Content, Context, and Collaboration: An Actionable Strategy for Structured Success in DNP Practice Scholarship.

Even if everything is done right in justifying the clinical benefit of a healthcare initiative, it cannot be sustainable if, first and foremost, the temperament of the practice environment, including the wider institutional hierarchy, is not accurately gauged. The purpose of this article is to provide the Doctor of Nursing Practice (DNP) researcher with a systematic structure enabling a review of the larger context of the proposed clinical innovation. This review supports a DNP-led healthcare initiative through self-analysis of the researcher's role; forging a relationship with a mentor; the analysis and mitigation of institutional, collaborative, and organizational barriers; and negotiating strategic partnerships with colleagues and departments and sharing their work and expertise. The blueprint that can change the interface of these elements is the creation of a specific research advisory committee (RADCOMM). The RADCOMM can be the impetus for transforming the institution into a place for learning, personal and professional growth and development, and patient safety, as well as one that results in new common resources and improved practice scholarship. The next generation of scholars and their capacity to understand their position in healthcare is inherently inhibited by not integrating the role and value of practice scholarship. The success of a DNP-led healthcare initiative, however, can positively affect the researcher's mental health, productivity, and career satisfaction.

Connect, Engage: Televisits for Children With Asthma During COVID-19 and After.

Despite the many barriers to receiving care, children with asthma must have access to regular care and frequent follow-up visits. The usual barriers to the provision of asthma care have been made even more complicated by the current coronavirus disease 2019 pandemic. To minimize the disruption of care due to the necessary constraints dictated by coronavirus disease 2019, the televisit provides a practical solution that can assess the child's current level of symptom control, reinforce asthma education, and determine treatment options. This article provides the tools and guidelines to facilitate the implementation of successful televisits to provide uninterrupted care for children with asthma.

Missed opportunities for HPV vaccination in adolescent girls: a qualitative study.

OBJECTIVE: The goal of this study was to identify the rationale by parents/guardians and providers for delaying or administering human papillomavirus (HPV) vaccination to girls. METHODS: Qualitative interviews were conducted with parents/guardians accompanying their vaccine-eligible 11- to 17-year-old daughters to medical visits. Interviews were conducted in 1 public clinic and 3 private practice settings to ascertain why girls did or did not receive HPV vaccination. Questions probed vaccine decision-making from the point of view of parents/guardians and providers. RESULTS: A total of 124 parents/guardians and 37 providers participated. The most common reasons parents reported for not vaccinating their daughters was the lack of a physician recommendation (44%). Both parents and providers believed that HPV vaccination provided important health benefits, but the timing of vaccination with relation to sexual activity was an important theme related to vaccine delay. Providers with lower self-reported vaccination rates delayed vaccine recommendations in girls perceived to be at low risk for sexual activity, and several parents reported that their providers suggested or supported delaying vaccination until their daughters were older. However, parents/guardians and providers agreed that predicting the timing of sexual debut was extremely difficult. In contrast, providers with high vaccination rates presented HPV vaccination as a routine vaccine with proven safety to prevent cancer, and parents responded positively to these messages. CONCLUSIONS: Although most parents and providers believe that HPV vaccination is important, missed opportunities result from assumptions about the timing of vaccination relative to sexual activity. Routinely recommending HPV vaccination as cancer prevention to be coadministered with other vaccines at age 11 years can improve vaccination rates.

Shared medical appointments: facilitating care for children with asthma and their caregivers.

As important members of the health care team, patients and caregivers must be empowered to recognize their asthma status and to act accordingly. Education about asthma, complications, and successful management of asthma provide the best way to empower children and their caregivers. A Shared Medical Appointment (SMA) is a unique health care delivery approach that integrates disease management and patient education. The SMA described here is a 90-minute group appointment for four to nine patients who share a diagnosis of asthma, bronchospasm, or wheeze and their caregivers. The appointment includes a brief individual examination, health education delivered to the group, and the opportunity for interaction between group members. Because a supporting theoretic framework is not identified in the original design proposals for the SMA model or in the literature on its use, for the purposes of this project, Social Cognitive Theory is identified as the theoretical framework that best explains and reinforces the benefits of the SMA. The theoretic framework is important to direct the development and continued success of this treatment model. This project report describes the first nurse practitioner-led SMA as a tool for improving quality of care and service for children with asthma and their caregivers.