Article: Long-term ventilation in children

A good overview of long term ventilation (LTV) in the UK.  It covers the demographics, the different types of LTV, indications of why children require it, decision-making, the discharge process, home care packages, outcomes, ongoing dependence, transition and the future of LTV.

Brookes, I.  Long-term ventilation.  Paediatrics and Child Health, 29 (4) p 167 - 171.

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Article: Advice on resolving disagreements with the families of critically ill children

A two page analysis and commentary on the Nuffield Council briefing on how nurses should manage cases where parents can come into conflict with decisions about life sustaining treatment. It includes a summary of four cases that hit the headlines in recent years.

Evans, N. 2019.  Advice on resolving disagreements with the families of critically ill children.  Nursing Children and Young People, 31 (4) p 8 - 9.

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Article: A review of Apps for calming, relaxation, and mindfulness interventions for pediataric palliative care patients

Mindfulness Apps and relaxation based apps have been noted for their positive effect and psychological well being of patients with chronic complex medical conditions.  A US Children's Palliative care team searched smartphone application platforms for apps relevant to calming, relaxation and mindfulness interventions.  16 apps were assessed using a mobile application rating scale.  All were available in English with four available in Spanish.  Mood and sleep patterns were the main symptoms targeted by the apps. Details are provided in the article.

Weekly, T. et al. 2018.  A review of Apps for calming, relaxation, and mindfulness interventions for paediatric palliative care patients.  Children, 5 (16) epub.

Full text available here

Article: Noisy upper respiratory tract secretions: pharmacological management

Written from an adult palliative care perspective, this short article reviews the practical management of noisy upper respiratory tract secretions.

Boland, J. & Boland, E. 2019. Noisy upper respiratory tract secretions: pharmacological management. BMJ Supportive & Palliative Care.  Online.

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Article: Professionals' views and experiences of paediatric advance care planning

This study explored health professionals' views and experience of paediatric advance care planning in 3 hospitals, community settings and a children's hospice in the North of England.  Twenty one health care professionals participated.   Two themes were generated from the study: the timing of conversations, including waiting for a relationship to form with the family, the introduction of parallel planning and avoiding a crisis situation.  The second theme involved how to approach the topic and where to have the conversation.   For all healthcare staff, the timing of when to start the conversation is an issue.  The value of doing this in stages and the environment were noted as important. The study reported on suggestions to help the process.

Jack, B. et al.  2018.  Professionals' views and experiences of paediatric advance care planning.  BMC Palliative Care.  online

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Article: Clinical holding: ethical guidance for children's nurses working in the UK

There has been an increasing body of evidence published over the last 20 years to suggest the complex and challenging area of clinical holding is not always well managed, with mixed messages about consent, choice and practice.  This article proposes an ethical framework allowing for increased engagement, empowerment and support on behalf of children and young people in relation to clinical holding decision making.

Page, A. et al. 2019. Clinical holding: ethical guidance for children's nurses working in the UK.  Nursing Standard, 31 (4) p 28 - 33.

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Article: Transcribing: what the new guidance states

From the Nursing Standard, an overview of the new Royal Pharmaceutical Society (RPS) and Royal College of Nursing (RCN) guidance on medicines management which replaced the now defunct NMC Medicines Management standards earlier this year.  Focusing on transcribing, the article emphasises how the new guidance puts the onus on the employer to have policies and procedures in place for transcribing.

Griffiths, M. 2019.  Transcribing: what the new guidance states.  Nursing Standard, 34 (7) p 61 - 62.

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Article: Hospice and palliative care for children: converging stories

An interesting article about children's hospices and particularly useful for anyone working in a commissioning role.  The article notes that the services hospices offer are highly valued by families but it is not always clear that hospices can be described as "specialists", making it difficult for hospices to negotiate appropriate commissioning arrangements with the statutory sector.  The article provides a detailed look at the history of the hospice movement, the differing services they offer today, and then considers the future.

Hain, , R. 2019.  Hospices and palliative care for children: converging stories.  British Medical Bulletin, 130 (1) p 81 - 87.

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Use of a PEG for refractory epilepsy and medication refusal

This article describes the use of PEG placement for refractory epilepsy in children who refused oral medication. The study involved 10 children over a 9 year period.  Parents reported back via a survey on seizure control and quality of life.  All families reported  an improvement in the ease of administering medications, nine children had a decrease in seizure frequency and eight reported a significant improvement in quality of life. 

Howard, C. et al. 2019.  Percutaneous endoscopic gastrostomy (PEG) for refractory epilepsy and medication refusal.  Archives of Diseases in Childhood, 104 (7) p 690-692

Full article available via Athens, or contact the library for a copy

Article: Children's unmet palliative care needs: a scoping review of parents' perspective

An interesting article, identifying in the literature the views of parents and their support needs in children's palliative care.  The most commonly reported unmet needs were respite services, communication and interpersonal skills of professionals, co-ordination and organisation of services and emotional and psychological  support. The authors note a number of limitations to the review, including the fact that over half the papers reviewed were conducted over 10 years ago so it is likely that many of these services may well have changed.

Constantinou, G. et al. 2019.  Children's unmet palliative care needs: a scoping review of parents' perspective.  BMJ: Supportive and Palliative Care, epub.

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Article: Bereaved parents' experiences of research participation

Designing and obtaining approval for studies involving bereaved parents can be difficult.  The aim of this Australian study was to explore bereaved parents' experience of research participation.  Nineteen parents whose children had died in an intensive care unit were contacted.  Participants were asked to reflect on their experience of research participation with a focus on recruitment methods, timing of research contact, and the location of interviews. The findings showed that despite being emotionally difficult, parents' overall experience of research participation was positive.  Their views provide insight to researches and research committees on the best way to conduct research with bereaved parents.

Butler, A. et al. 2019.  Bereaved parents' experiences of research participation.  BMC Palliative Care.

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Article: Dilemmas of e-rostering old and new: towards intelligent systems?

By 2021 the NHS wants all clinical staff to be rostered electronically.  Following on from an article published in 2014 on e-rostering, this article takes stock of progress made since then, and the new challenges still to be solved.

Drake, R. 2019.  Dilemmas of e-rostering old and new: towards intelligent systems?  Nursing Times, 115 (6) p 19 - 23.

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Article: A nurse-led initiative teaching patients to self-administer IV antibiotics

An article describing the nursing staff at Addenbrookes NHS Trust who set up the Out Patient Parenteral Antimicrobial Therapy (OPAT) service, teaching patients to self administer IV antibiotics at home.  The article describes the background to the project, the teaching, videoing, colleague support and safety measures that were all required to get the service up and running.

Cole, E. 2019. A nurse-led initiative teaching patients to self-administer IV antibiotics.  Nursing Standard, 34 (7) p 42 - 46.

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Article: The usefulness and acceptability of a personal health record to children and young people living with a complex health condition

Communication between children and young people (CYP), their families and health professionals can be challenging.  The use of a personal health record (PHR) is one potential strategy for improving communication by promoting CYP's health advocacy skills. The aim of this article is to identify the factors which help or hinder the use of PHR's with CYP living with a complex health condition.

Diffin, J. et al. 2019.  The usefulness and acceptability of a personal health record to children and  young people living with a complex health condition.  Child, Care, Health and Development epub.

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