Current trends in pediatrics.pptx

Trends is defined as the dynamic changes going on in the pediatrics community to achieve and uplift the already existing facilities .
The new development can be in the form of newer drugs , new diagnostic technique or treatment plan .

1. Current Principles, Practices, and Trends in pediatric nursing 04-07-2022 1

2. INTRODUCTION Pediatrics is the specialty of medical science concerned with the physical, mental, and social health of children from birth to young adulthood. The first printed book on pediatrics was in Italian named “Little book on disease in children”. The first English book on children’s disease was “Book of children” written by Thomas Phaser (1545 AD) and world’s first pediatricians were two Indians Kashyapa and Jeevaka . Child Health Care has changed dramatically in recent years due to advances in medical knowledge and understanding of the emotional response of children. 04-07-2022 2

3. The modern concept of child health emphasizes continuous care of the “whole child”. According to UNICEF , assistance for meeting the needs of children should no longer be restricted to one aspect like nutrition, but it should be broad-based and geared to their long-term personal development ensuring holistic health care of children. At present, more emphasis is given on preventive approach rather than on curative care . Primary Health Care concepts with a team approach and multidisciplinary collaboration are adopted for child care. Increased public awareness, and family participation in child care are newer trends. Family health, Need-to is based, problem-oriented, risk approach is practiced for better child health. 04-07-2022 3

4. Special attention is given to the children at risk like orphans, destitute, slum dwellers, child laborers, and handicapped children. Movement against gender bias, female feticide, child abuse, neglect, and maltreatment are in highlight at present. The interest of political leaders and understanding the importance of child health, the constitution of national health policy for children, and the implementation of various health programs for the improvement of child health are great achievements for children. The growth of subspecialties for the super-specialized care of children is a recent trend. The sub-areas are neonatology, pediatric surgery, pediatric cardiology, etc. So, child health will also progress by various movements towards the aim to improve the survival and wellbeing of all children. 04-07-2022 4

5. PRINCIPLES 1 . Respect child’s need to regress and help him to accept dependence on others if he resists this. 2. Have an awareness of the child’s need for help in reconquering the negative counterpart of the core problem in the stage of development to which he has regressed. 3. Protect the child family interpersonal relationship. 4. Awareness of the feeling of others and readiness to respond to them to strengthen their resources to cope with stress is a major principle underlining effective emotional support. 5. Children can tolerate discomfort if they are prepared for it, comprehend its real purpose, and are adequately prepared. 6. To a child, play is a note of time out from daily living, but rather an essential part of it that enables him to grow and mature through the various stages of development. 04-07-2022 5

6. PRACTICES IN PEDIATRICS NURSING The primary goals of child health nursing care can be stated simply as the promotion and maintenance of optimal family health to ensure the cycle of optimal child-rearing. The range of practice includes. Care of children during the perinatal period Care of children from infancy through adolescence. In all settings and types of care, keeping the family at the center of care delivery is an essential goal. If the family’s level of functioning is low the emotional, physical, social health and potential of the individuals in the family can be adversely affected. 04-07-2022 6

7. Child health nursing is family- centered , community- centered . Research oriented. Serves as an advocate Child health nursing uses a high degree of independent nursing functions because teaching and counselling are so frequently required. Promoting health is an important nursing role because this protects the health of the next generation. Childhood illness can be stressful. They can alter family life. 04-07-2022 7

8. STANDARDS OF CHILD HEALTH NURSING PRACTICE STANDARD 1 : Quality of care STANDARD 2:Performance appraisal STANDARD3:Education STANDARED4:Collegiality STANDARD 5:Ethics STANDARD 6:Collaboration STANDARD 7:Research STANDARD 8:Resource utilization 04-07-2022 8

9. SPECIAL LEGAL CONCERNS 04-07-2022 9

10. CURRENT TRENDS IN PEDIATRICS NURSING Modern approach Growth of specialization Independent practitioner Visiting Rooming in Care by parent units Parent support groups Self care Hospital based & facilities for minor surgical care Pediatric unit Intermediate care unit Pediatric research centre Outpatient department of hospital Family centered care 04-07-2022 10

11. ADVANCEMENTS Managed care High technology care Evidence based practice Atraumatic care Cost containment Prevention & health promotion Infusionarium Temperature monitoring 04-07-2022 11

12. Home pediatric care Extender-Based care Pediatric Nurse Practitioners (PNPs) Way forward 04-07-2022 12

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14. PRINCIPLES OF FAMILY CENTERED CARE 04-07-2022 14

15. ADVANCES IN PEDIATRIC PHARMACOLOGY The  Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection May 22, 2018 for initiating ART in children aged ≥1 year who are asymptomatic or who have mild symptoms and who have CD4 T lymphocyte (CD4) cell counts ≥1,000 cells/mm 3   (for those aged 1–6 years) or CD4 cell counts ≥500 cells/mm 3 (for those aged ≥6 years); the Panel now recommends that  all  children receive ART, regardless of symptoms or CD4 count. 04-07-2022 15

16. Short-term doxycycline use in children (June 2018) Tetracycline antibiotics have traditionally been avoided in children <8 years because of permanent tooth discoloration associated with repeated use. However, doxycycline binds less readily to calcium than other tetracycline's, and the risk of dental staining with short courses of doxycycline is minimal. Updated recommendations from the American Academy of Pediatrics now permit doxycycline for ≤21 days in children of all ages . Children who use doxycycline should avoid excess sun exposure given the photosensitivity associated with this agent. 04-07-2022 16

17. Epinephrine auto injector for infants and toddlers (May 2018) Children with serious allergies require access to injectable epinephrine, but the standard dose available in pediatric auto injectors (0.15 mg) is relatively high for infants and small toddlers. A lower-dose epinephrine auto injector that delivers 0.1 mg has been developed which is labeled for use in infants and toddlers 7.5 to 15 kg (16.5 to 33 lbs ), and may be an easier option for some families, after consideration of cost and availability. 04-07-2022 17

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19. Integrative Medicine in Paediatrics Up to 75% of pediatric patients, especially those with chronic health disorders, have used some form of ‘‘Complementary medicine” . Integrative medicines includes: Biochemical therapies Life style factors Bio energetic therapies Mind body therapies 04-07-2022 19

20. Smart Pills Smart pill technology involves a normal, prescription medication that’s embedded with a minute sensor that sends a signal to a patch worn on the patient’s body. It forwards the information, e.g., to the patient’s computer, which sends the information a care provider, allowing them to monitor prescription compliance. Children’s Health in Dallas, Texas is the first organization to utilize the technology for pediatrics. The technology also allows to monitor patients’ heart rates, sleep levels, and physical activity. 04-07-2022 20

21. ADVANCES IN PEDIATRICS DIAGNOSTICS 04-07-2022 21

22. FMRI (Functional Magnetic Resonance Imaging) FMRI is one of the most recently developed forms of neuroimaging Functional magnetic resonance imaging (fMRI) measures the small changes in blood flow that occur with brain activity. It may be used to examine the brain’s functional anatomy. 04-07-2022 22

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24. CT Enterography It is a new non-invasive imaging technique that offers superior small bowel visualization compared with standard abdomino -pelvic CT. Often used to identify and locate problems within the bowel, such as inflammation, bleeding, obstructions and Crohn’s disease 04-07-2022 24

25. CB-NAAT test Cartridge-based nucleic acid amplification test (CBNAAT) is a recently introduced polymerase chain reaction (PCR) based method for detection of TB, and it also shows if the child has resistance to the drug rifampicin (Rif).  04-07-2022 25

26. CBNAAT is a Mycobacterium tuberculosis-specific automated, cartridge based nucleic acid amplification assay, having fully integrated and automated amplification and detection using real-time PCR, providing results within 100 minutes. It is a highly specific test as it uses 3 specific primers and 5 unique molecular probes. 04-07-2022 26

27. Pill camera / Capsule endoscopy Pill camera is a diagnostic Imaging System, comes in capsule form and contains a camera, lights, transmitter and batteries. The latest pill camera is sized at 26*11 mm and is capable of transmitting 50,000 color images during its traversal through the digestive system of patient. 04-07-2022 27

28. The capsule is swallowed with a small amount of water. At this the point, the patient is free to move about. Patients should avoid ingesting anything other than clear liquids for approximately two hours after capsule ingestion. Patients can eat food approximately 4 hours after they swallow the capsule without interfering with the examination. Produces two images per second, approximately 2,600 high quality images Seven to eight hours after ingestion, the examination can be considered complete, and the patient can return the antenna array and recording device to the physician. 04-07-2022 28

29. Genomics Genomics  is an interdisciplinary field of science focusing on the structure, function, evolution, mapping, and editing of genomes. A genome is an organism's complete set of DNA, including all of its genes. In contrast to genetics, which refers to the study of individual genes and their roles in inheritance, genomics aims at the collective characterization and quantification of genes, which direct the production of proteins with the assistance of enzymes and messenger molecule 04-07-2022 29

30. Tools such as chromosomal microarray and exams sequencing are being increasingly used to investigate individuals with suspected genetic conditions Testing for imprinting and epigenetic disorders. Imprinting disorders offer unique challenges for genetic testing given a requirement for differentiating between maternally and paternally inherited alleles. Our understanding about imprinting disorders stems largely from characterization of a handful of conditions, including Prader-Willi, Angelman, and Beckwith-Wiedemann syndromes 04-07-2022 30

31. ADVANCES IN PEDIATRICS THERAPIES Music Supports Children's Development 04-07-2022 31

32. Pain management in paediatrics 04-07-2022 32 Buzzy device Thermo-mechanical simulator

33. Alternative therapies Guided Imagery Distraction Comfort therapy Aqua therapy Tone and strengthening Desensitization 04-07-2022 33

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39. Junvenile Justice ( Care & protection of children amendment act , 2021) 04-07-2022 39

40. The Protection of Children from Sexual Offences Rules, 2020 04-07-2022 40

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42. CHANGING ROLE OF PEDIATRIC NURSE SHIFT FROM FOCUS ON Disease- centered care. Child centered care Discouraging the families on the neglect of the female child Taking special care of the female child as she is the future mother. Immunization of all girls for tetanus and rubella before marriage. Starting care of women after she becomes pregnant. Health education on planned parenthood and guarding maternal health before conception. Special care during the last trimester and the post-natal period to the child born with congenital anomalies and hereditary disorders. Early identification and family counseling based on biochemical screening and chromosomal studies to prevent congenital anomalies and hereditary disorders in children. Only caring for the child after the birth of a child. Guarding the health against the day of conception. Only care for the sick children in the hospital The participation in prevention of illness, health promotion activities. 04-07-2022 42

43. Caring for the physical condition of the child in isolation. Comprehensive care of the child about his home and the community in which he lives and providing emotional support to the family. Not allowing the parents to be with the child in the hospital and rigid visiting hours. Ensuring the children have one parent stay with them in the hospital and participate in care. Flexible visiting hours in children’s ward . one that is health-oriented. Only cleanliness and treatment-oriented. Warmth and love-oriented. Providing tactile stimulation to the infants. Only curative and rehabilitative to the children in hospitals. Health promotion activities by ensuring environmental stimulation and intelligent manipulation of the environment. Adequate play activities. Services related to fertility, sex education, and counselling. The concept of pediatrics is infant feeding and care of a few diseases of children. The comprehensive care of the child in its totality from conception to maturity within the framework of his family and community. Adapting indifferent attitude to child neglect and abuse by family and society Safeguarding and protecting children’s rights by health providing cultural practices 04-07-2022 43

44.   CHANGING TRENDS IN HOSPITAL CARE: PREVENTIVE, PROMOTIVE AND CURATIVE ASPECTS OF CHILD HEALTH In earlier days, present medical techniques were treating both adults and children as same. Now child care has the prime importance, as mortality and morbidity are higher in this group. High infant mortality Low birth weight Child mortality Immunization rates 04-07-2022 44

45. Modern trends/concepts of child health include: INSTITUTIONAL CARE Sick children care in hospitals. Isolation . Children are ambulated as soon as possible. 04-07-2022 45

46. ALTERNATIVE SETTINGS AND STYLE FOR HEALTH CARE  The home community centres, outpatient clinics, well-baby clinics, schools, and group form are some settings where comprehensive health care may be administered. P rovides immunization, screening, health and safety education, counselling, crisis intervention, parenting classes, and care of ill children and families. Shortening of hospital stays : Many hospitals perform children’s surgery such as a tonsillectomy or umbilical or inguinal hernia repairs without requiring an overnight stay. Short-term hospitalization requires intensive health teaching by the nursing staff and followed by home care nurses. A child’s parents must be taught to watch for danger signs in the child without being frightened.  Increase in the number of intensive care units : Over the past 20% care of infants and children has become more intensive. It is generally assumed that new burns with a term birth weight will thrive at birth. A no. of infants is born each year, however with birth weight low birth 2500 gm or who are ill at and not thrive. Such infants are regularly transferred to a neonatal intensive care unit. 04-07-2022 46

47. SUMMARY 04-07-2022 47

48. CONCLUSION As children reach maturity, new cycle beings and new support become necessary the nurses’ role in all these phases focuses on promoting health and illness. Over the past 25 years, extensive technological and medical advances have had a major impact on the way pediatric nursing is practiced. Pediatric nurses have expanded their nursing roles, established professional organizations and certification standards to ensure clinical competence at the bedside, and tirelessly advocated for the health care needs of children and their families. In addition, pediatric nurses have collaborated with other health care providers to institute family-centered and developmentally appropriate philosophies of care. All of these advances will assist pediatric nurses to remain focused on the most important aspect of their work: Supporting the unique needs of children and their families. 04-07-2022 48

49. REFERENCES Deol Rupinder. Current principles, practices, and trends in pediatric nursing. https://aiimsrishikesh.edu.in/newwebsite/wp-content/uploads/2019/01/988_Current_principles_practies_and_trends_in_pediatric_nursing.pdf Natesan Muruganandan . Nt current principles, practices, and trends in pediatric nursing(2). 15dec,2012. https://www.slideshare.net/muruganandan.n/nt-current-principles-practices-and-trends-in-pediatric-nursing-2 Jyothi Gnana. Current principles, practices, and trends in pediatric . May 5, 2016. https://www.slideshare.net/gnanajkanchi/current-principles-practices-and-trends-in-pediatric Principles of pediatric nursing.Nurses’diary . April 01, 2017. https://nursingon.blogspot.com/2017/04/principles-of-paediatric-nursing.html Five principles of family- centered care in pediatric nursing. Master of Science in Nursing. Regis College. https://online.regiscollege.edu/blog/five-principles-family-centered-care-pediatric-nursing/ Kodi Malar. Advances and updates in pediatric medicine for nurses. 2018 Nov [cited 2022 June 26]. https://www.researchgate.net/publication/331629321_recent_advances_and_updates_in_pediatric_medicine_for_nurses 04-07-2022 49

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