NURS3018 Paediatric, Child and Youth Health Nursing - Lecture Notes

Unit Overview

  • The unit aims to develop a beginning knowledge and ability to provide effective nursing care for children, young people, and their families in pediatric, child, and youth health settings.
  • Students will gain knowledge of children and young people’s experiences of illness.
  • Students will become familiar with contemporary issues impacting their health.

Learning Outcomes

  1. Apply models of pediatric, child, and youth health nursing to nursing practice.
  2. Demonstrate the application of child health and development theory to practice.
  3. Demonstrate knowledge and skills in undertaking comprehensive assessment of a child or young person and their family to plan nursing interventions for health maintenance/or improvement.
  4. Demonstrate effective interpersonal and communication skills in the practice of child and youth health nursing, including developmentally appropriate communication and deep listening skills.
  5. Apply knowledge of primary health care, health promotion, and child-centered care to nursing practice.
  6. Support children, young people, and families to access adequate, accessible services to meet identified health needs and facilitate partnership in their health care.
  7. Identify the clinical governance requirements, including legal and ethical parameters of nursing practice and specific legislative requirements relating to pediatrics and child health.

Unit Content

  • Pediatric nursing practice issues
  • Models of care and practice
  • The rights of the child in healthcare and society
  • Informed consent and informed decision making
  • Child protection issues
  • Child Health and Development
  • Principles of pediatric and child health nursing
  • Age considerations for nursing assessment and clinical intervention
  • Recognition of the Sick Child, the deteriorating child, and pediatric resuscitation
  • Systematic approach to assessing the Sick & Deteriorating Child
  • Vital Signs observations in Pediatrics
  • Assessing & Monitoring the Sick Child
  • Pediatric Basic Life Support and Resuscitation
  • Mental health and illness in childhood and adolescence
  • Mental health problems and disorders of childhood
  • The physical, emotional, and social development of teenagers
  • Assessing the various aspects of adolescent health
  • Pediatric Pain Management
  • Pain assessment in children
  • Pain management options
  • Pain experience for the child and family
  • Communicating with children and their families
  • Chronic Conditions in Childhood and Adolescence
  • Screening and early intervention in child health
  • School Health Nursing, Community, and Culture
  • Health assessments, screening, and referral
  • Health promotion and health education in the school environment

Assessments

Assessment 1A - Clinical Education Resource Document Plan

  • Weight: 15%
  • Learning Outcomes: 1, 5, 6
  • Format: Written Assessment
  • Submission: Online via CANVAS
  • Length: 500 words
Steps for Assessment 1a
  1. Pick a topic for the Clinical Education Resource Document from the provided list (Asthma, Gastroenteritis, Bronchiolitis, Pyrexia of unknown origin, Meningitis and encephalitis, Head Injury, Type 1 diabetes - newly diagnosed, Croup, Burns - acute management, Seizures, Eczema, Jaundice in early infancy, Eating disorders) and provide a brief overview (100 words).
  2. Identify the learning outcomes of your Clinical Education Resource Document (100 words).
  3. Identify and reference 5 evidence-based sources for developing your document. These sources should include peer-reviewed published studies, systematic/meta-analyses, scoping reviews, and clinical practice guidelines (300 words).

Assessment 1B - Written Assessment

  • Weight: 40%
  • Learning Outcomes: 1, 5, 6
  • Format: Digital presentation
  • Submission: Online via CANVAS
  • Length: Equivalent to 2000 words
Details for Assessment 1b
  • Assessment 1B involves creating a digital presentation of your Clinical Education Resource Document (CERD) using Microsoft Sway.
  • The CERD is designed as an educational/information resource for newly registered nurses working in a pediatric, child health, or adolescent health setting.
  • The resource must be based on current evidence-based materials, including clinical practice guidelines and peer-reviewed research (including systematic reviews), to enhance the clinical skills of new registered nurses.
  • The CERD should include various engaging resources such as videos, links to useful materials, pictures, and illustrations to enhance learning.
  • The CERD should cover topics like an overview of anatomy and physiology specific to the condition, pathophysiology, principles of nursing assessment and management, pharmacology interventions and nursing considerations, communication, legal responsibilities, and current research on best practices.
  • The document should be nursing-focused, providing information necessary for a newly registered nurse to perform their role.

Assessment 2 - Final Exam

  • Weight: 45%
  • Duration: 2 hours
  • Format: Short answer questions
  • Covers content from the entire semester (tutorials, lectures, and labs).

Readings

  • Fraser, J., Waters, D., Forster, E., and Brown, N. (2022). Paediatric Nursing in Australia and New Zealand (3rd edition). Port Melbourne, VIC : Cambridge University Press
  • Forster, E., and Fraser, J. (2018). Paediatric Nursing Skills for Australian Nurses. Port Melbourne, VIC : Cambridge University Press

Professional Practice Issues in Child and Adolescent Health and Care

Key Skills in Paediatric Nursing

  • Communication: The cornerstone of therapeutic relationships.
  • Assessment: Ongoing and requires knowledge of normal growth and development.

Standards of Practice

  • Overarching standards are set by the Australian Nursing and Midwifery Council (ANMAC).
  • Standards specific to pediatric nursing are provided by the Australian College of Children and Young People’s Nursing (ACCYPN).
  • Association for the Wellbeing of Children in Healthcare (AWCH) standards include:
    • Recognition of rights
    • Provision of child and family-friendly health service facilities
    • Child-specific equipment
    • Appropriately trained staff

Nurses’ Role in Ethical Decision Making

  • Recognizes power inequity in the relationship between children, families, and the healthcare agency or institution.
  • Clarifies their own values, beliefs, and attitudes to recognize biases and potential for influencing parents.
  • Facilitates the child’s and parents’ decision-making.
  • Advocates for the child.

Ethics and Law in Children’s Nursing

  • The age for consent for medical treatment differs across jurisdictions:
    • WA: 18 years
    • NSW: dual consent from 14 years
    • SA: 16 years
  • In NSW, a child mature enough to understand the nature and consequences of treatment may legally consent.
  • A competency assessment may be used to ascertain the minor's level of capacity.
  • Section 49 of the Minors (Property and Contracts) Act 1970 protects medical practitioners from legal action if they provide treatment to:
    • A child 14 and over who has consented
    • A child under 16 where parents have consented on their behalf

Confidentiality

  • Young people (YP) may request that their parents not be informed of their access to a service or the treatments accessed.
  • If a YP has the capacity to consent to service provision, you are not required to inform the parent/carer of the YP health information.
  • Only if the YP does not have the capacity to consent may you consider releasing information for the purposes of medical treatment.
  • If a parent/carer requests access to files and the YP is over 14 years of age, you need the YP consent.

Child Protection Legislation

  • During 2019-20, 1 in 32 Australian children received child protection services.
  • Aboriginal and Torres Strait Islander children were 8 times as likely as non-Indigenous children to have received child protection services.
  • Child abuse may be:
    • Physical
    • Sexual
    • Emotional
    • Psychological
    • Neglect
    • Witness to domestic violence
  • Child abuse and neglect notifications are substantiated when, “in the professional opinion of the officers concerned, there is reasonable cause to believe that the child has been, is being, or is likely to be abused or neglected” (AIHW, 2017).

Health Professionals Role and Responsibilities

  • Mandatory reporting of known and suspected child abuse and neglect
  • Identification, evaluation, and documentation of injuries
  • Collaboration with law enforcement, social services, and the criminal justice system
  • Appears to be under-reported by health professionals

Mandatory Reporting

  • Practitioners are advised to contact the NSW mandatory reporter guide in all cases where there is a reasonable suspicion of inflicted harm.

Recognizing Child Abuse Red Flags

  • Delayed presentation
  • Story inconsistent with injury
  • Inappropriate for developmental stage
  • Vague or varying story
  • Different caregivers give different stories
  • Multiple bruises/fractures of different ages and distinctive patterns
  • Fractured bones < 1 year of age
  • Certain patterns of injuries (types of fractures, burns, and/or bruises)