Catherine Burns

Managing the hair and skin of African American pediatric patients

In Africa, the ancestral home of most African Americans, hair is viewed as the epitome of beauty. However, when Africans were brought to America as slaves, they were unable to care for their hair and skin adequately and were exposed to the predominant white culture, which valued straight hair and light skin. As a result, many African Americans lost self-esteem because of the characteristics of their hair and skin. In this article we examine the anatomic and physiologic features of African American hair and skin and typical African American hair and skin care practices. Common African American hair and skin disorders and their management are discussed. The goal of this article is to help primary care providers understand the special hair and skin care required for African American children (as well as other dark-skinned patients). With good patient education, understanding ones own hair and skin characteristics can also support positive self-esteem.

A new assessment model and tool for pediatric nurse practitioners.

This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordons Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

Implementing the Use of Chemical-Free Products in a Perinatal Unit

OBJECTIVE To develop a process to identify, adopt, and increase individual awareness of the use of chemical-free products in perinatal hospital units and to develop leadership skills of the fellow/mentor pair through the Sigma Theta Tau International Maternal-Child Health Nurse Leadership Academy (STTI MCHNLA). DESIGN Pretest/posttest quality improvement project. SETTING Tertiary care 80-bed perinatal unit. PATIENTS Mothers and newborns on perinatal unit. INTERVENTIONS/MEASUREMENTS The chemical hazard ratings of products currently in use and new products were examined and compared. Chemical-free products were selected and introduced to the hospital system, and education programs were provided for staff and patients. We implemented leadership tools taught at the STTI MCHNLA to facilitate project success. Pre- and postproject evaluations were used to determine interest in the use of chemical-free products and satisfaction with use of the new products. Cost savings were measured. RESULTS Products currently in use contained potentially harmful chemicals. New, chemical-free products were identified and adopted into practice. Participants were interested in using chemical-free products. Once new products were available, 71% of participants were positive about using them. The fellow and mentor experienced valuable leadership growth throughout the project. CONCLUSIONS The change to chemical-free products has positioned the organization and partner hospitals as community leaders that set a health standard to reduce environmental exposure for patients, families, and staff. The fellow and mentor learned new skills to assist in practice changes in a large organization by using the tools shared in the STTI MCHNLA.

Using a comprehensive taxonomy of diagnoses to describe the practice of pediatric nurse practitioners: Findings of a field study

The goal of this study was to develop and field test a classification of diagnoses for use by pediatric nurse practitioners. A secondary goal was to describe the clinical practice of pediatric nurse practitioners in a way using a classification that integrates medical, nursing, and developmental diagnoses. Six pediatric nurse practitioners were oriented to the system, established interrater reliability, and then used the system to record their diagnoses for 240 consecutive patients each. The pediatric nurse practitioners used more than 3000 diagnoses with 1450 cases. Their scope of practice included 1% developmental problems, 72% pediatric diseases, which included 51% illnesses and 21% disease prevention and screening, and 27% daily living problems. Pediatric nurse practitioner coders evaluated the system in positive terms. Issues related to the use of a taxonomy such as this one for practicing clinicians were discussed.