Impact of Hospital Admission Care at a Pediatric Unit Hospitalization especially in children causes great emotional impact. Anxiety is created by being away from the home environment which can be more traumatic for children than for the adults. From the time of admission to a hospital, specifically when unplanned, is considered the most stressful moment for both the children and the parents. The admission care process is defined as “the first nursing care a child receives when he or she is admitted to the hospital, where the child’s health condition and needs will be assessed” (Macias, 2015 p. 285). According to the research, parents’ and children’s anxiety can be significantly reduced depending on how the admission process is conducted. …show more content…
The aim of this study was to explore perceptions and experiences related to the process of admission to a pediatric unit from the perspective of parents and four different staff groups; physicians, nurses, nurse assistants, and orderlies (Macias, 2015). Title The title succinctly conveys key information, which is explained in the textbook as a valid title (Polit & Beck, 2010). While keeping the title brief, the researcher reveals the community and the key phenomenon. The textbook states, “In qualitative studies, conceptual definitions of key phenomena may be a major end product” (Polit & Beck, 2010 p. 44). Hence, admission care being the major end product that needs to be studied, concerning the impact. Abstract In regards to the abstract, the information was presented clear and concise. The main features of the report were summarized; including details of the focus groups, categories of perception in the parents’ perspective, and various ways to improve trust and confidence in a parent-professional relationship (Macias, 2015). Introduction The qualitative study “explored the process in-depth, constructing meaning through the participant’ own life experiences” (Macias, 2015 p. 286). Even though the text does not reveal the phenomenon of interest, the researchers do describe the views of phenomenology. The textbook clarifies, “Phenomenology is an approach to thinking about what life experiences of people are like and what they mean” (Polit & Beck, 2010 p. 48). Both the phenomenon and the problem were unambiguously stated throughout the entire piece. Literature Review The researchers referenced to eight other studies that all correlate and provide additional insight to pediatric care in the admission process. The literature review adequately expresses the methods used to try grasping the various perspectives that are incorporated with the first form of nursing care. Little is known about parents’ perspectives regarding the admission process, less is known from the professionals’ point of view (Macias, 2015). Due to the lack of evidence, a solid basis for the new study has been developed. Research Questions According to Pilot and Beck (2015), “Research questions are the specific queries researchers want to answer, which guide the type of data to be collected in a study” (p. 100). Since the aim of the study explores perceptions and experiences of the process of admission to a pediatric unit, focus groups were conducted. Open ended questions began each of the gatherings and the moderator guided the discussion to achieve a better understanding (Macias, 2015). Despite the fact the research questions were not explicitly stated, the researchers provided information as to how the open ended questions created a relaxed atmosphere which allowed participants to speak freely without judgement (Macias, 2015). Method/Sample and Setting The research tradition phenomenology was continuously upheld throughout the data collection process and the data analysis. The population of interest and the setting was described sufficiently in detail. In regards to selection, purposive sampling was selected to ensure diversity of subsequent participants. The sample size was a smaller group of 12 parents and six health professionals (Macias, 2015). Pilot and Beck (2010) declare, “If participants are able to reflect on their experiences and communicate effectively, saturation can be achieved with a relatively small sample” (p. 286). As the text states, the sample size for this study was of smaller proportion, saturation was still accomplished due to the consistent inquiries of lived experiences. Data Collection Appropriate methods were used to gather data for example, collecting informed consent and providing privacy to the participants.
As for data triangulation the textbook further explains, “Data triangulation involves the use of multiple data sources for the purpose of validating conclusions. There are three types of data triangulation: time, space, and person” (Polit & Beck, 2010 p. 327). Only person triangulation was used throughout this study. Polit and Beck (2015) explain, “Person triangulation involves collecting data from different types or levels of people, with the aim of validating data through multiple perspectives on the phenomenon” (p. 327). Even though only one method of triangulation was used, a sufficient amount of data was gathered. The information collected contained one common theme, six categories and quotes from focus groups used to illustrate findings drawn from the discussion (Macias, 2015). Given all the data that was obtained a sufficient depth and richness was …show more content…
achieved. Procedures First, informed consent was obtained, then the participants agreed on a date to conduct the focus groups. All groups were audiotape recorded and then transcribed (Macias, 2015). Both the data collection and recording procedures were sufficiently described while appearing appropriate. The recruitment of staff for the service providers’ sample, professionals who were working or had previously worked in the pediatric unit were contacted by the nurse unit manager who knew them personally, allowing the investigators to recruit professionals who did not know each other (Macias, 2015). With the knowledge that the participants do not know each other, prevention of behavioral distortions or bias can be avoided. The staff that partook in the study included two nurses who volunteered for recruitment, both having relationships with individuals in the pediatric unit and being trained to do so. Also, two investigators from the research team experienced in conducting focus groups, with no professional connection to the participants, led all focus groups to further prevent any partiality. The researchers took extra precautions to safeguard the rights of the participants for instance, all participants were verbally informed of the aim of the research study, its design, the voluntary nature of participation, the right to withdraw from the study at any time, and the confidential treatment of the data (Macias, 2015). Enhancement of Rigor The trust worthiness of the results were addressed through reasoning and by stepwise reanalysis, leading to the refinement of categories and themes to reproduce precisely and effectively the results of the observed outcome. Preliminary results were also discussed with qualitative research experts to increase the credibility of the analyzed data. Further, when the focus group ended, the moderator summarized the main conclusions, which were confirmed by the participants (Macias, 2015). Data Analysis The data management and methods used were sufficiently described by including the step by step process. The analysis of the data was strictly based off of the participants lived experiences which maintained the research tradition of phenomenology. During data analysis, researchers identified emerging and repetitive categories so the results were formulated into one main common theme, yielding an appropriate product (Macias, 2015). The analytic procedure did not suggest the possibility of any biases. Findings The findings were effectively summarized with good use of experts. The themes of the data capture the meaning and impact admission care makes. The researchers suitably conceptualize the themes in the data and incorporated quotes from the focus groups. The analysis provided insight on how to create a more positive experience for the child and parents throughout the admission process. Theoretical Integration The themes were logically connected to one another and in doing so created a holistic impression. The figures were used effectively, especially in figure one, the information was presented in a manner that condensed the article effectively conceptualizing the data. Discussion The findings of this study were interpreted within an appropriate social and cultural context. Prior studies discussed major findings such as, how professionals introduce themselves, parent satisfaction with the care received, and the information given on hospital general guidelines. The implications of this study are consistent with the limitations. The textbook defines transferability as, “the extent to which qualitative findings can be transferred to other settings” (Polit & Beck, 2010). In regards to the report, transferability is not specified but due to the fact that this topic is so broad, the findings can be used in every hospital to improve the patient and family member’s experience. Implications/Recommendations The researchers do discuss the implication of the study for clinical practice and help to understand how parents perceive their child’s hospitalization. The main findings from this study also suggest the need to design a multidisciplinary protocol for pediatric admission, and also to conduct training workshops for professionals on communication skills and a compassionate approach to care delivery, which are reasonable implications (Macias, 2015). Global Issue/Summary Assessment The report was well written, organized, and was sufficiently detailed for critical analysis. The interpretations, methods, and findings were vivid and rich with information and specifics. The study’s findings appear to be trustworthy and confidence in the truth of the results is without question.
In practice, this study can truly impact the nursing discipline. In guiding health care professionals towards better care of the patient and family members from the beginning of admission, the patient and parents will gain trust and confidence during such a stressful time. The admission process is the first form of treatment and that creates a baseline as to the experience and care that will be continued until being discharged. These findings can create a new approach for professionals to treat admissions not only as the first phase rather in a holistic approach to the care they will
receive. Conclusion The admission process is considered one of the most stressful experiences for a patient and the family (Macias, 2015). The findings that this study has found can create a large impact towards patient care. It suggests that providing parents with professional support based on trust and confidence from the moment of admission to the unit may help them and their children feel welcome and confident throughout the process of hospitalization (Macias, 2015).
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Often time, nurses has been viewed by patients, their family members and the medical team as basic emotional care givers, pill crushers or cart pullers and not as healthcare professionals who are more interesting in health promotion, disease prevention and better patient outcomes. They also often forget the emotional, physical, mental, and caring part that is involved with the profession. And to make matters worse, nurses are continued to be viewed as a threat by doctors more than ever before especially with the opening of Nurse Practitioners programs.
Nurses play a big role in supporting the parents while their child is in the NICU. Showing compassion and demonstrating caring actions when caring for the patient makes it more likely that the parents will trust the nurse and the information the nurse gives them regarding their child’s condition. This trust is important as it helps the parents feel confident in the decisions they are making about their child’s care. When the parents of an ill child in the NICU have decided to terminate treatment palliative care by the nurse and other healthcare providers comes into play. Palliative care is keeping the child comfortable by treating the symptoms and being there for the parents and child physically, emotionally, and spiritually (Eden & Callister, 2010).
The clinical setting can be terrifying for a nursing student. Nursing students are not only concerned about properly caring for patients, but they have just as much concern regarding the techniques of how to properly address patients and their families in a manner which conveys the care and concern they wish to possess when they become registered nurses. Certainly, heightened levels of anxiety may inhibit a student nurse’s ability to make sound judgment calls with regard to appropriate nursing interventions (Foley, 2016).
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
It will seek to demonstrate the appropriateness in supporting the patient and their family, whilst reflecting upon personal experience, and how literature may influence the healing effectiveness. The factors that enhance and inhibit the learning environment will be explored and suggested techniques to improve clinical learning will also be discussed. Finally the nurse-patient learning relationship will be explored along with the application of teaching and learning strategies will be examined.
Treating the patient and family as one, can have improved outcomes, decrease hospital stays, increased patient satisfaction, and improved reimbursements for the hospital. Developing a relationship with not only the patient, but family as well, can pay off in the long run by providing better communication, better quality of care, and trust. The patient and family can be strong advocates for improved performance improvement efforts. Including family in the treatment of the patient treats the “whole” patient through their hospitalization. Involving the family can enhance the patients care.
The transition from student to a qualified nurse can be a stressful and overwhelming ex-perience for many newly qualified nurses. This opinion is widely upheld throughout the literature with Higgins et al (2010) maintaining that many of the problems experienced are due to lack of support during this initial transition and a period of preceptorship would be invaluable.
Participant 4 stated, “I think just basically being there for the family as well…I think even just a cup of tea can go a long way with any family (McCallum & McConigley, 2013). Another theory that intertwines with Watson’s is Barbara Dossey’s Theory of Integral Nursing. Dossey articulates, “Healing is not predictable, it is not synonymous with curing but the potential for healing is always present even until one’s last breath,” (Parker and Smith, 2015, p. 212). Dossey believes that integral nursing is a comprehensive way to organize different situations in fours perspectives (nurse, health, person and environment) of reality with the nurse as an instrument in the healing process by bringing his or her whole self into a relationship with another whole self. In the HDU, the RN’s interacted with each patient while providing high quality care to create a healing environment for the patient and family even when their prognosis was otherwise. Patient 3 specified that “We still have to provide care...and make the family feel that they are comfortable and looked after” (McCallum & McConigley, 2013). These theories ultimately show the importance of a nurse through the aspects of caring to create and maintain a healing environment that is not only beneficial to the patient but to their loved ones as
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.
Being a nurse is a huge responsibility, and that obligation is only magnified when, as a nurse, you are working with children. Children are very delicate and are not able to bounce back from serious issues like older patients are. As a nurse, you are crucial in ensuring that the pediatric patients you see are on track in their growth and development. A lot of parents aren’t really sure about where their children should be at and need anticipatory guidance and other teaching so that they are aware when their children may be in danger. Nurses are extremely important in assessing children’s developmental level because if they do not, that child may be hindered for life.
When the baby is admitted to the NICU, the mother is unable to have the usual bonding moments where she holds and comforts her newborn. Rather, when visiting with her child, she is required to take endless precautions, has limited time to be with her baby, and must see her little child connected to many machines helping to keep the baby stable (Shanmugam & Ramachandra, 2015). In their study, Shanmugam and Ramachandra (2015) questioned 100 mothers of neonates in the NICU, and recorded the correlation between their stress level and coping strategies. They found that 38 of the mothers had severe stress, 28 had moderate stress, and the remaining had mild stress. Of these women, 25% had good coping, 50% had moderate coping, and 25% had poor coping. A large finding from this study was that nurses and health care providers played a very big role in helping to reduce the stress levels of the mothers by talking with them and listening to their concerns, while also providing adequate care for their children. If the mother is using negative coping strategies, such as holding in all of her concerns and filling her mind with the thoughts of death, financial issues, and fear of the unknown, she is going to cause her body great harm (Shanmugam & Ramachandra,
Triangulation is "the combination of methodologies in the study of the same phenomena" (Denzin 291). Triangulation is also defined as "a process by which the researcher can guard against the accusation that a study 's findings are simply an artifact of a single method, a single source, or a single investigator 's biases" (Patton 1197). There are different types of triangulation. Patton differentiates between four types: a) methods triangulations; b) triangulation of sources; c) analyst triangulation; and d) perceptive triangulation (1993). Triangulation can be used not only in qualitative research, but also in quantitative research. Bamberger states that: ".. triangulation is also used in quantitative research, usually
“Enabling” is the nurse 's’ responsibility to help the make a transition into the unknown. For
(2014) described the importance of triangulation is that all of the outcomes, whether convergent, inconsistent, and contradictory, should be filtered through other knowledge about the setting. As such, triangulation seldom provides a particular view of a circumstance, but can offer a rich and multifaceted representation of the phenomenon under study. Triangulation is typically a strategy or test for improving the validity and reliability of research or evaluation of findings.