Journal of Pediatric Health Care最新文献

Category/Date

Clinical Research Poster presented at NAPNAP's 45^th National Conference on Pediatric Health Care, Posters on the Move, March 13, 2024.

Background

Pediatric-focused nurse practitioners (NPs) play an essential role in achieving optimal child health. Yet, as a small portion of the overall NP workforce, unique challenges surround full role implementation (Gigli et al., 2019; Gigli et al., 2023).

Purpose

The purpose of this study was to identify challenges in pediatric-focused NPs’ practice that limit their ability to provide care.

Methods

We conducted a secondary data analysis of a cross-sectional mixed-methods survey of pediatric-focused NPs conducted by the National Association of Pediatric Nurse Practitioners (NAPNAP) in the Fall of 2021. The survey included three open-ended questions. We conducted inductive thematic analysis of one open-ended question: What is the biggest challenge to the pediatric-focused NP role? Each author open-coded a representative sample of the data, then met to group codes into themes. Using an iterative process, the final codebook compromised of 19 total themes (Runge et al., 2014). This abstract focuses on themes related to pediatric-focused NP role recognition which aligns with the NAPNAP research priority area - the pediatric workforce. The University of Texas at Arlington IRB deemed this study non-human subjects’ research.

Results

In total, 980 pediatric-focused NPs responded. A majority (67.9%) were primary care pediatric NPs, and 15.2% were acute care pediatric NPs. Nearly half (n=421, 43.0%) had 15 or more years of NP experience. Most respondents (n=952, 97.1%) provided an open-ended question response. Overall, respondents identified challenges with “who we are” and “what can we do”. Themes related to “who we are” included: role recognition, certification alignment, education quality, and workforce capacity. Respondents described challenges in “what can we do” with themes including: work to full scope and be valued as pediatric experts.

Conclusions

Pediatric-focused NPs identified barriers to role recognition that align with improving professional identify. Future research should address barriers to role recognition to increase the ability of pediatric-focused NPs to contribute to child healthcare delivery.

Category/Date

Evidence-Based Practice, Quality Improvement, & Practice Innovation Poster presented at NAPNAP's 45^th National Conference on Pediatric Health Care, Posters on the Move, March 14, 2024.

Background

Current research identifies the importance of comprehensive lactation knowledge among healthcare professionals to improve breastfeeding outcomes. There is a need for educational curricula to incorporate lactation content for student preparedness to provide competent care. PNPs are in a unique position to support, promote and manage lactation, however, it is unclear how they obtain the knowledge needed to support breastfeeding dyads.

Purpose

The aims of this study were to determine:

1. The amount and content of lactation education provided to PNP students in PNP-PC and PNP-AC/PC programs in the U.S.

2. The extent to which lactation education is included in clinical experiences.

3. Whether simulation is utilized to teach clinical lactation skills.

Details

A survey was deployed to PC and AC/PC Pediatric Nurse Practitioner programs in the U.S. using a LimeSurvey platform. The response completion rate was 44.7%. Data collection included program descriptors, lactation curricular volume, educational topics, faculty preparation, use of simulation, and clinical lactation experiences.

Outcomes

Analyses revealed significant variance among the programs regarding the volume of lactation content and clinical opportunities. Three programs offered specific lactation courses; 19% devoted 1-2 hours to didactic lactation content, 44% provided up to 3 hours. Students had the opportunity to practice lactation skills in 68% of programs; four offered lactation simulation. No programs report utilizing standardized lactation clinical competencies.

Discussion

The findings of this study indicate that although lactation education is provided within PNP curricula, the content of that education is varied and inconsistent. In addition, there is a lack of lactation competencies expected of students during their clinical practicums. Establishing clear lactation clinical competencies and threading of lactation content throughout PNP programs while incorporating use of simulation experiences is one approach to providing more a comprehensive base of lactation education for future PNPs.

Introduction

This hospital-based retrospective matched cohort study explored the association between preterm birth (PB) and health-related quality of life (HRQoL) in preschool children.

Method

PB children were matched by sex and day of birth (1:2) with full-term birth (FTB) children (PB = 89, FTP = 178). The children's parent-reported HRQoL was assessed using the TNO-AZL Preschool Children Quality of Life Questionnaire. The association between PB and HRQoL was examined using conditional logistic regressions.

Results

PB children were mostly moderate-to-mild preterm (64%) and exhibited a lower probability of presenting an HRQoL below the median in the sleeping (OR = 0.46; 95% CI = 0.23–0.91) and behavior (OR = 0.46; 95% CI = 0.23–0.85) subscales. Conversely, this probability in communication HRQoL was higher in the PB group (OR = 1.91; 95% CI = 1.01–3.64).

Discussion

PB was associated to better sleeping and behavior HRQoL, but poorer communication HRQoL. These findings could imply a potential normalization of developmental outcomes in moderate-to-mild PB.

Category/Date

Clinical Research Podium Presentations: Current Topics in Pediatric Research. Presented at NAPNAP's 45^th National Conference on Pediatric Health Care, March 14, 2024.

Background

Food and cooking skills are essential to putting dietary recommendations into practice, but modern teenagers have limited access to food and cooking education. Teens are a critical target for cooking and food skill development. The Texas Children's Mobile Clinic Program (TC-MCP) partnered with nutrition researchers to conduct a needs-based assessment of high school adolescents in a public charter school serving low-income students to understand needs and preferences for a healthy cooking and food skills intervention.

Methods

The study was conducted in southeast Houston, Texas. The research team developed a questionnaire from previously validated instruments examining student demographics, food insecurity, dietary intake, cooking self-efficacy, and preferences for intervention programming. The survey was distributed to all 11th and 12th graders via email or on paper.

Results

The survey was sent to 202 students, and 82 (41%) completed the survey. The majority of respondents were female (68.3%), just over 16 years old, and either Black/African American or Hispanic white (80.5%). The majority of students (70.7%) reported eating less than 1 cup of vegetables per day, and most (62.2%) reported eating fast food more than 2 times per week. Just over half (59.8%) reported eating more than 1 cup of fruit per day. Based on a 5-point Likert scale, respondents reported higher self-efficacy regarding their ability to cut up or prepare ingredients (mean=3.76) and shop or help shop for groceries (3.70), and lower self-efficacy regarding ability to cook without a recipe (3.11) and to make a meal for their family (3.13).

Conclusions

Students in low-income families face many health inequities. This project highlights the gaps in their food and cooking education. Mobile clinic collaboration with under-resourced schools may be key to addressing these types of issues among youth. However, more research is needed to understand how to optimize programs like this.

Introduction

This study examined the effectiveness of mobile phone reminders in improving the completeness and timeliness of childhood immunization.

Method

We conducted a parallel arm cluster randomized controlled trial in four primary health care facilities in Nigeria. Reminders were sent to eligible participants in the intervention group at specific intervals when their children were scheduled to receive the vaccines administered at the sixth, 10, and 14 weeks after birth. Immunization records of all participants’ children were then tracked to assess their immunization status.

Results

The immunization status of the intervention (n = 275) and control (n = 261) arms was analyzed. Completeness and timeliness of the vaccine series were significantly higher (p < .001) among children of participants in the intervention (n = 169, 61.5% and n = 138, 50.2%) than those in the control group (n = 35, 13.4% and n = 13, 5%) arm.

Discussion

Mobile phone reminders were established to be effective in increasing the completeness and timeliness of childhood immunization.

Importance

This study explores referral patterns in pediatric dermatology and assesses the diagnostic concordance between referring and dermatology providers.

Method

This retrospective cross-sectional study utilized referrals to an outpatient pediatric dermatology clinic. The review included patients referred between July 1, 2018 and June 30, 2019. Only patients who completed a clinic visit were included in the diagnostic concordance. Referral and first visit diagnoses were compared to determine concordance.

Results

A total of 8,682 charts were reviewed, and 3,738 completed a clinic visit. The most common referral diagnoses included atopic dermatitis, rash, lesion, melanocytic nevus, and warts. Physicians (78.5%) and APRNs (18.1%) most frequently referred patients. The diagnostic concordance of physicians was 67.1% vs 66.3% for APRNs.

Conclusion

Physicians and APRNs showed similar rates of diagnostic concordance, yet a large proportion of diagnoses were discordant. Primary care providers may benefit from focused education around the most commonly referred and missed diagnoses.