Guest editorial: Publishing clinical nursing resaerch is critical for quality patient care
Professor Linda Johnston 
 
Accidental Paracetamol Poisoning
Sarah Guyder

Paracetamol poisoning is a significant contributor of accidental childhood poisoning. Between 1998-2001, there were 127 admissions to the Royal Children’s hospital, Melbourne, Australia due to paracetamol overdose; on average, paracetamol poisoning accounts for 75 admissions of children under 5 years of age to Victorian hospitals every year. Paracetamol poisoning can lead to acute hepatic failure, hepatotoxicity and, in rare cases, death. In 2003, the Australian Department of heath and Ageing commenced a public health education campaign promoting the safe use of paracetamol, including a fact sheet with specific information relating to the safe administration of paracetamol in infants and children. This paper will discuss the physiological effects of paracetamol overdose on children and the passing of new legislation, public health measures and implementation of parental educational strategies aimed at reducing the risk of paracetamol poisoning.
Keywords: paracetamol, overdose, physiology, treatment, education

A comparison of the effects of continuous positive airway pressure (CPAP) and headbox oxygen on nurses’ workload in the special care nursery
Jann Foster RN, John Bidewell, Adam Buckmaster, Kaye Spence, Debbie Green, David Henderson-SMart

Continuous positive airway pressure (CPAP) is increasingly used in special care nurseries (SCNs) worldwide. Little is known about the workload implications for nurses using CPAP instead of the more traditional headbox therapy in the SCN. The aim of the study was to compare nurses’ perceptions of workload intensity when attending to babies receiving either CPAP or headbox oxygen treatments for respiratory distress in non-tertiary SCNs. The relationship between perceived workload attributes was measured. Nurses’ preferences for either CPAP or headbox oxygen treatment were ascertained. Nurse workload was measured from August 2004 to June 2006 in five non-tertiary SCNs in two Australian States. All SCNs were using CPAP and headbox oxygen for infants with respiratory distress during a randomised controlled trial comparing these interventions. A total of 281 surveys from 71 nurses were analysed. Eighty-nine surveys were completed when caring for babies receiving headbox oxygen and 192 for babies receiving CPAP. Comparison of treatments on perceived workload intensity showed no significant difference. higher caseloads negatively affected the amount of time nurses could attend to the trial baby. Commencement of either treatment, time spent with the trial baby, and the use of substitute or casual staff were factors that increased nurses’ perceived workload intensity. In conclusion, nurses’ preferred CPAP over headbox oxygen. Factors other than CPAP or headbox treatment are associated with nurses’ workload when CPAP is already established in the SCN. The use of CPAP in the SCN was well accepted by the nurses.
Keywords: workload, special care nursery, continuous positive airway pressure, headbox oxygen.

An exploration of child health nursing practice in pharmacy baby clinics
Karen Flowers

An exploratory study of nursing practice in pharmacy baby clinics (PBCs) was undertaken in 2005 using a two phase research design. In Phase I, qualitative data were gathered from pharmacists, PBC staff and clients and from the PBC setting. In Phase II, surveys were employed to further explore and determine the extent of agreement on key findings from Phase I. The surveys were mailed to 160 Queensland pharmacies with a baby clinic, and given to 200 mothers at PBCs in South East Queensland. The survey response rates were low – pharmacists 18% (n=30), PBC staff 14% (n=23) and mothers 31% (n=62). The study identified core dimensions of the role of the PBC nurses which reflected the role of child health nurses (ChNs) in government-funded child health centres. However, variations in the context of PBCs impacted on the scope and nature of nursing practice and raised professional issues for the PBC nurses. While the PBC was valued by those who provided the service and those who used it, there is a need for minimum standards for PBCs, especially in relation to staff qualifications and remuneration and PBC facilities to ensure quality in the services provided. Government involvement in PBCs could also contribute to the implementation of standards to ensure the quality of the services.
Keywords: child health, pharmacy, nursing practice, well baby clinic.

ACCCN: looking to the future
Cheryl Norris

ACPCHN: the way ahead
Jan Pratt

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