ORLANDO, FL—When nurses verbalized a lack of comfort level in caring for pediatric patients, a model was created to address the challenges of educating staff that care for both adult and pediatric patients, a study reported at the ONS 40th Annual Congress.

Yet, 1 year later, staffing limitations continue to affect implementation, said Susan Mejstrik, RN, BSN, OCN®, Nebraska Medicine, Omaha, Nebraska.

She described a “robust comprehensive orientation that includes a Nurse Residency Program for new graduates and a comprehensive Oncology Nursing Fellowship Program (ONFP).”

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However, despite incorporating pediatric content into all orientation materials, experiences, the fellowship program, and having staff certified in Pediatric Advanced Life Support, staff nurses reported remaining uncomfortable caring for children. A contributing factor: the variability in pediatric vs adult patient volumes.

“To address this problem, the pediatric medical team, nurse managers, and nurse educators collaborated to find a working educational model moving forward,” Mejstrik said during the presentation.

A pediatric core team of nurses was formed that would consistently care for pediatric patients. Although all staff would maintain a level of competence in caring for pediatric patients, consistent exposure in caring for pediatric patients was believed to increase both the nursing staff and patient/family comfort level.

Varied learning opportunities in pediatric care were also developed with nurse educators and pediatric oncology nurse practitioners (APNs) that included nurses shadowing the APNs for a day, poster boards on pediatric topics, development of a Pediatric Resource Book, in-services by the APNs, in-services utilizing a simulation baby, and e-learning modules.

“We found nurses wanted a lanyard card with pediatric vital signs,” she said. “Outpatient nurses shadowed the inpatient pediatric unit for a day.”

“The biggest challenges in implementing our pediatric core team centered on variability in our pediatric volume and staffing,” said Mejstrik.

“At times, it has proven challenging to manage the experience of the nurse with patient acuity and age while trying to maintain consistent care-givers. Additionally, staffing limitations has made it difficult to allow staff off the unit for additional learning opportunities.”

“Results showed that nurses that were very uncomfortable became more comfortable with caring for pediatric patients,” Mejstrik concluded. “The most helpful educational experiences were caring for pediatric patients during orientation, shadowing with the APRNs, and the vital signs lanyard.”