Identifying and Ensuring Optimal Care for All Children at Risk of Developing Serious Respiratory Syncytial Virus Disease: A Canadian Nurses’ Perspective

Bracht, Marianne; Basevitz, Debbie; Cranis, Marilyn; Paulley, Rose; Paes, Bosco

doi:10.1891/0730-0832.31.6.369

Cited by 8 publications

(3 citation statements)

References 60 publications

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“…We controlled for covariates since randomization by cluster (treatment location) can leave imbalances between treatment groups by patient-level factors if the randomized locations have different characteristics. Children with lower socioeconomic status may have barriers to accessing healthcare that prevent receiving timely doses of palivizumab [12,24]. Also, younger children who are significantly premature may be identified as eligible during the first year of life more reliably than older children during their second season of eligibility or children who are eligible due to cardiac or lung problems.…”

Section: Covariatesmentioning

confidence: 99%

Clinical Decision Support and Palivizumab

Utidjian¹,

Hogan²,

Michel³

et al. 2015

Appl Clin Inform

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SummaryBackground and Objectives: Palivizumab can reduce hospitalizations due to respiratory syncytial virus (RSV), but many eligible infants fail to receive the full 5-dose series. The efficacy of clinical decision support (CDS) in fostering palivizumab receipt has not been studied. We sought a comprehensive solution for identifying eligible patients and addressing barriers to palivizumab administration. Methods: We developed workflow and CDS tools targeting patient identification and palivizumab administration. We randomized 10 practices to receive palivizumab-focused CDS and 10 to receive comprehensive CDS for premature infants in a 3-year longitudinal cluster-randomized trial with 2 baseline and 1 intervention RSV seasons. Results: There were 356 children eligible to receive palivizumab, with 194 in the palivizumab-focused group and 162 in the comprehensive CDS group. The proportion of doses administered to children in the palivizumab-focused intervention group increased from 68.4% and 65.5% in the two baseline seasons to 84.7% in the intervention season. In the comprehensive intervention group, proportions of doses administered declined during the baseline seasons (from 71.9% to 62.4%) with partial recovery to 67.9% during the intervention season. The palivizumab-focused group improved by 19.2 percentage points in the intervention season compared to the prior baseline season (p < 0.001), while the comprehensive intervention group only improved 5.5 percentage points (p = 0.288). The difference in change between study groups was significant (p = 0.05). Conclusions: Workflow and CDS tools integrated in an EHR may increase the administration of palivizumab. The support focused on palivizumab, rather than comprehensive intervention, was more effective at improving palivizumab administration.

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Section: Covariatesmentioning

confidence: 99%

Clinical Decision Support and Palivizumab

Utidjian¹,

Hogan²,

Michel³

et al. 2015

Appl Clin Inform

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“…In our diabetes instructions an aid [an application (app)] is not enough” (person two, focus group interview with PNs). If no interpreter was available, although contrary to recommendations from the literature (Bracht et al., 2012) and practice, relatives or employees were often used for such topics. It was observed that in many cases, a simple form of German was used by the nurses for communicating with the MPP and parents.…”

Section: Resultsmentioning

confidence: 99%

Communication challenges between nurses and migrant paediatric patients

Kaufmann¹,

Helfer

Pedemonte³

et al. 2020

Journal of Research in Nursing

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Background Many people receiving medical treatment in Switzerland speak none of the country’s four languages or English, which is a major communicative barrier for health staff. Appropriate treatment in hospitals depends on the successful communication between hospital staff and patients. Consequently, migrant patients can be particularly challenging for hospital staff. Aims The aim of this project was to examine the following topics: (a) which communicative challenges hospital nurses are confronted with in the care of migrant paediatric patients and how they cope with them, and (b) what requirements nurses (and other stakeholders) have regarding a digital communication aid to improve the care of migrant paediatric patients in the hospital setting. Methods This study used a qualitative approach. The following steps of data collection were undertaken: (a) two literature searches corresponding to the research questions, (b) a focus group interview with paediatric hospital nurses, (c) observation of communication between paediatric nurses/healthcare professionals and children/parents through shadowing, (d) short interviews with paediatric nurses who were being shadowed, and (e) a focus group interview with experts. Data analysis was based on thematic analysis and was supported by MAXQDA software. Results Evaluation of the data showed there are multiple communicative challenges that emerge in the care of migrant paediatric patients. These challenges influence each other and appear at different moments in the hospital stay. Additionally, the results revealed that digital communication aids must be user friendly and easily accessible. Conclusions This study highlights the areas of hospital care in which a digital communication aid could be feasible. However, many of the described communication challenges stem from issues that cannot be solved solely with a digital communication aid. Instead, strategies to tackle these issues must be embedded in the training of nursing staff, in the hospital management strategy and at the political level.

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“…11 Therefore, counseling parents on the purpose of RSV immunoprophylaxis, how it works, and the importance of adherence is also critical. 12,13 Parents should be educated about the fact that RSV immunoprophylaxis provides passive immunization rather than eliciting an active immune response against RSV; therefore, immunoprophylaxis must be administered monthly throughout the RSV season for it to be most effective. Furthermore, providing re-education at each follow-up visit regarding the mechanism of protection and the importance of monthly doses to derive the full benefits of protection would be expected to bolster adherence to the dosing schedule and help prevent RSV-related hospitalizations.…”

Section: Discussionmentioning

confidence: 99%

The Logistics and Coordination of Respiratory Syncytial Virus Immunoprophylaxis Use Among US Pediatric Specialists

Wong

Parimi

Domachowske

et al. 2016

Clin Pediatr (Phila)

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This study was conducted to survey US pediatric specialists about administration of respiratory syncytial virus (RSV) immunoprophylaxis, communication patterns among physicians and parents, and barriers to access. Separate surveys were sent to neonatologists, pediatricians, pediatric pulmonologists, and pediatric cardiologists. Most physicians (≥93.5%) routinely recommended immunoprophylaxis to high-risk children. Most respondents (≥71.8%) reported that >50.0% of eligible infants and young children received each monthly dose throughout the RSV season, with the first dose most commonly administered before discharge from the birth hospitalization. To ensure receipt of subsequent doses, specialists frequently scheduled a follow-up visit at the end of the current appointment. All specialists reported insurance denials as the biggest obstacle to the administration of immunoprophylaxis to high-risk children. These findings may be used to improve adherence to immunoprophylaxis by enhancing education and physician-parent communications about severe RSV disease prevention, and by reducing known barriers to use of this preventive therapy.

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Identifying and Ensuring Optimal Care for All Children at Risk of Developing Serious Respiratory Syncytial Virus Disease: A Canadian Nurses’ Perspective

Cited by 8 publications

References 60 publications

Clinical Decision Support and Palivizumab

Clinical Decision Support and Palivizumab

Communication challenges between nurses and migrant paediatric patients

The Logistics and Coordination of Respiratory Syncytial Virus Immunoprophylaxis Use Among US Pediatric Specialists

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