Aston Lydia, Eyre Caron, McLoughlin Michelle, Shaw Rachel
School of Life & Health Sciences, Aston University, Birmingham B4 7ET, UK.
Birmingham Children's Hospital Foundation NHS Trust, Steelhouse Lane, Birmingham B4 6NH, UK.
Healthcare (Basel). 2016 Jan 11;4(1):8. doi: 10.3390/healthcare4010008.
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.
目的是确定证据，以支持将特定危害用于开发儿童和青少年安全体温计（CYPST）。我们检索了1999年后的PubMed、Web of Knowledge和Cochrane图书馆，查找儿科环境中有关疼痛、皮肤完整性、外渗损伤以及儿科早期预警评分（PEWS）使用情况的研究。经过筛选，纳入了9篇相关文章。采用主题分析的聚合综合方法，结合使用一系列方法（定性、定量和混合方法）的研究结果。确定了一篇关于PEWS的综述，因此排除了该问题的其他研究。未找到关于外渗损伤的相关研究。因此，综合结果聚焦于疼痛和皮肤完整性。疼痛的测量和感知很复杂，且并非总是按照最佳实践进行。皮肤擦伤很常见，大多与器械相关损伤有关。研究结果表明，需要进一步研究疼痛感知以及父母与护理人员之间关于疼痛问题的有效沟通。减少器械相关损伤的策略值得进一步开展侧重于预防的研究。连同对PEWS的综述，这些综合研究结果支持将疼痛、皮肤完整性和PEWS纳入CYPST。
