CHANGING

TRENDS IN
HOSPITAL CARE
PREVE NTI VE, PROMOT IVE
& CURATI VE ASPECT OF
CH I LD HE ALTH
INTRODUCTION
The hospitals are necessary places for providing the
health care of ill children. Previously, the care of ill
child used to be completed at their birth places or at
their homes. Nowadays, the hospitals have become a
necessary organ of health chain, where all types of
health professionals can easily be made available.
 Previously, many young adults will remember their time
spent in the hospital with fear and trembling because of the
loneliness and pain they felt at an age when they could not cope
alone with these feelings. Nowadays needless to say, practices in
use, in some hospital today have changed little over the past 20
years.
 PREVENTIVE,
PROMOTIVE,
CURATIVE ASPECTS
OF THE CHILD
HEALTH
There are modern trends/modern concepts of hospitalized child
which are as follows:
1. Visiting :
• In earlier days, parents were permitted to visit their
hospitalized child for only 1 hour once a month. Children
were deprived from parental love. Today, many hospital
permits visiting from 2 to 8pm or from early in the morning
to bed time, while some hospital have flexible unlimited
visiting at any time during the day or night.
• If parents are unable to visit the child frequently ,
grandparents, aunts, uncles or babysitters may visit instead.
• Some hospital permits visiting by siblings between 2 and 12
years of age during certain hours of the day. A parent must
accompany a younger sibling during the visit. Siblings of ill
child are not permitted to visit of they have been exposed to
an infectious disease or have colds or other infection.
• If child’s room is restricted, some hospitals have a closed-
circuit television or telephone video system that allows two-
way visit between the child and visitors of all ages.
• If parents, family members, friends are not able to visit the
hospital because of difficulty in travelling or any other reason,
tape recordings can be made and played to the child to
maintain some contact with home, thus, reducing separation
anxiety. Topics such as favorite story or song, talking letter
from the family, or just a conversation with the child are
appropriate for recording.
2. Rooming-in
• Parents should never be required to stay at a child’s bed side, but
they are not prohibited from doing so if they desire.
• The parents who stay during the day time in the pediatric unit, some
hospital provide a comfortable lounge or waiting room where they
can relax. In some institution, meals can be served to the parents in
the child’s room so they can eat with their child or they may eat in
the hospital cafeteria or coffee shop. Food may be brought from home
for the child if there are no dietary restrictions and if the policy of
the institutions permits.
• Parents usually mothers of seriously ill children may be
encouraged to stay in the hospital if they desire to do so and if
facilities are available for their comfort. Some hospital have
rooms such as playroom in the pediatric unit where the parents
may sleep. Some hospitals have a wing of the hospitals or a
motel type of accommodation for parents and other relatives.
The parents may sleep on a chair, a cot, a folding bed, or a
convertible chair in the child’s room if it is large enough.
3. Care by Parent Units

• Some hospitals have care by-parent unit or family

participation unit with the child. This method of care has its
root in the orient, where the whole family becomes involved
with the care of the sick. In this system, the child gets
attention when it is needed each day from a familiar person,
under the supervision of the nurse.
• When the parents are near, children can continue to learn to
grow throughout the hospital experience. In these units,
parents may be too anxious or guilty or just may not want to
participate in the care of their children in the hospital, others
may welcome the opportunity to give their children a sense of
security through their presence.
4. Parent Support Groups
• Many support groups for parents meet outside the hospital,
some support groups started within the hospital for parents of
hospitalized children. Such group may be conducted by
nurses, by play therapist or by child life programme staff. In
these groups, a non-threatening atmosphere is provided,
where parents may feel comfortable enough to move away
from the hospital routine and ventilate their feelings and
concerns to relieve their anxiety and stress.
5. Self-care

• By the self-care framework nurses have the responsibility of

assessing the abilities of the hospitalized child and then
helping the child to learn self-care skills. The time and
methods used in teaching these skills depend on the child’s
cognitive abilities, emotional state, and readiness to learn.
6. Neighborhood Health Centre
or Clinic
The neighborhood or clinics are primarily concerned
with the care of children and the guidance of their
parents. If sickness occurs, the child may be cared at the
clinic for a mild temporary illness or referred to another
facility in further treatment.
  7. Emergency Facilities
Facilities where emergency care is given, may be located in hospital
emergency department or in community based emergency centers.
They have been designed primarily to fulfil a need for convenient,
accessible, low-cost medical services.
These community-based emergency care facilities are relative new
to the health care field. They have been designed primarily to fill a
need for convenient accessible low cost medical services. Some of them
provide services at all hours of the day and night and on weekends,
combining many to the functions of hospital emergencies room.
 The activity and drama often seen in
an emergency room may be very
frightened to children. To reduce their
anxiety when an emergency does occur,
they may be taken to an emergency
facility under non-stressful condition and
oriented to the for play in this stressful
environment should be a vital part of care
to reduce children’s anxiety to a tolerable
level.
8. Hospital Based and free Standing Facilities for
Minor Surgical Care
The advantage of care given in an ambulatory setting is that
the child does not have to remain away from home for more
than a few hours, resulting in less trauma and family
disturbance and less chance of infection from seriously ill
children in the inpatient hospital setting. Parents must assume
responsibility for the pre-operative routine preparation usually
carried out by nurses in the hospital including post-operative
care.
9. Pediatric Unit
Hospitalized children are usually segregated by care
requirement or by age or by both, children need are adequate
provision for care, protection from physical danger eg.infection
and accidents, and protection from a psychologically
threatening environment. In the pediatric unit the surrounding
should be home like and cheerful.
10. Pediatric newborn and Pediatric intensive
care unit (PICU)
Newborn and pediatric intensive care unit for the critically ill
are found in many pediatric hospitals and the large pediatric
departments in general hospital in some states. Newborn infants
who are critically ill are transferred from local hospital to these
centers for care. These units based on electrical instrument related
to vital signs and other physiology of newborn and pediatric.
11. Intermediate Care Unit
Here children who have been in the intensive care can be moved
if their conditions have improved. These children may still be too
ill for care in a standard pediatric unit.
12. The Pediatric Research Center
Some children’s hospital have pediatric research centers where
little understood diseases are under investigation. These centers
give nurses an opportunities to provide comprehensive care to
children.
13. Outpatient department’s hospitals.
During the 19th Century, hospitals in America began to provide
services for outpatients.
• Increasing number of private physicians use the outpatient
department for children with the problems requiring careful
diagnosis and treatment, such as complex medical or surgical
problems or psychological difficulties.
• Because of awareness of the needs to avoid the possible trauma of
hospitalization and the possibility of cross infection, more
children with pneumonia, abscesses, or urinary or other infections
can be treated on an outpatient basis if there is a responsible adult
in the home to provide care.
• One of the newer functions of the staff in outpatient departments
to provide genetic counseling.
• A play area is essential in the outpatient clinic, so that the child’s
attentions can be diverted and parents can have time for a
conference with the nurse.
• One of the function of nurse is to provide health teaching for
parents. The nurse needs to be approachable-one who listens,
teaches and cares-in order to make such communications a
learning situation for the parent and child.
• Parents who bring a child to the outpatient clinic may feel not
only anxious about the child’s condition. But also guilty about
their possible role in causing the illness. The nurse can help
parents discuss feelings openly and alleviate some distress.