Development and implementation of a paediatric cardiac intensive care advanced practice provider curriculum.

BACKGROUND: Education of paediatric advanced practice providers takes a generalist approach which lacks in-depth exposure to subspecialties like paediatric cardiac intensive care. This translates into a knowledge gap related to congenital cardiac physiology and management for APPs transitioning to the paediatric cardiac ICU. METHODS: A specialised interprofessional peer-reviewed curriculum was created and distributed through the Pediatric Cardiac Intensive Care Society. This curriculum includes a textbook which is complemented by a didactic and simulation review course. Course evaluations were collected following each course, and feedback from participants was incorporated into subsequent courses. Pediatric Cardiac Intensive Care Society partnered with the Pediatric Nursing Certification Board to develop a 200-question post-assessment (exam) bank. RESULTS: From December 2017 to January 2022, 12 review courses were taught at various host sites (n = 314 participants). Feedback revealed that courses improved preparedness for practice, contributed to advanced practice provider empowerment, and emphasised the importance of professional networking. 97% of attendees agreed/strongly agreed that the course improved clinical knowledge, 97% agreed/strongly agreed that the course improved ability to care for patients, and 88% agreed/strongly agreed that the course improved confidence to practice. 49% of participants rated the course as extremely effective, 42% very effective, 6% moderately effective, and 3% as only slightly effective. CONCLUSIONS: A standardised subspecialty curriculum dedicated to advanced practice provider practice in cardiac intensive care was needed to improve knowledge, advance practice, and empower APPs managing critically ill patients in the cardiac ICU. The developed curriculum provides standardised learning, increasing advanced practice provider knowledge acquisition, and confidence to practice.

Five-year retrospective study of inpatient occupational therapy outcomes for patients with multiple sclerosis.

OBJECTIVE: This study was a retrospective chart analysis spanning 5 yr that investigated associations between occupational therapy interventions and goal-based positive outcomes in patients with multiple sclerosis (MS) and related disorders at discharge in an urban inpatient rehabilitation setting. METHOD: Using descriptive statistics, we examined demographic characteristics in the first analysis phase. In the second phase, we performed a series of correlational analyses to identify treatment variables associated with positive outcomes. RESULTS: Generally, patients improved in their FIM scores at discharge. Increasing occupational therapy intensity had a positive effect on functional performance in all categories except feeding, with significant correlations in upper-extremity dressing (r = .153, p < .05) and memory (r = .204, p < .01). CONCLUSION: Occupational therapy was associated with positive functional outcomes for patients with MS. Future treatment protocols should include cognitive skills training, community reintegration, and self-care, because these treatments were found to be significantly correlated with positive changes in FIM scores.

Working with Children Affected by Hurricane Katrina: Two Case Studies in Play Therapy.

In August 2005 Hurricane Katrina hit the Louisiana and Mississippi Gulf Coast Regions. Throughout history, mental health professionals have primarily focused on adults as the identified victims of natural disasters. More recently, mental health professionals are focused on integrating mental health services to children and adolescents. This article discusses the impact natural disasters have on children, and the related traumatic stress response and post traumatic stress disorder often experienced by children. Treating children can be complicated and a developmentally appropriate intervention is needed. Evidenced-based research has shown play therapy to be a developmentally effective intervention with traumatised children. This article presents two case studies of play therapy with children affected by Hurricane Katrina.

The identifying and counseling of breastfeeding women by pharmacists.

OBJECTIVE: Concerns about medications influence breastfeeding decisions. Mothers may stop breastfeeding when they take medications. After the distribution of Thomas Hale's Medications and Mother's Milk (MMM) (Hale Publishing, Amarillo, TX, 2006) by the Rhode Island Department of Health (Providence, RI) in November 2006 to Rhode Island pharmacies, we investigated, during the summer of 2007, what strategies and resources pharmacists were using to identify breastfeeding women and guide medication recommendations. METHODS: Copies of MMM were sent to 47 pharmacies in Rhode Island. Subsequently, one pharmacist at each site completed a confidential, 10-question written survey. RESULTS: The survey response rate was 92%. More than half (58%) of the pharmacists surveyed never asked women if they were breastfeeding. Most (85%) of pharmacists reported feeling somewhat or very comfortable giving advice to breastfeeding women. All but one pharmacist who had received MMM reported using the reference at least monthly. More than half (52%) of the pharmacists reported using the Physician's Desk Reference (Thomson PDR, Montvale, NJ). DISCUSSION: Pharmacists need a consistent approach to identify breastfeeding women and access to reliable, continuously updated resources to guide their advice about medication use to breastfeeding women. Physicians and pharmacists should collaborate to prevent medication use from being a barrier to breastfeeding.