Journal of Pediatric Surgical Nursing

Nurses' clinical uniforms and scrubs may become a vehicle for the transmission and contamination of pathogenic microorganisms. This study aims to identify the relationship between nursing care, in which there is contact between the clinical uniforms or scrubs, and patients up to 3 years old, the way nurses manage their uniforms, and the microorganisms present.

A quantitative, descriptive–correlational, cross-sectional study was conducted with a sample of 24 pediatric nurses, who filled out demographic surveys and from whom microbiological collections of their clinical uniforms were obtained. In this study, clinical uniforms refer to uniforms, specialized clothing, scrubs, laboratory coats, or whatever is worn by the pediatric nurse who is providing hands-on patient care.

Factors contributing to contamination of clinical clothing (e.g., therapeutic procedures, holding, feeding, hygiene care) were analyzed. The methods for reusing and/or sanitizing the uniforms were studied. The nurses' uniforms had the following microorganisms found: Staphylococcus aureus (58.3%), Bacilli group (41.7%), and Streptococcus bacteria (41.7%), with a higher percentage of microorganisms in the abdomen and left thorax regions. A statistically significant relationship was found between contact during nursing care for the infant and the risk of microbiological contamination in the modified kangaroo method (clothed nurse holding infant to chest) and holding for comfort, transport, or restraint.

Proper management of clinical clothing requires special care in its handling by pediatric nurses and the need to standardize practices and adapt behaviors to minimize the risk of contamination. The use of disposable personal protection equipment and the daily changing of uniforms and scrubs are recommended. Institutions should ensure proper management of uniforms.

It was noted that caregivers of pediatric surgical patients are often not able to speak to the correct disposal of leftover narcotic pain medication. The purpose of this process improvement project was to increase the knowledge and use of activated-carbon-based deactivation kits during the discharge process to increase safe medication disposal.

A team was formed to increase safe disposal. The team developed a plan for the pharmacy to provide quick facts when dispensing narcotic pain medication, giving instructions to the parents about how to obtain an activated-carbon-based deactivation kit if they had unused narcotic medication. In addition, the dangers of incorrect disposal of narcotics were included. The nurses provided verbal education to the parents on the safe disposal at discharge to home. Furthermore, parents were reminded of the opportunity to utilize an activated-carbon-based deactivation kit provided from the hospital pharmacy to dispose of the narcotics during postsurgical follow-up call.

The hospital pharmacy saw a sixfold increase in the dispensing of activated-carbon-based deactivation kits since the education was initiated. Caregivers noted a 68% increase in reporting of proper disposal of narcotics.

Implementation of a standardized educational practice for the families of patients being discharged with narcotic medication resulted in an increased awareness of safe disposal of narcotics and an increase in dispensing of activated-carbon-based deactivation kits. Ultimately, this resulted in the families having a greater confidence in caring for their children at discharge as reported on patient satisfaction surveys.

Successful resuscitation of pediatric trauma patients requires a team of individuals to come together to provide coordinated, efficient care to the injured child. Lack of specific education in team dynamics and trauma resuscitation skills, combined with a constantly changing membership of pediatric trauma teams, creates barriers to excellence in care delivery. Therefore, it is essential for teams to practice these high-risk, low-volume skills to establish and maintain competency.

An online educational program consisting of team dynamic training, hospital-specific trauma roles/responsibilities, and exposure to a trauma resuscitation checklist was delivered to 40 interprofessional participants who were representative of the pediatric trauma team. Team members then attended an in-situ simulation of two pediatric trauma resuscitation scenarios.

Forty interprofessional team members participated in the program. Education and simulations were well received by the overwhelming majority of participants, with mean scores for achievement of program objectives ranging from 4.75 to 4.85 based on a Likert scale from 1 to 5. Logistical details such as scheduling, equipment setup and takedown, stakeholder buy-in, and validation for continued program funding were determined to be sustainable in that the overall program was not labor intensive, the scheduling system was user friendly, and the financial impact was minimal.

This project provided participants with a baseline of education and the opportunity to practice pediatric trauma resuscitation using simulated scenarios that allowed for assessment of team functioning and clinical performance. The results reinforced the acceptance of interprofessional education and identified subject matter for future educational programs.