Pediatric Nursing Interventions and Skills

Pediatric patients who are hospitalized require individualized care based on their developmental level. As the nurse caring for a hospitalized child, you’ll prepare them and their caregivers for procedures while promoting their comfort and safety.

When providing care, begin by establishing rapport and trust with the child and their caregivers. You can do this by using therapeutic communication skills, like speaking in a calm tone, listening actively, and practicing therapeutic body language, like sitting down and leaning forward toward your patient.

When explaining the plan of care, remember to avoid words that can cause confusion or fear. So, instead of using medical jargon like “edema,” you can describe a swollen body part as being “puffy.” Likewise, instead of “shot” when talking about an injection, you can use less threatening language like “medicine under the skin.” You can also ensure your patient and caregivers are familiar with other members of the health care team and their role in the child’s care.

Lastly, be sure to collaborate with the child life specialist, who can provide therapeutic play activities that can decrease fear and anxiety in children and their families.

Now, before your patient undergoes a procedure, you’ll need to ensure that informed consent is obtained from their caregiver, by verifying that the health care provider has explained the condition, proposed treatment plan, treatment alternatives, as well as potential risks and benefits of the procedure.

As the nurse, you’ll witness the signatures on the consent form and reinforce the information provided by the health care provider.

Also be sure to include the child in the discussion, and obtain their assent, as appropriate. During teaching, you may use a doll or stuffed animal to show a younger child where electrodes are placed or where their surgical dressing will be; whereas, with an adolescent, you can provide them with detailed information, since they’re typically eager to receive health teaching.

Okay, let’s move on to the safety measures you’ll put in place during your patient’s hospital stay. Keep in mind that your patient will have unique needs for safety, depending on their developmental age.

So, for infants, be sure to keep the crib siderails raised and secure; and when the crib is open, maintain hand contact on the child to prevent them from falling out of the crib.

Also, for patients 1 year of age and younger, remember to always place them on their back to sleep with no additional toys or blankets in the crib.

And, since toddlers are interested in exploring their surroundings, be sure that electrical outlets are covered; windows blinds and cords are out of reach; small objects, like syringe caps and needle covers, are disposed of promptly; and that furniture is secured in place, to avoid tipping over onto the child.

Another way to promote safety is to follow infection control measures, like performing hand hygiene; using clean or sterile techniques, as indicated; and implementing transmission-based precautions, when appropriate.

Also be sure to also teach the child and their caregivers the importance of handwashing and about any special infection control measures that have been implemented for their child.

Now, sometimes you may need to use some type of restraint to keep your patient safe and to prevent them from interfering with their care, like by itching or rubbing a wound, pulling out a line or drain, or by acting violently or aggressively.

If you suspect your patient requires restraint, you’ll complete a comprehensive assessment to determine if there’s a true need; and you'll use alternative methods first, such as encouraging the presence of a caregiver; moving the child closer to the nurse's station; or promoting diversional activities, like music or coloring.

If use of a restraint is unavoidable, choose the least restrictive type and frequently assess for removal based on your facility’s policies.

As far as medication safety goes, be sure to always administer medications according to principles of safe medication administration and follow your facility’s policy for pediatric dosing.

Most pediatric medications are dosed according to the patient’s current weight using either a prescribed dosage per kilogram of body weight or body surface area, so be sure to calculate doses appropriately and have another nurse check them prior to administration.

Alright, as a quick recap... Pediatric patients who are hospitalized require individualized care based on their developmental level.

As the nurse caring for a hospitalized pediatric patient, you’ll prepare them and their caregivers for procedures as well as promote their comfort and safety.