Pediatric Nursing News Briefs
Study: Parents Want Straight Talk from Nurses
For parents of sick children, one of the most important measures of quality hospital care is how well nurses communicate about treatment, tests and pain management.
In the July-August 2008 issue of Pediatric Nursing, Susan Hong and her co-authors explore the relationship between nurses’ communication and pediatric parents’ satisfaction. The authors studied the pediatric unit of a United States teaching hospital on the west coast. The unit had received a lower than 50% ranking for nurse communication.
According to the authors, parents prefer language they can understand – not medical terminology, as well as assurance from caregivers in uncertain situations. They also want to build a sense of trust with nurses and health care providers.
In the study, the researchers tested the hypothesis that patient/parent satisfaction ratings would rise if an inservice to improve nurses’ communication was offered and if a handout was given to parents regarding effective pain management. The authors surveyed 50 randomly selected parents of discharged patients both before and after these interventions took place.
In their findings, the authors report there were positive trends in nurse communication cited by the parents after the interventions (an increase from 81.6% to 85.3% in overall satisfaction), nurse instructions for treatments and tests (78% to 82%) and for pain management (80.8% to 82.4%). As a result, the pediatric units of the hospital now provide the handout to parents of patients with pain issues and the authors recommend that future inservices may also be a useful intervention. (Parental Satisfaction with Nurses’ Communication and Pain Management in a Pediatric Unit; Susan S. Hong, MS, FNP-C, RN; Susan O. Murphy, DNS, RN; and Phyllis M. Connolly, PhD, APRN-BC, CS; Pediatric Nursing, July-August 2008; www.pediatricnursing.net)
Nurses Accurately Assess Pain in Children, Research Shows
Managing children’s pain is a crucial role for nurses, however there have been conflicting studies about nurses’ pain assessment and treatment responses.
In the July-August 2008 issue of Pediatric Nursing, Ruth A. Griffin and co-authors report results from a national survey of nurses that explored how nurses rated children’s pain levels and how much analgesia they would recommend.
To obtain results, the researcher mailed questionnaires to 700 RNs, with 334 responding. The survey presented three cases and asked the nurses how they would rate each child’s pain level, the dose of medication they would recommend and if they would use any nonpharmacologic pain relief methods (breathing, distraction with music or toys, etc.). The researchers also considered the nurses’ backgrounds, such as level of education, clinical experience and personal experience with intense pain.
The most important finding, according to the authors, was that the nurses evaluated children’s pain at the same high levels at which the children reported it. In addition, there was no link between the nurses’ backgrounds and the pain treatments they chose. The authors note that the results contrast with previous studies, perhaps because “this study relied on a more representative national sample of nurses than in earlier work.” They recommend continued research because “much remains to be learned about pain management decision made by nurses and other providers.” (Nurse Characteristics and Inferences About Children’s Pain; Ruth A. Griffin, RN; Denise F. Polit, PhD; and Mary W. Byrne, PhD, MPH, RN, FAAN; Pediatric Nursing, July-August 2008; www.pediatricnursing.net)
Research on Children Presents Ethical Dilemmas
The thorny issue of conducting medical research on children is one of the most difficult ethical debates in health care today.
In the Pediatric Ethics, Issues, & Commentary column of the July-August 2008 issue of Pediatric Nursing, author Pam Pieper examines two schools of thought regarding this controversial topic. Central to the debate is whether or not a child’s assent to participate in research should be mandated, considering that in some cases, the child may be unable or too young to give such assent.
Pieper presents two theories: deontology, an “ethical stance, where one’s actions are based on what is morally correct, irrespective of the consequences.” This viewpoint states such research is ethical only when it potentially benefits the child and includes the child’s consent. The second theory, utilitarianism, focuses on a course of action that results in the greatest good for the greatest number of people. In other words, research that benefits many children but possibly puts a few at risk is justified by the final result. Under this theory, assent is not mandated.
“Children have often been denied the benefits of research advancements because of restrictions against their participation in research,” Pieper writes. She adds that some children may choose to participate in research and that there should not be sweeping restrictions that take away their autonomy, especially when others could benefit. Utilitarianism is the more widely accepted perspective, she says, and even when children can’t assent, if parental permission and appropriate safeguards are added into the mix, they should still be given the opportunity to participate in studies. |
