Holding children for invasive procedures: preparing student nurses

Valler-Jones, Tracey; Shinnick, Andrea

doi:10.7748/paed.17.5.20.s22

Cited by 6 publications

(4 citation statements)

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“…Most of the respondents (61%, n = 522/867) had not undertaken any formal training relating to a child being held still for clinical procedures. The findings from this study corroborates evidence that the preparation of health professionals for undertaking clinical holding is limited (Graham and Hardy, 2004; Kirwan and Coyne, 2017; Lewis et al, 2007; Pearch, 2005; Valler-Jones and Shinnick, 2005), this is despite professional guidance within the United Kingdom clearly stating that ‘all staff must not be asked to be involved in restraining a child without proper training’ (BMA, 2016). In contrast to previous evidence (Brenner et al, 2015), findings from this study indicate that those who had undertaken training (whether formal or informal) held children less frequently than those who had not received training.…”

Section: Discussionsupporting

confidence: 76%

Holding children for procedures: An international survey of health professionals

Bray

Carter

Ford

et al. 2018

J Child Health Care

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Children undergoing clinical procedures can experience pain and/or anxiety. This may result in them being unwilling to cooperate and being held still by parents or health professionals. This study aimed to capture an international perspective of health professionals' reported practices of holding children still for clinical procedures. An online questionnaire was distributed through network sampling to health professionals working with children aged under 16 years of age. A total of 872 responses were obtained from Australia ( n = 477), New Zealand ( n = 237) and the United Kingdom ( n = 158). Responses were from nurses ( n = 651), doctors ( n = 159) and other professionals ( n = 53). Health professionals reported children as held still for clinical procedures quite often (48%) or very often (33%). Levels of holding varied significantly according to country of practice, profession, student status, length of time working within a clinical setting, training received and the availability of resources in the workplace. Health professionals who gained permissions (assent from children and/or consent from parents) before procedures were less likely to hold children still for a clinical procedure than those who did not. Holding children still for procedures is an international practice, which is influenced by training, access to guidance, country of practice and profession. Children's permission and parental consent is often not sought before a child is held for a procedure to be completed.

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Section: Discussionsupporting

confidence: 76%

Holding children for procedures: An international survey of health professionals

Bray

Carter

Ford

et al. 2018

J Child Health Care

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“…There is a danger that nurses may rely upon other staff when making decisions about restraint which may perpetuate bad practice such as using restraint because it is the quickest or easiest option. Restraint practices are often learned from other staff members rather than evidence based (Jeffery, 2010; Valler-Jones and Shinnick, 2005) and restraint may be used more often because of staff shortages, ward culture and uneducated healthcare staff (Kangasniemi et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Use of restraint with hospitalized children

Kirwan

Coyne

2016

J Child Health Care

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Restraint is often perceived as necessary to ensure that medical procedures are carried out safely. The limited research into nurses' perceptions of restraint practices with hospitalized children hinders understanding the extent of the problem. A survey design was used to investigate nurses' perceptions of restraint use from five units in one children's hospital in Ireland. Findings revealed that restraint is a common practice, with physical and psycho- logical restraints most commonly used and newborn to 4-year-old children most likely to be restrained. Restraint was most often used for cannulation and latterly for administering medication and preventing interference to intravenous lines. To promote the use of thera- peutic holding for the safe delivery of procedures, nurses require education and skills training. Restraint should only be used as a last resort and in all situations, nurses should assess the need to use restraint and explore any alternatives in order to gain the child's cooperation. More research is needed into the situational variables that can lead to restraint usage in order to identify learning needs and promote the use of alternative interventions.

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“…Few studies have been undertaken to clarify the situation. Instead, there appear to be very few formal training courses (Valler-Jones and Shinnick, 2005) and an emphasis on getting parents to hold (McGrath et al, 2002;McGrath and Huff, 2003), absolving healthcare staff of any of the responsibility or guilt around any perceived issues. When answering the question of why they thought there were no best practice or national guidelines on therapeutic holding, the participants all expressed the opinion that no one gives this practice 'a second thought' and there is no agreement on a term which defines clearly what is done, under what circumstances, and why.…”

Section: Beliefs About Therapeutic Holding and Restraintmentioning

confidence: 99%

Holding children and young people: defining skills for good practice

Page

McDonnell²

2013

Br J Nurs

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Physical holds are used to help children and young people receive clinical care in situations where their behaviour may limit the ability of nurses and allied professionals to deliver treatment effectively. This article provides an overview of a qualitative study of 11 nurses and allied professionals who were interviewed with semi-structured questions. The major findings suggest there is a lack of clear and agreed terminology and nurses and allied professionals are guessing at how to describe the practice. As a result, there was no discussion or documentation of the practices of holding (whether successful or unsuccessful) within the clinical area. For the last decade, professional opinion was that this is an 'uncontested practice'. It can therefore be questioned whether this practice has moved from being 'uncontested' to 'indifferent'. Nurses and allied professionals need to revive a common definition of 'good' around the actions of holding, which can hopefully lead to holding skills being more clearly defined and evidence-based.

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Holding children for invasive procedures: preparing student nurses

Cited by 6 publications

References 0 publications

Holding children for procedures: An international survey of health professionals

Holding children for procedures: An international survey of health professionals

Use of restraint with hospitalized children

Holding children and young people: defining skills for good practice

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