Primary Care Nursing and Liver Management: A Qualitative Study from a Telemedicine Education Program (ECHO Ontario Liver)
Notice bibliographique
Résumé
CONTEXT: Nursing primary care providers (PCPs) are well-positioned to address central gaps in screening, linkage to care, and treatment of liver diseases within their teams. The Extension for Community Healthcare Outcomes (ECHO) Model™ is a telementoring education program that connects PC providers from underserved areas to an interprofessional specialist team. Each session includes a didactic lecture and a patient case presentation. ECHO Ontario Liver launched in 2017 with the goal of disseminating hepatology best practices appropriate for PC and improving PC providers’ knowledge and self-efficacy. OBJECTIVE: This study aims to explore the impact of ECHO on nursing PCPs and their role in interprofessional liver care. STUDY DESIGN: We conducted a qualitative study with nursing PCPs who attended ECHO sessions from 2017 to 2021. Focus groups were conducted virtually, recorded, and transcribed. ANALYSIS: Transcripts were analyzed using thematic content analysis. Researchers met regularly to discuss themes until consensus was reached. SETTING: Ontario, Canada POPULATION STUDIED: Nursing professionals (nurse practitioners, NPs, registered nurses, RNs, and registered practical nurses, RPNs) INTERVENTION: ECHO Ontario Liver OUTCOME MEASURES: Focus group discussions explored PCPs’ experience in ECHO, their role in liver care management (interprofessional collaboration), and impact of ECHO on practice. RESULTS: Three focus groups were conducted between November 2021 and January 2022. Six participants were NPs, four were RNs, and one was a RPN. Six (55%) providers practiced in rural communities. All were female. Nursing PCPs involved in different levels of liver management were interviewed. They played active management roles from coordinating appointments to providing wraparound patient services. ECHO allowed participants to access specialty knowledge and education they did not receive in their training. Though PCPs practiced on a team, these individuals become the point person on their team to attend ECHO, gaining advanced training in this disease area. Participants also used the ECHO patient case presentation and recommendations as a means of advocating for care on their clinical teams. CONCLUSIONS: Nursing PCPs play a variety of roles within the management of liver disease on their clinical teams. ECHO Ontario Liver increased participants’ access to specialty liver knowledge and case presentations and recommendations were often used as a means of advocacy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,013 | 0,007 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».