Gold Anna, Wray Jo, Kosmach-Park Beverly, Bannister Louise, Wichart Jenny, Graham Ashley, Piotrowski Caroline, Mayersohn Gillian, Shellmer Diana A, Patterson Catherine
The Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Transplant. 2024 Feb;28(1):e14541. doi: 10.1111/petr.14541. Epub 2023 Aug 7.
With improved survival in pediatric solid organ transplantation (SOT) care has focused on optimizing functional, developmental, and psychosocial outcomes, roles often supported by Allied Health and Nursing professionals (AHNP). However, there is a scarcity of research examining frameworks of clinical practice.
The International Pediatric Transplant Association AHNP Committee developed and disseminated an online survey to transplant centers as a quality improvement project to explore AHNP practice issues. Participant responses were characterized using descriptive statistics, and free-text comments were thematically analyzed. Responses were compared across professional groups; Group 1: Advanced Practice Providers, Group 2: Nursing, Group 3: Allied Health.
The survey was completed by 119 AHNP from across the globe, with responses predominantly (78%) from North America. Half of respondents had been working in pediatric transplant for 11+ years. Two-thirds of respondents were formally funded to provide transplant care; however, of these not funded, over half (57%) were allied health, compared to just 6% of advance practice providers. Advanced practice/nursing groups typically provided care to one organ program, with allied health providing care for multiple organ programs. Resource constraints were barriers to practice across all groups and countries.
In this preliminary survey exploring AHNP roles, professionals provided a range of specialized clinical care. Challenges to practice were funding and breadth of care, highlighting the need for additional resources, alongside the development of clinical practice guidelines for defining, and supporting the role of AHNP within pediatric SOT. Professional organizations, such as IPTA, can offer professional advocacy.
随着小儿实体器官移植（SOT）患者生存率的提高，护理工作重点已转向优化功能、发育和社会心理方面的治疗效果，这些工作通常由专职医疗和护理专业人员（AHNP）提供支持。然而，研究临床实践框架的研究却很匮乏。
国际小儿移植协会AHNP委员会开展并向移植中心发放了一项在线调查问卷，作为一项质量改进项目，以探索AHNP的实践问题。使用描述性统计对参与者的回答进行特征分析，并对自由文本评论进行主题分析。对不同专业组的回答进行比较；第1组：高级执业提供者，第2组：护理人员，第3组：专职医疗人员。
来自全球的119名AHNP完成了该调查，其中大部分回复（78%）来自北美。一半的受访者从事小儿移植工作已超过11年。三分之二的受访者有正式资金用于提供移植护理；然而，在这些没有资金支持的受访者中，超过一半（57%）是专职医疗人员，而高级执业提供者仅占6%。高级执业/护理组通常只为一个器官移植项目提供护理，而专职医疗人员则为多个器官移植项目提供护理。资源限制是所有组和所有国家实践中的障碍。
在这项探索AHNP角色的初步调查中，专业人员提供了一系列专业临床护理。实践面临的挑战是资金和护理范围，这凸显了需要额外资源，同时需要制定临床实践指南来界定和支持AHNP在小儿SOT中的作用。像国际小儿移植协会这样的专业组织可以提供专业支持。
