Myra Martz Huth

Imagery reduces children's post-operative pain

&NA; This un‐blinded experimental study investigated the effectiveness of imagery, in addition to routine analgesics, in reducing tonsillectomy and/or adenoidectomy pain and anxiety after ambulatory surgery (AS) and at home. Seventy‐three children, aged 7–12, were recruited from five AS settings. Thirty‐six children randomly assigned to the treatment group watched a professionally developed videotape on the use of imagery and then listened to a 30‐min audio tape of imagery approximately 1 week prior to surgery (T1). They listened to only the audio tape 1–4 h after surgery (T2), and 22–27 h after discharge from AS (T3). The 37 children in the attention‐control group received standard care. Pain and anxiety were measured at each time‐point in both groups. Measures of sensory pain were the Oucher and amount of analgesics used in AS and home; affective pain was measured with the Facial Affective Scale (FAS). Anxiety was measured using the State Trait Anxiety Inventory for Children (STAIC). When controlling for trait anxiety and opioid and non‐opioid intake 1–4 h before the pain measures, MANCOVA showed significantly lower pain and anxiety in the treatment group at T2, but not at T3. When controlling for trait anxiety, a two‐way RM MANCOVA indicated no significant group differences in combined opioid and non‐opioid use between the groups, or between times. Appropriately trained health care providers should use imagery to reduce post‐operative pain following tonsillectomy and/or adenoidectomy in AS. Teaching parents about adequate home administration of analgesics may increase the effectiveness of imagery at home.

Evidence-based practice and the road to Magnet status.

Conducting research and using evidence-based practice play a major role in achieving Magnet status, the sought-after recognition awarded by the American Nurses Credentialing Center to healthcare institutions that exhibit nursing excellence. The authors present a synopsis of a conference sponsored by a Sigma Theta Tau International consortium in which a panel of nurse leaders distinguishes between research and evidence-based practice and discusses strategies to achieve both in the journey to Magnet status.

Pediatric inpatient falls and injuries: A descriptive analysis of risk factors

PURPOSE This study identified patient characteristics and environmental factors related to falls and injuries at one pediatric hospital. DESIGN AND METHODS This descriptive study was part of a multisite study based on inpatient pediatric falls reported over a 6-month period. RESULTS Fall prevalence was .84/1,000 patient days. Thirty-one of the 53 falls (58.5%) resulted in injury; 17% required treatment. Of the injured children, 83% were developmentally appropriate, 58% were in the hospital room, and five fell from a bed. PRACTICE IMPLICATIONS Comprehensive fall prevention programs are required to promote patient safety.

Aligning the forces of magnetism to achieve exemplary professional practice.

This clinical paper presents the evolution of a Point of Care Scholars (POCS) program, which embodies three components of the Magnet model: exemplary professional practice, new knowledge, innovations, and improvements, and empirical outcomes. The drive to achieve Magnet designation and redesignation provides a focused approach on innovation. The innovative POCS program is structured to introduce new knowledge to point-of-care staff with improvements that will lead to quality outcomes. Empirical outcomes of the POCS program include practice and policy changes, improved safety, program cost, dissemination, professional advancement, and program satisfaction.

The difficulties of studying children's pain at home.

Children experience moderate to severe pain in the days after tonsillectomy surgery. This article describes the challenges of analyzing data from pain diaries 24 hours after ambulatory tonsillectomy surgery. Instructions were to record pain levels every 4 hours and the analgesic as given; however, the number of entries was inconsistent, making comparison of groups difficult. The use of analgesics can threaten the construct validity of cause and must be considered and controlled statistically. Opioids were converted to morphine equivalents and the nonopioids were held as a separate covariate. This article describes the steps taken to find an appropriate statistical means of dealing with inconsistent diary entries and analgesic use. Hierarchical linear modeling (HLM) provides a means to analyze unbalanced data and control for analgesics. Issues of control must be addressed in research that measures childrens pain in the home. HLM can address issues of incomplete data in repeated-measures studies.Children experience moderate to severe pain in the days after tonsillectomy surgery. This article describes the challenges of analyzing data from pain diaries 24 hours after ambulatory tonsillectomy surgery. Instructions were to record pain levels every 4 hours and the analgesic as given; however, the number of entries was inconsistent, making comparison of groups difficult. The use of analgesics can threaten the construct validity of cause and must be considered and controlled statistically. Opioids were converted to morphine equivalents and the nonopioids were held as a separate covariate. This article describes the steps taken to find an appropriate statistical means of dealing with inconsistent diary entries and analgesic use. Hierarchical linear modeling (HLM) provides a means to analyze unbalanced data and control for analgesics. Issues of control must be addressed in research that measures childrens pain in the home. HLM can address issues of incomplete data in repeated-measures studies.

Quite an Accomplishment

LASTWEEKWEattended, alongwithmore than 750 other pediatric nurses, the 25th Annual Conference of the Society of Pediatric Nurses, entitled Celebrating the Past, Embracing the Future. This conference certainly lived up to its theme as there were respectful reminders of the societys past, presentations of innovative clinical practice models and programs, informative sessions of the scholarship and research undertaken by our colleagues and futuristic views of pediatric nursing practice and our professional development. Dr. Margaret Miles, the founding President of the Society of Pediatric Nurses and honored conference invitee, reminded the membership of the origins of the Society of Pediatric Nurses, whose beginnings are traced back to a pediatric nursing conference meeting 25 years ago at the same Disneyland Hotel. It was during this pivotal meeting that the name of Society of Pediatric Nurses was conceived. Originally, a tentative organizational name of the National Association of Pediatric Nursing was floated as a possibility; however, Dr. Corinne Barnes, Professor of the University of Pittsburg School of Nursing and the Editor of the Maternal–Child Nursing Journal, strongly advocated that the nascent organization be called the Society of Pediatric Nurses as this organization should be envisioned as a leader in promoting pediatric nursing practice, scholarship and research. Those were wise words indeed from an important pediatric nursing leader then and from our perspective are relevant 25 years later. At this years conference, there were considerable numbers of posters representative of the vast array of innovative programs developed and implemented by pediatric nursing colleagues across this country. Poster presenters shared information about innovative clinical programs for children

Usability of an evidence-based practice website on a pediatric neuroscience unit

Evidence-based practice (EBP) is an established method for improving clinical practice and has been shown to improve cost-effectiveness of patient care. Despite the evidence that EBP promotes positive outcomes, nurses have been slow to incorporate this process into practice. One major barrier to nurses implementing evidence in their daily work is the lack of time to search the literature. The objective of this study is to design, implement, and evaluate an inpatient unit-specific website which allows nurses and other direct care providers to easily access literature on specific nursing and pediatric neuroscience care issues. The goal is to minimize time dedicated to the literature search as a barrier to implementing EBP.