Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions

Abstract

The survival rates of youth and young adults (YYAs) diagnosed with long-term conditions have improved considerably as 90% now enter adulthood; health care transition planning (HCTP) has emerged as a nursing practice priority. The aim of this national online survey was to investigate the extent to which nurses, recruited from two major United States pediatric nursing organizations are involved with HCTP including assessing YYA self-management abilities (SMA). Findings of a 9-item assessment of self-management abilities subscale of the nurses’ role in HTCP tool are reported. The nurse respondents ( n = 1269), identified the most frequently assessed SMA was the YYAs’ ability to understand and speak about their condition and its treatment ( M = 2.3, SD = .89). The least frequently assessed was the YYAs’ ability to identify community advocates to help them become more independent ( M =1.5, SD = .90). Regression analysis identified significant predictors of the frequency nurses assess YYA for SMA included nurses’ level of knowledge, perceived level of importance, HCTP and skills identified in job description, and caring for YYA. Findings indicate HCTP care advancements will necessitate HCTP training and development of nurse-led service efforts to facilitate optimal outcomes for YYA.

Feasibility and use of a transition process planning and communication tool among multiple subspecialties within a pediatric health system

“…Findings are consistent with existing literature on EMR-based documentation tools (Horwitz et al, 2012;Player et al, 2010;Schnipper et al, 2008) and indicate health professionals from various subspecialties are willing to adopt new EMR-based methods for transition planning documentation. Nurses were the highest adopters of the T-PPACT in this study, which is consistent with previous research identifying HCT planning as a critical element of clinical practice for advanced practice nurses and nurses caring for YSHCN (Betz et al, 2020;Disabato et al, 2019).…”

“…Pediatric nursing professionals play an integral role in facilitating the transition process for YSHCN, and HCT planning has become a critical element of pediatric nursing practice (Betz, 2017;Betz et al, 2020).…”

“…While this transfer of care represents a discrete event in which YSHCN re-establish their medical home with an adult provider (Sharma et al, 2014), the process of HCT involves moving to an adult care model and may include transfer to a new provider (Betz et al, 2020;White et al, 2018). As global pediatric survival rates improve, particularly in countries with limited resources and in developing nations (Vos et al, 2020), the need for tools to assist with the transition process is critical.…”

Health care transition planning: A potpourri of perspectives from nurses

“…As the analysis of the 9‐item Assessment of Self‐Management Abilities NR‐HCTP subscale supported, knowledge predicts performance. Nurses most frequently assessed the YYA's self‐management abilities that were associated with chronic condition management, and least often assessed were those abilities specific to HCT planning activities such as promoting self‐advocacy and referrals to community‐based services (Betz et al, 2020). The evident service needs of this growing population of AEAwLTC as described in theme Support the Need for Transition are also bolstered by the issues identified in the themes, Lack of Service Linkages to Adult Providers and Difficulty Letting Go that necessitate the provision of clinical guidance to provide the evidence based HCT services and support to enabling improved HCT outcomes for AEAwLTC.…”

“…The main instrument NR‐HCTP, which is used to measure the nurses' provision of, knowledge of, and perceived importance of 13 HCTP activities, has demonstrated internal reliability ( α = .949; Disabato et al, 2019). The Assessment of Self‐Management Abilities subscale, used to measure the frequency of which nurses evaluate the youth and young adults (YYA) ability to perform self‐management skills related to their condition, has demonstrated internal reliability ( α = .930; Betz et al, 2020). In addition, this instrument explores the HCT educational needs of nurses and their overall observations of this field of practice.…”