Stakeholder perspectives: Communication, care coordination, and transitions in care for children with medical complexity.

IF 1.2 4区 医学 Q3 NURSING
Journal for Specialists in Pediatric Nursing Pub Date : 2021-01-01 Epub Date: 2020-10-24 DOI:10.1111/jspn.12314
Lori J Williams, Katherine Waller, Rachel P Chenoweth, Anne L Ersig
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引用次数: 9

Abstract

Purpose: The purpose of this study was to obtain feedback on communication, care coordination, and transitions in care for hospitalized children with medical complexity (CMC).

Design and methods: This descriptive, mixed-methods study used online surveys with forced-choice and open-ended questions to obtain stakeholder feedback. Stakeholders included parents, healthcare providers, and nurses. Participants over 18 years of age were recruited from a Midwest children's hospital inpatient unit dedicated to care of CMC. Quantitative data were analyzed using t-tests and one-way analysis of variance. Qualitative description was used to analyze responses to open-ended questions.

Results: Parents' ratings of communication, care coordination, and transitions in care were generally high. Transitions from other facilities to the emergency department and unit received lower ratings. Providers and nurses gave high ratings to overall care, communication among providers and nurses on the patient unit, and experiences with discharge; however, between unit communication and unit-based coordination received lower ratings. Providers and nurses had higher ratings for discharge preparation than parents (p ≤ .001). Three themes were identified in responses to the open-ended questions: establishing balanced and collaborative relationships between the care team and families, taking a proactive approach to care coordination, and the importance of an inclusive, interdisciplinary, and centralized approach to care coordination and communication.

Practice implications: Collaboration among all stakeholders is needed to achieve coordinated care, inclusive communication, and transitions with positive outcomes during hospitalization. Parents identified a need for consistent communication from care teams, with the primary inpatient team taking a lead role. Including parents in care coordination and transitions in care is key, as they are the experts in their children's health and well-being.

利益相关者的观点:沟通,护理协调,和过渡照顾儿童的医疗复杂性。
目的:本研究的目的是了解医疗复杂性(CMC)住院儿童的沟通、护理协调和护理转变的反馈。设计和方法:这项描述性、混合方法的研究采用在线调查,带有强制选择和开放式问题,以获取利益相关者的反馈。利益相关者包括家长、医疗保健提供者和护士。18岁以上的参与者是从中西部儿童医院住院病房招募的,专门照顾CMC。定量资料采用t检验和单因素方差分析。定性描述用于分析对开放式问题的回答。结果:家长在沟通、护理协调和护理过渡方面的评分普遍较高。从其他设施转移到急诊科和单位的评分较低。提供者和护士对整体护理、提供者和护士之间的沟通以及出院经历给予了很高的评价;但是,单位间的沟通和单位间的协调得到的评价较低。提供者和护士对出院准备的评分高于家长(p≤0.001)。在回答开放式问题时,确定了三个主题:在护理团队和家庭之间建立平衡和合作的关系,采取积极主动的护理协调方法,以及采用包容、跨学科和集中的方法进行护理协调和沟通的重要性。实践意义:需要所有利益相关者之间的合作,以实现住院期间的协调护理、包容性沟通和积极结果的过渡。家长们认为需要与护理团队保持一致的沟通,主要住院团队发挥主导作用。让父母参与护理协调和护理过渡是关键,因为他们是儿童健康和福祉方面的专家。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
7.70%
发文量
27
审稿时长
>12 weeks
期刊介绍: Linking science and practice by publishing evidence-based information on pediatric nursing and answering the question, ''How might this information affect nursing practice?'' The Journal for Specialists in Pediatric Nursing (JSPN) is the international evidence-based practice journal for nurses who specialize in the care of children and families. JSPN bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses'' passion for achieving the best outcomes. The journal values interdisciplinary perspectives and publishes a wide variety of peer-reviewed papers on clinically relevant topics.
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