Journal of Pediatric Surgical Nursing

Gastrostomy tube (G-tube) placement is commonly performed on pediatric patients but has high rates of emergency department (ED) utilization. We hypothesized that a nurse-practitioner-driven G-tube clinic would reduce ED visits and complications and improve provider and patient satisfaction.

After institutional review board approval, a retrospective chart review was conducted for all patients < 18 years old undergoing G-tube placement between January 2014 and June 2018. Data collected included demographics, indication, and type of G-tube as well as ED visits, clinic visits, and outcomes up to 1-year postoperative. Surveys were distributed to providers and parents to assess attitudes toward the clinic.

There was a decrease in the number of physician clinic visits, but there was no difference in overall 30- or 90-day ED visits after institution of the G-Tube Clinic. In the cohort of patients who had problematic G-tube-related problems, such as granulation, plugged tube, or tube dislodgement, creation of the G-Tube Clinic significantly reduced 30-day (0.37 vs. 0.07, p = .0008), 90-day (0.27 vs. 0.73, p = .0031), and 1-year (0.6 vs. 1.18, p = .014) ED visits. Surgeon and patient satisfaction were improved with clinic implementation.

Implementation of a nurse-practitioner-managed clinic resulted in reduction in 30-day, 90-day, and 1-year ED visits among patients with gastrostomy issues and is associated with high levels of patient and provider satisfaction.

Radiation or radiotherapy is a kind of cancer treatment where high-intensity rays are used to destroy abnormal cells. It is used for therapeutic as well as diagnostic purpose of various malignant diseases. The purpose of the study is to determine the parent's anxiety on radiotherapy and render valid radiotherapy teaching materials. A case study on Wilms' tumor is used to frame the study for pediatric surgical nurses.

A longitudinal, single-center, quasi-experimental one-group pretest–posttest research design was adopted. Samples were based on convenient sampling techniques for those who fulfilled the inclusion criteria. Separate instruments were used for demographic information and the anxiety of parents. Data were collected from November 2018 to December 2019.

Demographic characteristics measured by descriptive statistics in 26 patients. Most of the participants were aged between 36 and 45 years (n = 17, 65.4%); participants were fathers (n = 19, 73.1%) who had completed high school or college (n = 23, 88.5%) and parents with one or two children. There were no significant differences in parents' age, gender, and number of children. Most of the children were of preschool age (n = 23, 88.5%) and were male (n = 16, 61.5%) diagnosed with a malignant tumor (n = 18, 69.2%).

For the parents, education and family income were associated with less preoperative anxiety (p = .05). There were no significant differences in variables of the child's gender and type of tumor, whereas younger age was found significant for more anxiety (p = .05). The effectiveness of results showed that the paired t test was −10.25; mean and standard deviation in preintervention and postintervention were 70.61 ± 4.85 versus 54.80 ± 9.26, respectively.

The present study finding was supported by previous studies, which imply that educational materials, charts, printed materials, and pamphlets remained highly significant on anxiety scores of parents of under-five children. Hence, the researcher assumed that preradiotherapy education intervention was effective for parents of under-five children.