scholarly journals Engaging Parents in Analgesia Selection and Racial/Ethnic Differences in Analgesia Given to Pediatric Patients Undergoing Urologic Surgery

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 277
Author(s):  
Carl Lo ◽  
Patrick A. Ross ◽  
Sang Le ◽  
Eugene Kim ◽  
Matthew Keefer ◽  
...  
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Care Delivery ◽  
Black Parents ◽  
Regional Block ◽  
Parental Preferences ◽  
Centered Care ◽  
Parent Decisions ◽  
Racial Ethnic ◽  
Family Centered

Background: Family-centered care aims to consider family preferences and values in care delivery. Our study examines parent decisions regarding anesthesia type (caudal regional block or local anesthesia) among a diverse sample of children undergoing urologic surgeries. Differences in anesthesia type were examined by known predictors of health disparities, including child race/ethnicity, parental English proficiency, and a proxy for household income. Methods: A retrospective review of 4739 patients (including 25.4% non-Latino/a White, 8.7% non- Latino/a Asians, 7.3% non-Latino/a Black, 23.1% Latino/a, and 35.4% others) undergoing urologic surgeries from 2016 to 2020 using univariate and logistic regression analyses. Results: 62.1% of Latino/a parents and 60.8% of non-Latino/a Black parents did not agree to a regional block. 65.1% of Spanish-speaking parents with limited English Proficiency did not agree to a regional block. Of parents from households below poverty lines, 61.7% did not agree to a caudal regional block. In regression analysis, Latino/a and non- Latino/a Black youth were less likely to receive caudal regional block than non- Latino/a White patients. Conclusions: We found disparities in the use of pediatric pain management techniques. Understanding mechanisms underlying Latino/a and non- Latino/a Black parental preferences may help providers reduce these disparities.

Theories in Action and How Nursing Practice Changed

2009 ◽  
Vol 23 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Deborah A. Jasovsky ◽  
Mary R. Morrow ◽  
Pamela S. Clementi ◽  
Paula A. Hindle
Keyword(s):  
Diffusion Of Innovation ◽  
Nursing Practice ◽  
Care Delivery ◽  
First Year ◽  
Nursing Administration ◽  
Model Of Care ◽  
Educational Training ◽  
Daily Care ◽  
Centered Care ◽  
Family Centered

Rogers’ theoretical framework of diffusion of innovation guided the successful infusion of the educational training and implementation of the Magis model of care at a 570 bed hospital in the Chicagoland area. The Magis model of care was derived from several nursing theories along with information from the Institute of Family-Centered Care. By incorporating the components that relate to the institution’s values and Magnet theme, the stages of innovation were readily adopted and sustained over the first year of implementation. The model has spread beyond the original and sister units as demonstrated by another department creating the Magnet poster with the various elements that they have incorporated into daily care delivery. What is so invigorating to the nursing administration is hearing how nursing staff articulates the care they give to the various components of the model and the theory that supports this practice.

Oncologists' attitudes towards patient and family-centered care.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 111-111
Author(s):  
Timothy K. Nguyen ◽  
Glenn Bauman ◽  
Christoper J Watling ◽  
Karin Hahn
Keyword(s):  
Patient Autonomy ◽  
Care Delivery ◽  
Family Centered Care ◽  
Structured Interviews ◽  
Roles And Responsibilities ◽  
Continued Education ◽  
Creative Solutions ◽  
Centered Care ◽  
Physician Support ◽  
Family Centered

111 Background: Patient and family-centered care (PFCC) represents an evolution from traditional models of provider-focused and patient-focused care that places a strong emphasis on optimal patient communication, patient autonomy, and shared decision-making within care teams. A shift towards PFCC requires participation across all provider groups. Despite the importance of physician buy-in, research examining physicians’ perspectives on PFCC is lacking. We sought to explore oncologists’ familiarity with the principles of PFCC and perceived barriers to implementing principles of PFCC. Methods: In this qualitative exploratory study, we conducted semi-structured interviews with 18 oncologists (8 radiation, 4 medical, 4 surgical, 2 hematologist-oncologists) at a single Canadian academic cancer institution. Interview data were analyzed using coding principles drawn from grounded theory. Constant comparisons were used to identify recurring themes. Results: We identified 3 dominant themes related to physicians’ interpretations of PFCC: 1) Physicians expressed a limited understanding of the formal principles of PFCC, 2) Physicians identified patient autonomy as essential to PFCC and 3) Disparities between patient and physician objectives exist and result in compromises that may affect the quality of PFCC delivered. Oncologists perceived that spending more time with patients improved PFCC, but also recognized that it would leave less time for other necessary activities. Participants also identified a number of ‘system’ barriers to PFCC, including limited staff and clinical space, excessive case load, a lack of physician support and input into operational decisions, and funding constraints. Many felt that PFCC was challenged by inefficiencies in the system of care delivery, and that progress might lie in reorganization to more clearly match health care staff’s roles and responsibilities to their credentials and skills. Conclusions: Advancing PFCC in our institution will require continued education of physicians regarding the principles of PFCC, acknowledgement and preservation of the PFCC behaviors already in practice and creative solutions to address the system issues that may hamper their abilities to enact PFCC.

Family Presence in the Adult Burn Intensive Care Unit During Dressing Changes

2013 ◽  
Vol 33 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Sarah M. Bishop ◽  
Mandi D. Walker ◽  
I. Mark Spivak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Care Delivery ◽  
Infection Rates ◽  
Family Presence ◽  
Staff Members ◽  
Discharge Readiness ◽  
University Of Louisville ◽  
Centered Care ◽  
Family Centered

ObjectivesTo improve communication, discharge readiness, and satisfaction of burn patients and their families.MethodsIn March 2009, the burn intensive care unit at University of Louisville Hospital, Louisville, Kentucky, incorporated family presence during dressing changes. Adverse family events during observation, measures of patient- and family-centered care according to a standardized patient satisfaction survey, infection rates, and staff members’ response to the intervention were tracked.ResultsThrough December 2011, no adverse family events occurred, patients’ satisfaction scores increased, and infection rates did not increase. Staff members responded positively to the project.ConclusionsAllowing family presence during dressing changes provides an opportunity to educate and include patients’ family members in care delivery.

Pediatric Nurses’ Experiences in Caring for Non–English Speaking Patients and Families

2021 ◽  
pp. 104365962098660
Author(s):  
Jennifer M. Stephen
Keyword(s):  
Limited English Proficiency ◽  
Phenomenological Study ◽  
English Proficiency ◽  
Medical Center ◽  
Future Research ◽  
Inpatient Setting ◽  
Pediatric Nurses ◽  
Face To Face ◽  
Centered Care ◽  
Task Oriented

Introduction: Language barriers challenge patient- and family-centered care. Literature guiding pediatric nurses caring for patients and families with limited English proficiency in the inpatient setting is nonexistent. The purposes of this phenomenological study were to understand pediatric nurses’ experiences in caring for patients and families with limited English proficiency and to explore how nurses navigate the communication gap. Method: A purposive sample of 15 pediatric Registered Nurses at a large urban children’s medical center participated in face-to-face semistructured interviews. Verbatim transcribed interviews were analyzed line-by-line and categorized into themes. Results: Themes included personal framework of care, consequences of caring, starting off right, nurse sensing, verbal/nonverbal methods, and interpreters. Discussion: Nurses did not perceive differences in task-oriented care; they described compromised personal paradigms, held negative feelings, and utilized verbal/nonverbal communication methods. Future research is needed exploring patients’ and families’ perceptions regarding care by other language–speaking nurses.

scholarly journals Educating Clinicians to Improve Telemedicine Access for Patients with Limited English Proficiency

Challenges ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 34
Author(s):  
Tiffany M. Shin ◽  
Pilar Ortega ◽  
Karol Hardin
Keyword(s):  
Medical Education ◽  
Limited English Proficiency ◽  
English Language ◽  
English Proficiency ◽  
Care Delivery ◽  
The United States ◽  
Patient Portals ◽  
Medical Interpreters ◽  
Language Needs ◽  
Electronic Health Information

The COVID-19 pandemic prompted the rapid incorporation of telemedicine into healthcare systems, resulting in increased access challenges for patients in the United States with limited English proficiency (LEP). Non-English-language speakers face challenges with telemedicine that magnify pre-existing barriers to language-appropriate care, such as difficulty accessing professional medical interpreters and navigating both electronic health information and online patient portals. Improved medical education on telehealth would increase equitable care for linguistic minorities. Medical education targeting telehealth care delivery should include clinician instruction on working with interpreters in telehealth contexts, increasing patient access to telehealth resources, and addressing patients’ language needs for telemedicine.

scholarly journals Geographic, Racial/Ethnic, and Sociodemographic Disparities in Parent-Reported Receipt of Family-Centered Care among US Children

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Romuladus E. Azuine ◽  
Gopal K. Singh ◽  
Reem M. Ghandour ◽  
Michael D. Kogan
Keyword(s):  
Low Income ◽  
Health Care Disparities ◽  
Parent Report ◽  
Family Centered Care ◽  
Centered Care ◽  
Sociodemographic Disparities ◽  
English Speaking ◽  
Us Children ◽  
Racial Ethnic ◽  
Family Centered

This study examined geographic, racial/ethnic, and sociodemographic disparities in parental reporting of receipt of family-centered care (FCC) and its components among US children aged 0–17 years. We used the 2011-2012 National Survey of Children’s Health to estimate the prevalence and odds of not receiving FCC by covariates. Based on parent report, 33.4% of US children did not receive FCC. Children in Arizona, Mississippi, Nevada, California, New Jersey, Virginia, Florida, and New York had at least 1.51 times higher adjusted odds of not receiving FCC than children in Vermont. Non-Hispanic Black and Hispanic children had 2.11 and 1.58 times higher odds, respectively, of not receiving FCC than non-Hispanic White children. Children from non-English-speaking households had 2.23 and 2.35 times higher adjusted odds of not receiving FCC overall and their doctors not spending enough time in their care than children from English-speaking households, respectively. Children from low-education and low-income households had a higher likelihood of not receiving FCC. The clustering of children who did not receive FCC and its components in several Southern and Western US states, as well as children from poor, uninsured, and publicly insured and of minority background, is a cause for concern in the face of federal policies to reduce health care disparities.

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