TRENDS IN PEDIATRICS AND

PEDIATRIC NURSING

ByMr. Mahaveer swarnkar

M.Sc. Child Health Nursing

INTRODUCTION

Pediatric regarded as the medical science which enables an anticipated newborn to grow into a healthy adult, useful to the society

PEDIATRICS AS AN INDEPENDENT MEDICAL SPECIALITY

the health problems of children differ from those of adults in many a way.

children’s response to an illness is influenced by age.

management of childhood illness is significantly at with that of an adult.

Finely children also need special care since they are among the most vulnerable in the society

TRENDS IN PEDIATRIC NURSING

Remarkable changes have occurred in the field of pediatric nursing in recent years due to changing needs of society, medical and technological advancing political interests and changing trends within the nursing profession.

HISTORICAL PRESPECTIVEThe modern child care is part of a great historical pageantry that involved cultures of many people present day child health nurse should know something of the part to appreciate the present fully.

• PRE HISTORIC TIME (BEFORE 3000 BC

In early civilization of Egypt, china, India children were reared according to tradition passed down from previous generation children made to follow their parents, girls followed mothers, boys followed the father

The medical practice was a combination of indigenous system of medicine and magic. Local practioners treat adults and children with diet, rituals, magic and herbs.

CONT…. In modern world sareneos in 2nd century

wrote 1st known manuscript devoted to pediatrics

in India kasayapa tantra written in BC had a chapter on koumara maritya this is 1st record of pediatrics anywhere in the world.

Sushruta the Indian Hippocrates chapter on koumara maritya in 2nd century AD

The 1st asylum or hospital was founded in 787 which was only a shelter for abandoned children this foundlings home were deadly due to overcrowding, poor hygiene, and sanitation. No public measure were available and death toll was very high so this period was considered as the dark ages of health

RENAISSANCE AND EARLY MODERN WORLD (1350-1800 A.D.)

Renaissance brought tremendous changes in the course of human life. In 16th century 2 great medical books were published ‘THE BOOK OF CHILDREN’ by Thomas phare

(father of English pediatrics) ‘THE CHILDRENS BOOK’ BY Felix wurtz in Germany

They found there were lot of hazardous practices in feeding, clothing and rearing. Rarely infant were breast feed, instead infant received different types of soups and sugar solutions or water

Modern World (1800 Ad to Date)

In 1748 William cadogans easy on nursing called attention to unhealthy childcare practices and identified over dressing, over feeding and poor diet as contributing factors to childhood illness. This encouraged breast feeding and urged parents to dress infants in loose and lightweight garments.

Abraham Jacobi (1830-1919)(father of pediatrics).He Started pediatric department in several new York hospital and was one of the founder of the American pediatric society in 1888.

During 19th century, people recognized the effects of childhood illness and injury, the bad effect of childhood labor, poverty and neglect the end of 19th century is often regarded as the dark age of pediatrics and 1st half of the 20th century as down of improved health care of children.

Now a movement towards ‘humanized pediatric care’ has emerged out as a major source to reduce trauma to hospitalized children. At present children are prepared emotionally for medical procedure.

DEVELOPMENT OF PEDIATRIC NURSING The nursing school associated with some of

the earliest children hospitals were devoted to the training of nurses to the care of sick children.

In India, pediatric nursing was not given due in recognition in syllabi in the earlier periods of nursing training but with the introduction of under graduate degree programme in nursing in madras university CMC vellor,RAK Delhi, pediatric nursing as a course was introduced date back from 1950s.

In present INC syllabus for all types of undergraduate nursing programme gives due waightage to pediatric nursing as a specialty

MODERN CONCEPT

OF CHILD CARE

MODERN CONCEPT OF CHILD CARE

Child health nursing is undergoing tremendous advancement just like pediatric medicine and surgery. The current trends in the practice are based on researches that have taken make place in the field of pediatric nursing

CONT…..Trends are as following:Family centered careHigh technology careEvidence based practiceAtraumatic careCost containmentPrevention and health promotion

1. FAMILY CENTERED CARE It is based on philosophy that quality care can be

provided in an environment that support family integrity and promote psychological and physiological health of the family.fcc provide a holistic approach than simply providing medical and nursing care. Parents know best about their Childs need more, aware of their Childs behaviour and habits.

The 2 basic concepts of family centered care are

Enabling

Empowering

ENABLING

All the family member are helped by the professional to create opportunities and mean to utilize their present ability competence and acquire new skills that are necessary to provide care to their ill children.

EMPOWERING

Empowering help to faster the strength of family member to cope up and withstand stress related to sickness of their childrenIn FCC the nurse need to move further from describing what is upsetting to families to describing intervention that are helpful and providing the same recipients of care, nurses should help families to make responsible decisions education

2. HIGH TECHNOLOGY CARE Advancement in medical field has created the

care of children too technologically versatile. The nurse also needs to be technologically competent enough to meet the nursing care needs of children. The advancement in diagnostic technology has made detection of many disorders even in the fetal period

3. EVIDENCE BASED PRACTICE In evidence based practice nurses need to make

decisions on the best available evidence EBP in nursing provides a systematic approach to enable nurse to effectively use. Clinical practice guidelines (CPGs) and patient centered multidisciplinary, multidimensional plans of Care will help nursing team move toward evidence based practice and improve the process of care delivered. The nurse needs to be vigilant in practicing EBP in nursing children.

PRIMARY NURSING

4. ATRAUMATIC CARE It is the provision of therapeutic care is

setting by personnel and with intervention eliminates or minimizes the psychological and physical distress experienced by child and their families in health care system.

principles of atraumatic care:- interventions

5. COST CONTAINMENT

Cost containment is a management technique utilized to reduce the cost of hospitalization. It is reduced in many ways in hospitals either by cutting nursing positions or by improving process of care and tightening non labour resources.

6. PREVENTION AND HEALTH PROMOTION

The pediatric nurse applied health promotion and health maintenance in all setting in which children are served. The nurse possesses a compheransive background on all aspects of children and an understanding of child growth and development. the family is role in the children’s health is critical child health depends upon preventive care. Majority of the child health problems are preventable. Modern concept of child health emphasize on continuous care of whole child.