Biomedical subjects
Publications and source records attributed to J Selekman.
Sexuality and sexual identity are developmental milestones that occur throughout the life span with sexual maturation usually occurring during adolescence. Parents and health care providers must prepare children with chronic conditions for this important component of adulthood to which they are entitled.
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The field of pediatric rehabilitation nursing is a relatively new one in which professionals have raised many pertinent questions. A theoretical basis and an organizing framework are needed in this specialty field in order to assure that we are providing comprehensive and holistic care.
Immune deficiency in children comes in many different forms. This article differentiates these forms from a physiologic perspective and identifies implications for the pediatric nurse.
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Once again, the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (1994) issued new guidelines for immunizations. Pediatric nurses should be aware of these new recommendations, summarized in this article.
These clinical practice guidelines set forth a comprehensive program for identifying, diagnosing, and treating newborns and infants with sickle cell disease and recommend education and counseling strategies for their parents. Sickle cell disease comprises a group of genetic disorders characterized by the production of hemoglobin S, anemia, and acute and chronic tissue damage secondary to the blockage of blood flow by abnormally shaped red cells. Sickle cell anemia is the most common form of the disease, and it affects approximately 1 in 375 African-American infants. Although in the United States sickle cell disease is most commonly found in persons of African ancestry, it also affects other populations. The panel recommends screening of all newborns for sickle cell disease, since targeting specific groups will miss some infected infants. Samples of dried blood on filter paper or liquid blood samples should be used for hemoglobinopathy screening. Hemoglobin electrophoresis, isoelectric focusing, and high performance liquid chromatography are acceptable, reliable, and accurate testing methods. Infants identified on initial screening must be retested to establish a definitive diagnosis. Affected infants must be given twice-daily oral penicillin beginning at 2 months of age to reduce pneumococcal, conjugated Haemophilus influenzae, and hepatitis B vaccines. Infants with sickle cell disease require the same well-child care as infants without the disease. Education and nondirective genetic counseling should be offered to all parents of infants with sickle cell disease. The guidelines stress the need for a comprehensive and fully integrated approach to reduce morbidity and mortality from sickle cell disease.(ABSTRACT TRUNCATED AT 250 WORDS)
PURPOSE: To describe the perceptions of pediatric nurses about restraint use in children. METHOD: A descriptive survey using a questionnaire collected data from nurses working in four types of pediatric facilities. Nurses were asked to rate reasons for using restraints and alternatives to restraints on a Likert Scale. Analysis of variance analyzed the nurses' responses according to type of institution and age of the child. An open-ended question asked nurses to list reasons for using restraints. RESULTS: Responses were collected from 60 nurses. There were significant differences in responses according to age of the child and according to the type of hospital. There were no interaction effects. The perceived need for restraints was highest between 1 and 6 years of age. Reasons for using restraints differed among types of facility. CONCLUSIONS: Restraint policies may need to vary according to the type of institution. Intervention and outcome studies are needed regarding the use of physical restraints in children.
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Within health care institutions, nursing policies often serve as the gold standard for nursing practice. Policies regarding the use of physical restraints on children are typically not based on any scientific evidence. This article analyzed multiple hospital policies and makes recommendations to better assess whether or not restraints are needed, suggests a list of least to most restrictive devices, identifies interventions for the child in restraints, and offers alternatives to the use of restraints.
As pediatric units in acute care hospitals close, as lengths of stay shorten, and as increasing numbers of procedures are completed on an outpatient basis, faculty must find different learning experiences for their prelicensure students. Some programs have discontinued pediatric rotations, others are seeking clinical experiences in community settings. These community experiences hopefully produce a more well-rounded, globally thinking nurse to practice in the 21st century, yet they also raise a number of concerns.
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For decades, health care providers have administered immunizations for common childhood infections. These have been given at predicted times according to an agreed-upon schedule. However, in the past decade, common immunizations have been changed, the number of immunizations has increased, and the schedule for administration of vaccines officially changes every January. In addition, as science continues to grow, new vaccines are being developed faster than ever before.