Improving documentation of treatment escalation decisions in acute care.

The aim of this project was to improve the documentation of treatment escalation decisions at a district general hospital in southwest England. A pilot "Ceiling of Treatment" proforma was trialled on the care of the elderly wards at the Royal United Hospital (RUH), Bath. Successive PDSA cycles enabled revision of the proforma for use across the Trust.

Family nursing and the management of pain in children.

Most of the issues around children and pain have been identified and yet children's pain continues to be poorly managed. This review aims to take a fresh look at this topic through the use of family nursing theory and children's policy and rights perspectives. Family nursing and children's policy have a valuable contribution to make to assessment issues; nurse education needs to combine family-centred care concepts and children's rights in the teaching of pain management.

Outcome of critically ill children before and after the establishment of a pediatric retrieval service as a component of a national strategy for pediatric intensive care.

OBJECTIVE: To compare outcomes of critically ill children transferred for intensive care by specialist and nonspecialist retrieval before and after the establishment of a dedicated pediatric intensive care transfer service. DESIGN: Prospective, observational study. SETTING: All hospitals that admitted children in a defined geographic region of the United Kingdom.