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Introduction
At the moment, there are many unresolved problems of nursing in pediatrics. The most significant is the expansion of the area of professional activity of nurses. Therefore, is necessary to establish a list of skills and competencies that a specialist with a nursing education has. The most apparent indicator of nurses’ lack of qualification in pediatrics is nosocomial infections or postoperative complications. As a rule, they are associated with the mistakes of nurses who do not have all the necessary skills to care for the patient.
The study aims to identify special skills critical for a nurse in pediatrics, the lack of which can lead to negative consequences for patients. The study will analyze the mistakes made by nurses that led to hospital-acquired infections or surgical complications in patients. As a result of the study, a list of experimental manipulations that nurses should be perfectly proficient in for organizing effective nursing care will be compiled. The skills that meet the new, relatively high requirements for the theoretical and practical training of a nurse as an independent specialist will be listed.
The nursing process brings a new understanding of the role of nurses in practical healthcare. It requires them to have not only good theoretical training but also the ability to treat patient care creatively. This fact and the constantly expanding field of activity of nurses associated with it determined the choice of a theoretical basis for this study. The scientific base of the work includes recent studies devoted to innovative methods in the training of nurses by both American and foreign scientists. They are written to improve the effectiveness of public health protection through the use of new technologies in the training of nurses. These papers indicate the skills acquired by nursing personnel during multi-level training, which serve as the basis for this study.
The structure of the study is determined by its goals and objectives. The first part reveals the relevance of the topic, which confirms the expediency and practical significance of the research. In the second part, the literature is analyzed, which demonstrates the theoretical basis of the work. In the third chapter, the course of the research is formulated in detail, the method and its ethical side are justified. The work is completed by a list of references representing current international research in pediatrics and nursing. The list of sources used reflects independent creative work and general methodological training when writing a project.
The problem of structural adjustment of the pediatric industry requires new approaches to solving complex socio-psychological issues in rational use of labor resources. This study is aimed at solving one of these problems, namely, a redistribution of functions between the pediatrician and the secondary medical staff, between the secondary and junior medical staff. Thus, there is a need to identify the list of skills that nursing staff should possess in pediatrics. It is essential to summarize the material of modern scientific works. Also, with the help of practical research, the skills of a nurse when working with both healthy and sick children need to be highlighted. This study will serve to form students ‘ professional competencies in the field of Nursing in pediatrics.
The relevance of identifying a specific list of skills that a nurse in pediatrics should have is beyond doubt. It is caused by a high level of morbidity, mortality, socio-economic and moral damage caused to patients’ health as a result of insufficient qualifications of medical personnel. The results obtained will contribute to the development of best practices in nursing. It will allow to streamline the unsystematic range of roles that nurses have formed in recent years. Research is necessary to identify in practice the skills needed for pediatric nurses. The lack of it can negatively affect the patient’s health, up to the occurrence of post-surgical complications and nosocomial infections.
Literature Review
The selection of literature plays a decisive role in the organization of the study. Bennett’s article dwells on the gap between nursing education and clinical skills (Bennett, 2017). The author emphasizes the importance of a continuous learning process in nursing. It is mentioned that one of the critical factors that make it possible to improve the quality of medical care provided to patients is the system of postgraduate education. Thus, the list of nursing skills presented in the study should include not only the skills acquired during the years of study but also those that are acquired directly during work.
As an evidence-based illustration of the theory given by Bennet, the study of Mehdipour–Rabori, Bagherian, and Nematollahi (2021), can be cited. The researchers note that with the help of models, students are better able to master professional skills. Nurses studying for the bachelor’s degree better assimilate the options for influencing the course of the disease and compare the effectiveness of various medical aids. In the article, one can find confirmation that not only theoretical knowledge but also practical skills of nurses are essential.
In the next article, confirmation of the advantages of the modeling method can be found (Brown & Rode, 2018). In the research, game models are used which are various kinds of medical games. With their help, conflict situations can be resolved, and psychological assistance provided. Scientists consider a nursing qualification from another group of skills, namely leadership qualities. Researchers identify such qualities of nurses closely related to the makings of a leader: demanding and social energy. Thus, this study allows to pay attention to another vital aspect of nursing skills which is sociological competence.
Turkish scientists continue the topic of modeling in their research, comparing it with traditional experience (Arslan et al., 2018). They reach the example of nursing in the pediatric field, which is highly relevant to this study. The use of modeling is especially appropriate in pediatrics when there are limited opportunities to practice skills on the patient. Several advantages highlighted by the scientists generally coincide with those highlighted by the researchers from the articles discussed above. Therefore, the future specialist masters such essential skills as tactile memory, communication with the patient, thinking independently and working in a team.
Shorey et al., like Arslan and Brown, emphasize the importance of social skills for a nurse (2019). They claim that nursing, along with the friendly, technically competent performance of medical procedures and manipulations, implies communication between a nurse and a patient. This statement is especially applicable to nurses working in pediatrics since children have increased emotionality and require a unique approach. Communication competences are necessary to gain the trust of the patient and his family, interact with doctors and other specialists involved in the treatment process.
Next article summarizes the above research, clearly and vividly illustrating the relationship between practical and theoretical skills in the pediatric field of nursing According to Brasher, Becklenberg, Darcy, Ross, and Stapel-Wax (2021), by applying academic information about the stages of brain formation in practice, a nurse can establish contact with children of different ages. Successful application of physiological skills is impossible if the nurse does not have psychological and social skills and vice versa. Theory and practice are two inextricably linked aspects of nursing interaction with children. The success of a nurse’s activity is ultimately determined by how correctly and consistently the principle of combining theoretical skills with practical ones is implemented.
Among the main concepts mentioned in the literature studied above, the obsolescence of the traditional method of teaching nurses can be singled out. The use of the modeling method allows to master the practical skills necessary to fulfill professional duty to a greater extent. Each lesson that includes this method helps to form professional skills for diagnosing and treating children’s patients at the outpatient stage of medical care. The modeling method can be applied to the development of different types of skills. Its application allows the doctor to master the communicative culture. The practical and communicative skills of the doctor have closely intertwined. The development of new technologies and the opportunity to equally master both theory and practice allow to produce a qualified specialist with a system of general cultural and professional competencies.
This study concerns the allocation of professional skills of nurses of the pediatric department. Therefore, the scientific works presented above allow to compile a list of theoretical and practical skills that a modern specialist should have when working with children. Most researchers emphasize the particular importance of forming communication skills with patients. Indeed, the ability of a nurse to work with children, as well as with their parents or legal representatives, an understanding of the psychology of children, is crucial. In the absence of contact with the child, the pediatrician cannot fully provide him with qualified assistance. Thus, the study of the literature presented above allowed us to streamline the nursing skills necessary for high-quality pediatric care.
Design and Methodology
To determine the model of a specialist “Nurse in Pediatrics,” it is necessary to specify the types of work that this specialist should perform. It is essential to analyze the theories and concepts of research scientists supported at the international level in implementing nursing and considering issues related to this specialty. The main elements of the “Nurse in Pediatrics” model should be determined by the training goals, research subjects, and professional skills in nursing. To select the model of a specialist “Nurse in Pediatrics,” it is necessary to apply a method of collecting and scientifically developing information. It could establish indicators of a specialist’s complex competence by conducting a questionnaire using specially designed questions.
In addition, it is necessary to complete a survey of the patients’ parents regarding the work of the nursing staff. One of the most critical indicators of qualified nursing care is the absence of postoperative complications. Therefore, it is necessary to compile statistics on the development of surgical purulent-septic postoperative complications and nosocomial infections. Then they have to be compared with the general statistics presented on the U.S. Department of Health and Human Services website.
The survey should be conducted only among the full-time employees of a particular hospital (freelance employees and interns should not take the survey). The survey is selective since only a specific category of employees is interviewed – nurses of the pediatric department. It is also necessary to compile statistics of nosocomial infections in patients of the department over the past year. When conducting an anonymous survey of nurses, it is necessary to compile a list of knowledge and skills acquired during training and practice working with children.
They will have to highlight essential skills, and if possible, offer their options. The study in the form of an anonymous questionnaire for parents aims to identify the established communication between parents, patients, and nurses. Comparative analysis of data on nosocomial infections and postoperative complications includes work with medical histories and initial filling in the complication log.
The survey of nurses and parents and the collection of statistical data and their comparative analysis should be carried out based on the pediatric department of a separate hospital. The survey is selective and is conducted only for nurses of the pediatric department in a state hospital. For this reason, there are restrictions on the distribution of results. The distribution plan of the results will include a check for compliance with the pre-established limit value for this survey and then a direct recalculation.
The degree of correlation between the quality of the nurses’ work and the number of nosocomial infections will be determined by the Pearson coefficient. This indicator is used to study the relationship of variables that were measured in the same sample. Evaluating the quality of services provided by the parents of patients will be considered a variable X. Respectively, the variable Z is the effectiveness of the nurse’s work associated with the availability of the skills stated in the questionnaire. The third variable, Y, will be the number of nosocomial infections and postoperative complications in patients.
It is necessary to create a sample of all nurses from the population of employees of the medical department. From the population of patient representatives, it is essential to select those whose children are on treatment. Also, parents whose children completed therapy no more than three months before the start of the study can participate in the study. Since this work is a study of average accuracy, about 200 respondents are needed. They include nurses and representatives of their patients. From the population of the medical history, the sample will consist of those that record a postoperative complication or an intra-hospital infection in a patient from a year ago or less.
One of the most critical questions that the researcher faces when planning a medical study is determining the minimum required sample size of the studied observation units. The wrong attitude to the solution of this issue can negate the results of this study. It may be necessary to take samples for patients in the hospital due to an intra-hospital infection or a postoperative complication. Patients are prescribed blood, urine, and exudate tests; samples are also taken using puncture, radiological, and endoscopic methods. The choice of sampling procedure will depend on the structure and localization of the pathology.
The informed consent instruction consists of two parts: information for the patient or nurse and the consent form that must be signed. The patient or nurse is informed that they are participating in scientific research, during which it is planned to obtain new data and the purpose of the study. It is also reported that the subject’s participation in the survey is voluntary. They can refuse to participate or withdraw from the study at any time without any sanctions for them or loss of the benefits.
The informed consent form contains the following statements on behalf of the patient’s representative or nurse: “I, FULL NAME, have carefully read this document and understood the above information. I asked the doctor/researcher all the questions about the incomprehensible aspects of the study and received detailed answers. I agree to participate in the study.” This is followed by a place for the signature of the parent, nurse, and the research doctor.
A statistical information system will be used to implement data collection and processing; it consists of two main modules and service subsystems. The main modules are represented by a server application that provides storage, transmission, and compatibility of data and web services operating within the medical information systems of a medical institution. Web services allow them to be remotely reprogrammed and configured to meet the current research needs. The information system will be entrusted with data transformation functions, automatic transfer to the statistics processing center as questionnaires are filled in, and automatic calculation of statistical indicators.
The method that will work most effectively for solving research problems is factor analysis of data. Factor analysis is based on the idea that there is a relatively simpler structure behind the complex relationships of clearly defined features. It reflects the most significant features of the phenomenon under study, and external features are functions of hidden general factors that determine this structure. The specificity of this method is that when combining parameters into elements, each factor accumulates general patterns in all parameters, discarding the features of each parameter separately.
The material for factor analysis is the correlation relationships, or rather, the Pearson correlation coefficients, which are calculated between the variables included in the survey. Factor analysis is suitable for this study due to the main tasks of the research. The investigation is designed to reduce the number of variables. The interviewed nurses and parents of patients will give various responses. The application of the method will allow forming a generalized group of skills that a nurse of the pediatric department should have, based on them. The method of factor analysis is also used to determine the structure of relationships between variables. Thus, a link will be established between nosocomial diseases or surgical complications and the lack of necessary skills in a nurse.
This study is justified, as it is directly related to establishing the necessary skills of a nurse in the pediatric department; the usefulness of the survey determines its validity. Thus, the obtained data can be used to minimize the number of hospital complications and increase patient satisfaction with the quality of medical care. This study can be called reliable since its critical analysis revealed all the elements that affect the reliability. The most crucial factor was the correctly selected method used at various stages of the study, which improved the effectiveness of the study.
The study fully meets ethical considerations because all participants (both nurses and parents of patients) were fully informed about the nature of the study. In addition, through the anonymity of the questionnaire, the independence of choice and the confidentiality of the participants are guaranteed. The research does not carry any possible risks, therefore, permission to conduct research from the ethics committee is not required.
References
Arslan, F. T., Türkmen, A. S., Çelen, R., Özkan, S., Altıparmak, D., & Şahin, A. (2018). Comparing traditional and simulation-based experiences in pediatrics with undergraduate nursing students in Turkey. Clinical Simulation in Nursing, 16(6), 62-69.
Bennett, L. L. (2017). The gap between nursing education and clinical skills. ABNF Journal, 28(4), 96-102.
Brasher, S., Becklenberg, A., Darcy, M., Ross, K., & Stapel-Wax, J. (2021). Integrating early brain science and skills into prelicensure nursing curriculum to promote parent-child interaction. Nurse Educator, 46(4), 75-78.
Brown, K. M., & Rode, J. L. (2018). Leadership development through peer-facilitated simulation in nursing education. Journal of Nursing Education, 57(1), 10-19.
Mehdipour – Rabori, R., Bagherian, B., & Nematollahi, M. (2021). Simulation-based mastery improves nursing skills in BSc nursing students: A quasi-experimental study. BMC Nursing, 20(10), 72-78.
Shorey, S., Ang, E., Yap, J., Debby, E., Lau, S. T, & Chui, C. K. (2019). A virtual counseling application using artificial intelligence for communication skills training in nursing education: Development study. Journal of Medical Internet Research, 10(9), 58-65.
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