Leveraging Collaboration in Pediatric Multidisciplinary Colorectal Care Using a Telehealth Platform

Nurses' Experiences and Perspectives of the Telehealth Working Environment and Educational Needs

BACKGROUND

The continuing evolution of health care and the nursing profession includes the exponential growth of telehealth platforms. The goal of this study was to describe nurses' experiences with and perspectives on their practice with and future need for telehealth.

METHOD

A cross-sectional descriptive mixed methods study was conducted with nursing graduates from a single university. Completed survey questions focused on demographics, current work status, plans for employment participation, and telehealth experience. Descriptive analysis was conducted with statistical software, with directed content analysis for narrative responses.

RESULTS

A total of 305 of 5,080 participants completed the survey (6% response rate). Nurses described perceived benefits and barriers to working in a telehealth environment. Nurses identified continuing education needs that could form the basis for a telehealth continuing education program to increase confidence in telehealth delivery.

CONCLUSION

The identified telehealth educational needs will positively influence the formation of continuing education opportunities for practicing nurses. [J Contin Educ Nurs. 2023;54(11):501-508.].

Parent and provider satisfaction of telehealth in pediatric surgical subspecialty care: A systematic review

INTRODUCTION

Telehealth is becoming an increasingly common presence in health care, particularly amidst the coronavirus disease 2019 pandemic. We aimed to investigate ways in which telehealth has been implemented in pediatric surgical specialties, as well as the success and satisfaction rates of these interventions.

METHODS

A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, and CINAHL databases for telehealth and pediatric surgical specialties on August 20th, 2021. There were 1227 studies screened and 17 studies met final inclusion criteria for patient, parent/guardian, or physician satisfaction measures of a telehealth intervention in the United States.

RESULTS

Studies implementing telehealth interventions included all major pediatric surgical subspecialties with a total of 2926 patients. Of the 17 studies, common themes were the use of telehealth for synchronous video and/or telephone virtual visits, including comparing virtual visits to in-person clinic visits (nine studies) and postoperative virtual visits (six studies). Telehealth was also used in the perioperative setting to deliver care instructions via mobile application or text message (two studies). Telehealth interventions had a high rate of parent satisfaction (75%-98%), and 57%-75% of parents stated they would choose or prefer virtual appointments in the future, often citing travel and cost savings as benefits. Provider satisfaction was also high with satisfaction scores ranging from 7.5 to 9.4/10.

DISCUSSION

This systematic review suggests that both parent and physician satisfaction with telehealth in pediatric surgical specialties is generally high. Expanding telehealth applications allow greater access to care, particularly for specialized surgical services which often pose significant costs and travel burdens.

Hirschsprung disease outcomes

Hirschsprung disease (HD) is a complex surgical and medical problem that appears to have varied health and social outcomes with the age and neurodevelopmental state of patients. In general, long-term outcomes are thought to be good for the majority of patients despite recognized problems with constipation and/or fecal incontinence. However, there are no universally accepted pathways regarding post-operative bowel management programs nor clearly defined follow-up pathways making the current outcome measures difficult to interpret. Further, other factors that may influence outcome including age at the time of procedure and procedure type continue to lack consensus. Improved support of children in resource limited environments and during periods of transition into the adult medical care environment are needed to improve outcome.  Recent proliferation of multidisciplinary care teams and consortia may help to better understand outcomes and address current knowledge gaps. Continuing these collaborations will be imperative to continuing improvements in care which may ultimately impact outcome.