Protection of Nurses Working with Children and Young People

Guidance to raise awareness among nurses and their managers of the complex issues surrounding safeguarding in the context of relationships between nurses and children and young people | RCN

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For the vast majority of nurses, harming those in their care, or even the possibility that another professional/colleague could, is the farthest thing from their minds. However, the RCN recognises that there are child abusers who target young people when they are at their most vulnerable. Abusers of children sometimes actively seek access to children by joining professions such as nursing, medicine, social work and teaching.

While in most identified cases, sexual abuse against children is carried out by men, it is important to recognise that women do it too. It is also important to keep things in perspective – the vast majority of nurses provide high standards in all aspects of caring for children and young people and protecting them from harm.

 

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The role of nurses’ clinical impression in the first assessment of children at the emergency department

This study explores the diagnostic value and determinants of nurses’ clinical impression for the recognition of children with a serious illness on presentation to the emergency department (ED) | Archives of Disease in Childhood

Main outcome measures: Diagnostic accuracy of nurses’ clinical impression for the prediction of serious illness, defined by intensive care unit (ICU) and hospital admission. Determinants of nurses’ impression that a child appeared ill.

Results: Nurses considered a total of 1279 (20.0%) children appearing ill. Sensitivity of nurses’ clinical impression for the recognition of patients requiring ICU admission was 0.70 (95% CI 0.62 to 0.76) and specificity was 0.81 (95% CI 0.80 to 0.82). Sensitivity for hospital admission was 0.48 (95% CI 0.45 to 0.51) and specificity was 0.88 (95% CI 0.87 to 0.88). When adjusted for age, gender, triage urgency and abnormal vital signs, nurses’ impression remained significantly associated with ICU (OR 4.54; 95% CI 3.09 to 6.66) and hospital admission (OR 4.00; 95% CI 3.40 to 4.69). Ill appearance was positively associated with triage urgency, fever and abnormal vital signs and negatively with self-referral and presentation outside of office hours.

Conclusion: The overall clinical impression of experienced nurses at the ED is on its own, not an accurate predictor of serious illness in children, but provides additional information above some well-established and objective predictors of illness severity.

Full reference: Zachariasse, J.M. et al. (2017)  The role of nurses’ clinical impression in the first assessment of children at the emergency department. Archives of Disease in Childhood. Published Online First: 10 June 2017

Protection of Nurses Working with Children and Young People

This guidance aims to raise awareness among nurses and their managers of the complex issues surrounding safeguarding in the context of relationships between nurses and children and young people.

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Image source: http://www.rcn.org.uk

In the publication, the Royal College of Nursing  include the age range of 0-18 (up to 25 years in line SEND reforms) in this definition and also advocate the need for special consideration in view of children and young people who may have a disability, or other need that affects their mental capacity to make decisions. This guidance concentrates on allegations of abuse made against staff such as smacking a child and inappropriate physical contact.

Click here to view this guidance.

Facilitators & barriers of palliative care in the neonatal unit

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Kilcullen, M. & Ireland, S. Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery. BMC Palliative Care | Published online: 11 May 2017

Background: Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit.

Conclusions: This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in supporting quality palliative care provision in the neonatal care setting. Study findings will be used to inform clinical education and practice.

Read the full article here

Digital educational programme on nurses’ knowledge, confidence and attitudes in providing care for children and young people who have self-harmed

Manning, J.C. (2017) BMJ Open. 7:e014750.

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Objectives: (1) To determine the impact of a digital educational intervention on the knowledge, attitudes, confidence and behavioural intention of registered children’s nurses working with children and young people (CYP) admitted with self-harm.

(2) To explore the perceived impact, suitability and usefulness of the intervention.

Intervention: A digital educational intervention that had been co-produced with CYP service users, registered children’s nurses and academics.

Conclusions: The effect of the intervention is promising and demonstrates the potential it has in improving registered children’s nurse’s knowledge, confidence and attitudes. However, further testing is required to confirm this.

Read the full article here

A-EQUIP midwifery supervision model

The model supports a continuous improvement process that builds personal and professional resilience, enhances quality of care and supports preparedness for appraisal and professional revalidation | NHS England

The ultimate aim of using the A-EQUIP model is that through staff empowerment and development, action to improve quality of care becomes an intrinsic part of everyone’s job, every day in all parts of the system.

With the help of midwives, the Local Supervising Authority national taskforce and the projects Editorial Board, ‘A-EQUIP Operational Guidance’ has been developed.

The guidance is in four parts:

  • Part one describes the impact of the legislative change on midwifery regulation and the changes to midwifery supervision
  • Part two describes the A-EQUIP model and its benefit to midwives and users of maternity services
  • Part three has a clinical focus. Case studies show how the model can be deployed to support staff working in clinical and non-clinical roles and the benefits of the model to the multidisciplinary team
  • Part four provides guidance for:
    • Midwives and providers of maternity services and describes key actions for maternity providers
    • CCGs
    • HEIs

Full guidance can be found here

RCM publishes new guidance for members and managers on women’s choice of midwife

The Royal College of Midwives (RCM) has published new guidance to help midwives and their mangers to better meet the needs of responding to women’s wishes for a specific midwife to be present at their birth.

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Image source: RCM

Facilitating women’s choice of midwife: Practical approaches to managing with flexibility; was produced by the RCM in response to requests for help from members.

The RCM recognises that while it is important  to accommodate women’s wishes, it can be a challenge within the constraints of running an efficient service and managing shift patterns.

RCM developed the guidance on how requests can be facilitated by consulting widely amongst midwives and also sought input from the Clinical Negligence Scheme for Trusts, one of the local supervising authority midwifery officers, and the NHS England maternity lead.

Read the full overview here

Read the full guidance here