Conectar
Commentary on:Michelson KA, Rees CA, Florin TA, et al. Emergency department volume and delayed diagnosis of serious pediatric conditions. JAMA Pediatr. 2024;178:362–8. doi:10.1001/jamapediatrics.2023.6672
Implications for practice and research Low-paediatric-volume emergency departments (EDs) can increase paediatric readiness by improving diagnostic tools, expanding paediatric expertise (eg teleconsultation) and using electronic clinical decision support. Further research is needed to examine the costs and effectiveness of specific interventions to improve readiness in low-volume paediatric EDs.
Children sometimes have subtle illness presentations and symptom overlap with non-serious conditions.
To gain insight into healthcare professionals' perceptions and needs regarding hospital-to-home transitions.
Qualitative phenomenological study.
Hospital and primary care professionals participated in focus groups and interviews. Participants were recruited from a Dutch University hospital and from our networks between May and September 2023. Data were analysed using thematic analysis.
We conducted seven focus groups and twelve interviews. Three themes emerged: “Collaboration and information exchange between professionals”, “Coordination and continuity of care”, and “Interaction between professionals, patients, and families”.
This study suggests that professionals would benefit from clear guidelines and arrangements for communication with colleagues to support care coordination and continuity. Collaboration and information sharing are essential for providing integrated, patient-centred care. Additionally, involving patients and families in decision-making regarding hospital-to-home transitions, in a way that considers their needs, is important for effective care.
This study highlights the importance of clear communication and collaboration between professionals to ensure continuity of care. It emphasises the need for integrated care, where patients and families are actively involved without being overwhelmed.
Transitions from hospital-to-home are often hindered by fragmented, non-individualised care. Improved collaboration, clear coordination, and patient-family involvement can address this. This research can positively impact professionals across different settings, policymakers, and advocacy groups aiming to improve integrated patient-centred care.
The interview guide was developed with professionals who reviewed it and provided feedback. Professionals provided us with their lived experiences by participating in interviews and focus groups.
This study adhered to the COREQ guidelines.
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To explore the role of health communication in Shared Decision-Making (SDM) between nursing staff and older people in the community setting.
Society and healthcare services are marked by an exponentially ageing population, leading to a significant proportion of patients being older adults with highly demanding care needs. Scientific literature supports shared decision-making as a process that engages patients in their care. However, the increasing use of technology and the consequences of the COVID-19 pandemic have influenced how nurses communicate with older patients. Therefore, it is crucial to understand how to develop health communication to reach effective, shared decision-making processes.
Whittemore and Knafl's integrative review method, the literature search comprised five databases: PubMed, CINALH, Web of Science, Scopus and PsycINFO.
The 12 included studies were synthesised into three study patterns: (1) nurse–older patient health communication relationship, (2) older patients' perspectives and (3) nontherapeutic communication in end-of-life care.
This review underscored the crucial role of effective health communication in shaping SDM dynamics between nursing staff and older people in the community setting. Key elements included transparent information exchange, establishing trust and maintaining communication channels with informal caregiving networks. SDM actions were aligned with preserving older people's autonomy, but communication challenges persisted, particularly in end-of-life situations. Advanced care planning was recommended to address these shortcomings and improve communication among older people, healthcare professionals and families.
Implementing educational measures based on verbal and nonverbal health communication in nursing training could be beneficial. Nursing research could continue to develop and refine specific communication strategies adapted to the social determinants of health for diverse clinical situations regarding older adults in the community setting.
The authors have adhered to relevant EQUATOR guidelines through the PRISMA 2020 checklist.
No Patient or Public Contribution.
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