HISTORY,

PRINCIPLE AND
SCOPE OF
CHILD HEALTH
NURSING
INTRODUCTION

Pediatric regarded as the

medical science which enables
an anticipated newborn to
grow into a healthy adult,
useful to the society.
PEDIATRICS AS AN
INDEPENDENT MEDICAL
SPECIALITY

The health problems of children differ from those of adults in

many a way. Children’s response to an illness is influenced by age
and environment. Management of childhood illness is significantly
different with that of an adult. Finely children also need special
care since they are among the most vulnerable in the society.
TRENDS IN PEDIATRIC
NURSING
Remarkable changes have occurred in the field of
pediatric nursing in recent years due to changing needs of
society, medical and technological advancing political
interests and changing trends within the nursing
profession.
HISTORICAL
PRESPECTIVE
The modern child care is part of a great historical
pageantry that involved cultures of many people.

Present day child health nurse should know something

of the part to appreciate the present fully.
PRE HISTORIC TIME (BEFORE 3000 BC
 In early civilization of Egypt, china, India children
were reared according to tradition passed down from
previous generation children made to follow their
parents, girls followed mothers, boys followed the
father.
 The medical practice was a combination of indigenous
system of medicine and magic. Local practioners treat
adults and children with diet, rituals, magic and
 In modern world Streneos in 2nd century wrote
1st known manuscript devoted to pediatrics.
 In India kasayapa tantra written in Before Criest
had a chapter on “koumarabharitya balroga”
this is 1st record of pediatrics anywhere in the
world.
 The 1st asylum or hospital was founded in 787
which was only a shelter for abandoned children
 This foundlings home were deadly due to
overcrowding, poor hygiene, and sanitation.
 No public measure were available and death toll
was very high so this period was considered as the
dark ages of health.
EARLY MODERN WORLD (1350-
1800 A.D.)
 European brought tremendous changes in the course of
human life. In 16th century 2 great medical books were
published.
 ‘THE BOOK OF CHILDREN’ by Thomas Phare (father of
English pediatrics)

 ‘THE CHILDRENS BOOK’ BY Felix Wurtz in Germany

 They found there were lot of hazardous
practices in feeding, clothing and rearing.
 Rarely infant were breast feed, instead infant
received different types of soups and sugar
solutions or water.
Modern World (1800 Ad to Date)
 In 1748 William Cadogans easy on nursing
called attention to unhealthy childcare
practices and identified over dressing, over
feeding and poor diet as contributing factors
to childhood illness. This encouraged breast
feeding and urged parents to dress infants in
loose and lightweight garments.
Abraham Jacobi (1830-1919)(father of
pediatrics).
 He Started pediatric department in
several new York hospital and was one of
the founder of the American pediatric
society in 1888.
 During 19th century, people recognized the
effects of childhood illness and injury, the bad
effect of childhood labor, poverty and neglect the
end of 19th century is often regarded as the dark
age of pediatrics and 1st half of the 20th century
as down of improved health care of children.
 Now a movement towards ‘humanized
pediatric care’ has emerged out as a major
source to reduce trauma to hospitalized
children.
 At present children are prepared
emotionally for medical procedure.
DEVELOPMENT OF PEDIATRIC
NURSING

 The nursing school associated with some of the

earliest children hospitals were devoted to the
training of nurses to the care of sick children.
 In India, pediatric nursing was not given due in
recognition in syllabi in the earlier periods of
nursing training but with the introduction of
under graduate degree programme in nursing in
madras university CMC Vellore, RAK Delhi,
pediatric nursing as a course was introduced date
back from 1950s.
 In present INC syllabus for all types of
undergraduate nursing programme gives due
waightage to pediatric nursing as a specialty
MODERN CONCEPT OF CHILD
CARE

 Child health nursing is undergoing tremendous

advancement just like pediatric medicine and
surgery. The current trends in the practice are
based on researches that have taken make place
in the field of pediatric nursing.
Trends are as following:
 Family centered care
 High technology care
 Evidence based practice
 Atraumatic care
 Cost containment
 Prevention and health promotion
1. FAMILY CENTERED CARE

 It is based on philosophy that quality care can be provided in

an environment that support family integrity and promote
psychological and physiological health of the family. fcc
provide a holistic approach than simply providing medical
and nursing care. Parents know best about their Childs need
more, aware of their Childs behaviour and habits.
The 2 basic concepts of family centered
care are
 Enabling
 Empowering
ENABLING
All the family member are helped by the
professional to create opportunities and mean to
utilize their present ability competence and acquire
new skills that are necessary to provide care to their
ill children.
 EMPOWERING
Empowering help to faster the strength of family member
to cope up and withstand stress related to sickness of their
children.

In FCC the nurse need to move further from describing

what is upsetting to families to describing intervention that
are helpful and providing the same recipients of care, nurses
should help families to make responsible decisions making.
2. HIGH TECHNOLOGY CARE

Advancement in medical field has created the care

of children too technologically versatile. The nurse
also needs to be technologically competent enough to
meet the nursing care needs of children. The
advancement in diagnostic technology has made
detection of many disorders even in the fetal period.
3. EVIDENCE BASED PRACTICE
In evidence based practice nurses need to make decisions on the
best available evidence EBP in nursing provides a systematic
approach to enable nurse to effectively use. Clinical practice
guidelines (CPGs) and patient centered multidisciplinary,
multidimensional plans of Care will help nursing team move
toward evidence based practice and improve the process of care
delivered. The nurse needs to be vigilant in practicing EBP in
4. ATRAUMATIC CARE

It is the provision of therapeutic care is setting by

personnel and with intervention eliminates or minimizes
the psychological and physical distress experienced by
child and their families in health care system.
5. COST CONTAINMENT

Cost containment is a management technique

utilized to reduce the cost of hospitalization. It is
reduced in many ways in hospitals either by cutting
nursing positions or by improving process of care
and tightening non labour resources.
6. PREVENTION AND HEALTH
PROMOTION
The pediatric nurse applied health promotion and health maintenance
in all setting in which children are served. The nurse possesses a
compheransive background on all aspects of children and an
understanding of child growth and development. The family role in the
children’s health is critical, child health depends upon preventive care.
Majority of the child health problems are preventable. Modern concept
of child health emphasize on continuous care of whole child.
 PRINCIPLES
OF
CHILD HEALTH NURSING
1. In Nursing Practice

Concerned with the well being of the child.

Developmental needs are integrated in Nursing
care.
Nursing care is delivered to the family child
unit.
 Nursing practice provides a unifying feature for
the integration of theory into nursing practice.
 An interdisciplinary approach is used to plan
and provide care.
 Attention is paid to the ethical, legal and moral
dilemmas present in the provision of health care.
2. Related to Child
Each child is a unique person and family member
with needs and concerns are unique and increased
and complicated during illness and hospitalization.
Growth and Development are functions of genetic
endowment and an environment which provides a
meaningful experience.
 The child’s coping response to illness or
hospitalization is a function of his developmental
capabilities, threats, challenges, frustration,
gratification.
 Anticipatory guidance techniques help the child
master the potentially traumatic experience of
illness and hospitalization
3. Related to the Family
The integrity of family is supported during illness/
hospitalization
The family’s culture and religious beliefs are
supported during illness and health
The family’s style of coping with stress is
strengthened during illness and health.
 SCOPE
IN
CHILD HEALTH
NURSING
Expanded role of Paediatric Nurse:
 Family centered care
 Child initiated care
 Nursing Process Approach
 Inter disciplinary approach
 Rooming in approach
 Minimal hospital stay policy
 Intensive care Unit
Extended roles of Paediatric Nurse
 Paediatric nurse practitioner/Nurse specialist
 Paediatricnurse clinician- oncology,
neonatology, community
 Child and family advocate
 Paediatric Nurse collaborator/Co ordinator
 Paediatric nurse researcher
 Paediatric nurse educator
 Paediatric nurse Administrator
 Primary Paediatric nurse
 Community Paediatric nurse
OTHER
 Child Guidance clinic
 Child Development Centers
 Development of Genetic engineering and Molecular
biology
 Computer technology in Paediatric Nursing
 Comprehensive care of children
FUTURE SCOPE
 Prevention and promotion

 Home care

 Community care

 Cost containment

 Increasing Accountability

 Increased dedication

 Leadership