Nani Nurhaeni

Medical-Device Related Pressure Injuries to Children in the Intensive Care Unit

ABSTRACT Medical devices that are attached to children put pressure on their skin or mucous membranes, and the devices can lead to injuries. The objective of this study was to determine the effectiveness of injury-prevention guidance about children who need to have medical devices attached to their bodies as part of their treatment. The research used a randomized controlled trial method, along with a cross-over design in 50 respondents with age ranges from 1 day to 18 years. The control group was treated in accordance to hospital routine, while the intervention group was given medical treatment based on Kiss and Heiler’s guidelines. Skin assessment was conducted for 3 days. Incidence of Grade 1 pressure injuries on the respondent’s skin or mucous membranes with a mean score of Neonatal Skin Risk Assessment Scale < 13 and average Braden Q score > 15 were observed. Health devices that caused pressure injuries on respondents were: ETT (13%), OGT (12%), NGT (11%), and SpO2 probe (6%). There were no significant differences between the control group and intervention group in terms of the number of pressure injury incidences. Skin trauma and pressure injuries caused by medical devices were within the low-risk category; therefore, nurses should not be complacent with the NSRAS and Braden Q scores in preventing pressure injuries. Further research is recommended to improve the power of related research and development in risk assessment of pressure injuries caused by medical devices in children.

Could a Certain Sitting Position Reduce the Pain Experienced by a Child? The Benefits of Parental Holding and an Upright Position

ABSTRACT Intravenous injection is the most feared medical procedure and gives rise to an experience of mild to severe pain in children. Unrestrained pain has a negative effect on the child. Pain management in the form of a convenient sitting position is needed by children who undergo intravenous injection procedures. This study aims to determine the effect of parental holding and an upright position on children’s pain during intravenous injection procedures. The study used the Randomized Clinical Trial method involving 34 respondents, aged 1–4 years, who were included in the intervention and control group. The result of a Mann-Whitney U test analysis showed a significant difference in the pain score between the intervention and control groups (p value = .000; α = .05). The parental holding and upright position can be applied as a nonpharmacological pain management strategy for children who undergo intravenous injection procedures.

The Pediatric Yorkhill Malnutrition Score Is a Reliable Malnutrition Screening Tool

ABSTRACT Children often experience malnutrition while they are hospitalized. Therefore, the prevention of malnutrition and nutritional management need to be done properly using malnutrition screening tools. This study aimed to determine the sensitivity and specificity of the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Risk of Impaired Nutritional Status and Growth (STRONGkids) when compared to the Subjective Global Nutritional Assessment for Children (SGNA). This study involved 81 pediatric patients with ages ranging from 1 to 16 years old. The two screening tools and the SGNA were examined in each subject. The results of this study determined that the sensitivity and specificity of the PYMS were 95.7% and 66.7%, respectively, while in the STRONGkids they were 52.2% and 41.7%, respectively. This indicates that the PYMS is the most appropriate malnutrition screening tool to be used for a malnutrition screening policy.

Effect of Audiovisual Distraction on Distress and Oxygenation Status in Children Receiving Aerosol Therapy

ABSTRACT Aerosol therapy, a treatment for children with disorders of the respiratory system, often causes distress, especially in young children. Distress during aerosol therapy can decrease the effectiveness of the treatment. This study aimed to determine the effect of audiovisual distraction on distress levels and oxygenation status (measured by oxygen saturation and respiratory frequency) in children who receive aerosol therapy for disorders of the respiratory system. A quasi-experimental design was employed, specifically a non-equivalent control group, pre-test–post-test design. The study sample consisted of 38 children who were divided into 2 groups (control and intervention), each group consisting of 19 children. The results of this study showed that there were significant differences in distress scores between the control group and the intervention group (p = .0001). There were also significant differences in the mean value changes in oxygenation status before and after intervention between the control and intervention groups. These findings could be used to prevent distress and increase oxygenation status in children who receive aerosol therapy.

The Effects of Music Therapy on the Physiological Response of Asthmatic Children Receiving Inhalation Therapy

ABSTRACT The clinical manifestation of asthma in children can interfere with their daily activities. Music therapy may become one of the alternative approaches to making children feel comfortable during inhalation therapy. The aim of the study was to identify the effects of music therapy on the physiological response of asthmatic preschool and school-age children receiving inhalation therapy. This study used a quasi-experimental, nonequivalent control group with a pre-test–post-test design. The 44 respondents consisted of preschool and school-age children assigned to intervention and control groups. The results showed a significant difference in average oxygen saturation, heart rate, and respiratory rate between the control and intervention groups before and after intervention (p < α; α = .05). Music therapy can be used as a nursing intervention to improve the physiological response of children with breathing problems.

Warm Water Compress as an Alternative for Decreasing the Degree of Phlebitis

ABSTRACT Intravenous fluid therapy is an invasive procedure which may increase the risk of patient complications. One of the most common of these is phlebitis, which may cause discomfort and tissue damage. Therefore, a nursing intervention is needed to effectively treat phlebitis. The purpose of this study was to investigate the effectiveness of applying a warm compression intervention to reduce the degree of phlebitis. A quasi-experimental pre-test and post-test design was used, with a non-equivalent control group. The total sample size was 32 patients with degrees of phlebitis ranging from 1 to 4. The total sample was divided into 2 interventional groups: those patients that were given 0.9% NaCl compresses and those given warm water compresses. The results showed that both compresses were effective in reducing the degree of phlebitis, with similar p values (p = .000). However, there was no difference in the average reduction score between the two groups (p = .18). Therefore, a warm water compress is valuable in the treatment of phlebitis, and could decrease the degree of phlebitis both effectively and inexpensively.