This is the second of two articles which aim to provide children’s nurses with an opportunity to develop their knowledge and skills of medicines management when caring for children and young people. The first article considered the processes associated with effective medicines management, including the concept of human error. This article addresses essential numeracy and calculation skills that have been identified as an important risk factor associated with medication errors in children. The range of activities throughout the article will help you develop and practise numeracy skills, with the answers for each activity at the end of the article.

This is the first of two articles that aim to provide children’s nurses with an opportunity to develop their skills and knowledge of medicines management when caring for children and young people. This first article outlines the principles of effective medicines management including the pharmacology language required to accurately read prescriptions, the way children respond to medicines, managing risk, including the concept of human error, and working in partnership with children, young people and families. The second article, to be published in September, will focus on numeracy and calculation skills, identified as an important risk factor associated with medication errors in children.

Aim To explore and describe child-parent shared decision making for the management of childhood asthma.

Methods A qualitative, descriptive, interview-based study was undertaken. Eight children and nine parents participated. The framework approach underpinned data analysis.

Findings A dynamic model of the way children and parents transfer, shift and share asthma management decisions was uncovered. Asthma management decisions between children and parents were non-linear, with responsibility transferring from parent to child under different conditions. Children made a range of decisions about their asthma, often sharing decisions with their parents. However, during acute illness episodes, children often relied on parents to make decisions about their asthma.

Conclusion Neither the child nor parent has complete autonomy over asthma management decisions. Decision making is a dynamic, shifting and shared process, dependent on contextual factors and child and parent decision preferences.

Aims To explore parents’ involvement in the care of their child’s hydrocephalus and the ways in which parents and professionals collaborate when assessing a child with potential shunt malfunction.

Methods Two exploratory studies were undertaken using interview and observational methods.

Findings Although there is co-operation with parents, conflicts emerged when parents disagreed with the professionals’ opinions. Parents also perceived that their expertise was not always valued by professionals and not used to inform decisions about care.

Conclusion Despite identifying collaboration with parents as the desired care model, health professionals find integrating parents’ expertise on their child’s condition challenging during assessment and when planning care.

Aim To evaluate the impact of a structured pain education programme on pre-registration children’s nursing students’ knowledge of and attitudes to the management of child pain.

Method A total of 127 pre-registration children’s nursing students participated. A pre/post-intervention design was used to compare participants’ knowledge of and attitudes to pain and pain management in children before and after they attended a pain education programme. A group of similar students who did not undertake the programme until after the study were used as controls. Data were analysed using descriptive statistics.

Results Participants’ knowledge about pain management improved slightly, as shown by comparison of questionnaire answers before and after the programme for the intervention group. Although the proportion of students achieving correct answers in the intervention group was better overall than that of the controls, the percentages were disappointing and for some questions were less than 50%. However, the education intervention improved students’ knowledge of pain in children and attitudes towards managing children’s pain.

Conclusion A bespoke pain management education programme has the potential to develop a positive student attitude to children’s pain management. However, knowledge of the physiology and pharmacology of pain needs to be revisited throughout the undergraduate curriculum, as students struggle with these concepts.

Supplementary information Additional data (tables 3-5) from the results of this study are available on the Nursing Children and Young People website at rcnpublishing.com/r/NCYP334