Overview of Pediatric Nursing Care

NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 9781284375473_CH01_001_013.indd 1 Care Pediatric Nursing of Overview UNIT I Care Across ClinicalSettings 2 CHAPTER CHAPTER 1 NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC Introduction to Children’s Introduction HealthCare NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC © Jones & Bartlett Learning, LLC. NOT FORSALEORDISTRIBUTION. © Jones&Bartlett Learning,

© Rawpixel.com/Shutterstock NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 06/07/17 2:03 PM NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning, LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 9781284375473_CH01_001_013.indd 2 CHAPTER 1 Children’s Health Care Introduction to NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 6. 5. 4. 3. 2. 1. LEARNING OBJECTIVES OBJECTIVES LEARNING common pediatricstaﬀ–family encounters. Apply the philosophy offamily-centered care to blended familiesand culturally diverse families). parenting by grandparents, families, extended constellations (teen parents, singleparents, Analyze thecare needsoffamilies ofdiverse applied to thecomplexities ofpediatricnursing. that canbe Analyze thinking modelsofcritical ments may aﬀ nursingpractice. ect children rural environ- inurban andsuburban Identify how theconcept of “new morbidity” for Pediatrics. Futures” created by Academy theAmerican of Identify and applythecomponents of “Bright practice. health may beencountered inpediatricnursing Analyze how issuesinchildren’s contemporary NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC © Jones & Bartlett Learning, LLC. NOT FORSALEORDISTRIBUTION. © Jones&Bartlett Learning,

New morbidity morbidity New strengths Family care Family-centered family Extended Enabling Empowerment thinking Critical learning Concept-based judgment Clinical family Binuclear guidance Anticipatory KEY TERMS TERMS KEY NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC NOT FORSALEORDISTRIBUTION © Jones&BartlettLearning,LLC 06/07/17 2:03 PM Introduction: Contemporary Issues in Children’s Health 3

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORIntroduction: SALE OR DISTRIBUTION Contemporary Issues NOT FOR SALE OR DISTRIBUTION in Children’s Health Providing comprehensive well-child and health restora- tion nursing care for children© Jones across & Bartlett the developmental Learning, LLC © Jones & Bartlett Learning, LLC period is a complex endeavor.NOT ChildrenFOR SALE are part OR of families, DISTRIBUTION NOT FOR SALE OR DISTRIBUTION and families are unique in their composition, strengths, and needs. Children progress from total dependence on caregivers as babies to independence as young adults. is time period—from birth to young adulthood—is dynamic© Jones and can &be Bartlettchallenging. Learning, Pediatric nurses LLC must be © Jones & Bartlett Learning, LLC preparedNOT to FORprovide SALE support, OR education, DISTRIBUTION and meticulous NOT FOR SALE OR DISTRIBUTION care to children from diverse cultural, racial, and ethnic backgrounds, and from diverse family structures. Some Figure 1-2 © Monkey Business Images/Shutterstock families are able to provide for their children’s basic needs © Jones &such Bartlett as health Learning, care, whereas LLC others experience stressors© Jones & Bartlett Learning, LLC that adversely inuence their children’s health and well- NOT FOR SALE OR DISTRIBUTION NOTLavorato, FOR SALE & Patten, OR 2013). DISTRIBUTION A comprehensive plan for being (Figure 1-1). Contemporary times have brought both a child’s health should include early assessments and economic and health challenges that can greatly inuence screenings, immunizations, disease prevention, acute a pediatric nurse’s experiences in caring for children and care for illness and injuries, and, if needed, chronic care their families. for lifelong conditions that rst present in childhood. In today’s world, any© given Jones child & may Bartlett experience Learning, many eLLC term anticipatory guidance© Jones is used &to Bartlettdenote the Learning, LLC socioeconomic factorsNOT that inuenceFOR SALE his or OR her DISTRIBUTIONhealth. process of preparing parents,NOT guardians, FOR orSALE caregivers OR DISTRIBUTION Current research shows that large numbers of families for what to expect as the child grows, develops, and in the United States and elsewhere are experiencing matures (Figure 1-2). unemployment, frequent moves, food insecurity, and lack of© consistentJones & health Bartlett care andLearning, insurance. LLC Hunger— © Jones & Bartlett Learning, LLC a basic human experience—has been documented as NOT FOR SALE OR DISTRIBUTION FAMILY EDUCATIONNOT FOR SALE OR DISTRIBUTION a national problem with adverse health and cognitive Deﬁnitions of Anticipatory Guidance consequences, aecting physical, academic, and social functioning during childhood (Coleman-Jensen, Rabbitt, Anticipatory guidance is a phrase used to deﬁne informa- Gregory, & Singh, 2015a, 2015b; Kushel, Gupta, Gee, & tion provided to parents so they can expect, plan for, and © Jones &Haas, Bartlett 2006; Melchior Learning, et al., LLC 2012; Weinreb et al., 2002)© Jonescope with & Bartlett actual or potential Learning, problems LLC associated with normal growth and development of a child before those NOT FORand SALE contributing OR DISTRIBUTION to long-term mental health issuesNOT FOR SALE OR DISTRIBUTION from adolescence into adulthood (McIntyre, Williams, problems arise. As a child progresses from infancy to adolescence, particular points along the developmental path require preparation. Anticipatory guidance gives the healthcare team the opportunity to teach parents or care- © Jones & Bartlett Learning, LLCgivers about what to expect. For© instance, Jones teaching & Bartlett about Learning, LLC NOT FOR SALE OR DISTRIBUTIONthe increasing mobility of infants,NOT which FOR progresses SALE from OR DISTRIBUTION rolling over to crawling to walking, will help parents plan for a safe environment and prevent falls or other accidents. Teaching parents about toddlers’ needs for constant super- © Jones & Bartlett Learning, LLC vision and their© Jonesinherent clumsiness& Bartlett can Learning,help parents plan LLC to prevent accidents and injuries. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Pediatric nurses must be committed to viewing their patients and families in a holistic and comprehensive light. © Jones & Bartlett Learning, LLC © Jones e key & to Bartlett understanding Learning, the complexity LLC of providing NOT FORFigure SALE 1-1 OR DISTRIBUTION NOTpediatric FOR SALEnursing careOR is DISTRIBUTION to understand the important role © Nolte Lourens/Shutterstock that childhood plays in a developing person. Child health

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALERESEARCH OR DISTRIBUTIONEVIDENCE NOT FOR• Preterm SALE infant: OR DISTRIBUTION Born prior to 36 weeks’ gestation • Neonate: First 28‒30 days of life ith globalization and immigration, pediatric healthcare • Infant: One month to end of the rst year Wteams must be aware of international child health • Toddler: One year old through second year of life concerns. One major concern that arises on an international • Preschooler: ird birthday through h year of life scale is poverty. Currently,© Jones approximately & Bartlett 20% of U.S.Learning, families LLC• School-age child: Sixth© birthday Jones through & Bartlett 12th year Learning, LLC are living in poverty.NOT On a globalFOR scale,SALE poverty OR aﬀects DISTRIBUTION ap- of life NOT FOR SALE OR DISTRIBUTION proximately 50% of the world’s pediatric population. There are • Adolescence: 13th birthday up to 18th birthday currently 2.2 billion children in the world, 1 billion of whom live in poverty (Shah, 2013). New Morbidity Research shows that “persistent poverty” has more det- © Jones & Bartlett Learning, LLC e term new© Jones morbidity & Bartlett was coined Learning, in the 1980s LLC by pe- rimentalNOT FOReﬀects SALEon a child’s OR socioemotional DISTRIBUTION functioning, NOT FOR SALE OR DISTRIBUTION IQ, and school achievement than “transient poverty.” Poor diatrician Robert Haggerty to denote concerns that are children experience less home-based cognitive stimula- brought about by current environmental and social issues tion, lower teacher expectations, inconsistent parenting, that decrease quality of life, as distinguished from issues and poorer academic-readiness skills—all factors that can of the past centuries such as infectious disease (Hag- © Jones & Bartlettslow their Learning,development (KursmarkLLC & Weitzman, 2009). © Jonesgerty, & 1995). Bartlett Attention Learning, diculties, LLC adolescent mood and NOT FOR SALE OR DISTRIBUTION NOT FORanxiety SALE disorders, OR suicide, DISTRIBUTION homicide, access to rearms, school bullying and violence, and the eects of media on obesity, sexual activity, and violence are all considered is one of the most inuential factors in adult health and contemporary issues that create concerns about health well-being, so it should be focused on the prevention of and injury and, therefore, are titled new morbidities. illness, injury, and ©development Jones & ofBartlett chronic Learning,conditions. LLCContemporary scholars and ©practitioners Jones & have Bartlett since added Learning, LLC High priority must beNOT given FOR to performing SALE ORcomprehensive DISTRIBUTION to Haggerty’s list and incorporatedNOT FOR evidence-based SALE OR best DISTRIBUTION assessments, promoting good health, fostering family practices to address these issues, leading to a revised set life, and creating support systems and safe home/school/ of “New Morbidities 2.0” (Giardino & Sanborn, 2013). neighborhood environments to help children grow, play, Nurses, as part of their roles in caring for children, are learn,© Jones and become & Bartlett healthy and Learning, productive LLC adults. in a good ©position Jones to &assess Bartlett for morbidity Learning, concerns LLC and NOT FOR SALE OR DISTRIBUTION provide direction,NOT FOR support, SALE referrals, OR DISTRIBUTION and counseling. Frameworks of Pediatric Health Four general categories of concerns related to these new morbidities have been identied (Lucey, 2001): e care of children is oriented toward the child’s developmental stage, rather than chronological age. Neverthe- • Physical and environmental factors aecting be- © Jones & Bartlettless, for classication Learning, purposes, LLC childhood is divided into© Jones havior& Bartlett and risk Learning, taking, such LLC as access to drugs and illegal substances, cigarettes, and alcohol NOT FOR SALEseven developmental OR DISTRIBUTION stages corresponding with averageNOT FOR SALE OR DISTRIBUTION • Variations of behavior and emotional development: age groupings (Figure 1-3): helping parents adapt to the unexpected and learn uniqueness of each child’s development • Child behaviors aecting physical risk, such as © Jones & Bartlett Learning, LLC smoking, drug use, and© medical Jones adherence & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION• Severe behavioral deviationsNOT andFOR their SALE management OR DISTRIBUTION needs

Healthy People 2020 © Jones & Bartlett Learning, LLC Healthy People© Jones 2020 is& a Bartlettfederal initiative Learning, that promotes LLC NOT FOR SALE OR DISTRIBUTION a set of nationalNOT FORgoals andSALE objectives OR DISTRIBUTION for improving the health of all people living in the United States over a 10-year period. e current series includes 1,200 objectives that are divided into 42 health-related topic areas, several of which pertain to the health and well-being of children (Table 1-1). © Jones & Bartlett Learning, LLC © Jones e objectives& Bartlett reect Learning, health indicators LLC that encourage NOT FOR SALEFigure 1-3OR DISTRIBUTION NOT FORprioritization SALE of OR key DISTRIBUTIONhealth issues and actions to be taken ©Inti St Clair/Blend Images LLC/Getty toward achieving maximal health for the population.

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR TABLESALE 11 ORHealthy DISTRIBUTION People 2020: Children’s Health Concerns and GoalsNOT FOR SALE OR DISTRIBUTION Goals for Maternal, Infant, and Child Health Improve the health and well-being of women, infants, children, and families. › Determines the health© ofJones the next & generation Bartlett and Learning, helps to predict LLC public health challenges for families© Jones in the future& Bartlett Learning, LLC (morbidity, mortality, poverty, and ethnic disparities). NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION › Risks of maternal and infant mortality and morbidity, as well as pregnancy-related complications, can be reduced by increasing access to care and identifying early any health conditions of infants related to disease, disability, or death. › The© health,Jones nutrition, & Bartlett and behaviors Learning, of mothers LLC highly influence the physical and© Jonescognitive &development Bartlett ofLearning, infants. LLC Breastfeeding has been widely acknowledged as beneficial for growth, health, development, and immunity (Figure 1-4). PromotingNOT FOR breastfeeding SALE isOR a primary DISTRIBUTION goal. NOT FOR SALE OR DISTRIBUTION › Some objectives include: • Reduce the rate of fetal and infant deaths © Jones & Bartlett• Reduce Learning, cesarean births LLC among low-risk women © Jones & Bartlett Learning, LLC NOT FOR SALE• Reduce OR theDISTRIBUTION number of infants with low birth weight andNOT very lowFOR birth SALE weight OR DISTRIBUTION • Reduce preterm births • Increase abstinence from alcohol, cigarettes, and illicit drugs among pregnant women • Increase the proportion of infants who are breastfed Goals for Early and Middle© Jones Childhood & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Improve the health and well-being of the early (birth to year 8) and middle (ages 6 to 12) childhood developmental periods. › The period of early and middle childhood provides the social, emotional, physical, and cognitive foundation for lifelong health and well-being. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Goals include research and interventions in reducing obesity, increasing physical activity, and preventing injury and › NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION violence. › The three top developmental milestones of this period include motor skills, language development, and emotional regulation and attachment. These milestones can become significantly delayed when children experience negative risk factors and environmental stressors. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC › Early and middle childhood also set the stage for the following accomplishments: NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Eating habits • Self-discipline • School success • Health literacy © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Conflict negotiationNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Ability to make decisions during risky situations › Children in early and middle childhood are at particular risk for: • Asthma © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Obesity NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Dental caries • Child maltreatment • Developmental and behavioral disorders © Jones & Bartlett• Unintentional Learning, injuries LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION (continues)

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALETABLE OR11 DISTRIBUTIONHealthy People 2020: Children’s Health Concerns andNOT Goals (continued)FOR SALE OR DISTRIBUTION Goals for Adolescent Health Improve the health and well-being of the adolescent developmental period (ages 10 to 19). › Behavioral patterns© duringJones this & developmental Bartlett Learning, period inﬂuence LLC not only current health state, ©but Jones also risk for& chronicBartlett illness Learning, LLC and diseases duringNOT later FOR adulthood. SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION › During this developmental transition period, teens are sensitive to contextual inﬂuences (surroundings) such as family, peers, environment, school, and neighborhood. › Teens are negotiating puberty, increasing independence, and exploring many aspects of their lives. › ©Adolescents Jones & who Bartlett perceive Learning,that they have goodLLC communication and are bonded© Jones with an & adult Bartlett are less likelyLearning, to engage LLC in NOTrisky behaviors. FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION › Parents who provide supervision and are involved with their adolescent’s activities promote a safe environment in which to explore opportunities. › Adolescents who live in distressed neighborhoods with high poverty rates are at increased risk for poor physical and mental © Jones & Bartletthealth, delinquency,Learning, and LLC risky sexual behavior. © Jones & Bartlett Learning, LLC NOT FOR SALE› Health OR disparities DISTRIBUTION are related to outcomes among ethnicNOT and racial FOR groups, SALE in that OR those DISTRIBUTION persons who live in poverty or who are African American, Hispanic, or American Indian have greater obesity, higher rates of teen pregnancy, more tooth decay, and poorer educational achievement. › Adolescent public health and social problems include, but are not limited to, the following conditions: • Smoking © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • HomelessnessNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Homicide • Suicide • Motor vehicle crashes, including those caused by drinking and driving © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Substance use and abuse NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Sexually transmitted infections (STIs) • Unplanned pregnancies

Data from Office of Disease Prevention and Health Promotion. (2014). Maternal, infant, and child health. Retrieved from https://www.healthypeople.gov/2020/; Office of Disease Prevention and Health Promotion. (2014). Early and middle childhood. Retrieved from https://www.healthypeople.gov/2020/; Office of Disease Prevention and Health Promotion. (2014). Adolescent health. Retrieved from https://www.healthypeople.gov/2020/ © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Nurses, as the largest workforce in health care, can be highly inuential in developing and evaluating programs © Jones & Bartlett Learning, LLCthat address the identied healthcare© Jones concerns & Bartlett over each Learning, LLC NOT FOR SALE OR DISTRIBUTION10-year span of time coveredNOT by the FOR Healthy SALE People OR initia DISTRIBUTION- tive. Top priorities for pediatric nurses include education and interventions for children before birth through young adulthood. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Bright Futures NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION e American Academy of Pediatrics has developed a national health promotion and disease prevention program addressing the healthcare needs of children, known as Bright Futures (https://brightfutures.aap.org/Pages/default.aspx). © Jones & Bartlett Learning, LLC © Jones is program& Bartlett provides Learning, direction in LLC the context of both family NOT FOR SALEFigure 1-4OR DISTRIBUTION NOT FORand community. SALE OR It includes DISTRIBUTION tools, principles, and guidelines © KidStock/Blend Images/Getty intended to strengthen the ties and interactions between

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORlocal, SALE regional, OR andDISTRIBUTION state programs. e Bright Futures toolNOT FOR SALE OR DISTRIBUTION and resource kit provides a variety of assessment forms and screening tools to identify high-risk behaviors, all of which can be used during child/family healthcare encounters. Pediatric nurses can benet from reviewing the © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Bright Futures visit forms that oer guidance on assessments, health screenings,NOT and FOR interviews SALE of familiesOR DISTRIBUTION with NOT FOR SALE OR DISTRIBUTION children in infancy, early childhood, middle childhood, and adolescence. Components of the tool kit, which can enhance the quality and thoroughness of a healthcare visit, include© educationalJones & handouts,Bartlett screening/assessment Learning, LLC tools, © Jones & Bartlett Learning, LLC ideas NOTfor preventive FOR SALE care, and OR instructions DISTRIBUTION on how to de- NOT FOR SALE OR DISTRIBUTION velop linkages between families and community resources. Figure 1-5 © FatCamera/E+/Getty BEST PRACTICES © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR BrightSALE Futures OR DISTRIBUTION Tool Kit NOTFamily FOR Strengths SALE OR DISTRIBUTION Pediatric nurses do not need to develop educational Every family is unique. As a family grows, interacts, and materials and screening forms from scratch. They can ﬁnd has experiences, the formation of family strengths provides multiple holistic, comprehensive, and validated tools at a foundation for growth. ese assets provide an optimal the American Academy of Pediatrics’ Bright Futures © Jones & Bartlett Learning, supportLLC system for individuals ©within Jones the family & Bartlett as well as Learning, LLC website: https://brightfutures.aap.org/materials-and-tools NOT FOR SALE OR DISTRIBUTIONfor the family as a whole (FigureNOT 1-5). AccordingFOR SALE to Sittner, OR DISTRIBUTION /tool-and-resource-kit/Pages/default.aspx. Hudson, and Defrain (2007), family strengths include the following characteristics: • Aection and appreciation Caring© Jones for Families & Bartlett Learning, LLC • Commitment© Jones & Bartlett Learning, LLC e denitionNOT FOR of aSALE family canOR be DISTRIBUTION a complex one. Many • Ability toNOT cope FORwith stress SALE and OR crisis DISTRIBUTION potential constellations exist, including nuclear, group, • Positive communication extended, blended, adoptive, foster, single-parent, same- • Time spent together as a unit sex parents, and untraditional such as a reconstituted or • Spiritual well-being communal. Given today’s high rates of marital separation Nurses can be instrumental in assisting families who © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC and divorce, growing up in a binuclear family, in which are experiencing a crisis. A child with a new diagnosis of NOT FORa SALEchild’s livingOR DISTRIBUTION time is divided between two or moreNOT chronic FOR illness, SALE acute OR illness, DISTRIBUTION or injury can be supported households, is not uncommon. e most important con- by assisting family members to develop or demonstrate sideration when assessing the structure of a child’s family components of the family strengths model. Identifying is highlighted by a commonly used phrase: A family is and supporting existing family strengths components, who they say they are.© Jones & Bartlett Learning,and LLC helping the family to implement© Jones those &strengths, Bartlett will Learning, LLC NOT FOR SALE OR DISTRIBUTIONhelp the family identify and achieveNOT goalsFOR for SALE their childOR DISTRIBUTION (Feeley & Gottlieb, 2000). BEST PRACTICES Determining the Family’s Primary Care Decision Maker © Jones & Bartlett Learning, LLC RESEARCH ©EVIDENCE Jones & Bartlett Learning, LLC OneNOT aspect FOR of caring SALE for families OR is DISTRIBUTION determining who the NOT FOR SALE OR DISTRIBUTION decision maker is. This person may not always be one of Family Strengths the child’s parents or the direct care provider. Cultural One quality associated with family strength is positive sensitivity is important when making this determination, communication. Communication that is respectful and as compliance and adherence may be based on engaging uses active conversation and listening skills to process and © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC and showing respect toward the primary care decision talk about important issues, without attacking others, is NOT FOR makerSALE of theOR family. DISTRIBUTION NOTconsidered FOR SALE a key familyOR DISTRIBUTIONstrength (Sittner et al., 2007).

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEFamily-Centered OR DISTRIBUTION Care NOT FORfamily SALEmembers OR (Frost, DISTRIBUTION Green, Gance-Cleveland, Kersten, In recent decades, health institutions across the United & Irby, 2010). Family-centered care can be implemented States have begun to recognize the importance of regardless of the clinical setting or environment. extended family family-centered care and adopt the principles of this model. Siblings and members should be invited to interact and provide care for the child (Figure 1-6). e Based on the premise© thatJones the family & Bartlett is a key Learning,constant in LLC © Jones & Bartlett Learning, LLC family should be supported with respect to its constellation, the child’s life, the family-centeredNOT FOR SALE care modelOR DISTRIBUTION suggests NOT FOR SALE OR DISTRIBUTION recognizing that all family members are aected by the ability, presence (many care providers have to continue to injury, illness, hospitalization, or healthcare need that work and may be absent for periods of time), economic the child is experiencing. Providing support based on status, and family functioning, without care providers mak- encouragement, enhancement of strengths, competence, ing judgments based on these aspects. Child Life specialists and© collaboration Jones & Bartlett provides the Learning, foundation forLLC interactions should be involved© Jones with & the Bartlett assessment Learning, of the family’s LLC needs andNOT successful FOR outcomes.SALE OR DISTRIBUTION and availableNOT to assistFOR with SALE medical OR play, DISTRIBUTION education, and e principles of the family-centered care model guidance for all family members. Reaching out beyond the promote a partnership approach in which the family and clinical settings is also important to family-centered care, healthcare team work together to identify the best way with schools, primary providers and community resources to provide care for the child (Kuo et al., 2012). Issues are being identied and engaged as necessary. © Jones & Bartlett Learning, LLC © JonesIn & a Bartlettfamily-centered Learning, care model, LLC the nursing sta will NOT FOR SALEprioritized OR based DISTRIBUTION on the family’s identied critical issues,NOT FOR SALE OR DISTRIBUTION and the team provides support based on what the family recognize that a child-friendly environment is a crucial identies as most important. For example, if the child has component of pediatric care. Play areas, brightly colored a chronic illness and the family cares for the child, the walls and decorations, and avenues for distraction and family will know the details of what the child needs and developmental growth are all essential. how to best respond© to Jones these needs. & Bartlett Family-centered Learning, care LLC © Jones & Bartlett Learning, LLC provides a structureNOT to support FOR the SALE strengths OR of theDISTRIBUTION family BEST PRACTICES NOT FOR SALE OR DISTRIBUTION through a families-as-partners approach, while providing ediatric healthcare team members should adhere to the for the child’s medical and nursing needs. following guidelines when delivering family-centered care: Although dierent variations of a family-centered care P approach exist, they all rely on ve main principles (Kuo • The family is the constant in the child’s life. © Jones & Bartlett Learning, LLC • The ©family Jones is one &unit Bartlett and should Learning, be treated as such.LLC et al., 2012): NOT FOR SALE OR DISTRIBUTION • The NOTfamily caringFOR for SALE a child withOR a DISTRIBUTION chronic illness • Information sharing knows what the child needs and should be encour- • Respecting and honoring dierences aged to demonstrate the best-care practices with • Partnership and collaboration which they are familiar. • Negotiation • The family should be assisted to develop or continue to grow in both empowerment (competence and © Jones & Bartlett• Care inLearning, context of family LLC and community © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR conﬁdence)SALE OR and DISTRIBUTION enabling (provision of sound care). ese principles are exemplied by two key ideas: • The family should be provided with education and enabling and empowerment. Enabling a family and child educational materials; information sharing is a priority. means that the professional healthcare team provides op- • The family and providers are collegial care team members and should be treated with dignity, respect, portunities for the family to gain and show mastery of the © Jones & Bartlett Learning, LLC and collaboration. © Jones & Bartlett Learning, LLC care required by the child. Learning required skills such • The family should be encouraged to take on as suctioning, catheterizing,NOT FOR changing SALE dressings, OR DISTRIBUTION provid- decision-making roles. NOT FOR SALE OR DISTRIBUTION ing enteric nutrition, and organizing needed supplies are • The family should be provided support to live with nor- examples. e pediatric team should provide the time, sup- malcy and should be given information about outside plies, support, and education that build the family’s sense resources, community support networks, and education. of enabling. Empowerment suggests that the family feels • Siblings and extended family members should be © Jones & Bartlett Learning, LLC included© Jones in care and& Bartlett planning. Learning, LLC competentNOT FOR to provide SALE care OR for DISTRIBUTION their child as a result of the NOT FOR SALE OR DISTRIBUTION support, education, and trust built through interacting with Data from American Hospital Association. (2015). Resources: Strategies the team. For example, one healthcare institution success- for leadership: Patient and family-centered care. Retrieved from http:// fully incorporated family-centered care into its pediatric www.aha.org/advocacy-issues/quality/strategies-patientcentered .shtml; Institute for Family-Centered Care. (2015). Patient- and family- unit through an emphasis on hope, engaged care, and love, © Jones & Bartlett Learning, LLC © Jonescentered & Bartlett care. Retrieved Learning, from http://www.ipfcc.org; LLC Institute for with the family’s skills and interactions being supported Healthcare Improvement. (2016). Person- and family-centered care. NOT FOR SALEand strengthened; OR DISTRIBUTION this model allowed for the developmentNOT FORRetrieved SALE from http://www.ihi.org/topics/pfcc/pages OR DISTRIBUTION /default.aspx of a collaborative partnership between care providers and

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOTCritical FOR Thinking SALE in OR Pediatrics DISTRIBUTION e complexity of pediatric nursing is such that the application of a mode of thinking clearly and eciently to complex child/family clinical presentations helps to solve © Jones & Bartlett Learning, problems.LLC Critical thinking, in general,© Jones is a problem-solving & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONmeans of thinking through a complexNOT FOR situation SALE and draw OR- DISTRIBUTION ing conclusions that will best help a child and their family. Critical thinking in pediatric nursing is used to separate what is known from what is unknown while helping a team of concerned healthcare providers devise a plan to © Jones & Bartlett Learning, LLC assist a child ©in Jonesneed. According & Bartlett to Papathanasiou Learning, et al.LLC NOT FOR SALE OR DISTRIBUTION (2014), criticalNOT thinking FOR is SALEa method OR of DISTRIBUTIONproblem solving that combines creativity with a specic set of cognitive skills—specically, critical analysis (e.g., the Socratic method), inference, and concluding justication—to assess © Jones &Figure Bartlett 1-6 Learning, LLC © Jonesand evaluate & Bartlett information. Learning, By using a LLCcritical thinking mode NOT FOR© Westend61/GettySALE OR DISTRIBUTION NOTof problemFOR SALE solving, OR pediatric DISTRIBUTION nurses can identify problems early and devise systems and interventions to assist a child in need. Table 1-3 summarizes the components of the Papathanasiou et al. critical thinking model. Concept-Based Care in Pediatrics Sometimes critical thinking is considered a program Historically, the education© Jones of nurses & Bartletthas been basedLearning, on outcome.LLC In Staib’s (2003) interactive© Jones model of& critical Bartlett think Learning,- LLC highly structured theoryNOT courses FOR that SALE use memorization, OR DISTRIBUTION ing, the basic structures of thoughtNOT are FOR what SALEcreate sound OR DISTRIBUTION linear thinking, and theoretical application. More recently, thinking and eective problem solving. Staid describes concept-based nursing has gained great respect and in- eight essential components of thinking that are needed terest as an alternative to traditional nursing education in the development of a program with distinct outcomes: and learning.© Jones Concept-based & Bartlett Learning,learning uses LLC a dynamic • Raise questions.© Jones & Bartlett Learning, LLC approachNOT to FOR the ever-growing SALE OR body DISTRIBUTION of scientic nursing • GenerateNOT a purpose. FOR SALE OR DISTRIBUTION knowledge; it focuses on key concepts that can be applied • Use information. to various situations and settings. e understanding of • Utilize concepts. interrelated concepts helps with the mental organization • Make inferences. of large amounts of information, and in turns makes • Make assumptions. © Jones &learning Bartlett logical. Learning, An example LLC of concept-based learning© Jones• Generate & Bartlett implications. Learning, LLC NOT FORis SALE presented OR in DISTRIBUTIONTable 1-2. NOT •FOR Embody SALE a point OR of DISTRIBUTION view.

TABLE 12 Concept Versus Traditional Learning Example of Content© Jones Traditional & Bartlett Learning Learning, LLC Concept-Based© Jones Learning & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Issues with respiratory Disease-based content such as asthma, cystic ﬁbrosis, Ventilation system bronchiolitis, and epiglottitis, and their associated Oxygenation symptoms, treatments, and nursing care Perfusion © Jones & Bartlett Learning, LLC © Jones &Safety Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FORInfection SALE control OR DISTRIBUTION Comfort Skin diseases Disease-based content such as rashes, contact dermatitis, Skin integrity poison ivy, pressure ulcers, and acne, and their associated Infection control © Jones & Bartlett Learning, LLCsymptoms, treatments, and nursing© Jones care. & Bartlett Learning, LLC Comfort NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Symptom management

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALETABLE OR13 DISTRIBUTIONComponents of Papathanasiou et al. Model of CriticalNOT Thinking FOR SALE OR DISTRIBUTION Recognize Assumptions › Separate fact from opinion; use a Socratic question-and-answer method to distinguish knowledge from assumptions. › Do not assume information© Jones is true;& Bartlett notice, question, Learning, reveal, and LLC identify gaps or unfounded logic.© Jones & Bartlett Learning, LLC › When listening, doNOT not assume FOR informationSALE OR is reliable; DISTRIBUTION look for real evidence. NOT FOR SALE OR DISTRIBUTION › Seek common ground with patient in basic assumptions about values. Critical Thinking Enhancement Behaviors › Seek to maintain impartiality, integrity, and independence of thought. › ©Maintain Jones awareness & Bartlett of limitations Learning, of knowledge LLC and personal prejudices. © Jones & Bartlett Learning, LLC › NOTUse perseverance FOR SALE and spiritualOR DISTRIBUTION courage in seeking solutions. NOT FOR SALE OR DISTRIBUTION Problem Solving › Approach issues using empirical methods, the research process, and the scientiﬁc method. © Jones & Bartlett› The value Learning, of intuition is LLC greater with longer nursing experience.© Jones & Bartlett Learning, LLC NOT FOR SALE› In making OR DISTRIBUTION decisions, prioritize patients’ multiple needs. NOT FOR SALE OR DISTRIBUTION › Use worded, rational, and systematic approach to problem solving. Stages of Decision Making › Recognition of objective or purpose › Deﬁnition of criteria© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION › Exploration and consideration of alternative solutions › Design, implementation, and evaluation of solution Data from Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., & Kourkouta, L. (2014). Critical thinking: The development of an essential skill for nursing students. Acta Informatica Medica, 22(4), 283–286. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & BartlettQUALITY Learning,AND SAFETY LLC © Jones & Bartlett Learning, LLC NOT FOR SALECritical OR Thinking DISTRIBUTION for Safety NOT FOR• Evaluate SALE arguments. OR DISTRIBUTION Does evidence exist that the child is at risk for poor care? Does evidence exist that the Critical thinking can be applied to safety in pediatric nursing. child has been neglected? Do the complications of For example, if a pediatric nurse is caring for a child with compli- the family dynamics place the child at risk for neglect? cated family dynamics, a diagnosis of severe cerebral palsy and Are the basic care needs of this child being met at failure to thrive, and ©possible Jones evidence & Bartlett of abuse Learning,and neglect, LLC home? © Jones & Bartlett Learning, LLC using components ofNOT critical FOR thinking SALE can help OR to formulateDISTRIBUTION a • Draw conclusions. The child’sNOT safety FOR is paramount. SALE OR The DISTRIBUTION plan for safety. physical and emotional needs of the child must be met. Supportive resources such as nutrition, warmth, • Recognize assumptions. Children with severe cerebral rest, appropriate clothes, medicine and medical care, palsy may be considered vulnerable to child abuse be- play and distraction, and safe supervision must be © Jonescause they & areBartlett dependent, Learning, often nonverbal, LLC sometimes secured.© JonesIf the family & cannotBartlett provide Learning, for the child LLC with NOTtechnology FOR SALE dependent, OR skills DISTRIBUTION demanding, and seen as severeNOT cerebral FOR palsy SALE and complex OR DISTRIBUTIONmedical needs, “diﬀerent.” Care providers may not be able to provide then reporting the evidence of child abuse/neglect is for their complex needs. The failure to thrive may be as- warranted. sumed to be based on neglect, the most common form of child maltreatment. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORClinical SALE Judgment OR DISTRIBUTION NOTProfessional FOR SALE ORPediatric DISTRIBUTION Nursing Care Clinical judgment is a term that is sometimes considered Pediatric nurses care for both the child and the family. interchangeable with “problem solving,” “decision mak- Nurses who care for children with complex health con- ing,” and “critical thinking.” It comprises the analysis, ditions understand the need for professional care based interpretation, and drawing of conclusions about a patient’s © Jones & Bartlett Learning, onLLC concepts, theory, and skills© specic Jones to &children Bartlett while Learning, LLC condition, including the patient’s holistic needs, concerns, NOT FOR SALE OR DISTRIBUTIONapplying a knowledge base thatNOT focuses FOR on the SALE promotion OR DISTRIBUTION health problems, and areas of needed action or intervention of normal growth and development. (Tanner, 2006). Pediatric nurses must use sound clinical Many professional organizations provide education, judgment to provide high-level holistic care. Nurses’ clini- best practices information, and collegial support for cal judgment is inuenced by their experience, expertise, relationships© Jones with & patients Bartlett and Learning, families, and LLC working as pediatric nurses.© Jones e Society & Bartlett of Pediatric Learning, Nurses (SPN) LLC a teamNOT member. FOR According SALE OR to TannerDISTRIBUTION (2006), ve con- is an internationallyNOT FOR focused, SALE U.S.-based OR DISTRIBUTION organization clusions can be drawn about the use and application of that provides a multitude of opportunities for mentor- clinical judgment: ing, education, research, and scholarly development. SPN publishes Journal of Pediatric Nursing, which pro- • Clinical judgments are more strongly inuenced by vides state-of-the-science research and best practices © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC what nurses bring to the situation than by the data information on caring for children and families. Other NOT FOR SALE(objective) OR DISTRIBUTION collected concerning the situation. NOTprofessional FOR SALE nursing OR organizationsDISTRIBUTION have focus groups • Clinical judgments about patients are highly inu- or specialty practice subgroups that provide support for enced by the situational context and the culture of pediatric nurses. the nursing environment. Because most hospitalized patients are adults, pediatric • Knowledge of both the patient and the patient’s typ- ical pattern of responses,© Jones complemented & Bartlett by Learning,engage- nursesLLC are fewer in number and© o Jonesen practice & Bartlettin isolation, Learning, LLC ment with the patientNOT and FOR family, SALE have theOR greatest DISTRIBUTION such as in pediatric clinics or pediatricNOT FOR units, SALEcontributing OR DISTRIBUTION inuence on sound clinical judgment. to the need for collaboration among the profession as a • Improved clinical reasoning and the development whole. It is imperative that these nurses become aware of of clinical knowledge follow from reection upon national initiatives, research endeavors, and best practices one’s© Jones practice. & Bartlett Learning, LLC projects to move© Jones the profession & Bartlett of pediatric Learning, nursing LLC for- ward. Table 1-4 lists selected organizations that support • NursesNOT FORmake clinicalSALE judgments OR DISTRIBUTION based on a variety NOT FOR SALE OR DISTRIBUTION of single or combined reasoning patterns. the profession of pediatric nursing.

© Jones &TABLE Bartlett 14 SelectedLearning, Professional LLC Organizations That Support Pediatric© Jones Nursing & Bartlett Learning, LLC NOT FOR SocietySALE of ORPediatric DISTRIBUTION Nurses (www.pedsnurses.org) NOT FOR SALE OR DISTRIBUTION Sigma Theta Tau International Nursing Honor Society (www.nursingsociety.org) Association for Vascular Access (www.avainfo.org) Association of Pediatric Hematology/Oncology© Jones & Bartlett Nurses Learning, (www.aphon.org) LLC © Jones & Bartlett Learning, LLC American Academy of PediatricsNOT FOR (www.aap.org) SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Pediatric Nursing Certiﬁcation Board (www.pncb.org) Transcultural Nursing Society (www.tcns.org) National League for Nursing (www.nln.org) © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC EmergencyNOT FORNurses AssociationSALE OR (www.ena.org) DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Association of Camp Nurses (www.acn.org) American Nurses Association (www.nursingworld.org) National Association of Pediatric Nurse Practitioners (www.napnap.org) © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Case Study © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Zack, a 3-month-oldNOT infant, hasFOR been SALE admitted OR to the DISTRIBUTION pediatric 4. Which of the following NOTaspects FOR of the SALE family’s ORback- DISTRIBUTION unit from the emergency department (ED). Zack has a history ground is likely to have the greatest impact on their son’s care? of poor feeding, weight loss, irritability, low-grade fevers, and A. Cultural background intermittent periods of shortness of breath and tachypnea. B. Ethnic background The© Jones family brought & Bartlett Zack to the Learning, emergency departmentLLC after C. Language© Jones fl uency & Bartlett Learning, LLC heNOT vomited FOR four SALE times in OR one DISTRIBUTIONday and became listless. The D. SocioeconomicNOT FOR background SALE OR DISTRIBUTION ED staff evaluated Zack and found him to be anemic, with After explaining to Zack’s parents why his treatment can- an abdominal mass and organic failure to thrive. The on-call not be delayed, the father—who until now has done all the pediatric oncologist was called and immediately admitted talking—states that he cannot authorize treatment until he Zack into the ward with a diagnosis of neuroblastoma. The has conferred with Zack’s grandmother. He excuses himself © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC family was stunned, very emotional, and frightened. The team to make a phone call. Left alone with Zack’s mother, the nurse NOT FOR SALEimmediately OR DISTRIBUTION began to prepare Zack for placement of a centralNOT FORasks if sheSALE has any OR questions DISTRIBUTION about her son’s condition and line and evaluation for cancer treatment. treatment, stating, “I know these treatment decisions are diffi cult, so anything I can tell you to help you, I’m happy Case Study Questions to explain.” The mother replies that any decisions about 1. How can the staff use the principles of family-centered Zack’s care will come from her husband’s mother, the family care to provide© support Jones for Zack& Bartlett and his family? Learning, LLC © Jones & Bartlett Learning, LLC 2. Which team membersNOT shouldFOR be SALE involved OR with theDISTRIBUTION delivery matriarch. NOT FOR SALE OR DISTRIBUTION of family-centered care? 5. According to family theory in pediatric nursing, which 3. What does the family need during the fi rst 24 to 48 hours of the following statements would be considered after admission to the pediatric ward? correct? A. A family represents its cultural and/or ethnic group. © As Jonesthe Case &Evolves. . . Bartlett Learning, LLC B. A family© Jones is considered & Bartlett extended Learning, if multiple genera- LLC NOT FOR SALE OR DISTRIBUTION tionsNOT reside FOR in the SALE home. OR DISTRIBUTION Zack has been admitted and evaluated by a pediatric on- C. A family has a distinct decision maker who is easy cologist. His parents, a working-class East African immigrant to identify. couple in their early 20s, are meeting with an oncology D. A family is whoever they state they are. nurse-practitioner to discuss the next steps in their son’s care. 6. Which of the following key principles are most important in implementing a family-centered care plan for Zack, © Jones & BartlettIt quickly becomesLearning, apparent LLC that although both speak English© Jones & Bartlett Learning, LLC fl uently, the parents are having diffi culty understanding what given the complexities of his family situation? NOT FOR SALE OR DISTRIBUTION NOT FORA. SALE Empowerment OR DISTRIBUTION and enabling is wrong with Zack and how treatment usually progresses in B. Respect and independence neuroblastoma. The father, who is self-employed running the C. Support and collaboration family’s restaurant, asks if delaying treatment until he can save D. Supervision and teaching up extra money is an option. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter Summary ◆ Contemporary issues in children’s health include a vari- program that addresses the healthcare needs of children ©ety Jones of concerns. & Bartlett Issues surrounding Learning, poverty, LLC nutrition, in the context© Jones of family & Bartlett and community. Learning, LLC NOTeducation, FOR family SALE support, OR DISTRIBUTION and medical adherence all ◆ e termNOT “new FOR morbidity” SALE is ORused DISTRIBUTION to denote concerns in uence a pediatric nurse’s care foci. associated with current environmental and social issues. ◆ A variety of frameworks can be used to examine pedi- Attention di culties, adolescent mood and anxiety atric health care. e Healthy People 2020 initiative sets disorders, suicide, homicide, access to rearms, school © Jones & Bartlettgoals for Learning, the health of allLLC Americans, while the American© Jones bullying & Bartlett and violence, Learning, and the eLLC ects of media on obesity, NOT FOR SALEAcademy OR DISTRIBUTIONof Pediatrics has developed Bright Futures,NOT FORsexual SALE activity, OR and DISTRIBUTION violence are all considered contempo- a national health promotion and disease prevention rary issues that create concerns about health and injury.

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR◆ SALETools, principles, OR DISTRIBUTION and guidelines have been developedNOT Feeley, FOR N., SALE& Gottlieb, OR L. (2000). DISTRIBUTION Nursing approaches for working to strengthen the ties and interactions among local, with family strengths and resources. Journal of Family Nursing, regional, and state programs. For example, the Bright 6, 9–24. Futures tool kit provides a variety of assessment forms Frost, M., Green, A., Gance-Cleveland, B., Kersten, R., & Irby, C. and screening tools to identify high-risk behaviors, all (2010). Improving family-centered care through research. Journal © Jones & Bartlett Learning, LLCof Pediatric Nursing, 25, 144–147.© Jones & Bartlett Learning, LLC of which can be used during child/family healthcare NOT FOR SALE OR DISTRIBUTIONGiardino, A. P., & Sanborn, R. D.NOT (2013). FOR New morbidities SALE OR 2.0. DISTRIBUTION encounters. Journal of Applied Research on Children: Informing Policy for ◆ Based on the premise that the family is the constant in Children at Risk, 4(1), 2. the child’s life, the family-centered care model suggests Haggerty, R. J. (1995, October). Child health 2000: New pediatrics in that all family members are aected by the injury, ill- the changing environment of children’s needs in the 21st century. ness,© Joneshospitalization, & Bartlett or healthcare Learning, need that LLC the child Pediatrics, 96©(4), Jones 804–812. & Bartlett Learning, LLC is NOTexperiencing. FOR SALEProviding OR support DISTRIBUTION based on encour- Institute for Family-CenteredNOT FOR SALECare. (2015). OR Patient- DISTRIBUTION and family- agement, enhancement of strengths, competence, and centered care. Retrieved from http://www.ipfcc.org collaboration establishes a solid foundation for positive Institute for Healthcare Improvement. (2016). Person- and family- interactions and successful outcomes. centered care. Retrieved from http://www.ihi.org/topics/pfcc/pages ◆ Two ideas underlying the principles of the family-centered /default.aspx © Jones & Bartlettcare model—empowerment Learning, LLC and enabling—promote© JonesKuo, D. Z.,& Houtrow,Bartlett A. J.,Learning, Arango, P., Kuhlthau, LLC K. A., Simmons, J. M., & Ne, J. M. (2012). Family-centered care: Current appli- NOT FOR SALEan approach OR DISTRIBUTION in which the family and healthcare teamNOT FOR SALE OR DISTRIBUTION cations and future directions in pediatric health care. Maternal work together to identify the best way to provide care and Child Health Journal, 16(2), 297–305. for the child. Kursmark, M., & Weitzman, M. (2009, May). Recent ndings con- ◆ Critical thinking can be applied to the complexities cerning childhood food insecurity. Current Opinion in Clinical of pediatric nursing.© In Jones pediatric & nursing, Bartlett it is Learning, used to LLCNutrition and Metabolic Care, 12©(3), Jones 310–316. & Bartlett Learning, LLC separate what is knownNOT from FOR what SALE is unknown OR DISTRIBUTION while Kushel, M. B., Gupta, R., Gee, L., NOT& Haas, FOR J. S. (2006). SALE Housing OR DISTRIBUTION helping a team of concerned healthcare providers devise instability and food insecurity as barriers to health care among a plan to assist a child in need. Papathanasiou et al.’s low-income Americans. Journal of General Internal Medicine, model of critical thinking includes recognizing assump- 21(1), 71–77. tions, enhancing critical thinking behaviors, taking a Lucey, J. (2001). e new morbidity revisited: A renewed commit- reasoned© Jones approach & Bartlett to problem Learning, solving, and LLC following ment to the© psychosocial Jones & aspects Bartlett of pediatric Learning, care. Pediatrics, LLC a four-stageNOT FOR decision-making SALE OR DISTRIBUTIONprocess. 108(5), 1227–1230.NOT FOR SALE OR DISTRIBUTION McIntyre, L., Williams, J. V. A., Lavorato, D. H., & Patten, S. (2013). ◆ Many professional organizations provide education, Depression and suicide ideation in late adolescence and early best practices information, and collegial support for adulthood are an outcome of child hunger. Journal of A ective pediatric nurses. Disorders, 150(1), 123–129. © Jones & Bartlett Learning, LLC © JonesMelchior, & M., Bartlett Chastang, Learning,J.-F., Falissard, LLCB., Galéra, C., Tremblay, NOT FORBibliography SALE OR DISTRIBUTION NOT FORR. E., Côté, SALE S. M., OR & Boivin, DISTRIBUTION M. (2012). Food insecurity and children’s mental health: A prospective birth cohort. PLOS One, American Hospital Association. (2015). Resources: Strategies 7(12), e52615. for leadership: Patient and family-centered care. Retrieved Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., & from http://www.aha.org/advocacy-issues/quality/strategies Kourkouta, L. (2014, August). Critical thinking: e develop- -patientcentered.shtml© Jones & Bartlett Learning, LLCment of an essential skill for nursing© Jones students. &Acta Bartlett Informatica Learning, LLC Centers for Disease ControlNOT and Prevention. FOR SALE (2010, JuneOR 4). DISTRIBUTION Youth Medica, 22(4), 283–286. NOT FOR SALE OR DISTRIBUTION risk behavior surveillance—United States, 2009. Morbidity and Shah, A. (2013). Poverty facts and stats. Retrieved from http://www Mortality Weekly Report, 59(SS-5), 8. Retrieved from http://www .globalissues.org/article/26/poverty .cdc.gov/mmwr/pdf/ss/ss5905.pdf Sittner, B., Hudson, D. B., & Defrain, J. (2007). Using the concept Coleman-Jensen, A., Rabbitt, M. P., Gregory, C., & Singh, A. (2015a). of family strengths to enhance nursing care. American Journal Household© Jones food security& Bartlett in the United Learning, States in 2014 LLC. U.S. Depart- of Maternal/Child© Jones Nursing, & 32 Bartlett(6), 353–357. Learning, LLC mentNOT of Agriculture, FOR SALE Economic OR Research DISTRIBUTION Service, September 2015. Staib, S. (2003).NOT Teaching FOR and measuringSALE OR critical DISTRIBUTION thinking. Journal Retrieved from https://www.ers.usda.gov/webdocs/publications of Nursing Education, 42(11), 498–508. /err215/err-215.pdf Tanner, C. (2006). inking like a nurse: A research-based model Coleman-Jensen, A., Rabbitt, M. P., Gregory, C., & Singh, A. (2015b). of clinical judgment in nursing. Journal of Nursing Education, Report summary: Household food security in the United States 45(6), 204–211. © Jones & Bartlettin 2014. U.S. Learning, Department of LLC Agriculture, Economic Research© JonesWeinreb, & L., BartlettWehler, C., Perlo, Learning, J., Scott, R., LLC Hosmer, D., Sagor, L. & NOT FOR SALEService, ORSeptember DISTRIBUTION 2014. Retrieved from https://www.ers.usdaNOT FORGundersen, SALE C. (2002). OR Hunger:DISTRIBUTION Its impact on children’s health .gov/webdocs/publications/err194/53740_err194 and mental health. Pediatrics, 110(4), 41.

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