Mikki Meadows-Oliver

Abstract

Among the many lessons that have been reinforced by the SARS-COVID-19 pandemic is the failure of our current fee-for-service health care system to either adequately respond to patient needs or offer financial sustainability. This has enhanced bipartisan interest in moving forward with value-based payment reforms. Nurses have a rich history of innovative care models that speak to their potential centrality in delivery system reforms. However, deficits in terms of educational preparation, and in some cases resistance, to considering cost alongside quality, has hindered the profession’s contribution to the conversation about value-based payments and their implications for system change. Addressing this deficit will allow nurses to more fully engage in redesigning health care to better serve the physical, emotional, and economic well-being of this nation. It also has the potential to unleash nurses from the tethers of a fee-for-service system where they have been relegated to a labor cost and firmly locate nurses in a value-generating role.

Abstract

Human trafficking is a pandemic human rights violation with an emerging paradigm shift that reframes an issue traditionally seen through a criminal justice lens to that of a public health crisis, particularly for children. Children and adolescents who are trafficked or are at risk for trafficking should receive evidence-based, trauma-informed, and culturally responsive care from trained health care providers (HCPs). The purpose of this article was to engage and equip pediatric HCPs to respond effectively to human trafficking in the clinical setting, improving health outcomes for affected and at-risk children. Pediatric HCPs are ideally positioned to intervene and advocate for children with health disparities and vulnerability to trafficking in a broad spectrum of care settings and to optimize equitable health outcomes.

Abstract

Focusing on common pediatric conditions seen in primary care settings, this text provides novice, expert, and student nurse practitioners with increased knowledge onthe most up to date recommendations about common childhood diseases and conditions. Health promotion and maintenance, child development, and family-centered care are consistently featured in each chapter, emphasizing the need to holistically carefor a child based on their specific background and condition. Growth and developmental concepts are grounded in evidence-based research to help practitioners appreciatethe physiologic and cognitive differences in children along with diverse community and cultural aspects ofcare. User-friendly information is consistently organized in outline/bulleted format to facilitate speedy access to vital knowledge. Organized by body system, each chapter providesthe reader with useful information such as the etiology, epidemiology, clinical manifestations, physical findings, diagnostic tests, differential diagnosis, treatment, follow-up and complications, and family education. Case scenarios explore each topic further and include questions and answers that help the clinician choose the best interventionfor the patient and their family. Key Features:Delivers comprehensive, evidence-based practice pediatric guidelines for experienced and novice clinicians; Stresses theimportance of the nurse’s role in pediatric health promotion; Written in outline/bulleted format for speedy access to key information; Contains abundant case studies and related Q& As to determine the best intervention; Includes a full-color image bank of dermatological conditions.

Abstract

Background: Worldwide, it is estimated that 235-334 million people have been diagnosed with asthma. In Nicaragua, the current asthma rate for children 13–14 years of age was 15.2%. Purpose: The purpose of this study was to determine the prevalence of asthma at this school-based health clinic in Managua, Nicaragua, associated symptoms or diseases, determine asthma classification, medications, and hospitalization rates. Methods: A retrospective chart review was performed on all pediatric patient's medical records seen in the clinic during a 5-day period (n = 105). Results: A total of 23 patients (21.9%) had asthma documented in the medical chart and were included in the analysis. Of the 23 patients, 3 (13%) patients were classified with intermittent asthma while the rest of the patients (87%) were not classified. Albuterol was prescribed for 19 (86%) of the patients with two patients who had both albuterol and QVAR® prescribed. Six (26%) patients had a family history of asthma. Discussion: This study demonstrated the prevalence of asthma in school-aged children in Nicaragua is significant and higher than previously reported. The lack of a classification of asthma prevents patients from potentially being treated appropriately.