Editorial: Can we meet our challenges?
Kaye Spence 

Invited paper
The future nursing workforce:neonatal, paediatric and child health nurses
Christine Duffield 

Modern technology and treatments are improving survival rates of children, but with the consequence of an increasing number of children growing up with chronic disease and disability. The increase in numbers will provide challenges for families caring for these children, the community, health services and the nursing workforce. This paper discusses some of the challenges facing the paediatric, neonatal and child health nursing workforce in meeting future demands. Issues such as increasing specialisation, direct entry and separate registration, disparity in nomenclature of positions, future role development and advanced nursing practice will be discussed.

The development, dissemination and evaluation of written information as a component of asthma management forparents of children with asthma
Christine Burns, Melinda Gray, Richard Henry

Assisting parents of children with asthma to achieve effective self-management requires information, assessment of symptom management, regular medical review, and a written action plan. This paper describes the development and dissemination of the children’s asthma information pack (the pack) across an area health service and its subsequent evaluation to determine parents’ satisfaction with the resource and evidence for appropriate use by clinicians.
The pack was developed through a collaborative effort, the purpose being to develop a pack that provided current written asthma information as well as integrating tools to promote and facilitate asthma self-management. Clinicians had in-service on appropriate use of the pack followed by a postal survey of all parents of children with asthma who presented to three hospitals within an area health service over a 13 week period. A total of 642 parents were sent the survey, and 184 (29%) were completed and returned. Nearly all responses, 98%, 99% and 94%, were in strong agreement or agreement with the ease of understanding, usefulness and help with management of asthma respectively. Further, 87% of parents indicated they had received asthma education in conjunction with the pack, and 87% indicated that their child had an asthma action plan. In summary, parents of children with asthma responded positively to the pack. Evidence was consistent with appropriate use, and with the pack being coordinated with asthma management, not in isolation from it.
The pack, perceived by parents of children with asthma as a valuable resource, aims to promote optimal asthma self-management when provided in coordination with asthma management. The adaptation and utilisation of the pack by other major paediatric hospitals across the NSW paediatric network has been a positive step for standardising asthma information for parents of children with asthma.

Nurse led clinical research:neonatal nurses’ perceptions and experiences
Karen New, Fiona Bogossian 

Over the last 2 decades, nurses have had increased exposure to research. In spite of this, the literature reports that many nurses have not begun to undertake or use research. A qualitative study of neonatal nurses would add depth to our understanding of nurses’ experiences relative to nurse led clinical research in neonatal nursing. The purpose of this study was therefore to understand the experiences of clinical neonatal nurses in participating or conducting nurse led clinical research. Phenomenology was used to explore the perceptions and experiences of clinical neonatal nurses. A purposive sample of five neonatal nurses were interviewed; semi-structured, face-to-face interviews were used to collect data. Themes were explicated and analysed from audiotaped interviews. Two conceptually distinct themes, current culture and embryonic culture, emerged from the data. Current culture had three sub-themes – role, time, access. Embryonic culture also had three sub-themes – engagement, nurturing and preparedness.
In the context of current culture, clinical research remains burdensome on the nurse and nurse led research is still not considered to be a central concern in the clinical nurses’ role in neonatal care. If neonatal nursing practices are to be based on the best available research evidence, organisations need to be acutely attuned to the culture in neonatal nurseries and address these issues.

Evaluation of an undergraduate child development teaching program using a home visit and the Ages and Stages Questionnaire (ASQ)
Pam Nicol

Undergraduate nursing students at a Western Australian university completed a child developmental assessment program which included the parent-completed Ages and Stages Questionnaire (ASQ), a validated population-based screening tool. The aim of introducing the ASQ within a home visiting program was to increase the students’ knowledge of developmental stages and their skill in observing and recording developmental progress in a child by using a validated tool. The study complements a previous qualitative evaluation by the author of the educational use of the ASQ with medical students.
There was a significant difference between pre-test and post- test observational skills of students in assessing a child at play; this has valuable application for use in clinical practice. However, there was no evidence from this evaluation that students learn specific developmental stages by this method of learning. The study raises questions related to the content of child development assessment curricula and how to most effectively assess this learning in undergraduate nursing students.

10 Steps to Publication
Denise Harrison

Book reviews