An interdisciplinary telemedicine innovation to enhance pediatric diabetes care in rural communities: A proposed practice initiative.

PURPOSE: The COVID-19 pandemic highlighted disparities in healthcare access and outcomes, particularly among individuals with chronic conditions. A positive outcome of the pandemic was an increased use of telehealth and the creation of innovative models of care. In many organizations, nurses became the leaders for these new models. Before this change, pediatric medicine had far fewer telehealth models than adult medicine due to limited Medicaid reimbursement and equipment that was not designed with children in mind. This article describes a new model of care for children with diabetes. We will review how a nurse-led initiative with the incorporation of telehealth modalities can improve access and outcomes while reducing cost. Successful models of care will be reviewed, as well as programmatic planning, financial implications, and regulatory considerations. CONCLUSIONS: It is no longer necessary for families living in rural communities to drive long distances, missing school and work, to attend the frequent appointments needed for optimal management of pediatric diabetes. Telemedicine can bridge gaps in access to specialty care, and is feasible, reimbursable, and well-accepted by families and providers. PRACTICE IMPLICATIONS: Nurses in both primary care and pediatric specialty offices can initiate and support innovative telehealth models of care, such as this proposal. To win the backing of practice leadership, the availability of cost-effective videoconferencing equipment and software, improvements in telehealth reimbursement prompted by the pandemic, and enhanced patient and parent satisfaction and outcomes should be emphasized.

Evaluating Advanced Practice Nurses' Burnout and Potential Helping Modalities.

Health care providers are experiencing increased stress during the coronavirus disease 2019 pandemic. While it is understood that increased stress leads to burnout, limited research has been conducted to evaluate advance practice nurse response to coronavirus disease 2019, and more specifically, self-identified modalities that may decrease stress in the workplace or at home. This pilot study evaluated advance practice nurse-perceived burnout and evaluated perceived needs and/or perception of modalities aimed at reducing stress and improving well-being, such as essential oils, quiet room, soothing music, art therapy, pet therapy, and mobile applications, that could be easily accessed in the workplace.

Application of the unified theory of acceptance and use of technology model to predict dental students' behavioral intention to use teledentistry.

Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Dental students' intention to use teledentistry after completing dental school has not been investigated. PURPOSE: The unified theory of acceptance and use of technology (UTAUT) was used to predict intentions to use teledentistry among 4th-year U.S. dental students. METHODS: A cross-sectional approach was performed for a 7-week period in Spring 2019. All U.S. dental schools (N = 66) were invited to participate and 16 schools agreed to participate. An anonymous survey link was emailed to academic deans for dissemination to students. A total of 1416 4th-year dental students received the anonymous survey link and 210 students completed the survey (response rate = 14.8%). The survey included questions and scales that measured the UTAUT constructs of performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC), and behavioral intentions (BI). Data were analyzed using SPSS version 24. The study was deemed exempt by institutional review board. RESULTS: The dental students' BI to use teledentistry was significantly predicted by PE (R2 = 33%, P < 0.01), EE (R2 = 24%, P < 0.01), SI (R2 = 24%, P < 0.01), and FC (R2 = 14%, P < 0.01). The UTAUT model was statistically significant in predicting the BI and explained 40% of BI variance (R2 = .40, P < 0.01). CONCLUSIONS: Dental students' perceptions about PE, EE, SI, and FC were associated with BI. Therefore, exposure to teledentistry while in dental school could increase the likelihood of use as a practicing provider.