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1.
Policy Polit Nurs Pract ; 24(1): 36-50, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36349365

ABSTRACT

Medication administration is a critical safety issue in hospitals and the community. Children are especially at risk because of their dependence on adults to safely administer medications. The purpose of this study was to examine non-compliance with state child care medication administration regulations and factors associated with improved compliance. The data included routine, unannounced inspections of child care programs by state licensing specialists collected in two time periods over 10 years. Factors potentially associated with regulatory compliance were included in this secondary analysis. Most child care center medication administration regulations showed decreased non-compliance between the two time periods. However, regulations pertaining to prescriber orders and parent permission revealed a significant increase in non-compliance (58.4%). Factors positively associated with medication administration regulatory compliance included: compliance with annual professional development (p < 0.0001 in both periods), achievement of accreditation (p = 0.0115 in Time 1), and among centers with children under 3 years of age, compliance with a weekly mandatory visit by a nurse consultant (p = 0.0004 in Time 2). Though family child care homes had a lower frequency of medication administration non-compliance, only 19% were administering medications in Time 1. High quality, safe, and affordable child-care is essential for all children including those with special health care needs. This study highlights the importance of medication safety practices in child care programs, national child care health and safety standards, federal and state policies regarding medication administration regulations, and the critical role of nurse child care health consultants in promoting safe medication administration in child care programs.


Subject(s)
Child Care , Consultants , Humans , Child , Child, Preschool , Child Day Care Centers , Accreditation
2.
Matern Child Health J ; 24(8): 1019-1027, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32350728

ABSTRACT

OBJECTIVE: To analyze how engagement with a staffed family child network is associated with compliance on health and safety regulations among family day care (FDC) homes. METHODS: Publically available data on health and safety inspection violations on FDC homes were merged with engagement data from a staffed family child network. Descriptive analysis, logistic regression, and latent class analysis were used. RESULTS: Network FDC homes, compared to non-network FDC homes, were less likely to have health and safety violations in the areas of Child/Family/Staff Documentation (43.1% vs. 53.6%, p = 0.001) and Indoor Safety (36.0% vs. 42.6%, p = .041). Controlling for area median income and for decades since obtaining license, network FDC homes had fewer violations, fewer violation categories, and less variety of violation categories. Additionally, FDC homes which were not engaged with the staffed family child network but were in the city or town in which the network offered services, performed better compared to FDC homes in cities or towns without network resources. CONCLUSIONS FOR PRACTICE: The better compliance among network FDC homes and among FDC homes in cities and towns where the network offers services, suggests that the network is having positive effects on health and safety quality in FDC homes. A staffed child care network may be a means to improve child care quality and may be a means of improving educational and health outcomes for children.


Subject(s)
Child Care/standards , Eligibility Determination/statistics & numerical data , Health Status , Patient Safety/standards , Child Care/methods , Child Care/statistics & numerical data , Child, Preschool , Facility Regulation and Control/statistics & numerical data , Family Health/standards , Family Health/statistics & numerical data , Female , Humans , Income/statistics & numerical data , Infant , Male , Patient Safety/statistics & numerical data
3.
Res Nurs Health ; 43(4): 329-340, 2020 08.
Article in English | MEDLINE | ID: mdl-32306413

ABSTRACT

Racially and ethnically diverse young children who live with socioeconomic adversity are at high risk for sleep deficiency, but few behavioral sleep interventions (BSIs) are tailored to their needs. To support the future development of a feasible, acceptable, and culturally relevant sleep intervention, we conducted a community-engaged, mixed-methods study with 40 low-income, racially, and ethnically diverse parents to describe sleep characteristics, sleep habits, and parental sleep knowledge of their 6-36-month-old children and to examine the associations between children's sleep characteristics and sleep habits. This report presents quantitative data from this mixed-methods study. We measured objective (actigraphy) and parent-reported sleep (Brief Infant Sleep Questionnaire) characteristics, sleep habits at bedtime, sleep onset, and during night awakenings, parental sleep knowledge, psychological function (Brief Symptom Inventory), and parenting stress (Parenting Stress Index). Children had low sleep duration (537.2 ± 54.7 nighttime and 111.2 ± 29.8 nap minutes), late bedtimes (22:36 ± 1.5 hr), and high bedtime variability (mean squared successive difference = 3.68 ± 4.31 hr) based on actigraphy. Parental knowledge about sleep recommendations was limited. Sleep habits before bedtime, at sleep onset, and during night awakenings were varied. Sixty-five percent of parents reported co-sleeping. Feeding near bedtime or during the night was associated with later bedtimes, more fragmented sleep, and increased bedtime variability. These findings suggest the need for BSIs to support earlier bedtimes and improve sleep duration and continuity by addressing modifiable behaviors. Tailored BSIs that consider socioecological influences on the development of sleep habits are needed.


Subject(s)
Ethnicity/psychology , Parent-Child Relations , Parenting/psychology , Parents/psychology , Poverty/psychology , Sleep Initiation and Maintenance Disorders/therapy , Sleep , Adult , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Sleep Initiation and Maintenance Disorders/epidemiology , Surveys and Questionnaires , United States/epidemiology
4.
J Dev Behav Pediatr ; 41(7): 540-549, 2020 09.
Article in English | MEDLINE | ID: mdl-32282623

ABSTRACT

OBJECTIVE: To describe the perceptions of (1) parents, childcare, and health care providers regarding sleep health among multiethnic infants and toddlers living with socioeconomic adversity, (2) factors that contribute to sleep health and its consequences, and (3) best ways to promote sleep health in these children. METHODS: Nested within a larger community-engaged mixed methods study, we used a descriptive qualitative design to describe the experience of multiethnic young parents who were raising 6- to 36-month-old children, pediatric health care providers, and childcare providers living and working in an urban under-resourced community. Semistructured interviews with 25 parents and 16 providers were conducted, transcribed, coded, and analyzed using thematic analysis by a 6-member research team. Interviews continued until themes were saturated. RESULTS: Parent responses and provider responses resulted in overlapping and divergent findings. Common themes among all respondents were the importance of sleep, interest and desire for more sleep health information, and common environmental/social impediments to healthy family sleep. Divergent themes included the importance of bedtime routines and timing, views on the family bed, importance of naps, and healthy sleep aids. Childcare centers were suggested as good sites for sleep health promotion programs. CONCLUSION: Sleep is a topic of interest and importance for young families. There are unique family challenges to be considered in any sleep health promotion program tailored to the needs of the community. The voices of parents and community providers are valuable assets informing the development of novel family-friendly approaches for decreasing sleep disparities and improving the health of young children and families.


Subject(s)
Child Care , Parents , Child , Child Day Care Centers , Child Health , Child, Preschool , Humans , Infant , Qualitative Research , Sleep
5.
J Pediatr Health Care ; 32(1): 10-20, 2018.
Article in English | MEDLINE | ID: mdl-28927681

ABSTRACT

INTRODUCTION: The purposes of this project were (a) to examine criteria derived from evidence-based pediatric acute asthma exacerbation assessment tools, asthma scores, and the acute asthma prediction rule validated and used in the emergency department and (b) to adapt these criteria for pediatric primary care. METHOD: The three stages of the project included (a) identification of criteria in a literature review, (b) validation of the criteria by an expert panel, and (c) adaptation of the criteria in the design of an assessment tool. RESULTS: The criteria were validated and adapted in the design of The Pediatric Acute Asthma Exacerbation Severity Assessment and Disposition Decision-Making Tool for Pediatric Primary Care. DISCUSSION: The adaptation of criteria derived from the evidence and validated by an expert panel will inform and guide clinicians in assessing severity and support decision making in determining disposition of pediatric patients presenting with an acute asthma exacerbation in primary care.


Subject(s)
Asthma/diagnosis , Decision Support Systems, Clinical , Pediatrics , Primary Health Care , Acute Disease , Asthma/therapy , Child , Evidence-Based Practice , Humans , Pediatrics/organization & administration , Primary Health Care/organization & administration , Severity of Illness Index
6.
Res Nurs Health ; 41(1): 19-29, 2018 02.
Article in English | MEDLINE | ID: mdl-29277901

ABSTRACT

Beginning early in life, sleep health, including adequate quality, quantity, and consistent sleep routines, is critical to growth and development, behavior, and mental and physical health. Children who live in economically stressed urban environments are at particular risk for sleep deficiency and its negative consequences. Although efficacious sleep health interventions are available, few address the context of economically stressed urban environments. The purpose of this paper is to describe a two-phase protocol for an ongoing NIH/NINR-funded community-engaged study designed to understand the perspectives of parents, community child care and pediatric health care providers about sleep habits, factors that contribute to sleep and sleep habits, sleep difficulty, and potentially useful sleep promotion strategies among children living in economically stressed urban environments. The social-ecological model guides this study. Phase I employs a convergent mixed-methods design, in which we are conducting semi-structured interviews with parents, childcare providers, and primary health care providers. We are collecting 9 days of objective sleep data (wrist actigraphy) from children who are 6-18 months (n = 15) and 19-36 months of age (n = 15) and parent reports of sleep and sleep-related factors using standard questionnaires. In Phase I, we will use a qualitative descriptive approach to analyze the interview data, and descriptive statistics to analyze the survey and actigraph data. In Phase II, we will use the information to develop a contextually relevant program to promote sleep health. Our long-term goal is to improve sleep health and sleep-related outcomes in these children.


Subject(s)
Child Health Services/organization & administration , Community Health Services/organization & administration , Health Promotion/methods , Nursing Research , Primary Health Care/organization & administration , Sleep Wake Disorders/therapy , Urban Population/statistics & numerical data , Child, Preschool , Connecticut , Female , Humans , Infant , Male , Surveys and Questionnaires
7.
J Sch Nurs ; 32(2): 81-5, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26547091

ABSTRACT

Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result, nurses' time is poorly utilized and students may suffer adverse outcomes including delayed school entry. In response to this pressing public health issue, a school medical advisor and director of school nurses in a local health department successfully negotiated access for school nurses to three health record systems: a state immunization tracking system, an electronic lead surveillance program, and an electronic health record system. This negotiation process is presented within a framework of the Theory of Diffusion of Innovation and provides a strategy for other school nurses seeking access to student health information.


Subject(s)
Electronic Health Records , Negotiating , School Nursing/methods , Students , Diffusion of Innovation , Humans , Immunization
8.
Matern Child Health J ; 20(5): 984-92, 2016 May.
Article in English | MEDLINE | ID: mdl-26699789

ABSTRACT

OBJECTIVES: To determine frequency of non-compliance with child care regulations among family day care homes (FDCH) and identify the role of income in compliance. METHODS: We analyzed non-compliance in 746 routine, unannounced inspection and re-inspection reports of FDCH collected by the Connecticut Department of Public Health licensing specialists in 2007-2008 and linked results to median income of zip code data. We grouped the 83 state regulations into 12 regulation categories, analyzed 11 categories, and used latent class analysis to classify each FDCH as high or low compliance for each category. We used logistic regression analysis to estimate the odds ratios of low compliance. RESULTS: Among the 746 FDCH inspections (594 first inspections and 152 re-inspections), we found high rates of non-compliance in inspection regulations in immunizations (32.9 %), water temperature (35.6 %) and hazards (30.0 %). Among the 11 regulation categories, 4 categories (indoor safety, emergency preparedness, child/family/staff documentation, and qualifications of provider) had regulations with high non-compliance. Median household income of FDCH zip code was lower for re-inspection sites than for inspection sites ($34,715 vs. $57,118, p < 0.0001) and FDCH in the lowest quartile of income had greater odds of low compliance in indoor safety (OR 1.86, 95 % CI 1.04, 3.35, p < 0.05). CONCLUSIONS: The majority of FDCH were in compliance with the majority of regulations, yet there are glaring non-compliance issues in inspections and re-inspections and there are income-based inequities that place children at higher risk who are already at high risk for suboptimal health outcomes.


Subject(s)
Child Day Care Centers/standards , Facility Regulation and Control/legislation & jurisprudence , Government Regulation , Guideline Adherence , Income , Safety Management/standards , Child Day Care Centers/legislation & jurisprudence , Child, Preschool , Connecticut , Humans , Licensure , Regression Analysis
9.
BMC Public Health ; 14: 215, 2014 Mar 01.
Article in English | MEDLINE | ID: mdl-24580983

ABSTRACT

BACKGROUND: To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). METHODS: A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. RESULTS: Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. CONCLUSIONS: The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic. TRIAL REGISTRATION: National Clinical Trials Number NCT01921842.


Subject(s)
Health Knowledge, Attitudes, Practice , Pediatric Obesity/prevention & control , Body Mass Index , California , Child Day Care Centers , Child, Preschool , Connecticut , Female , Humans , Male , Motor Activity , North Carolina , Nutritional Status , Pediatric Obesity/physiopathology , Treatment Outcome
10.
Am J Public Health ; 103(10): e52-8, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23948016

ABSTRACT

OBJECTIVES: We assessed the prevalence of regulatory noncompliance of licensed child care centers and identified factors associated with improved compliance. METHODS: We analyzed 676 routine, unannounced reports of child care centers collected by the Connecticut Department of Public Health licensing specialists over a 2-year time period, included characteristics of centers, and created categories of regulations. RESULTS: The sample included 41% of licensed child care centers. Of the 13 categories of regulations in the analyses, 7 categories (outdoor safety, indoor safety, indoor health, child and staff documentation, emergency preparedness, infant-toddler indoor health, and infant-toddler indoor safety) had regulations with center noncompliance greater than 10%. Playground hazard-free was the regulation with the highest frequency (48.4%) of noncompliance. Compliance with the regulation for 20 hours of continuing education per year for child care providers was the characteristic most frequently associated with regulations compliance. CONCLUSIONS: Efforts to support continuing education of child care providers are essential to improve and sustain healthy and safe early-care and education programs. Analyses of state child care licensing inspection reports provide valuable data and findings for strategic planning efforts.


Subject(s)
Child Day Care Centers/standards , Guideline Adherence , Licensure , Research Report/standards , Safety Management/standards , Specialization , Child Day Care Centers/legislation & jurisprudence , Child, Preschool , Confidence Intervals , Connecticut , Humans
11.
J Nutr Educ Behav ; 45(6): 595-601, 2013.
Article in English | MEDLINE | ID: mdl-23860100

ABSTRACT

OBJECTIVE: To describe the perspective and strategies of family child care providers (FCCPs) to reduce children's suboptimal weight trajectories. DESIGN: In-person, in-depth interviews with FCCPs. SETTING: Family child care homes. PARTICIPANTS: Seventeen FCCPs caring for children 6 weeks to 9 years old; 94% caring for children paying with a state subsidy. PHENOMENON OF INTEREST: Strategies of FCCP to reduce children's suboptimal weight trajectories. ANALYSIS: Constant comparative method of qualitative data analysis. RESULTS: Family child care providers described 3 core strategies: (1) improving children's behavior, (2) engaging and educating parents, and (3) leveraging influences external to their relationship with parents to effect positive change and to avoid parental conflict. These strategies were framed within their knowledge of child development, parental communication, and community services. CONCLUSIONS AND IMPLICATIONS: The findings suggest that FCCPs' role in obesity prevention may be framed within knowledge that may be commonly expected of a child care provider. Partnerships between public health policy makers and FCCP may reduce obesigenic environments by employing training and resources that link obesity prevention and child care provider expertise.


Subject(s)
Caregivers , Child Care , Child Nutritional Physiological Phenomena , Health Knowledge, Attitudes, Practice , Obesity/prevention & control , Adult , Caregivers/psychology , Caregivers/statistics & numerical data , Child , Child Care/methods , Child Care/psychology , Child Day Care Centers , Child, Preschool , Female , Health Education , Humans , Infant , Meals , Middle Aged , Nutritive Value , Qualitative Research
12.
J Spec Pediatr Nurs ; 17(2): 129-35, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22463473

ABSTRACT

PURPOSE: The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. DESIGN AND METHODS: A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. RESULTS: Fifty-nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. PRACTICE IMPLICATIONS: Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.


Subject(s)
Child Care/trends , Curriculum/trends , Education, Nursing, Baccalaureate/trends , Education, Nursing, Graduate/standards , Schools, Nursing/statistics & numerical data , Schools, Nursing/trends , Child , Forecasting , Humans , Nurse's Role , Surveys and Questionnaires , United States
13.
Policy Polit Nurs Pract ; 12(3): 141-9, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21957085

ABSTRACT

Safe medication administration is an essential component of high-quality child care. Its achievement in New Jersey was impeded by a controversy over whether teaching child care providers medication administration involves registered nurses in the process of nursing delegation. Through the theoretical framework of the Diffusion of Innovation, this paper examines how the interpretation of regulatory policy related to nursing practice in New Jersey was adjusted by the Board of Nursing following a similar interpretation of regulatory policy by the Board of Nursing in Connecticut. This adjustment enabled New Jersey nurses to continue medication administration training for child care providers. National data supporting the need for training child care providers in medication administration is presented, the Diffusion of Innovation paradigm is described; the Connecticut case and the New Jersey dilemma are discussed; the diffusion process between the two states is analyzed and an assessment of the need for further change is made.


Subject(s)
Child Day Care Centers/legislation & jurisprudence , Diffusion of Innovation , Education, Nursing/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Child Care , Child, Preschool , Drug Therapy/nursing , Female , Humans , Male , Medication Errors/prevention & control , Needs Assessment , New Jersey , Nursing, Practical/legislation & jurisprudence , Policy Making
14.
J Magn Reson Imaging ; 33(2): 364-71, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21274978

ABSTRACT

PURPOSE: To investigate the reliability, feasibility, and validity of a computer-assisted manual segmentation (outlining) technique for measuring magnetic resonance imaging (MRI) bone erosion and edema at the wrist in rheumatoid arthritis (RA). MATERIALS AND METHODS: The 3T MRI scans were obtained in 22 RA patients (<2 years). Bone erosion and edema volumes were scored by two readers using outlining and were compared with RAMRIS scores. RESULTS: Using outlining, intraobserver reliability for erosions and edema was high: intraclass correlation coefficients (ICCs) = 0.994 (0.991, 0.997) and 0.996 (0.994, 0.998), respectively (Reader 1). Interobserver reliability was high for bone erosion (ICC [90% confidence interval, CI] = 0.80 [0.64, 0.92]) and comparable to RAMRIS scoring (ICC 0.78 [0.64, 0.92]), but was only moderate for bone edema (0.46 [0.00, 0.96]), compared with RAMRIS (ICC = 0.84 [0.73, 0.94]). The methods were highly correlated for erosion scores, r = 0.90, 0.82 (Readers 1 and 2) and moderately correlated for edema, r = 0.57, 0.87. CONCLUSION: Segmentation (outlining) can be used to measure the volume of MRI bone erosion and edema at the wrist in RA patients. When compared with RAMRIS scoring, outlining had similar reliability for quantifying erosions but reliability was lower for bone edema, possibly reflecting difficulty delineating the borders of affected bone.


Subject(s)
Algorithms , Arthritis, Rheumatoid/diagnosis , Edema/diagnosis , Image Interpretation, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Osteolysis/diagnosis , Pattern Recognition, Automated/methods , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/complications , Artificial Intelligence , Edema/etiology , Feasibility Studies , Female , Humans , Image Enhancement/methods , Male , Middle Aged , Observer Variation , Osteolysis/etiology , Pilot Projects , Reproducibility of Results , Sensitivity and Specificity , Wrist Joint/pathology
15.
J Prof Nurs ; 27(1): 10-8, 2011.
Article in English | MEDLINE | ID: mdl-21272831

ABSTRACT

In 2004, the Association of Faculty of Pediatric Nurse Practitioners was awarded a grant by the Commonwealth Fund to plan, implement, and evaluate a strengthened national curriculum for students in 20 pediatric nurse practitioner programs throughout the United States. Curricular changes focused on increasing the knowledge and skills of students in the area of evidence-based mental and behavioral health care for children and adolescents. The processes through which this national initiative was undertaken were described in "Strengthening PNP Curricula in Mental/Behavioral Health and Evidence-Based Practice" (B. M. Melnyk et al., 2010). This article focuses on the important perspectives of academic faculty and clinical preceptors and provides critical insight for nursing faculty when planning implementation of significant curricular change. The purpose of this descriptive study was to determine the challenges and facilitators of implementing a strengthened curriculum in didactic and clinical courses to inform nationwide dissemination of this curriculum to all PNP programs throughout the country. Confidential, structured, individual telephone interviews were conducted with academic and clinical preceptors from the schools that had participated in the implementation study. Curricular change presents challenges in most schools of nursing and will be affected by characteristics unique to each institution. Faculty need to be educated regarding the factors that are likely to enhance the process of making important and timely changes in curriculum. Finally, valuable lessons regarding the necessary early engagement of clinical preceptors should inform future curricular change initiatives.


Subject(s)
Curriculum/standards , Education, Nursing/methods , Evidence-Based Practice , Mental Health Services/organization & administration , Preceptorship , Quality of Health Care
16.
J Pediatr Health Care ; 24(2): 81-94, 2010.
Article in English | MEDLINE | ID: mdl-20189060

ABSTRACT

INTRODUCTION: The incidence of mental health/behavioral and developmental problems in children and teens is escalating. However, many primary care providers report inadequate skills to accurately screen, identify, and manage these problems using an evidence-based approach to care. Additionally, educational programs that prepare pediatric nurse practitioners (PNPs) have been slow to incorporate this content into their curriculums. METHODS: The purpose of this project was to implement and evaluate a strengthened curriculum in 20 PNP programs from across the United States that focused on: (a) health promotion strategies for optimal mental/behavioral health and developmental outcomes in children, and (b) screening and evidence-based interventions for these problems. An outcomes evaluation was conducted with faculty and graduating students from the participating programs along with faculty and students from 13 PNP programs who did not participate in the project. RESULTS: Participating schools varied in the speed at which components of the strengthened curriculum were incorporated into their programs. Over the course of the project, faculty from participating programs increased their own knowledge in the targeted areas and reported that their students were better prepared to assess and manage these problems using an evidence-based approach. Although reports of screening for certain problems were higher in the graduating students from the participating schools than the non-participating schools, the overall use of screening tools by students in clinical practice was low. DISCUSSION: There is a need for educational programs to strengthen their curricula and clinical experiences to prepare students to screen for, accurately identify, prevent, and provide early evidence-based interventions for children and teens with mental health/behavioral and developmental problems. This project can serve as a national model for curriculum change.


Subject(s)
Curriculum , Evidence-Based Nursing , Mental Disorders/diagnosis , Mental Health Services , Nurse Practitioners/standards , Pediatric Nursing/standards , Adult , Educational Status , Female , Health Knowledge, Attitudes, Practice , Humans , Incidence , Male , Mass Screening , Mental Health , Middle Aged , Nurse Practitioners/statistics & numerical data , Pediatric Nursing/statistics & numerical data , Program Evaluation , Psychometrics , Young Adult
17.
J Pediatr Health Care ; 23(5): 289-97, 2009.
Article in English | MEDLINE | ID: mdl-19720263

ABSTRACT

INTRODUCTION: Given the significant proportion of children in nonparental child care and the importance of early life experiences on development, interventions to improve a child care provider's ability to enhance a young child's development and behavior are essential. Such interventions require understanding of and responsiveness to the provider's self-perceived roles, responsibilities, and willingness to engage in such interventions, yet prior research is limited. The purpose of the study was to characterize licensed family child care provider perspectives as a first step toward designing effective provider-based interventions to improve children's development and behavior. METHOD: We conducted a qualitative study using in-depth interviews with licensed family child care providers serving economically disadvantaged children. Interviews were audiotaped, transcribed, and synthesized into common themes using the constant comparative method of qualitative data analysis. RESULTS: The family child care providers described five domains related to their role in child development and behavior: (a) promotion, (b) assessment, (c) advising parents, (d) acknowledging barriers, and (e) their own skill development. DISCUSSION: The family child care providers we interviewed describe how the developmental and behavioral health of children is an important aspect of their role and identify innovative and feasible ways to enhance their skills. Understanding the self-perceived role, responsibility, and willingness of child care providers is an important foundation to designing effective interventions to achieve high-quality child care.


Subject(s)
Child Behavior , Child Care/methods , Child Development , Health Promotion/methods , Nurse Practitioners , Adult , Child, Preschool , Humans , Middle Aged , Qualitative Research , Vulnerable Populations
18.
Pediatr Nurs ; 35(2): 93-100, 2009.
Article in English | MEDLINE | ID: mdl-19472672

ABSTRACT

PURPOSE: To evaluate a pilot training program for 19 nurse child care health consultants, 14 child care directors, and 9 members of community teams, and to assess the effect of the training on nurses' and directors' perceptions of the health consultant role, nurses' knowledge and practice as health consultants, and child care center policies and practices. METHOD: Data were collected at the conclusion of the program to assess participants' evaluation of the program and the effect of training on directors' and nurses' perceptions of the health consultant's role. Pre- and post-training data were collected regarding nurses' health consultation knowledge in 13 content areas and practice activities, and the effect of training on child care program health and safety policies and practices. FINDINGS: Of the 42 participants, 93.5% rated the program as excellent, and many health consultants and directors reported that the training changed their perception of the health consultant role. Positive significant differences were found in health consultant knowledge and scope of practice, as well as some health and safety policies and practices post-training. CONCLUSION: These findings support the importance of preparation for the health consultant role and increasing evidence of the positive effect of health consultation on the health and safety of child care programs.


Subject(s)
Child Care/organization & administration , Consultants , Foster Home Care , Health Education/organization & administration , Nurse's Role , Pediatric Nursing/organization & administration , Attitude of Health Personnel , Child , Connecticut , Consultants/psychology , Curriculum , Educational Measurement , Foster Home Care/organization & administration , Health Knowledge, Attitudes, Practice , Humans , Nurse Clinicians/education , Nurse Clinicians/organization & administration , Nurse Clinicians/psychology , Nurse Practitioners/education , Nurse Practitioners/organization & administration , Nurse Practitioners/psychology , Nurse's Role/psychology , Nursing Education Research , Nursing Evaluation Research , Pediatric Nursing/education , Pilot Projects , Professional Competence/standards , Program Evaluation
19.
Fam Community Health ; 31(4): 326-34, 2008.
Article in English | MEDLINE | ID: mdl-18794639

ABSTRACT

Family child care providers may be well-suited to provide health promotion to young children and their families. The investigators conducted a qualitative study using in-depth interviews with family child care providers serving low-income children. Child care providers perceive that they have an important role in health promotion, including (1) the child's physical health, (2) the child's development, and (3) supporting and educating parents, and are willing to assume this role in the context of collaborative relationships with parents. Providing education and ongoing support to child care providers in developing collaborative partnerships may enhance opportunities for health promotion in this setting.


Subject(s)
Child Care/organization & administration , Family , Health Promotion/organization & administration , Poverty , Adult , Child , Child Development , Child, Preschool , Female , Health Education , Health Status , Humans , Infant , Interviews as Topic , Male , Middle Aged , Qualitative Research , Racial Groups
20.
J Spec Pediatr Nurs ; 13(2): 74-88, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18366375

ABSTRACT

PURPOSE: This study explored the nature of consultation between childcare providers and nurse childcare health consultants and identified factors that promote a collaborative relationship. DESIGN AND METHODS: A qualitative study using semistructured, individual interviews of five collaborative and five conflicted pairs of nurse childcare health consultants and childcare center directors. Data were analyzed following principles of grounded theory and applying the constant comparative method of analysis. RESULTS: Establishing a collaborative relationship was influenced by previous experiences and four themes in the relationship: open and active communication, commitment, respect, and congruent philosophies. PRACTICE IMPLICATIONS: Preparation in developing collaborative relationships should be incorporated into the education of nurse consultants and childcare directors and providers.


Subject(s)
Attitude of Health Personnel , Cooperative Behavior , Interprofessional Relations , Nurse Administrators/psychology , Nurse Clinicians/psychology , Pediatric Nursing/organization & administration , Adult , Child , Communication , Conflict, Psychological , Connecticut , Female , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Models, Nursing , Models, Psychological , Nurse Administrators/education , Nurse Administrators/organization & administration , Nurse Clinicians/education , Nurse Clinicians/organization & administration , Nurse's Role/psychology , Nursing Methodology Research , Philosophy, Nursing , Qualitative Research , Self Concept , Social Support , Surveys and Questionnaires
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