Although nurses are increasingly expected to fulfill the role of care coordinator, the knowledge and skills required to be an effective care coordinator are not well understood. The purpose of this study was to describe the knowledge and skills required in care coordination practice using an interpretive phenomenological approach. Fifteen care coordinators from 10 programs were interviewed over a 6-month period. Semi-structured face-to-face interviews were audio recorded, transcribed, and analyzed using interpretive phenomenology. The central theme of care coordination practice was bridging the patient and the healthcare systems. To bridge, care coordinators needed to have knowledge of the patient and healthcare system as well as the skills to identify and negotiate treatments appropriate for the patient. The most salient finding and new to this literature was that care coordinators who used their medical knowledge about available treatment options to discern and negotiate for the most appropriate care to the patient made differences in patient outcomes. Nurses with medical and healthcare system knowledge, combined with the skills to navigate and negotiate with others in an increasingly complex healthcare system, are well situated to be care coordinators and generate optimal outcomes. Further investigations of critical care coordinator competencies are needed to support nurses currently enacting the role of care coordinator and to prepare future nurses to fulfill the role.
Children shared that doing things, outdoors, with others, [emphasis added] made their life "really good". Children's stories yielded insightful and actionable information that is relevant to each individual child/family, and to nursing assessment, intervention, and advocacy. These child-granted insights also extend our attention beyond pharmacological and behavioral focused interventions, to include the children's own innate health promoting interests that help to make their life really good.
Background: The Get Outside: After School Activity Program (GO-ASAP) exemplifies how a rural community can utilize its natural resources and community partnerships to promote adolescent health. Methods: A qualitative descriptive inquiry was conducted using convenience sampling. Data were collected from students (n = 13/2018; n = 13/2019) via focus group and art-based method (2018 only) and parent (n = 6/2018) focus group. Data were analyzed via qualitative content analysis using the applied theoretical frameworks of Social Cognitive Theory and Social Determination Theory. Results: (1) Increasing Health-Related Competencies. Students increased their physical activity, improved their sleep, perceived less stress, and reported changes in dietary habits and electronic use. (2) Increasing Social Relatedness. Students made new friends, felt more connected, and spent less time home alone after school. (3) Increasing Autonomy and Intrinsic Motivation. Students recognized their emerging capabilities, and their increased confidence stimulated more action-oriented behavior. Parent-perceived changes support and mirror student reports. Conclusion: Outdoor, nature-based, activity programs are a novel upstream approach to promote adolescent health, especially in rural communities where natural resources often exceed health-service resources and community partnerships are a way of life.
Background: Registered nurses (RNs) working to the full scope of licensed practice can expand the capacity of the health care system and influence patient care quality. However, preparation of prelicensure nursing students to practice in primary care is particularly challenging due to curricular and practice site barriers. Approach: As part of a federally funded project to expand the primary care RN workforce, learning activities to teach key concepts of primary care nursing were designed and implemented. Students studied the concepts while placed in a primary care clinical setting and debriefed in a topical, instructor-facilitated, seminar. Current and best practices in primary care were explored, compared, and contrasted. Outcomes: Pre-and postsurveys revealed significant student learning related to selected primary care nursing concepts. Overall knowledge, skills, and attitudes increased significantly pre-to post-term. Conclusion: Concept-based learning activities can effectively support specialty nursing education in primary and ambulatory care settings.
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