Unit I of the Child Health Nursing Third year BSc N- KUHS

1. INTRODUCTION TO
PAEDIATRIC NURSING
Mrs Deepa P
Assistant Professor
Government College of Nursing
TD Medical College
Alappuzha,Kerala,India

2. PAEDIATRICS
Pedia
Means
Child
A perfect gift

3. PAEDIATRICSPAEDIATRICS
 IatrikeIatrike means treatmentmeans treatment
 IcsIcs means branch of sciencemeans branch of science

4. Differences between Adult and PaediatricDifferences between Adult and Paediatric
NursingNursing
Treating a child is not like treating a miniature adult.
 Anatomical differences- body size
differences
 Maturational changes- Body systems
 Physiological- lack of reserves
 Congenital defects & genetic
variances
 Developmental issue CommunicationCommunication
barriersbarriers
 Legal issues
 Emotional DifferencesEmotional Differences
 Procedures

5. DEFINITION-
PAEDIATRICS
 Branch of medical science that deals withBranch of medical science that deals with
the care of children from conception tothe care of children from conception to
adolescence in health and illness.It isadolescence in health and illness.It is
concerned with preventive,promotive,concerned with preventive,promotive,
curative and rehabilitative care ofcurative and rehabilitative care of
children.children.

6. FATHER OFFATHER OF
PAEDIATRICS- DrPAEDIATRICS- Dr
Abraham JacobiAbraham Jacobi

7. Paediatric NursingPaediatric Nursing
• The specialised area of nursing practice
concerning the care of children during
wellness and illness. It includes
preventive, promotive, curative and
rehabilitative care of children

8. Pediatric NursingPediatric Nursing
• All round development of the body mind and
spirit of the growing individual.

9. Paediatric NursingPaediatric Nursing
• Involves in giving assistance ,care and
support to the growing and developing
children to achieve their individual
potential for functioning with fullest
capacity.

10. Paediatric NursingPaediatric Nursing
 Nursing of infants and childrenNursing of infants and children
is consistent with the definitionis consistent with the definition
of nursing as “the diagnosis andof nursing as “the diagnosis and
treatment of human responsestreatment of human responses
to actual or potential healthto actual or potential health
problems”.(Wong)problems”.(Wong)

11. Lilian Wald 1893 –the founder of visiting nursing in the U.S.,
begins teaching a home class on nursing for Lower East Side of
New york women after a trying time at an orphanage where
children were maltreated

12. GoalsGoals
 To provideTo provide skilful intelligent need
based comprehensive care to theto the
children inchildren in health and illnesshealth and illness

13. Goals contdGoals contd
 ToTo interpret the basic needs of
children to theirto their parents and family
members and to guide them in child careand to guide them in child care

14. Goals contdGoals contd
 ToTo promote Growth and
Development of children towardsof children towards
optimum state of health forfor
functioning at the peak of their capacity infunctioning at the peak of their capacity in
future.future.

15. Goals contdGoals contd
 ToTo prevent disease and alleviate
suffering in children.in children.

16. GoalsGoals
 Care to childrenCare to children

17. GoalsGoals
 Interpret needsInterpret needs

18. GoalsGoals
 Prevent diseasePrevent disease
and alleviateand alleviate
sufferingsuffering

19. GoalsGoals
 Promote growthPromote growth
and developmentand development

20. Qualities of a Paediatric NurseQualities of a Paediatric Nurse

21. PRINCIPLES- CHN

22. PRINCIPLES CHN
1. In Nursing Practice
• Concerned with the well being
of the child
• Developmental needs are
integrated in Nursing care
• Nursing care is delivered to
the family child unit

23. CONTD
• Nursing practice provides a
unifying feature for the
integration of theory into
nursing practice.
• An interdisciplinary approach is
used to plan and provide care.
Attention is paid to the ethical,
legal and moral dilemmas
present in the provision of
health care.

24. PRINCIPLES CHN
2. Related to Child
• Each child is a unique person and
family member with needs and
concerns that are unique that are
increased and complicated during
illness and hospitalisation.
• Growth and Development are
functions of genetic endowment and
an environment which provides a
meaningful experience.

25. CONTD
• The child’s coping response to
illness or hospitalisation is a
function of his developmental
capabilities, threats, challenges,
frustration, gratification.
• Anticipatory guidance techniques
help the child master the potentially
traumatic experience of illness and
hospitalisation

26. PRINCIPLES CHN
3. Related to the Family
• The integrity of family is supported during
illness/ hospitalisation
• The family’s culture and religious beliefs
are supported during illness and health
• The family’s style of coping with stress is
strengthened during illness and health.

27. Principles CHN

28. Family Centered Care

29. FAMILY
An institution where individuals
related through biology or enduring
commitments and representing
similar or different generations and
genders, participate in roles involving
mutual socialization, nurturance and
emotional commitment (Lerner,
Sparks and McCubbin)

30. Key Elements of Family
Centered Care
Family is the constant
Facilitate Family professional
collaboration
Care of an individual child
Program development and
Implementation
Policy formation

31. Family Centered Care contd…
Exchanging complete and unbiased
information
Honors the cultural diversity- ethnic
social racial economic educational
and geographic diversity.
Recognizing and respecting different
methods of coping and supporting
(developmental educational environmental
emotional and financial support).

32. Family Centered Care contd…
Family to family support-networking
Ensuring Services and support
systems - flexible, accessible and
comprehensive.
Appreciating families as families and
children as children.

33. Family Centered Care-
Concepts
Enabling
Enable families by creating opportunities
and means for all family members to
display their current abilities and
competencies to acquire new ones.
Empowering
Interact such that families maintain or
acquire a sense of control over their
lives and acknowledge positive changes.

34. Atraumatic Care
“FIRST DO NO HARM”

35. Atraumatic Care
Provision of therapeutic care in
settings, by personnel and through
the use of interventions that
eliminate or minimize the
psychologic and physical distress
experienced by children and their
families in the health care system.

36. Therapeutic care
Prevention
Diagnosis
Treatment
Palliation of acute and chronic
conditions

37. Settings
Home
Hospital
Health care setting

38. Personnel
Anyone directly involved in providing
therapeutic care

39. Interventions
• Psycho logic
Preparing for procedures
• Physical
Preparing space or room for the
family

40. Psychologic Distress
Anxiety
Fear
Anger
Disappointment
Sadness
Shame
Guilt

41. Physical Distress
Sleeplessness
Immobilisation

42. 3 Principles3 Principles
• Prevent or minimise child’s separation
from family.
• Promote a sense of control.
• Prevent or minimise bodily injury and pain.

43. ExamplesExamples
• Fostering parent child relation ship
• Preparing for unfamiliar procedure
• Controlling pain
• Allowing child privacy
• Providing play activities
• Providing choices
• Respecting cultural differences

44. Case Management
Best possible care with minimal costs
Prevent duplication of Nursing care

46. Roles
• Primary care giver

47. Roles
• Health educator

48. Roles
• Nurse counselor

49. Roles
• Social worker

50. Roles
• Team co ordinator

51. Roles
• Manager

52. Roles
• Child care advocate

53. Roles
• Recreationist

54. Roles
• Consultant

55. Roles
• Researcher

56. TRENDS IN CHN

57. TRENDS IN CHN
 Expanded role of Paediatric Nurse
 Family centred care
 Child initiated care
 Nursing Process Approach
 Inter disciplinary approach
 Rooming in approach
 Minimal hospital stay policy
 Intensive care Unit

58. Expanded roles of Paediatric
Nurse
 Paediatric nurse practitioner/Nurse specialist
 Paediatric nurse clinician- oncology,
neonatology, community
 Child and family advocate
 Paediatric Nurse collaborator/Co ordinator
 Paediatric nurse researcher
 Paediatric nurse educator
 Paediatric nurse Administrator
 Primary Paediatric nurse
 Community Paediatric nurse

59. TRENDS IN CHN contd
• Child Guidance clinic
• Child Development Centres
• Development of Genetic engineering and
Molecular biology
• Computer technology in Paediatric
Nursing
• Comprehensive care of children

60. FUTURE TRENDS
 Prevention and promotion
 Home care
 Community care
 Cost containment
 Increasing Accountability
 Increased dedication
 Leadership
 Research

61. ISSUES IN CHILD HEALTHISSUES IN CHILD HEALTH
NURSINGNURSING

62. Ethical IssuesEthical Issues
 Withdrawing and with holdingWithdrawing and with holding
life supportlife support
 Ideal observer theoryIdeal observer theory
 OmniscienceOmniscience
 Omni percipienceOmni percipience
 DisinterestDisinterest
 Dis passionDis passion
 ConsistencyConsistency

63. Legal IssuesLegal Issues
• Informed consentInformed consent
• Standard of care and QualityStandard of care and Quality
assuranceassurance
• Short staffing and staff floatingShort staffing and staff floating

64. Conceptual IssuesConceptual Issues
 AutonomyAutonomy
 CompetenceCompetence
 BeneficenceBeneficence
 PaternalismPaternalism
 Truth tellingTruth telling
 ConfidentialityConfidentiality
 Conflict of InterestConflict of Interest

65. Cultural IssuesCultural Issues
 Aware of the cultural beliefs andAware of the cultural beliefs and
interactive stylesinteractive styles
 Assess the effect of them on aAssess the effect of them on a
particular child and familyparticular child and family

66. Social IssuesSocial Issues
Broken familiesBroken families
Co habitationCo habitation
AdoptionAdoption
Disturbed home situationsDisturbed home situations
AIDS in childrenAIDS in children
Handicapped children- physical,Handicapped children- physical,
mental or socialmental or social

67. Social Issues contd.Social Issues contd.
 Prevention of handicappedPrevention of handicapped
1.1. Genetic counsellingGenetic counselling
2.2. Identification and early treatment of highIdentification and early treatment of high
risk grouprisk group
3.3. ImmunisationImmunisation
4.4. Proper nutrition of mothers and childrenProper nutrition of mothers and children
5.5. Health care of pregnant mothersHealth care of pregnant mothers

68. Social Issues contd.
Child abuse
Child labour
Child marriage
Infanticide

69. Genetic Issues
 Insemination with artificial donor
 Surrogate mothering
 Antenatal detection of abnormalities and
MTP

70. Research IssuesResearch Issues
• Right to privacy
• Right to informed consent
• Truth in experimentation
• Confidentiality

71. Declaration of
the Rights of the Child
 All children have the right to what follows, no
matter what their race, colour, sex, language,
religion, political or other opinion, or where they
were born or who they were born to.
 You have the special right to grow up and to
develop physically and spiritually in a healthy
and normal way, free and with dignity.
 You have a right to a name and to be a member of
a country.
 You have a right to special care and protection
and to good food, housing and medical services.

72. contdcontd
 You have the right to special care if
handicapped in any way.
 You have the right to love and
understanding, preferably from parents and
family, but from the government where
these cannot help.
 You have the right to go to school for free,
to play, and to have an equal chance to
develop yourself and to learn to be
responsible and useful.
Your parents have special responsibilities
for your education and guidance.

73. contdcontd
 You have the right always to be among the
first to get help.
 You have the right to be protected against
cruel acts or exploitation, e.g. you shall not
be obliged to do work which hinders your
development both physically and mentally.
You should not work before a minimum age
and never when that would hinder your
health, and your moral and physical
development.
 You should be taught peace, understanding,