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Practice Issue
The topic
Care for children who are five years old or younger.
The nursing practice issue related to the topic
In children under the age of 5 years old will providing coordination of patient care activities through technology compared to not using technology improve care coordination and result in improved clinical outcomes?
The scope of the practice issue
Issues such as the unwillingness of parents to hospitalize their children complicate numerous health outcomes among children under the age of 5 years old. The primary cause of the concerns is the lack of clinical competence among parents and their consequent inability to provide adequate care for their child. The use of telehealth and other technological interventions may improve care coordination and result in improved health outcomes for the target population group without requiring changes in their perceptions and behavior.
The practice area
The practice area is clinical.
How the practice issue was identified
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Safety/risk management concerns;
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Unsatisfactory patient outcomes;
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Difference between hospital and community practice.
The inability of parents to provide high-quality care for their children due to their lack of training creates risks for the latter, as clinical expertise is necessary to address many conditions, particularly in small children, who are unable to care for themselves. Nevertheless, parents often refuse to go to hospitals or allow their children to be hospitalized for extended periods of time, claiming, sometimes correctly, that they could achieve an adequate level of care in a home setting. However, their lack of knowledge on the matter and the possible complications make a quick response and information sharing system, which can be considered a part of community practice, necessary to ensure the best possible outcomes.
Evidence that must be gathered
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Literature search
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Patient Preferences
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Clinical Expertise
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Financial Analysis
The intervention should be based on research and methods that have been determined to be effective. Therefore, a literature search becomes necessary to find the approaches that have been attempted and evaluated in the past. After the form of the new policy is outlined, the concepts should be tailored to the population and their preferences. As the intervention involves community practice, it should be acceptable for the target population and provide potential users with an incentive to utilize it. This adjustment requires the collection and evaluation of patient preferences.
When the matters mentioned above have been examined and settled, the institution should apply financial analysis to the scheme. The costs for theoretical ventures are often unrealistic and do not justify the expected results, but a detailed review of the costs may be able to find sections that incur significant costs but do not have considerable influence on the outcomes and eliminate them without interfering with the project. Finally, once the plan for the intervention methods is complete, clinical expertise on conditions relevant to young children should be gathered into an accessible database and used as the starting point for the coordination system.
Evidence Summary
The practice problem with reference to the identified population, setting and magnitude of the problem in measurable terms
Young children are affected by a variety of conditions that can be mitigated or eliminated with the proper medical care that could be administered by non-specialists after some training. According to Janicke et al. (2014), 32% of children in the USA are considered overweight, a condition that can be addressed with behavioral interventions. However, parents often do not report the issues or visit hospitals until the problem becomes severe. The establishment of technology-assisted long-distance care coordination may improve outcomes for children by improving the quality of the care administered by parents.
The objectives of the systematic review article
The article aims to research the influence of comprehensive behavioral family lifestyle interventions on pediatric obesity.
The questions addressed in the work and in relation to the practice issue
Childhood obesity is a notably prevalent issue that leads to a variety of physical and mental complications. The research by Janicke et al. (2014) shows that parent weight status is one of the most significant predictors of child weight, as they establish the eating patterns in the family. The results of the research show that behavioral interventions are effective at reducing the weight of obese children, and the outcomes improve with the duration and intensity of the treatment. However, the authors note that the methods for the delivery of the interventions, particularly technologically assisted ones, require further development.
The interventions the authors of the systematic review suggest to improve patient outcomes
The authors suggest the use of education on the importance of physical activity, encouragement to increase it, the implementation of recommended physical activity guidelines, and the introduction of structured physical activity times for children.
The main findings by the authors of the systematic review
Janicke et al. (2014) conclude that comprehensive behavioral family lifestyle interventions reduce childhood obesity, particularly with regards to body weight. The findings are derived from the significant amount of scholarly studies they have reviewed. However, the authors note that the clinical significance of this weight reduction is not a well-explored topic, and further investigation is necessary. They also remark that the delivery of the interventions by non-specialists requires changes in the intervention structure and suggest technologically assisted approaches as a promising field.
Vigil et al. (2015) describe the application of telehealth in assisting families with children who have complex or chronic health conditions. They state that the approach is practical and proven and can benefit children with complex health as well as their families while reducing health care costs.
Korhoheh, Nordman, and Eriksson (2016) investigate the perception of technology use in health care by patients. In particular, the authors concern themselves with the ethical implications of technology use for patient care. They note that not all parents are willing to use technology, and its application should be an optional treatment. Furthermore, they add that knowing the patients expectations and experiences is vital when developing or introducing new technology, which is the topic of this project.
Evidence-based solutions for the project
I will consider the implementation of telehealth, technology-aided, and social media-based interventions to improve care coordination with parents of children under the age of 5 years old.
Limitations to the studies
The studies are primarily theoretical, and only the practical use of telehealth is described in detail. Further research and testing will be necessary before the implementation of the tools.
References
Janicke, D. M., Steele, R. G., Gayes, L. A., Lim, C. S., Clifford, L. M., Schneider, E. M.,& & Westen, S. (2014). Systematic review and meta-analysis of comprehensive behavioral family lifestyle interventions addressing pediatric obesity. Journal of Pediatric Psychology, 39(8), 809-825.
Korhonen, E., Nordman, T., & Eriksson, K. (2016). Patients Experiences of Technology in Care: A Qualitative Meta-Synthesis. Archive of Nursing Practice and Care, 2(1). Web.
Vigil, J., Kattlove, J., Calouro, C., Kwong, M. W., Litman, R., & Marcin, J. (2015). Realizing the promise of telehealth for children with special health care needs. Web.
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