Bakgrund: Smärta är en subjektiv upplevelse vilket skattas individuellt då varje enskild person upplever smärta olika. Cirka 95 000 barn vårdas på sjukhus årligen i Sverige. Obehandlad akut smärta kan leda till bland annat långvarig smärta samt påverkan fysiskt, psykiskt och socialt. Sjuksköterskan bör sätta barnet i centrum och kartlägga dennes behov och önskemål för omvårdnad vid smärta för en personcentrerad vård. Syfte: Syftet är att beskriva sjuksköterskans erfarenhet av och attityd vid akut smärta hos barn inom slutenvården. Metod: Litteraturstudien är strukturerad med inslag av den metodologi som används vid systematiska översikter. Litteratursökningen genomfördes i databaserna CINAHL och PubMed med relevanta sökord och begränsningar. Artiklarna analyserades och likheter mellan dessa kategoriserades vilket medförde till resultatet. Resultat: Huvudkategorier identifierades; Brister, Faktorer som underlättar omvårdnaden vid smärta hos barn samt Attityder med tillhörande underkategorier. Sammantaget påvisades en brist av sjuksköterskornas kompetens samt attityder och förhållningssätt vid omvårdnad av barn med smärta. Arbetsplatser världen över hade brister gällande rutiner, resurser och implementering av evidensbaserad vård. Sjuksköterskorna hade däremot en önskan och behov av vidare utbildning. Slutsats: Sjuksköterskor behöver mer utbildning då en stor brist av kompetens, attityder och förhållningssätt påvisades hos flera länder. Arbetsplatserna bör utvecklas för att implementering av ny kunskap ska vara möjlig. Detta är nödvändigt för att behandlingsmöjligheterna ska förbättras, vilket underlättar omvårdnaden av barn med smärta. Sjuksköterskan bör arbeta genom ett personcentrerat förhållningssätt där barnet är i fokus. Sjuksköterskan måste tänka på barnets bästa. / Background: Pain is a subjective experience which is estimated individually as each person experiences pain differently. Approximately 95,000 children are hospitalized annually in Sweden. Untreated acute pain can lead to, among other things, long-term pain and impact physically, mentally and socially. The nurse should put the child at the center and identify the child’s needs and wishes about pain care to get a person-centered care. Aim: The aim is to describe nurse's experience of and attitude to acute pain in children who are hospitalized. Method: The literature study is structured with elements of the methodology used in systematic reviews. The literature search is performed in the databases CINAHL and PubMed with relevant keywords and restrictions. The articles were analyzed and similarities between them were categorized, which was the result. The articles were analyzed and similarities between these were categorized which led to the result. Results: Main categories were identified; Deficiencies, Factors that facilitate nursing in pain in children and Attitudes with associated subcategories. Overall, a lack of nurses' competence as well as attitudes and approaches in the care of children with pain were proven. Workplaces around the world had shortcomings regarding routines, resources and implementation of evidence-based care. The nurses, on the other hand, had a desire and need for further training. Nurses need more education as a major lack of competence, attitudes and approaches was proven in several countries. Workplaces should developed to make the implementation of new knowledge possible. This is necessary to improve treatment options, which facilitates the care of children with pain. The nurse should work through a person-centered approach where the child is in focus. The nurse must think of the best interests of the child.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: Charles E. Begley. Includes bibliographical references.

The purpose of the dissertation Continuous Elimination Methods in Intensive Care in Prospective of Hospital Nurse is to inform about acute kidney injury and chronic kidney disease. These are major reason to use elimination methods at intensive care units and anesthesiological resuscitation departments. We further determine elimination issues. Continuous elimination methods in intensive care medicine are important medical treatment at acute kidney injury and chronic kidney disease. Particularly, acute kidney injury belongs to frequent complications at critically diseased patients, therefore will be properly discussed. It is afraid, because decreased renal function leads to incapability to excrete waste products of metabolism and sustain homeostasis. Mortality at acute kidney injury is higher than at chronic kidney disease so support or renal replacement therapy, in order to save life, is the only accepted method of choice at present time. The techniques of renal support or replacement therapy are integral part of instensive care medicine. The aim of this thesis is to elaborate latest accessible findings and specialized nursing care at continuous elimination methods. Ve have tried to create integrated, comprehensible summary of knowledge of this topic. We expect these findings are fundamental to high-quality nursing at patients with this disorder. The dissertation was conducted as a method of review and synthesis. As long as this part is purely theoretical-based, it gathers informations from czech and also foreign sources. The data was acquired from scientific publications, technical papers, monographs and web. The outcome of this work can be used for further research of this topic or contribute to resource information for paramedical staff. In the thesis we analyze acute kidney injury, briefly chronic kidney disease, then we proceed through the history of dialysis and its specifications. These are closely explained. We focus on technical aspect of various elimination methods, the division, indication to initation, advantage and disadvantage, vascular access will also be described. The possibilities of anticoagulation have been defined, the types of membrane hemofiltrates and dialysators, substitutional and dialysing solutions have been characterized, the need of dietary measures has been emphasized. The complications that can happen during the use of elimination method have not been left out of consideration. We describe the intensive care units, nurse competencies, their work, monitoration, patients' and elimination unit preparation and vascular access care.