Addisalem Geremew

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Well come…….PN !!!

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INTRODUCTION

What is paediatrics??

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What is paediatric nursing?

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 Introduction to Paediatric Nursing
 Children are the world's most important resource.
• Health of children was considered as a vital to all
society because, a basic resource for the future of
humankind.
• 'PEDIATRICS' comes from the Greek words :
• 'pedia' which means child,
• 'iatrike' which means treatment and
• 'ics' which means branch of science.
• Therefore, the word ‘pediatrics’ means;
“branch of science that deals with child treatement”
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 Introduction....
• Paediatric means the science of child care and scientific
treatment of childhood disease
• PAEDIATRIC is a branch of medicine that deals with
medical care for infants, children, and adolescents;
• Their growth and development; and
• Their opportunity to achieve full potential as adult
• Pediatrics :branch of medical science that deals with care
of children, from birth to adolescence, in health and
illness.
• It is concerned with promotive, preventive,
curative, & rehabilitative care of children.

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 What is PEDIATRIC NURSING?
 PEDIATRIC NURSING is the specialized area of
nursing practice concerning with care of children
during wellness and illness.
• It is the art and science of giving nursing care to
children from birth through adolescent.
 Pediatric nursing is concerned with health of
children and for their illness.
 integrate developmental need of children in to
nursing care with holistic approach.
 It includes promotive, preventive, curative and
rehabilitative care of children.
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Introduction....
 Paediatrics is a specialty governed by age.
• Neonate- less than 4 week’s age.
• Infants- less than 1 year age .
• Toddler- 1- 3 years.
• Preschool (young child) – 3- 5 years.
• School age children – 6-12 years.
• Adolescent- 13 - 18 years
 Child: 1-12 years

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Historical developments
 Early primitive people( nomad) were;
• Destroy those who were sick or weak.
• Children had to receive a minimum physical care
to live or
• Sick or malformed infants were either killed or
left behind to die.
• Believe that birth of a defective infant was also
Punishment for previous transgressions of the
parents
• Female infanticide
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 Care giver treated patients by using folk remedies
 In Egypt, as early as 1500 BC, children
received treatment, which differed from adults.
 Egyptian children were cared for by dressing loose
clothes and breast-feeding was encouraged.
 They encouraged children to learn as well as to
participate in out door activities.

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Historical developments
 Paediatrics is a relatively new medical specialty,
developing only in the mid-19th century.
 Pediatrics as speciality came in 1860 when,
• Dr.Abraham Jacob established first child clinic
in newyork and,
• He started giving lectures on diseases of
children .
• Abraham Jacobi (1830–1919) is known as the
father of paediatrics.

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Abraham Jacob…
• Abraham Jacobi, (born in Germany )
• He practiced in New York City and also a
strong advocate of breastfeeding, and
• Introduced the concept of bedside teaching
• He established the first clinic for diseases
of children in the United States (1860)
• He helps to start the "American Journal of
Obstetrics and Diseases of Women and Children"
in 1868

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History...
 The end of the 19th century is often regarded
• as “the dark ages of pediatrics”.

 The first half 20th century is regarded as

• “dawn of improved health care for
children”.

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History...
• The first paediatric hospital -
French( Paris) in June 1802 for
orphanage ,
• Children's Hospital of Philadelphia, dedicated to
helping and treating children is established in
1854 and becomes America's first children's
hospital
• The purposeof this hospital was to provide ;
• excellent child care and to decrease child
morality.
• Very soon after this many more children hospitals
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History...
• Edward Jenner did tests that led to
the first smallpox vaccine in 1796
• Dr. Eli Ives gave: lectures to medical students at
Yale about diseases in children (1813 and
1850)
• Two of the first textbooks in pediatrics
are published in 1825,
1. "Treatise on the Physical and Medical
Treatment of Children" by Dr. William Potts
Dewees and
2. "Practical Observations on Diseases of Children"
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History...
• Dr. Mary Putnam Jacobi : first woman that
opened a children's ward at the New York
Infirmary in 1886
• Dr. Elizabeth Blackwell becomes the first woman in
1849 to help start the New York Infirmary for Women
and Children
 Dr. Emily Partridge Bacon became the first

pediatric specialist in Philadelphia (1918).

• She was introduced the "well-baby" clinic.

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History...
• 1771- New York Hospital one of the 1st teaching
hospitals in USA provided classroom
presentations designed for nurses caring
children.
• 1855- one of the earliest known pediatric text
book “How to Nurse Sick Children” was
published.
• 1880- pediatric section of American medical
association was organized.
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 History..
•. Children Hospital training school in San
Francisco offered formal classes to educate
nurses in the care of ill children.
• During this period the role of the nurse was taking
care of children and
• They were responsible for maintaining nutrition,
hygiene and hydration.
• They played a major role in controlling the spread
of communicable disease by observing sanitary
measures.
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• 1886- Nurses practiced in home without
direct physician supervision.
• 1893- Lillian Wald opened the Henry Street
settlement house, which provided medical, social,
cultural and education services to the poor
children.
• 1896-Nurses Association Alumni of the
United States and Canada was founded.
• 1903- Recognition of paediatric Nurse
was Initiated.

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 History..
• .1975-Social security Act for children.
• 1980-The Child Welfare Act.
• 1986-The National Child hood Vaccine Injury
Act. Child survival act

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 Important vital statics in paediatrics
a. Perinatal mortality rate: still-births+ U1wk old death
b. Neonatal mortality rate: under 28 days of age death
c. post-natal mortality rate: 28 days-1year.
d. Infant mortality rate: under one year of age.
e. Child mortality rate: b/n 1 and 4 years

No. of death
No. of death per 1000 live birth = ------------------------------- X 1000
Total no. of live births

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 Overview of child health
globally/world
• Birth rate in 2021 is 17.873 births per 1000 people
• 385,000 babies are born each day
• 5.2 million children under age five died (2019),
• 14, 000 Under age 5 died every day (2019)
• About 6,700 newborns died every day in 2019.
• Under 5 Mortality : 38/1000 live births) (2019)
• U5MR in low income countries 73.1/1000LB.
• The neonatal mortality rate is 17/1000LB(2019)
• > 60 % are preventable
 GOALS for all country by 2030
- U5MR < 25/1000LB
- Neonatal mortality < 12 per 1000 LB 23
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Child health in Ethiopia
• Birth rate in 2021 is 31.186 births per 1000 people
• 10,600 live births per day
• under 15 years make up 44% of the population
• Ethiopia met the MDG 4 in 2012.
 Every year, >257,000 children U5 die and
• 120,000 die in the neo natal period.
• More than 60 percent of infant and 40 % of under-
five deaths in Ethiopia are neonatal deaths.
 Under 5 Mortality rate : 59/1000 live births) (2019)
 IMR(infant) : 47 /1000 live births) (2019)
 NMR(neonate): 33 /1000 live births) (2019)
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 Child health in Ethiopia….
• More-than 70% of these child deaths are
due to five diseases, namely:
• pneumonia,
• diarrhoea,
• malaria,
• measles and
• malnutrition

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 The major causes of U5M in Ethiopia are ;
• Acute respiratory infection (ARI) (18%),
• Diarrhea (13%),
• Prematurity (12%),
• Malnutrition :nearly 50% of under-five deaths.
• Newborn infection (10%),
• Asphyxia (9%),
• Meningitis (6%),
• Injury (6%),
• Measles (4%),
• Malaria (2%),
• TB (3%),
• Congenital anomalies (2%),
• HIV (2%), pertussis (1%) and others (17%). 48
Major cause of death for neonate in Ethiopia;
• Neonatal infection (36%),
• Birth asphyxia (25%),
• Preterm (17%),
• Tetanus (7%),
• Congenital problem (4%) and
• Diarrhoea (3%).
• Currently 42% of childhood deaths in
Ethiopia occur within the first 28 days of life.

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WHO strategy to decrease child hood deaths;
 Diagnosis and treatment of infectious diseases
 ORS supply
 Insecticide impregnated bed nets (ITN)
 Nutritional management
 Immunization
 HIV/AIDS management
 Neonatal care
 Breast feeding
 UNICEF- has under lined seven activities that are
thought to be the most effective in the prevention
illness/disease in children (GOBIFFF).
• G-rowth monitoring,
• O-ral rehydration,
• B-reast feeding,
• I-mmunization ,
• F-amily planning
• F-emale education,
• F-ood supplementation
• Clean water, Environmental sanitation, Early
diagnosis and treatment are recently added
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 Principles in pediatric nursing
• Build a working relationship with the parents and
their children( playing, joking, give toy, smile….)
• Should be aware that all behaviors should be
meaningful.
• Should accept parents and their children exactly
as they are.
• Allow them to know that their problems are
important, and the nurse is there to aid in their
solutions.
• Being kind, Need Patience
• Must cheerful (joking, playing……)
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 Principles in pediatric nursing….
• Have an empathy for parents and children
• Willing to acknowledge the parents right to their
own decisions concerning their treatment
• Speak a language understandable to the
parent and children

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 Modern concept of child care

Why we focus on paediatrics age group today?

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 Modern concept of child care..
Why we focus on paediatrics age group today?
• Majority of Childs morbidity increase in
frequency
• More vulnerable to various health problems
• 35 – 40% of total population are children below
the age of 15,
• Major consumers of health care,
• Needs special care to survive and
• Most of child mortality is preventable.
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What are Modern concepts of child care?
• Family centered care (The wellbeing of
children is associated with wellbeing of their
families, communities and the society in which
they live).
• Atraumatic care (prevent stress, injury)
• Holistic care
• Focus on prevention and promotion of health
• Research based practice

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 Qualities of Good Pediatric Nurse:
• Good observer.
• Honest and truthful.
• Empathetic,
• Kind,
• Patient
• Cheerful,
• Love to work with children,
• Interested in family care,
• Be friendly,
• Honest,
• Gentle and humorous,
• Able to provide teaching to children and their families.
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Communication with pediatrics patients
Communication with Infancy
o Respond to physical contact
o Gentle voice
o Sing-song quality
o High pitched
o Need to be held, cuddled
 Communication with age < 7 yrs
• Egocentric, interpret words literally
• Tell them what “they” can do
• Let them touch equipment
• Nonverbal messages should be clear
• Maintain eye level
• Use quiet, calm voice
• Be specific, be honest
• Use simple words, short sentences,
Communication with 6-12 yrs
• Give undivided attention
• Listen, be open-minded
• Avoid criticizing
• Make expectations clear
Communication with Adolescents
(13-18 yrs)
• Want to know why an object exists
• How it works
• Why it is being done to them
• Concerned about body integrity
 Hospital environment for sick child
• Hospitalization can be an unnecessary stress to
children
• Pediatric unit consists of the following facilities.
– Few beds in a room
– Sinks & latrine should be child & adult size.
– Playroom and recreation facilities
should be provided.
– Children should be placed in the ward according to
their age and their disease.
– Small & critically ill children have placed very near
to the nurse stations.
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 Role of nurses in neonatal and
child health
• Provide promotive, preventive,curative and
rehabilitative care
• Support the growth and development
• Giving counseling
• Provide Health education (feeding, disease
……)
• Prevention of infection
• Monitoring of vital signs, input and out put
• Taking sample for laboratory
• Follow the progress of the neonate/child
• Administration of fluid ,electrolytes, drugs, 44
 Role of nurses in neonatal and
child health.....
• Perform pediatric nursing procedure
• Manage common neonatal and children illness
• Administering Vaccination
 Monitor adverse effect of the medication
 Follow for any complication
 Educate family about disease condition
 Health education on how to keep their health and
feeding.
 Teaching mother how to administer drug in home
 Give Reassurance and Psychological support
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