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Reviewing the Evidence Base for the Children and Young People Safety Thermometer (CYPST): A Mixed Studies Review
Lydia Aston1, Caron Eyre2, Michelle McLoughlin3
1School of Life & Health Sciences, Aston University, Birmingham B4 7ET, UK. astonlr@aston.ac.uk.
Insights
This study highlights the complexity of pain management and device-related skin injuries in children. Findings support including pain, skin integrity, and pediatric early warning scores (PEWS) in safety tools.
Area of Science:
- Pediatric Patient Safety
- Healthcare Quality Improvement
- Clinical Nursing Research
Background:
- Developing a Children and Young People's Safety Thermometer (CYPST) requires evidence on specific patient harms.
- Existing literature reviews on pediatric early warning scores (PEWS) were identified.
- Research gaps exist regarding extravasation injuries in pediatric settings.
Purpose of the Study:
- To identify evidence supporting the inclusion of specific harms in the CYPST.
- To synthesize findings on pain and skin integrity in pediatric patients.
- To inform the development of enhanced pediatric patient safety monitoring tools.
Main Methods:
- Systematic literature search of PubMed, Web of Knowledge, and Cochrane Library (post-1999).
- Convergent synthesis using thematic analysis of qualitative, quantitative, and mixed-methods studies.
- Exclusion of studies on PEWS (due to existing review) and extravasation injury (due to lack of relevant studies).
Main Results:
- Pain measurement and perception in children are complex and not consistently aligned with best practices.
- Skin abrasions are prevalent, primarily linked to device-related injuries.
- Effective communication of pain concerns between parents and nursing staff requires improvement.
Conclusions:
- Further research is needed on children's pain perception and parent-nurse communication.
- Preventative strategies for device-related injuries warrant focused investigation.
- Pain, skin integrity, and PEWS are supported for inclusion in the CYPST.
Abstract:
The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods). A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.
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