ROLE OF THE NURSE IN THE MANAGEMENT OF CHILDRENS HEALTH CARE NEEDS AT THE REGIONAL HOSPITAL LIMBE

Abstract

Growth in childhood is altered by illness and disease processes. These are health risks that place marked discomfort to individuals both the young and the old; making it difficult for a steady healthy state to be maintained.

Managing the undesired circumstances which the illness causes involve providing care to restore and promote health. Pediatrics hereby is a medium whereby in addition to handling the pathophysiological aspects of illness, care is taken to ensure that children’s health problems are addressed from a broader perspective, to promote their growth and their wellbeing.

The main aim behind this study was to understand the management of children’s health needs, which involved assessing the nurses’ knowledge on children’s health assessment and their needs and assessing the roles of the pediatric nurse.

A cross-sectional study was carried out in which a simple structured multiple-choice questionnaire was administered to get their opinions and collect the necessary information.

The results obtained show that the majority of the participants assessed to understand what providing care for children is all about and what it entails, but are unable to apply this theoretical knowledge into practice.

Effectively, it must be noted that the care of children through efficiency needs to be improved so as to ameliorate standards for the delivery of care to children as well as to ensure that healthy growth and development is guaranteed.

CHAPTER ONE

INTRODUCTION

1.1   Background

Children require care at each stage of growth in order to sustain and lead healthy lives.

Providing such care becomes complicated especially when the child turns out ill. Illness is a condition that causes major problems to individuals [1], accompanied by evidence of pain or harm [2].

Evidence of the increasing complexity in providing care for children is demonstrated in the physical and psychological demands from the child which are altered due to the illness process. This thus involves adopting pediatric nursing roles which thereby go to suit the child’s condition and satisfy the needs.

Pediatric nursing thus involves understanding that, unlike adults, children possess a wide range of physical and psychological differences which make them have lesser abilities and lower resistance [3].

In line with these differences, the health and wellbeing of every child are very important, thus pediatric nursing will also involve providing restorative and preventive health services to children such as; immunizations, nutrition as well as ensuring proper hygiene and sanitation for the child [4].

This broadens the tasks of the pediatric nurse making it unlimited and also involving that their abilities in identifying and managing children’s health needs must always remain standard.

There are also major considerations of pain in children [5]. As often as children fall ill, the discomfort placed by the illness causes a great deal of pain thus placing a high need for management which is a pediatric nursing responsibility.

It is a necessity and must remain a priority for the pediatric nurse to make sure that children who report health problems at any given time should be attended to promptly so as to reduce risks of early death [6].

We are thus yet to conclude that pediatric nursing roles have no defined dimension as these roles change with the complexity and the severity of the condition in which the child may be.

We therefore must know that despite the case or situation, the pediatric nurse must know the basis of providing care for children by knowing the essentials of all they need in order to enhance their growth both physically and psychologically.

In a study carried out in the United Kingdom by [7], there was a perceived need for improving on staff qualifications to ensure that health care delivered to children and young people will be at its optimum.

In line with this, there were issues based on identified facts discussed on the improvement of the health outcomes of children and young people [8]. This in effect explained an approach to ensuring better results from the care provided to children and young ones.

Furthermore, in Australia, [9], it was discovered that there was a need for the improvements of the nurses’ management of children with fevers. This involved assessing the nurses’ knowledge and practices in the management of fever as well as the challenges faced, which hinder effective management.

Also in a document titled ‘Safeguarding Children and Young People; Roles and competencies of health care staff, published by a group of institutions such as the Royal College of Nursing (RCN) and the Pediatric Intensive Care Society (PICS), there were discussions on increasing the efficiency of health care staff ensuring that children benefit from improved health outcomes.

An overview of all these publications is aimed at sustaining the lives of children worldwide and also reducing the early deaths which occur amongst children at very tender ages.

Awareness from these studies and discussions is geared towards improving and boosting the standards of health care delivery thereby protecting children’s health and wellbeing of children.

This study titled ‘Role of the Nurse in the Management of children’s health needs’ has its main focus on the assessment of children and management of their health needs. It involves understanding that children’s health is affected by different factors which affect their growth positively or negatively.

According to the WHO Reports on child health, the number of under-5 deaths has declined from 12.7 million in 1990 to 6.3 million in 2013. This shows a marked decrease in the number of deaths occurring amongst children below 5 years every day.

Though with this decrease, countries like India and Nigeria account for more than a third of under-five deaths worldwide as well as other countries such as Pakistan, the Democratic Republic of Congo and China whose child mortality rates are still unstable. Information from the GHO (Global Health Observatory Data Resource) shows that 83% of the deaths amongst children are as a result of infectious diseases, neonatal or nutritional conditions and the best way possible in preventing these deaths is seeking adequate child health care.

Furthermore in line with the increasing need for pediatric care in all hospitals, information from the RCPCH (Royal College of Pediatrics and Child Health) and the RCN (Royal College of Nursing) in the background report on Nurse staffing in Children and Young People’s Health care, children make up at most 25%-30% of all intakes at the Emergency and assessment units which are indicative of an increased need for adequate pediatric nursing care, particularly for the young ones.

A study in Africa by [10] states indicators for the challenges in reducing child mortality rates.

Indicators:

–           Low coverage interventions and weak delivery systems: interventions geared towards ensuring survival amongst children remains a challenge in all health care settings. With this the coverage for child survival interventions in most African countries is extremely low.

Amongst preventive interventions listed for children, only measles, breastfeeding and vitamin A had an overall coverage of 50% amongst children.

In the southern part of Africa, it was thus found out that children with no guardian or parental support are more exposed to malnutrition and early deaths.

–           Poor performance of nursing staff contributes to the incidence of deaths amongst children which could have been prevented with the provision of preventive and curative services in pediatric care settings. In recent years the following conditions and percentages of deaths are as follows:

• Neonatal conditions-27%
• Pneumonia-21%
• Malaria-18%
• Diarrhea-16%
• HIV/AIDS-6%
• Measles-5%
• Injuries-2% and others 5%
• Malnutrition accounts for 54% of the underlying deaths.

With this, we can thus know that most of these conditions warrant admission and constant nursing care particularly since children are concerned.

We, therefore, need to boost up efforts as concerns improvements made in carrying out the roles of the pediatric nurse as some of these deaths can be prevented with a lot coming from the nurse.

1.2 Problem Statement

The roles of the pediatric nurse are always in accordance to their academic knowledge and professional demands.

As a result of heavy work-loads, neglect sets in and thus barriers set in making it difficult for the nurse to effectively exercise roles. With such, many children are at risk of not receiving adequate nursing care.

As a result of massive workloads and parental fears and demands, it is evident that pediatric nurses face a wide range of challenges in effectively exercising their roles and providing adequate care for the child.

Thus with these challenges, the pediatric nurse is unable to sustain a dynamic workflow and thus they face bigger challenges in assessing children to determine their health needs making it more difficult to manage these needs and thus children are at greater risks of facing bigger complications which end up being life-threatening.

1.3 Purpose of Study

The aim for carrying out this study is to understand major considerations and important aspects of pediatric nursing and how important nursing roles are to the child’s life.

It involves understanding how nurses apply systemic methods in assessing children in order to identify the most important needs and effectively manage these needs.

This also involves understanding major considerations on what affects the health assessment of children beginning with their age and cutting through environmental influences on their health.

1.4 Justification

There is a universal need for efficacy in pediatric nursing in order to reduce complications which are likely to result in early mortality in children.

Thus with this study, we will be able to achieve a standard in understanding the various roles of the pediatric nurse.

By so doing improving efforts geared towards effectively attaining optimal management of children’s health need, therefore meeting up with parental expectations and reducing fears and anxiety of parents whose children are sick.

1.5 Objectives

1.5.1 General objective

To describe the management of children’s health needs and pediatric nursing roles.

1.5.2 Specific objectives

1. To assess nurses’ knowledge and practices in assessing children.
2. To assess nurses’ knowledge of children’s health care needs
3. To describe nurses’ roles and the management of children’s health care needs.
4. To identify the challenges faced by pediatric nurses.