Pharmacology in pediatric population has specific needs in pharmacovigilance. The lack of studies in children leads mostly to "off-label" prescribing and to an increased frequency of adverse drug reactions. Additionally, younger ages, male sex, prolonged and previous hospitalization, indication of antibiotics, and the number of prescribed drugs are factors associated with a higher risk of ADRs. Consequently, ADRs represent an additional burden of morbidity. This chapter will be focused on the most common adverse drug reactions in children (including infants and newborns), challenges, and new legislative tools in pediatric pharmacovigilance by using the Word Health Organization global individual case safety report database (VigiAccess) and results from a Latin American study.
Background. Advanced practice nursing (APN) requires nurses to support their knowledge and clinical experience in a nursing care model that delivers holistic and comprehensive care adjusted to the needs of each patient. Objetives. To identify the technological tools available to nurses in a chemotherapy unit, to select one of the specific technologies used and to generate a proposal that can be used in advanced practice. Methods. Data was collected using non-participant observation in an adult outpatient chemotherapy unit. Results. It was observed that nurses properly used hard technologies in their unit. In so far as hard-soft technologies, although there is a specialized knowledge in oncology, there is no theoretical framework associated to the nursing care provided. With regards to the use of soft technologies, their use seems to be related more with personal characteristics that a structured and conscious intervention. Conclusions. Technologies are tools that, coupled with nursing expertise, allow nurses to provide safe and effective care. The chemotherapy unit is a center where APN could be conducted. This study proposes enhancing patient-oriented care based on the knowledge of the discipline as expressed in three different models that are suggested, thus making it possible to state that advanced practice nursing is being provided to patients undergoing ambulatory chemotherapy
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