Perceptions of U.S. and U.K. Incident Reporting Systems: A Scoping Review.

OBJECTIVE: The aim of the study is to evaluate the extent, range, and nature of the literature that concerns healthcare providers' perceptions following the use of incident reporting systems (IRSs) in the United States (U.S.) and the United Kingdom (U.K.). Literature was compared describing providers' perceptions of reporting patient safety incidents using IRSs from healthcare systems built on public, private, for-profit, or nonprofit insurers in the U.S., with providers' perceptions using an IRS within a universal government supported healthcare system in the U.K. METHODS: This scoping review searched literature from 4 electronic databases, producing 4863 articles between January 2010 to March 2023. RESULTS: Eleven U.S. and 8 U.K. articles met the inclusion criteria. Providers described system and individual barriers when using IRSs. The U.S. providers described more concerns regarding individual barriers (fear of punitive response or retaliation, feel incapable or shamed, unsure of what constitutes a patient safety incident, and concerned about litigation) than providers in the U.K. Both countries had similar responses regarding system barriers, except for U.K. providers who were more concerned than the U.S. about damage to professional culture. Providers in both countries believed incident reporting was ineffective and time consuming with hospital leaders seldom acknowledging or integrating improvement measures based on reported incidents. CONCLUSIONS: Sustainable improvements in patient care must be driven by hospital leadership who create just cultures where reporting of safety concerns is encouraged and respected within nonpunitive milieus.

A Systematic Review and Meta-analysis of the Initial Literature Regarding COVID-19 Symptoms in Children in the United States.

INTRODUCTION: COVID-19 symptom presentation among adults is mostly understood. However, understanding COVID-19 symptom presentation in children lags. METHOD: A literature search was conducted in three electronic databases. Twenty-three initial publications addressing COVID-19 symptom presentation among hospitalized children in the United States met the criteria for review and meta-analysis. RESULTS: Fever, the most common symptom, was present in nearly all cases. Gastrointestinal, respiratory, oral symptoms, and rash occurred in over half of the cases. Disease severity assessment showed that comorbidities were present in one-third of patients; intensive care was needed for half of the patients, and supplemental oxygen and mechanical ventilation were needed by 13.3% and 7.1%, respectively. DISCUSSION: The magnitude and significance of COVID-19 symptoms in children compared with those in adults and three common childhood viral illnesses: influenza, respiratory syncytial virus, and gastroenteritis, are discussed. Important clinical differences were found that may help clinicians distinguish COVID-19 from other illnesses.

A multisite transition to nursing program: an innovative approach to facilitate incoming nursing students' academic success.

OBJECTIVES: Evaluate effectiveness of a multisite program promoting the successful transition of baccalaureate and graduate entry (with a prior degree) students into pre-licensure curricula. Faculty concern around nursing students' successful completion of nursing programs and passage of the nursing licensure exam stems from challenges students encounter in core courses, study habits, and civility. METHODS: One hundred eighty-five students participated in a quasi-experimental pre-post-test mixed-methods study. Students completed content modules and open-ended surveys. RESULTS: Most students found the program helpful. Statistically significant improvements were shown in medication calculation, reading comprehension, and medical terminology. No statistically significant improvement was shown in anatomy and physiology. CONCLUSIONS: Our Transition to Nursing program shows promise and adds to proactive strategies in preparing students for a successful transition into nursing programs. Our innovative approach may serve as a model to nursing schools and colleges around the world to promote student success.

Nurse consultant to day/child care centers.

PURPOSE: Approximately 23.2 million children in the United States attend day care; however, many of these children often lack access to health care. Given the potential for advanced practice nurses to address this gap in health care, the authors sought to gain a better understanding of healthcare consulting provided by nurses to day/child care centers. The purpose of this scoping review is to examine the extent, range, and nature of evidence regarding the role of nurse consultants in day and childcare settings. DESIGN AND METHODS: A scoping review was conducted in CINAHL and PubMed, to report and summarize relevant literature published before 2020. Search terms included day or child care, nurse consultants, healthcare consultants, and day or child care health consultants. RESULTS: The search produced 92 publications; 21 publications met the inclusion criteria and are included in the review. After independently reading the publications, the authors identified and agreed upon seven central themes. Themes included an analysis of the consulting process, description of the nurse consulting role in individual and large day and childcare settings, director's perceptions of health consultants, impact of nurse consultants, education and training, barriers to the healthcare consultant role, and political advocacy. PRACTICE IMPLICATIONS: Advanced nurse practitioner, particularly pediatric nurse practitioners (PNPs), possess the skill set in acute and chronic conditions, as well as health maintenance and promotion that can be translated and used in the role of the nurse consultant to day and child care centers. Having PNPs in this role may help to address primary healthcare needs of children.

Use of Private, Parochial, and Public Schools in Baccalaureate Nursing Programs for Pediatric Practicum.

BACKGROUND: Clinical sites are increasingly difficult to secure due to shorter hospital stays, increased clinical site competition, and limited practicum sites. Little is known about the use of schools for pediatric clinical practicum. PURPOSE: To explore utilization of private, parochial, and public primary and secondary schools for pediatric clinical practicum sites. METHODS: Faculty (n = 108) completed a 38-item online survey. RESULTS: Twenty-seven faculty members (25%) reported using schools for pediatric practicum. Most nursing students (85.1%) spent 23 total hours or less in schools obtaining anthropometric measurements, reviewing immunizations, and providing health education to children, parents, and teachers. CONCLUSION: Using schools for the pediatric practicum is thought to be a common practice; our findings suggest otherwise. School-based practicums provide students with skills beyond acute care competencies. Nursing faculty need to seriously consider which pediatric clinical settings provide the best experience to prepare future nurses.

School Gardens' Impact on Students' Health Outcomes in Low-Income Midwest Schools.

Childhood obesity in Chicago, particularly in underrepresented communities of color, exceeds that of national rates. Access to healthy foods in these communities is also often limited. A garden-based education program was implemented in Chicago's South and West Side elementary, middle and high schools. Findings from this work augment the literature and illustrate that implementing gardens in elementary, middle, and high schools has a positive impact on availability, access, and consumption of fresh fruits and vegetables, as well as students' social emotional well-being. School nurses are in prime positions to advocate for students' health and well-being by collaborating with community programs, and championing policy development. Rigorous studies are needed to better understand the long-term health and social benefits of having school gardens on the prevention of obesity, positive mental health outcomes, and economic benefits, while controlling for socio-economic status.

Self-Concept Profiles of Youth at Risk for Maladaptive Behaviors.

Early alcohol use places youth at risk for adverse health, academic, and legal consequences. We examined the content of the total array of self-cognitions in urban youth to determine whether specific self-concept profiles were associated with early drinking, drinking-related self-cognitions, and conduct problems. We conducted a secondary analysis of data from a cross-sectional study with 9- to 12-year-old predominantly Black and Hispanic youth (N = 79) who attended urban school and summer youth programs. Measures included an open-ended self-description task and questionnaires to measure presence/absence of a drinking-related self-cognition, alcohol use, and conduct problems. We content analyzed 677 self-descriptors; cluster analysis revealed six unique self-concept profile groups. In a cluster group distinguished by negative self-content, 37% drank alcohol and 42% had a drinking-related self-cognition. Youth in this group also had conduct problems. School nurses are in prime positions to identify and intervene with youth who have at-risk self-concept profiles.

Pediatric Practicums Conducted in School Settings: An Integrative Review.

Background Examining nursing pedagogical strategies is important to assure that nursing students have opportunities to become knowledgeable and skilled clinicians. However, little is known about the nursing pedagogical strategy of using schools for pediatric practicum. The purpose of this review is to integrate the evidence regarding the use of schools as practicum sites for nursing students to obtain pediatric clinical experience. Method Searches were conducted in three electronic databases resulting in 70 publications; eight publications met the inclusion criteria. Results Five themes were identified using content analysis: description of practicum settings; level of education, number of students, clinical time and geographic region of the college; theoretical framework; nursing student activities and assignments; nursing student outcomes, evaluation of pediatric practicum experience, and school student health outcomes. Conclusion Findings support the use of schools for pediatric practicums.  This practicum broadens nursing students' knowledge of promoting health among well and chronically ill children.

Using Elementary Schools for Pediatric Practicum: An Alternative Approach.

Securing clinical sites that facilitate achievement of nursing skills to competently care for children is often challenging for nursing faculty. An additional challenge is helping nursing students learn the importance of conceptually driven practice and its application in the delivery of high quality care. This manuscript describes an alternative pedagogical approach that utilizes elementary schools for pediatric practicum, which is framed by the Whole School, Whole Community, Whole Child Model. Our model driven approach not only provides a framework by which baccalaureate nursing students gain the skills necessary to interact with, educate, and care for children, but also one in which they can gain a greater understanding of how the home, school and community influence the overall health and well-being of children. Subsequently, this pedagogy serves as an exemplar of how an alternative site can be utilized to successfully educate nursing students regarding the care of children.

Access to Fresh Fruits and Vegetables in School Lunches: A Policy Analysis.

Consumption of fresh fruits and vegetables helps to reduce childhood obesity and improves academic achievement and attendance. However, providing fresh fruits and vegetables is challenging for some schools due to cost, administrative burden, and concern for food waste. To address these challenges, the Fruit and Vegetable Access for Children Act proposes to allow federally funded programs to substitute fresh fruits and vegetables with canned, frozen, or pureed versions. In this policy analysis, we propose options for providing fresh fruits and vegetables to children enrolled in the National School Lunch Program. We recommend that school nurses actively facilitate the process of obtaining fresh fruits and vegetables by being appointed members of Team Nutrition giving them authority to collaborate with local famers, entrepreneurs, and land-grant universities in Farm to School Programs. This strategy empowers school nurses in promoting healthy eating habits, reducing obesity, and improving academic performance and school attendance.

Pulmonary Emboli and Deep Venous Thrombosis during Adolescence.

Pulmonary emboli (PE) and deep venous thrombus (DVT) are two conditions considered to affect primarily adults. These conditions, however, can and do affect neonates, toddlers, school-age children, and adolescents. Factors contributing to the development of PE and DVT are often associated with genetic mutations in Antithrombin III, Protein C, and Protein S. This article presents a primary care case study of an adolescent who was diagnosed with and underwent treatment for bilateral PE and a DVT, and reviews the underlying primary genetic mutations, diagnostic workup, and management of his clinical condition.

Children's knowledge of eating: An integrative review of the literature.

Behaviors associated with eating are often cited as one of many factors contributing to the development of childhood obesity. Behavior is thought to be guided, in part, by personal beliefs and tacit knowledge, which arise from the interpretation of sensory-motor experiences. Tacit knowledge, however, differs from declarative knowledge or the acquisition of factual information attained during formal education. Yet, there are no known publications that review children's and adolescent's tacit and declarative knowledge of eating. The purpose of this integrative review was to examine the evidence regarding children's and adolescents' knowledge of eating. Literature searches were conducted in CINAHL, PsycINFO, Web of Science, and Google Scholar. Selected publications included in the integrative review were empirical studies written in English that described children's and adolescent's knowledge of eating. A total of 548 publications resulted from the searches. Thirty met the inclusion criteria. Preschool-age children understood concepts related to edibleness, nutrition, and digestion as a result of their experiences with food and eating. School-age children and adolescents correctly identified not only facts about food, nutrition, and health, but also factors that influenced their decisions about eating. School-age children and adolescents also expressed concern about their diet, barriers to being healthy, and their appearance. Evidence presented in this integrative review revealed that children, including those of preschool-age, know a great deal about eating. Moreover, the evidence suggests that beliefs and tacit knowledge are more influential in directing eating behaviors than declarative knowledge or knowing facts about food, nutrition, the body, or health. Understanding what children believe and tacitly know about eating will be useful in tailoring interventions to prevent the development of childhood obesity.