ABSTRACT
INTRODUCTION: The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. METHODS: A repeated-measures, randomized crossover study comparing 2 different methods of pediatric triage education was conducted. Participants were general emergency nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was exposed in a random order to both educational methods: paper-based cases and high-fidelity simulation. RESULTS: All participants had substantial improvement in pediatric triage accuracy as measured by a standardized set of pediatric triage cases. The previously reported trend toward undertriage of the pediatric patient was observed despite a mean triage agreement rate of 73% at the end of the study period. No differences were observed between groups; the order of the educational intervention did not result in statistically significant differences in triage accuracy. CONCLUSION: A combined approach of paper-based cases and high-fidelity simulation was effective at improving pediatric triage accuracy among a group of general ED nurses with limited exposure to pediatric patients. The results from this study suggest that combining both methods of education may be a viable means of providing general emergency nurses with additional knowledge in pediatric triage; however, persistent trends in undertriage should be studied further.
Subject(s)
Emergency Nursing/methods , Pediatric Nursing/methods , Simulation Training/methods , Triage/methods , Adult , Cross-Over Studies , Female , Humans , Infant , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND: Low health literacy in older adults has been associated with poor health outcomes (i.e., mortality, decreased physical and cognitive functioning, and less preventive care utilization). Many factors associated with low health literacy are also associated with health disparities. Interaction with healthcare providers and sources of health information are influenced by an individual's health literacy and can impact health outcomes. PURPOSE: This study examined the relationships between health literacy, sources of health information, and demographic/background characteristics in older adults (aged 65 years and older) related to health literacy and disparities. METHODS: This descriptive, correlational study is a secondary analysis of the 2003 National Assessment of Adult Literacy, a large-scale national assessment. RESULTS: Older adults with lower health literacy have less income and education, rate their health as poor or fair, have visual or auditory difficulties, need help filling out forms, reading newspaper, or writing notes, and use each source of health information less (print and nonprint). Many of these characteristics and skills are predictive of health literacy and associated with health disparities. CONCLUSION: The results expand our knowledge of characteristics associated with health literacy and sources of health information used by older adults. Interventions to improve health outcomes including health disparities can focus on recognizing and meeting the health literacy demands of older adults.
Subject(s)
Health Literacy , Healthcare Disparities , Information Seeking Behavior , Aged , Female , Humans , Male , Surveys and Questionnaires , United StatesABSTRACT
Theories provide a roadmap for scientific inquiry, help organize knowledge, and establish the foundation for knowledge development. The Double ABCX Model of Family Stress and Adaptation is a middle-range theory developed in social science and widely used by researchers of various disciplines. This model encompasses the major variables of interest in this study, including stress, coping, duration of tracheostomy, and quality-of-life, and forms an excellent framework for this specific research study. The purpose of this article was to discuss relationships between various individual and environmental factors that can impact health and well-being in families. In addition, this article illustrates how the application of the model helps nurses and healthcare providers understand the significance of the family context on positive well-being and promote optimal caring practices to achieve a balance in the midst of illness and suffering.
Subject(s)
Caregivers/psychology , Family/psychology , Models, Nursing , Tracheostomy/nursing , Tracheostomy/psychology , Adaptation, Psychological , Adult , Child, Preschool , Disabled Children , Female , Home Care Services , Humans , Infant , Infant, Newborn , Male , Parent-Child Relations , Quality of Life , Social Support , Stress, PsychologicalABSTRACT
Newly graduated nurses (NGNs) are thrust into roles that some purport they are inadequately prepared to handle. This study investigated the experience of NGNs as they made clinical judgments in the critical care setting. Three themes emerged: developing confidence in practice, seeking assistance, and decision making. Nursing professional development educators can use the results to coordinate an education plan that extends beyond formal orientation and provides support for NGNs throughout the first year of practice.
