Simulation in pediatric nursing education: Are there enough evidence for future practice?

Research on simulation is still a developing field in nursing and simulation-based learning is gaining momentum with its application over the past two decades in nursing education. Simulation is utilized as a method of training, by helping the learners for competent practice and to improve patient safety, but not much evidence is available for its application in pediatric nursing education.This study aimed to (1) describe the application of simulation in teaching pediatric nursing education and (2) explore the evidence for its application in developing clinical competencies and skills in nursing students taking pediatric courses.A literature search was conducted in Google Scholar, PubMed, Medline, Science Direct & ProQuest for the relevant articles available on the internet. Descriptive, experimental, and systematic reviews concerning simulation in pediatric nursing were included.Mixed results were cited in studies about imparting the knowledge concerning the applicability of simulation in pediatric nursing courses. Available evidence shows that simulation can improve the competency of students in clinical practice and in improving patient care outcomes and communication skills. There is a paucity of studies about the applicability of simulation in pediatric nursing education. Simulation is found to be a useful strategy in providing a near-to-real experience for the students to practice high-risk, rare procedural skills in pediatric nursing education. However, further, evidence is required to replace clinical practice experience with simulation, for sustained improvement in patient care outcomes, and in critical thinking and knowledge retention in nursing students.

Designing a Healthcare Technology Platform Framework for Purpose-Driven Oncology in a Developing Country Healthcare Context (Preprint)

UNSTRUCTURED The rising cases of cancer in India and the unequal care has given rise to large out-of-pocket expenses and late stage of detection of cares, leading to higher mortality rates in many states across rural India. Investing in digital health in resource-constrained countries could provide cancer diagnosis and treatment at affordable costs, improve availability and health outcomes for the citizens. This paper introduces the framework and features of a healthcare technology platform for a developing country to democratise oncology health care services. The framework relies on participatory systems, patient first algorithms and digital health exchange mechanisms. The proposed platform is built on three key pillars of Technology, Managed Healthcare and Advisory, each with a unique value proposition, yet will be complementary, and tries to address specific requirements across the healthcare delivery value chain, thereby, providing a comprehensive solution to the overall problem of the ecosystem. We discuss the application of the framework and usage of curated data and robust workflow and rules engine to enable seamless flow of information across all levels, while bringing close home care to people. We propose that a technology platform, build on a connected care ecosystem, could improve cancer care outcomes in a developing country healthcare context.

Transportation barriers to care among frequent health care users during the COVID pandemic

Objective: To investigate transportation barriers to accessing health care services during the COVID-19 pandemic among high-frequency health care users.Data Sources: Between June 21 and July 23, 2021, primary survey data were collected for a sample of patients in North Carolina.Study Design: The study analyzed the prevalence of arriving late to, delaying, or missing medical care and examined how transportation barriers contributed to negative health care outcomes. Data Collection Methods: A web-based survey was administered to North Carolina residents aged 18 and older in the UNC Health system who were enrolled in Medicaid or Medicare and had at least six outpatient medical appointments in the past year. 323 complete responses were analyzed to investigate the prevalence of reporting transportation barriers that resulted in having arrived late to, delayed, or missed care, as well as relationships between demographic and other independent variables and transportation barriers. Qualitative analyses were performed on text response data to explain transportation barriers.Principal Findings: Approximately 1 in 3 respondents experienced transportation barriers to health care between June 2020 and June 2021. Multivariate logistic regressions indicate individuals aged 18–64 were significantly more likely to encounter transportation barriers. Costs of traveling for medical appointments and a lack of driver or car availability emerged as major transportation barriers; however, respondents explained that barriers were often complex, involving circumstantial problems related to one’s ability to access and pay for transportation as well as to personal health.Conclusions: To address transportation barriers, we recommend more coordination between transportation and health professionals and the implementation of programs that expand access to and improve patient awareness of health care mobility services. We also recommend transportation and health entities direct resources to address transportation barriers equitably, as barriers disproportionately burden younger adults under age 65 enrolled in public insurance programs.

The Interconnected Dynamics of Partnership and HIV: A Qualitative Exploration of Experiences from Heterosexual Individuals Newly Diagnosed with HIV

Background Recent studies have focused on the role of intimate partnership on HIV care outcomes among men who have sex with men in the United States (US) and heterosexual couples in some African studies, leaving a gap in the recent US-based literature on the role of having an intimate partner on HIV care outcomes among heterosexual couples. Therefore, the objective of this study was to explore the lived experiences of heterosexual individuals newly diagnosed with HIV regarding the role of partnership on HIV care. MethodsThis phenomenological study conducted one time, virtual, in-depth interviews with six heterosexual individuals newly diagnosed with HIV ≥2017. The data analysis followed Moustakas approach to identify themes and sub-themes. ResultsThe participants were predominantly female and African American with median age of 46 years. Four themes identifying association between partnership and HIV care included role of HIV on partnership, under which impact of HIV on partnership and presumed reaction if partner was diagnosed with HIV were identified; Impact of partnership on HIV identified perception on dealing with HIV diagnosis without a partner and role of family vs. partner in HIV care as sub-themes; forms of support from partner in HIV care identified partner support around the time of HIV diagnosis and linkage to HIV care and around retention in care; and perceptions on the types of partner-based clinic services, which identified areas such as couples therapy, assistance with partner communication on sensitive topics such as HIV disclosure, and HIV education of the partner. The findings showed that partnership played a vital role in HIV care among partnered individuals; and the importance of a partner in HIV care was acknowledged by unpartnered participants. Various support practices by partners around HIV diagnosis and retention in care were identified. Quality of partnership played a bigger role in HIV care than presence of partnership. ConclusionThe importance of partner-based interventions in improving the HIV care of the person with HIV (PWH) was acknowledged. While demonstrating views of mainly African American women living with HIV in the Southern US, findings may be transferrable to other heterosexual PWH in other locales.

Bringing the Nurse Back to the Bedside

As digitisation continues to increase across Australian health services, the nursing profession has focused on analysing and measuring the way care is provided to the patients. Focus on optimising nursing workflows and improved care delivery has presented challenges but this is now demonstrating improvements in patient care outcomes and time for care.

Delayed Diagnosis of McCune–Albright Syndrome

Background. McCune–Albright syndrome (MAS) is a rare heterogeneous genetic disorder that is characterized by a triad of polyostotic fibrous dysplasia (FD), café au lait spots (CAL), and multiple hyperfunctional endocrinopathies. In general, it is diagnosed clinically. From the triads, two of the findings are enough to make the diagnosis, but genetic testing can be done if it is available. Case Presentation. We report a female child who was symptomatic since the neonatal period with skin hyperpigmentation, breast enlargement, and vaginal bleeding. She was diagnosed with MAS at the age of five years. She had pathological fractures at multiple sites and had raised thyroid hormones since the age of 3½ years. The child developed severe morbidity as the result of delayed diagnosis and currently became wheelchair dependent. Conclusion. Thorough patient evaluation and appropriate interpretation of findings are crucial steps for timely diagnosis of MAS and better patient care outcomes.