially traumatic experience of illness and hospitalisation
  • 26. PRINCIPLES CHN 3. Related to the Family • The integrity of family is supported during illness/ hospitalisation • The family’s culture and religious beliefs are supported during illness and health • The family’s style of coping with stress is strengthened during illness and health.
  • 29. FAMILY An institution where individuals related through biology or enduring commitments and representing similar or different generations and genders, participate in roles involving mutual socialization, nurturance and emotional commitment (Lerner, Sparks and McCubbin)
  • 30. Key Elements of Family Centered Care Family is the constant Facilitate Family professional collaboration Care of an individual child Program development and Implementation Policy formation
  • 31. Family Centered Care contd… Exchanging complete and unbiased information Honors the cultural diversity- ethnic social racial economic educational and geographic diversity. Recognizing and respecting different methods of coping and supporting (developmental educational environmental emotional and financial support).
  • 32. Family Centered Care contd… Family to family support-networking Ensuring Services and support systems - flexible, accessible and comprehensive. Appreciating families as families and children as children.
  • 33. Family Centered Care- Concepts Enabling Enable families by creating opportunities and means for all family members to display their current abilities and competencies to acquire new ones. Empowering Interact such that families maintain or acquire a sense of control over their lives and acknowledge positive changes.
  • 35. Atraumatic Care Provision of therapeutic care in settings, by personnel and through the use of interventions that eliminate or minimize the psychologic and physical distress experienced by children and their families in the health care system.
  • 38. Personnel Anyone directly involved in providing therapeutic care
  • 39. Interventions • Psycho logic Preparing for procedures • Physical Preparing space or room for the family
  • 42. 3 Principles3 Principles • Prevent or minimise child’s separation from family. • Promote a sense of control. • Prevent or minimise bodily injury and pain.
  • 43. ExamplesExamples • Fostering parent child relation ship • Preparing for unfamiliar procedure • Controlling pain • Allowing child privacy • Providing play activities • Providing choices • Respecting cultural differences
  • 44. Case Management Best possible care with minimal costs Prevent duplication of Nursing care
  • 45.
  • 50. Roles • Team co ordinator
  • 57. TRENDS IN CHN  Expanded role of Paediatric Nurse  Family centred care  Child initiated care  Nursing Process Approach  Inter disciplinary approach  Rooming in approach  Minimal hospital stay policy  Intensive care Unit
  • 58. Expanded roles of Paediatric Nurse  Paediatric nurse practitioner/Nurse specialist  Paediatric nurse clinician- oncology, neonatology, community  Child and family advocate  Paediatric Nurse collaborator/Co ordinator  Paediatric nurse researcher  Paediatric nurse educator  Paediatric nurse Administrator  Primary Paediatric nurse  Community Paediatric nurse
  • 59. TRENDS IN CHN contd • Child Guidance clinic • Child Development Centres • Development of Genetic engineering and Molecular biology • Computer technology in Paediatric Nursing • Comprehensive care of children
  • 60. FUTURE TRENDS  Prevention and promotion  Home care  Community care  Cost containment  Increasing Accountability  Increased dedication  Leadership  Research
  • 61. ISSUES IN CHILD HEALTHISSUES IN CHILD HEALTH NURSINGNURSING
  • 62. Ethical IssuesEthical Issues  Withdrawing and with holdingWithdrawing and with holding life supportlife support  Ideal observer theoryIdeal observer theory  OmniscienceOmniscience  Omni percipienceOmni percipience  DisinterestDisinterest  Dis passionDis passion  ConsistencyConsistency
  • 63. Legal IssuesLegal Issues • Informed consentInformed consent • Standard of care and QualityStandard of care and Quality assuranceassurance • Short staffing and staff floatingShort staffing and staff floating
  • 64. Conceptual IssuesConceptual Issues  AutonomyAutonomy  CompetenceCompetence  BeneficenceBeneficence  PaternalismPaternalism  Truth tellingTruth telling  ConfidentialityConfidentiality  Conflict of InterestConflict of Interest
  • 65. Cultural IssuesCultural Issues  Aware of the cultural beliefs andAware of the cultural beliefs and interactive stylesinteractive styles  Assess the effect of them on aAssess the effect of them on a particular child and familyparticular child and family
  • 66. Social IssuesSocial Issues Broken familiesBroken families Co habitationCo habitation AdoptionAdoption Disturbed home situationsDisturbed home situations AIDS in childrenAIDS in children Handicapped children- physical,Handicapped children- physical, mental or socialmental or social
  • 67. Social Issues contd.Social Issues contd.  Prevention of handicappedPrevention of handicapped 1.1. Genetic counsellingGenetic counselling 2.2. Identification and early treatment of highIdentification and early treatment of high risk grouprisk group 3.3. ImmunisationImmunisation 4.4. Proper nutrition of mothers and childrenProper nutrition of mothers and children 5.5. Health care of pregnant mothersHealth care of pregnant mothers
  • 68. Social Issues contd. Child abuse Child labour Child marriage Infanticide
  • 69. Genetic Issues  Insemination with artificial donor  Surrogate mothering  Antenatal detection of abnormalities and MTP
  • 70. Research IssuesResearch Issues • Right to privacy • Right to informed consent • Truth in experimentation • Confidentiality
  • 71. Declaration of the Rights of the Child  All children have the right to what follows, no matter what their race, colour, sex, language, religion, political or other opinion, or where they were born or who they were born to.  You have the special right to grow up and to develop physically and spiritually in a healthy and normal way, free and with dignity.  You have a right to a name and to be a member of a country.  You have a right to special care and protection and to good food, housing and medical services.
  • 72. contdcontd  You have the right to special care if handicapped in any way.  You have the right to love and understanding, preferably from parents and family, but from the government where these cannot help.  You have the right to go to school for free, to play, and to have an equal chance to develop yourself and to learn to be responsible and useful. Your parents have special responsibilities for your education and guidance.
  • 73. contdcontd  You have the right always to be among the first to get help.  You have the right to be protected against cruel acts or exploitation, e.g. you shall not be obliged to do work which hinders your development both physically and mentally. You should not work before a minimum age and never when that would hinder your health, and your moral and physical development.  You should be taught peace, understanding,

Editor's Notes

  1. Children are minors and cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility and informed consent must always be considered in every pediatric procedure. In a sense, pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances.