Home infusion teaching practices at federally funded hemophilia treatment centers in the United States of America
Bibliographic record
Abstract
Unlabelled Box •Hemophilia nurses are expected to teach home infusion (HI) to patients and their caregivers. •A survey was conducted to identify current HI teaching practices in the United States of America. •Some nurses reported lacking confidence to teach; curricula exist but their use is not uniform. •The study supports the development of national guidelines and a standard curricula to teach HI. All authors equally contributed to the research design, research analysis and authorship of manuscript. We would like to thank the HTC nurses who participated in this study and those who submitted tools and resources used at their centers. We would also like to thank the Infusion Nurses Society for approving the use of their venipuncture practice survey questions. Lastly, we would like to thank the Dutch Network of Haemophilia Nurses and the Canadian Association of Nurses in Hemophilia Care who graciously shared their current HI curriculum/manual. Background Home management of hemophilia is standard of care in many countries. This study examined current nursing practices in teaching home infusion (HI) at hemophilia treatment centers (HTC) in the USA. Objectives The aims were to identify and compare tools and resources used, areas of unmet needs, and to discuss implications for nurses in practice. Methods An anonymous electronic survey was distributed to 574 HTC nurses; 156 responses were analyzed. Results The data demonstrated that nurses, more specifically nurse coordinators, were most responsible for teaching HI. However, many nurses lack the knowledge and confidence to do so: 23.0% responded feeling somewhat or not very confident with teaching. Of those 36.4% were staff nurses, 11.9% nurse coordinators, and 41.7% advanced practice registered nurses. The majority of nurses have worked more than 5 years as a nurse, with a mean length of time of 23.7 years (SD=11.12, range 3‐47) and a mean of 12.9 years (SD=10.29, range 1‐42) in a HTC. Thirty‐eight and a half percent of nurses have worked less than 5 years in a HTC. Most nurses appeared to follow the Infusion Nurses Society standards when performing venipunctures. Many centers reported using a formal tool or curriculum to teach HI. Nonetheless, these curricula are not uniform and their use is inconsistent between centers and regions. Conclusion There are currently no national guidelines or standards to assist nurses in this task. The data confirmed the need to develop guidelines and a standardized curriculum to teach HI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".