Pediatric Nurses' Role in Health Care Transition Planning: National Survey Findings and Practice Implications

Disabato, Jennifer A.; Mannino, Jennifer E; Betz, Cecily Lynn

doi:10.1016/j.pedn.2019.08.003

Cited by 25 publications

(19 citation statements)

References 33 publications

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“…This study found that over three-quarters of pediatric nurses working in acute-care settings assess YYA SMA pertaining to condition management more often than they assess YYA SMA pertaining to seeking/accessing community services and supports; this is not surprising because the latter often requires community-specific knowledge. Findings are consistent with earlier research indicating that only a small portion of respondents had specialized training in HCTP and that perceived knowledge of HCTP predicts delivery of care to this population (Disabato et al, 2019). These results support the need for education that embodies a tiered approach to training: support for clinical practice and standardization of practice for HCTP.…”

Section: Recommendationssupporting

confidence: 88%

“…The NR-HCTP instrument demonstrated adequate internal reliability with a Cronbach's coefficient alpha of α = .949. Significant findings from that study clarified the role, responsibilities, and educational needs of U.S. pediatric nurses and nurse practitioners (Disabato et al, 2019).…”

Section: Survey Questionnairementioning

confidence: 84%

“…Nurses who provide services to YYA with long-term conditions have important roles in facilitating their transfer to the adult health care system and transition to adulthood, which has been affirmed in pediatric nursing standards of care in the U.S. by the Society of Pediatric Nurses (Betz, 2017b) and the National Association of Pediatric Nurse Practitioners (Lestishock et al, 2020) and in the United Kingdom by the Royal College of Nursing ( 2013) and Haemophilia Nurses Association (Khair et al, 2020, in press). To better understand the extent to which pediatric nurses and nurse practitioners are involved in HCTP, this research team conducted a national study of U.S. pediatric nurses and nurse practitioners to investigate their knowledge and participation in HCTP for YYA with longterm conditions (Disabato et al, 2019;Mannino et al, 2018). Survey findings, specific to their involvement in promoting acquisition of SMA, are reported here.…”

Section: Purposementioning

confidence: 99%

“…A total of 1814 nurses responded representing a 14% response rate. As previously reported, the NR-HCTP instrument was developed specifically for the study using a rigorous validation process that served to elicit information from pediatric nurse respondents regarding the breadth and depth of their HCTP practice (Disabato et al, 2019;Lynn, 1986;Mannino et al, 2018). In all, 13 HCTP activities relating to communication, education, collaboration, and advocacy, were explored.…”

Section: Survey Questionnairementioning

confidence: 99%

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Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions

Betz

Mannino

Disabato

2020

J Child Health Care

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The survival rates of youth and young adults (YYAs) diagnosed with long-term conditions have improved considerably as 90% now enter adulthood; health care transition planning (HCTP) has emerged as a nursing practice priority. The aim of this national online survey was to investigate the extent to which nurses, recruited from two major United States pediatric nursing organizations are involved with HCTP including assessing YYA self-management abilities (SMA). Findings of a 9-item assessment of self-management abilities subscale of the nurses’ role in HTCP tool are reported. The nurse respondents ( n = 1269), identified the most frequently assessed SMA was the YYAs’ ability to understand and speak about their condition and its treatment ( M = 2.3, SD = .89). The least frequently assessed was the YYAs’ ability to identify community advocates to help them become more independent ( M =1.5, SD = .90). Regression analysis identified significant predictors of the frequency nurses assess YYA for SMA included nurses’ level of knowledge, perceived level of importance, HCTP and skills identified in job description, and caring for YYA. Findings indicate HCTP care advancements will necessitate HCTP training and development of nurse-led service efforts to facilitate optimal outcomes for YYA.

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Section: Recommendationssupporting

confidence: 88%

Section: Survey Questionnairementioning

confidence: 84%

Section: Purposementioning

confidence: 99%

Section: Survey Questionnairementioning

confidence: 99%

See 2 more Smart Citations

Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions

Betz

Mannino

Disabato

2020

J Child Health Care

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“…The strength of this study is that through our analyses of each participant's intervention experience, we identified transition indices and a typology of transition readiness to provide direction for clinical practice. The typology of transition readiness, the independent, ready, follow-up needed, and at-risk adolescent, provides a foundation for further personalization of transition readiness programs and approaches, reiterating to the vital role for pediatric nurses (Disabato et al, 2019) and for the engagement of other members of the interdisciplinary team (e.g., psychologists, occupational therapists) (Compás et al, 2017;Rogers, 2020).…”

Section: Discussionmentioning

confidence: 99%

A Typology of Transition Readiness for Adolescents with Congenital Heart Disease in Preparation for Transfer from Pediatric to Adult Care

Charles

Mackie

Rogers

et al. 2021

Journal of Pediatric Nursing

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To understand the effectiveness of a nurse-led transition intervention by analyzing qualitative data generated in the context of a clinical trial.Design & methods: Qualitative study of a two-session transition intervention conducted by registered nurses at two sites. Adolescents aged 16-17 years with moderate or complex congenital heart disease (CHD) had been randomized to a two-session transition intervention or usual care. Session 1 emphasized patient education including creation of a health passport and goal setting. Session 2, two months later, emphasized self-management. Qualitative data extracted from intervention logs, field notes and audio recordings of the sessions were analyzed for content and themes. Results: Data from 111 transition intervention sessions with 57 adolescents were analyzed. Creating a health passport, goal setting, and role-plays were the elements of the intervention most valued by participants. A typology of transition readiness was identified: 1) the independent adolescent (5%), already managing their own care; 2) the ready adolescent who was prepared for transition after completing the intervention (46%); 3) the followup needed adolescent who was still in need of extra coaching (26%), and 4) the at-risk adolescent who warranted immediate follow-up (14%). Baseline knowledge and transition surveys scores validated the typology. Conclusions: A two-session nursing intervention met the transition needs of approximately half of adolescents with CHD. However, additional transition-focused care was needed by 40% of participants (groups 3 and 4). Practice implications: These findings will guide pediatric nurses and other healthcare professionals to optimize an individualized approach for ensuring transition readiness for adolescents with CHD.

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Implementation of Rheumatology Health Care Transition Processes and Adaptations to Systems Under Stress: A Mixed‐Methods Study

Chang

Sears

Bitencourt

et al. 2022

Arthritis Care & Research

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Objectives. Despite poor health care transition outcomes among young adults with pediatric rheumatic diseases, adoption of transition best practices is low. We sought to understand how structured transition processes were operationalized within pediatric rheumatology practices and what factors were perceived to enable adaptations during a global pandemic.Methods. We conducted a mixed methods study of team leaders' experiences during an interim analysis of a pilot project to implement transition policy discussions at sites in the Childhood Arthritis and Rheumatology Research Alliance Transition Learning Collaborative. We combined quantitative assessments of organizational readiness for change (9 sites) and semistructured interviews of team leaders (8 sites) using determinants in the Exploration, Preparation, Implementation, Sustainment Framework.Results. Engagement of nursing and institutional improvement efforts facilitated decisions to implement transition policies. Workflows incorporating educational processes by nonphysicians were perceived to be critical for success. When the pandemic disrupted contact with nonphysicians, capacity for automation using electronic medical record (EMR)-based tools was an important facilitator, but few sites could access these tools. Sites without EMR-based tools did not progress despite reporting high organizational readiness to implement change at the clinic level. Lastly, educational processes were often superseded by acute issues, such that youth with greater medical/psychosocial complexity may not receive the intervention.Conclusion. We generated several considerations to guide implementation of transition processes within pediatric rheumatology from the perspectives of team leaders. Careful assessment of institutional and nursing support is advisable before conducting complex transition interventions. Ideally, new strategies would ensure interventions reach youth with high complexity.

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Pediatric Nurses' Role in Health Care Transition Planning: National Survey Findings and Practice Implications

Cited by 25 publications

References 33 publications

Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions

Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions

A Typology of Transition Readiness for Adolescents with Congenital Heart Disease in Preparation for Transfer from Pediatric to Adult Care

Implementation of Rheumatology Health Care Transition Processes and Adaptations to Systems Under Stress: A Mixed‐Methods Study

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