PURPOSE: Although the hospital remains the dominant site for delivering most pediatric cancer care, home-based care is increasingly provided. To effectively deliver comprehensive, relevant, and acceptable care in children's homes, the voices of these key informants must be considered. We examined the views of children with cancer, their family caregivers, and clinicians on home-based cancer care to identify necessary strategies to improve the delivery of care. METHODS: Children with cancer, their family caregivers, and multiprofessional clinicians who provide care at a tertiary pediatric care center or in the community participated in audio-recorded, semistructured interviews in French and English. Interviews were conducted until data saturation in each participant group was achieved. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS: Thirteen children, 20 family caregivers, and 22 clinicians participated. Home-based care was endorsed as a means to improve child health-, family social- and financial-, and system-level outcomes. The success of a home-based model is built on care that addresses child and family informational, treatment and care, material, and psychosocial needs. Mechanisms to improve care include enhanced homecare agency-hospital-family communication, training for homecare nurses in pediatric cancer care, virtual solutions, and an expanded breadth of services provided in-home. Child-, family-, and system-related factors affect the delivery of optimal home-based care. CONCLUSION: Children, families, and clinicians value a model of pediatric cancer care that incorporates home-based services. The insights of these key informants should be reflected in the principles that become the basis of home-based cancer care best practices.

Aims: To examine the effect of a pre‐operative DVD on parents’ knowledge, participation and anxiety and on children's distress, pain, analgesic requirements and length of recovery after same‐day surgery.Background: Very few parents are adequately prepared to participate in their child's care during a same‐day surgery. An educational DVD was developed to educate parents on how to actively support their child in the recovery room.Design: Single‐blind, post‐test randomized controlled trial. Study is registered at ClinicalTrials.gov NCT02766452.Methods: Between September 2011–September 2012, 123 parent–child dyads where the child underwent an ENT or dental same‐day surgery were recruited in a Canadian paediatric hospital. Dyads were randomly assigned to either the intervention (DVD and standard preparation) or control group (standard preparation). Parents and children were videotaped in the recovery room where parental participation and anxiety and children's distress were measured. Data on parents’ knowledge, children's postoperative pain, analgesic requirements and length of recovery were measured. Independent and paired t‐tests, chi square and repeated measures anova were used to analyse the data.Results: Parents in the intervention group gained greater knowledge of and used more positive reinforcement and distraction and relaxation methods than those in the control group. Children's postoperative pain in the day‐care surgery unit was significantly lower among the intervention group compared with the control group.Conclusion: A pre‐operative DVD can increase parents’ participation in the recovery room and decrease children's postoperative pain.

Although patient centredness is part of providing high-quality health care, little is known about the effectiveness of care transition interventions that involve patients and their families on readmissions to the hospital or emergency visits post-discharge. This systematic review (SR) aimed to examine the evidence on patient- and family-centred (PFC) care transition interventions and evaluate their effectiveness on adults’ hospital readmissions and emergency department (ED) visits after discharge. Searches of Medline, CINAHL, and Embase databases were conducted from the earliest available online year of indexing up to and including 14 March 2021. The studies included: (i) were about care transitions (hospital to home) of ≥18-year-old patients; (ii) had components of patient-centred care and care transition frameworks; (iii) reported on one or more outcomes were among hospital readmissions and ED visits after discharge; and (iv) were cluster-, pilot- or randomized-controlled trials published in English or French. Study selection, data extraction, and risk of bias assessment were completed by two independent reviewers. A narrative synthesis was performed, and pooled odd ratios, standardized mean differences, and mean differences were calculated using a random-effects meta-analysis. Of the 10,021 citations screened, 50 trials were included in the SR and 44 were included in the meta-analyses. Care transition intervention types included health assessment, symptom and disease management, medication reconciliation, discharge planning, risk management, complication detection, and emotional support. Results showed that PFC care transition interventions significantly reduced the risk of hospital readmission rates compared to usual care [incident rate ratio (IRR), 0.86; 95% confidence interval (CI), 0.75–0.98; I² = 73%] regardless of time elapsed since discharge. However, these same interventions had minimal impact on the risk of ED visit rates compared to usual care group regardless of time passed after discharge (IRR, 1.00; 95% CI, 0.85–1.18; I² = 29%). PFC care transition interventions containing a greater number of patient-centred care (IRR, 0.73; 95% CI, 0.57–0.94; I² = 59%) and care transition components (IRR, 0.76; 95% CI, 0.64–0.91; I² = 4%) significantly decreased the risk of patients being readmitted. However, these interventions did not significantly increase the risk of patients visiting the ED after discharge (IRR, 1.54; CI 95%, 0.91–2.61). Future interventions should focus on patients’ and families’ values, beliefs, needs, preferences, race, age, gender, and social determinants of health to improve the quality of adults’ care transitions.

Care transitions from the hospital to home are critical to the sustainability of our health care system. Ineffective care transitions can be caused by high incidences of post-discharge adverse events, by poor communication with patients, and/or by inadequate information transfer between providers from the hospital to home. Any one of these can lead to fragmented care, high readmission rates, increased visits to the emergency department, and ultimately poor patient outcomes. Despite the ongoing improvement efforts of health care organizations, the efficacy of person- and family-centered care transition interventions on the quality of care and on the patient experience are not known. The aim of this systematic review is to critically analyze the body of evidence regarding the effectiveness of person- and family-centered care transition interventions on the quality of care, and the experience of patients. We will conduct a systematic review using the Cochrane Handbook’s guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and the Cochrane Consumers and Communication Group. Following a two-step screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed. This systematic review will summarize and present the evidence base for person- and family-centered care transition interventions. This review will also inform further research and will lay the groundwork for more empirical studies on person- and family-centered care transitions. Specifically, the results of this systematic review may inform the development of measures to monitor safe and effective person- and family-centered transitions from the hospital to home. These results may also be important for policy makers, decision-makers, clinicians, and patients/families who are involved in navigating the health care system. PROSPERO CRD42017067990

Aim: This study provides an overview of the literature to identify and map the types of available evidence on self‐supporting mobile applications used by nurses in wound care regarding their development, evaluation and outcomes for patients, nurses and the healthcare system.Design: Scoping review.Review Method: Joanna Briggs Institute scoping review methodology was used.Data Sources: A search was performed using MEDLINE, Embase, CINAHL (via EBSCO), Web of Science, LiSSa (Littérature Scientifique en Santé), Cochrane Wounds, Érudit and grey literature, between April and October 2022, updated in April 2023, to identify literature published in English and French.Results: Eleven studies from 14 publications met the inclusion criteria. Mostly descriptive, the included studies presented mobile applications that nurses used, among other things, to assess wounds and support clinical decision‐making. The results described how nurses were iteratively involved in the process of developing and evaluating mobile applications using various methods such as pilot tests. The three outcomes most frequently reported by nurses were as follows: facilitating care, documentation on file and access to evidence‐based data.Conclusion: The potential of mobile applications in wound care is within reach. Nurses are an indispensable player in the successful development of these tools.Implications for the Profession and Patient Care: If properly developed and evaluated, mobile applications for wound care could enhance nursing practices and improve patient care. The development of ethical digital competence must be ensured during initial training and continued throughout the professional journey.Impact: We identified a dearth of studies investigating applications that work without Internet access. More research is needed on the development of mobile applications in wound care and their possible impact on nursing practice in rural areas and the next generation of nurses.Reporting Method: The Preferred Reporting Items for Systematic Reviews and Meta‐analysis Extension for Scoping Review guidelines were used.Patient or Public Contribution: No patient or public contribution.