Objective. Since 2010, the rheumatology community has developed guidelines and tools to improve healthcare transition. In this study, we aimed to compare current transition practices and beliefs among Childhood Arthritis and Rheumatology Research Alliance (CARRA) rheumatology providers with transition practices from a provider survey published in 2010. Methods. In 2018, CARRA members completed a 25-item online survey about healthcare transition. Got Transition's Current Assessment of Health Care Transition Activities was used to measure clinical transition processes on a scale of 1 (basic) to 4 (comprehensive). Bivariate analyses were used to compare 2010 and 2018 survey findings. Results. Over half of CARRA members completed the survey (202/396), including pediatric rheumatologists, adult- and pediatric-trained rheumatologists, pediatric rheumatology fellows, and advanced practice providers. The most common target age to begin transition planning was 15-17 years (49%). Most providers transferred patients prior to age 21 years (75%). Few providers used the American College of Rheumatology transition tools (31%) or have a dedicated transition clinic (23%). Only 17% had a transition policy in place, and 63% did not consistently address healthcare transition with patients. When compared to the 2010 survey, improvement was noted in 3 of 12 transition barriers: availability of adult primary care providers, availability of adult rheumatologists, and pediatric staff transition knowledge and skills (P < 0.001 for each). Nevertheless, the mean current assessment score was < 2 for each measurement. Conclusion. This study demonstrates improvement in certain transition barriers and practices since 2010, although implementation of structured transition processes remains inconsistent.

Asthma is a leading cause of pediatric hospital admissions. Parents of children under the age of 18 with asthma require education to recognize and manage the signs and symptoms of the disease. Parent education has shown to decrease their children's hospital admission and readmission rates. The purpose of this pilot project was to develop an asthma educational module for the parents of children with asthma and obtain parent feedback on the content. Families with children under the age of 18 who had been admitted to the hospital with a diagnosis of asthma, an asthma exacerbation, or status asthmaticus were invited to participate. A nurse practitioner provided three parents with information on the signs, symptoms, and medication management of asthma, as well as hands-on demonstration of inhaler use. Twenty-eight staff nurses provided verbal feedback on module content, including educational benefit and readability for parents. Parent and staff verbal feedback indicated the module was both a useful and effective tool for asthma education. Clinical leaders plan to expand the pilot study on two additional pediatric units using the same module used in the pilot program with intent to analyze readmission rates. The project promotes social change through parent empowerment to care for their child in the home environment.

Emergency department (ED) use for behavioral-health-associated diagnoses has steadily increased in adult and pediatric populations, accounting for 1 out of every 8 ED visits. The increase in pediatric behavioral health ED visits, combined with limited resources for treatment, has created a challenge for EDs faced with extended boarding and constant observation of this population. The generalized behavioral health guidelines used at the practice site have not been adapted for the pediatric population. This project focused on providing age- and developmentally appropriate best practice guidelines for children under constant observation in the children's emergency department (CED) using Havelock's theory of planned change as the framework. Practice in the CED was compared to best practice recommendations identified in the literature and community standards including workflow, defined roles and responsibilities, addressing the needs of the parent/guardians, and defined outcomes. These best practices were incorporated in a guideline developed to provide age- and developmentally appropriate recommendations. An expert panel comprising the behavioral health nurse manager and children's emergency department nurse manager reviewed the guideline using the AGREE II tool, and the guideline was revised based on the composite results from the 6 domains in the AGREE II tool. Based on these composite results and panel feedback, domain 5 was revised to include an auditing and monitoring plan. In addition to improving the safety and care for the CED patient population, this project also serves to increase awareness of the topic while emphasizing on the need for additional research and evidence-based practice focused on pediatric behavioral health patients.

Indiana University-Purdue University Indianapolis (IUPUI)

Indiana University-Purdue University Indianapolis (IUPUI)

No description available.

No description available.

No description available.

No description available.

No description available.