Development of a Self‐Management Theory‐Guided Discharge Intervention for Parents of Hospitalized Children

Background Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self‐management of their child\u27s care at home after discharge. Problem No theory‐based discharge intervention exists to guide pediatric nurses\u27 preparation of parents for discharge. Purpose To develop a theory‐based conversation guide to optimize nurses\u27 preparation of parents for discharge and self‐management of their child at home following hospitalization. Methods Two frameworks and one method influenced the development of the intervention: the Individual and Family Self‐Management Theory, Tanner\u27s Model of Clinical Judgment, and the Teach‐Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine‐domain conversation guide for use in acute care pediatric hospitals. Conclusions The theory‐based intervention operationalized self‐management concepts, added components of nursing clinical judgment, and integrated the Teach‐Back method. Clinical Relevance Development of a theory‐based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention

An Intelligent Clinical Decision Support System for Assessing the Needs of a Long-Term Care Plan

With the global aging population, providing effective long-term care has been promoted and emphasized for reducing the hospitalizations of the elderly and the care burden to hospitals and governments. Under the scheme of Long-term Care Project 2.0 (LTCP 2.0), initiated in Taiwan, two types of long-term care services, i.e., institutional care and home care, are provided for the elderly with chronic diseases and disabilities, according to their personality, living environment and health situation. Due to the increasing emphasis on the quality of life in recent years, the elderly expect long-term care service providers (LCSP) to provide the best quality of care (QoC). Such healthcare must be safe, effective, timely, efficiently, diversified and up-to-date. Instead of supporting basic activities in daily living, LCSPs have changed their goals to formulate elderly-centered care plans in an accurate, time-efficient and cost-effective manner. In order to ensure the quality of the care services, an intelligent clinical decision support system (ICDSS) is proposed for care managers to improve their efficiency and effectiveness in assessing the long-term care needs of the elderly. In the ICDSS, artificial intelligence (AI) techniques are adopted to distinguish and formulate personalized long-term care plans by retrieving relevant knowledge from past similar records

Supporting Youth in Transition to Adulthood: Lessons Learned from Child Welfare and Juvenile Justice

The Georgetown Public Policy Institute's Center for Juvenile Justice Reform and the Jim Casey Youth Opportunities Initiative collaborated to publish this paper that describes case assessment, case management, and other practices implemented in the juvenile justice and child welfare systems. The practices highlighted have shown promise in improving outcomes for the transition-age population

Evidence-informed discharge planning model for stroke rehabilitation

Stroke is a leading cause of long-term disability (Benjamin et al., 2017) and patients with this diagnosis have been found to have higher incidences of inappropriately long hospital lengths of stay (McDonagh, Smith, & Goddard, 2000). Generalist training in occupational therapy curriculum coupled with variable research utilization (Dysart & Tomlin, 2002; McKenna et al., 2005) leads to inconsistent methods of evaluation and decreased communication between providers across settings. Furthermore, there are currently no standardized discharge planning models or guidelines for clinicians to follow when evaluating patients or making recommendations (Ilett, Brock, Graven, & Cotton, 2010). An evidence-informed discharge planning model was created to address these issues. This model utilizes a multidisciplinary approach, with guidelines for selecting and administering evaluations to quantify a patient’s functional status. Assessments are clustered into four domains: activities of daily living, balance and mobility, cognition, and other (i.e. visual inattention, motor control and spasticity). These assessments supplement a basic patient evaluation, and results are used to guide clinical decision making regarding recommendations for the next level of care. Stroke rehabilitation and care cannot be standardized, but the methods used to select measures and make discharge recommendations should have distinct guidelines. By choosing from a core set of measures, clinicians can use a common “language” to describe patient function and measure progress across settings over time. This will ensure patients are discharged to the appropriate level of rehabilitation to optimize their recovery, and it will also help prevent excessively long hospital admissions