2.1. Data Sources
2.2. Search Strategy
|Pain||“pain score* OR measurement” OR pain OR “acute pain” OR “visceral pain”|
|Skin integrity||skin NEAR/3 integrity OR “pressure ulcer”|
|Extravasation||Extravasation * OR extravas * OR cannula|
|PEWS||PEWS OR neonatal OR p$ediatric early warning score* OR “rapid response system” OR “track and trigger aggregate score” OR “early warning score” OR “early warning system” OR “heart rate” OR “blood pressure” OR “blood gas result*”|
2.3. Inclusion Criteria
2.4. Critical Appraisal
2.5. Data Extraction and Synthesis
3. Results and Discussion
3.1. Study Selection
3.2. Study Quality
3.3. Study Characteristics
|Reference #||First Author & Date||Journal||Aim||Sampling Method||n =||Harm||Location||Data Collection Method||Analysis Method||Quality Rating|
|||Anthony (2010)||Journal of Tissue Viability, 19, 98–105.||To compare three risk assessment scales with respect to predictive validity||Review||Pediatrics: 236||Skin||England||Comparing patient data||Mann Whitney and logistic regression||75%|
|||Byrne (2001)||Journal of Psychometric Research, 50, 69–76.||(i) how pediatric nurses construed their patients’ pain; (ii) how these constructions were related to the emotional challenge of pain; and, (iii) how they influenced nurses’ communication with patients and specifically their management of pain.||Opportunistic||nurses: 13 Pediatrics: 16||Pain||England||Observations and interviews||Grounded theory||100%|
|||Curley (2003)||Nursing Research, 52(1), 22–33.||(a) Establish the predictive validity of the Braden Q Scale in an acutely ill pediatric population; (b) determine the critical cut-off point for classifying patient risk; and (c) determine the best time to assess patient risk.||Convenience||Pediatrics: 90||Skin||USA||Comparing patient data||Parametric and nonparametric statistics were used||50%|
|||Linhares (2012)||Brazilian Journal of Medical and Biological Research, 45, 1287–1294.||To examine the prevalence, assessment, and management of pediatric pain in a public teaching hospital.||Opportunistic||Infants: 70 Children: 36 Adolescents: 15||Pain||Brazil||Questionnaires and interview||Systematic categorical analysis and descriptive statistics||50%|
|||Noonan (2011)||Journal of Pediatric Nursing 2006, 21(6), 445–453.||The purpose of this paper was to describe the spectrum of alterations in skin integrity and skin care needs of hospitalized infants and children.||Convenience||Pediatrics: 252||Skin||USA||Skin integrity audit tool and the Braden Q scale||Descriptive Statistics||100%|
|||Schluer (2009)||Child and Adolescent Health, 18, 3244–3252.||The aim of the current study is to describe the frequency of pressure ulcers in a pediatric care setting and to identify the population at risk, as well as to assess the factors predisposing to the development of pressure ulcers.||Convenience||Children: 155||Skin||Switzerland||Direct systematic inspection of the skin, and a valid risk assessment instrument: Braden Scale||Descriptive and univariate statistical methods.||100%|
|||Suddaby (2005)||Pediatric Nursing, 31(2), 132–138.||To develop a simple, single-page measurement tool that evaluates risk of skin breakdown in the pediatric population and apply it to the acutely hospitalized child||Not specified||Children: 347||Skin||USA||Risk assessment instrument: The Starkid Skin Scale||Descriptive statistics and unconditional logistic regression||75%|
|||Taylor (2008)||Pain Research Management, 13: 25–32||To highlight areas of good practice, identify areas for improvement, and inform development of hospital standards, education, future audits, and the research agenda.||Not specified||Children: 241||Pain||Canada||Interviews and pain assessments.||Statistical analysis was performed, including nonparametric tests.||100%|
|||Willock (2009)||Journal of Wound Care, 18(1), 17–21||To develop a predictive pressure ulcer risk assessment scale based on patient data.||Prospective||Children: 265||Skin||England||Questionnaire, survey, and interview||Chi-square tests.||75%|
3.4.1. Mistrust of Pain Reports
3.4.2. Validated Pain Measures and Treatment of Pain
3.4.3. Device-Related Injury
3.4.4. Vigilance and Communication
3.4.5. Tissue Viability Risk Assessment Tools
Conflicts of Interest
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