3. PREPARING CHILDREN FOR HOSPITAL CARE.ppt

PREPARING CHILDREN FOR HOSPITAL CARE

1. Child Hospitalization
•Childhood illness and hospitalization affects the
concerned child and the entire family.
•Hospitalization may cause anxiety and stress at any
age.
•Children are often too young to understand what is
happening or are afraid to ask questions

2. Hospitalization
•Hospitalization is often confusing, complex, strange
and overwhelming to children and their families.
•This requires strategies that prepare children and
their families for experiences while at the same time
minimizing negative effects.
•Requires id needs of children and families through
assessment of verbal and non-verbal behaviors, when
validating the information and providing appropriate
responses and intervention.

3. Hospitalization cont…
•Assessing the learning needs and abilities of the child and
family.
–For the interventions to be successful, the nurse must
communicate and teach in the most effective method for
the individual child and family.

4. Hospitalization issues
Infancy
•Stressors
–New surroundings, bright lights, strangers
–Loud noise from hospital equipment
–Pain
•Reaction: despair/protest
•Intervention: provide consistency in care, provide for
pain control, minimize separation, provide distraction

5. Toddlers
•Hospitalization issues
–Loss of control
–Altered routines
–Regression
–Fear of body harm
–Separation anxiety
•Interventions
–Provide consistency in care
–Involve in care
–Give one direction at a time
–Parental presence and participation
–play

6. Pre- school 3-6 years
•Stressors
–Loss of control
–Regression
–Fear of bodily harm
–Misconceptions and misunderstanding abound
–Illness and procedures considered as punishment
•Interventions
–In cooperate in care
–Give choices where possible
–Clarify misconceptions
–Provide for safe areas
–Provide for opportunity for play

7. School age (7-12 yrs)
•Issues concerned
–Regression
–Altered body image(actual/perceived)
–Separation from peers and family
–Absence from school
–Questions on health and illness
–Decreased self esteem
•Interventions
–Encourage discussions on specific body/image changes
–Explain procedures using developmentally appropriate
language
–Allow participation in care
–Offer choices

8. School age
•Teach coping mechanisms during procedures
•Encourage keeping up with school work
•Introduce to peers

9. Late childhood (12 -18 yrs)
•Hospitalization stressors
–Loss of identity
–Impaired body image (real or perceived)
–Loss of control
•Interventions
–Nurse separate from younger children
–Provide for privacy
–Explain and prepare for procedures
–Offer education
–Involve in care
–Talk to and listen to them
–Allow them to express their thought and feelings

10. Adolescents
Stressors
–Separation from friends, peers and family
–Disruption of school and extracurricular activities
–Loss of independence and privacy
–Fear of body harm, deformity and death
Interventions
–Respect their privacy
–Get to know them, don’t treat them like children
–Encourage them to meet their peers
–Involve them in decision making and care plans
–Empower to self advocate their needs/concerns in the
health care environment

11. Preparation of children for
hospitalization
Family centered care
•FCC is based on the understanding that the family is the
child’s primary support and its perspectives and information
are important in clinical decision making (Mantovani, 2009)
•Families are given choices, provide input, and are provided
with information they can understand
•Enabled transition from merely parental presence to
involvement, participation and partnership

12. •Aim: support families in natural care giving roles to promote
patterns of health living at home and in the community.
–Emphasis is on strengthening role of families in promoting
health and well being of children
–Parents and professionals are viewed as equals in
partnership committed to excellence in health care.

13. Principles of FCC
•Respect each child and his family
•Honor racial, ethnic, cultural, and socioeconomic diversity
and its effect on individuals perception of care
•Recognize and build strength of individual child and family
•Support and facilitate choice of child and family on
approaches of care
•Ensure flexibility in organizational policies, procedures and
practices to enable needs, beliefs and cultural values of
individuals are met.

14. Principles of FCC
•Share honest and unbiased information with families on their
management on an ongoing basis.
•Provide and facilitate formal and informal support for child
and parents (Child-child, parent-parent).
•Collaborate with families at all levels of health care in caring
for individuals.
•Empower each child/family to discover their own strength,
build their confidence to make choices and decisions about
their health
•Together…., celebrate successes.

15. Role of the nurse in FCC
•Establish rapport with the family
•Identify the family’s needs and expectations
•Be available and open to questions
•Provide family education and empowerment
•Give and get feedback from children and families
•Manage conflicts effectively

16. Atraumatic Care

17. ATRAUMATIC CARE
•Provision of therapeutic care in a manner that eliminates or
minimizes psychological & physical distress experienced by
clients and their families while in the health care settings.
•Involves;
–Guiding children/families using FCC approach
–Use of age-appropriate/child-specific interventions
–Assist clients to cope with illness and hospitalization

18. Principles of atraumatic care
•Prevent or minimize child/family separation
–Hospital bed is a safe area
–Allow parents to accompany clients for procedures
•Promote sense of control and hope
–Offer education
–Orient to the ward area
–Teach on coping mechanisms
–Allow participation in care
•Prevent/ minimize physical and environmental stressors
–Pain control
–Minimize invasive procedures
–Control environmental stressors
–Provide consistency of care and providers.

19. Overview of child health status in
Kenya

20. Total Population 54,985,698
Population Growth (% annual) 2.2
Rural population (% of total) 78.40
Urban population (% of total) 21.60
Population ages 0-14 years (% of total)42.76
Population 65 years and above (% of total)2.66
Health demographics
(KDHS 2014/2015)

21. •Life expectancy- 66.9 (64/68)
•Top three causes of morbidity and mortality
HIV/AIDs-38%
Lower respiratory tract infections-10%
Diarrheal diseases-7%
•Characteristic youthful population with approximately 3/5 of
population under 25 yrs.
National health demography

22. •Under-five and infant mortality rates are two of the indicators
used to monitor child health under MDG #4
•Kenya
U5M-52/1000 (Nyanza 72 per 1000)
IM-39/1000 (Male/female : 44/37)
•NMR has exhibited the slowest rate of decline (33 percent).
•Main causes of morbidity and mortality- ARIs, fever , diarrhea,
NB: Malnutrition (70% of illness in children)
Child health

23. Mortality in under fives.

24. •The proportion of children fully immunized has increased
from 57 %(2003) to 77 % (2008) to 79 % (2014)
•Ownership and use of treated mosquito nets

•Promotion of appropriate breast feeding and infant feeding
practices.
•Integrated management of childhood infections.
Factors attributed to the success