FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Redirecting patients from the pediatric emergency department to community locations for care: A qualitative study of healthcare professional and leader perspectives

by Erica Qureshi, Quynh Doan, Jessica Moe, Steven P. Miller, Garth Meckler, Brett Burstein, Jehannine (J9) Austin

Objectives

Emergency department (ED) to community (ED2C) programs, which redirect patients from the pediatric ED to community healthcare professionals represent a promising strategy to reduce the impact of non-urgent visits on the pediatric ED. Given an ED2C program’s potential impact on various care professionals, we completed a qualitative study to explore key informants’ attitudes and perceptions of pediatric ED2C programs.

Methods

We conducted one-on-one semi-structured interviews with key informants in British Columbia, Canada. Participants included: pediatric ED staff – triage nurses and physicians; community professionals – pediatricians and family physicians; and health system leaders responsible for pediatric and emergency care in British Columbia. Interviews were recorded, transcribed verbatim, de-identified, and analyzed using reflexive thematic analysis within an interpretive description framework. A visual model was developed to depict key themes in attitudes and perceptions towards pediatric ED2C programs.

Results

We interviewed 24 participants: 6 community professionals, 11 pediatric ED professionals, and 7 healthcare leaders. Participants viewed the ED2C program as a valuable solution to address pediatric system strain provided that systemic barriers are addressed, and both emergency and community settings are equipped with adequate training and resources. Participants emphasized the need for clear guidelines on eligibility and operations to build confidence and enhance program effectiveness.

Conclusions

Our findings suggest there is support for ED2C programs as a means to reduce the impact of non-urgent pediatric ED visits and strengthen community-based care. Successful implementation will require coordinated planning, resource investment, and clear operational frameworks.

Whom to include? A cross-sectional survey study investigating how culture impacts diagnostic decision making for paediatric cancer in Pakistan

Por: Graetz · D. · Wardell · J. · Hameed · A. · Tul Quanita · A. · Najmi · A. · Ahmad · S. · Shafiq · M. · Naheed · A. · Munir · S. · Ferrara · G. · Staples · C. · Chen · Y. · Devidas · M. · Rodriguez-Galindo · C. · Jeha · S. · Mack · J. · Hamid · S. A. · Rafie Raza · M. · Ahmad · A.
Objectives

This study sought to explore decision making among caregivers of children with cancer in Pakistan, one of the largest lower middle-income countries in the world.

Design

Cross-sectional survey study

Setting

This study was conducted in Pakistan at Indus Hospital and Health Network in Karachi and Children’s Hospital of Lahore. Children’s Hospital of Lahore is a public sector hospital, and Indus Hospital has a foundation-based funding structure. Both are larger tertiary care centers. Over 2,500 new patients are seen at these centers annually, this accounts for almost 50% of all children with cancer in Pakistan

Participants

Eligible participants included bedside caregivers, defined as a parent or family member involved in communication with the medical team, of children with cancer (

Primary and secondary outcome measures

Primary outcome measures included caregiver priorities and experiences related to communication including decision-making role, involvement of the paediatric patient and decisional regret.

Results

Participants included 200 caregivers of children

Conclusions

Findings from this study highlight the importance of exploring preferences for decision making and empowering bedside caregivers while respecting cultural norms. In the Pakistani context, it may be specifically important to consider gender roles and the inclusion of extended family members. Future work should investigate paediatric patient involvement in diverse settings.

The Association of Health Literacy With the Quality of Discharge Planning and Readiness for Hospital Discharge in Jordanian Acute Myocardial Infarction Patients

ABSTRACT

Aim

To examine the relationship between health literacy with the quality of discharge planning and readiness for hospital discharge in acute myocardial infarction patients in Jordan.

Background

Acute myocardial infarction is a major heart disease caused by plaque formation in coronary arteries. Complications after acute myocardial infarction include readmission and physical complications such as chest pain, and limited health literacy increases the risk of complications. Improving the health literacy of patients can improve postdischarge outcomes and decrease complications.

Methods

This study was conducted using a cross-sectional design. Data were collected from 123 patients who were recruited from three hospitals in Jordan. A demographics questionnaire and three valid and reliable instruments (Health Literacy Questionnaire, Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale) were used to collect the data. The authors adhered to the STROBE checklist during the preparation of this study.

Results

The results demonstrated that the Readiness for Hospital Discharge had weak to moderate positive correlations with health literacy scales (r = 0.24–0.36, p < 0.05). The content subscale of the Quality of Discharge Teaching Scale showed weak positive correlations with navigating the healthcare system, finding good health information and understanding health information scales of the Health Literacy Questionnaire.

Conclusion

The results reported here indicate that health literacy positively correlates with readiness for hospital discharge and quality of discharge teaching.

Relevance to Clinical Practice

Improving the health literacy of acute myocardial infarction patients can enhance their discharge planning outcomes. The findings of this study are beneficial for healthcare providers in designing targeted interventions that correspond to health literacy among acute myocardial infarction patients.

Patient or Public Contribution

No patient or public contribution.

Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID‐19 pandemic: Testing an integrated model using structural equation modelling

Abstract

Purpose

A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic.

Background

Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety.

Methods

A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist.

Results

The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life.

Conclusion

The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.

Relevance to clinical practice

These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.

❌