Assessment Checklist Research Articles

Evaluation of Preclinical Class I Amalgam Cavity Preparation: A Comparison of Two Assessment Methods

Preclinical assessment forms an effective strategy in undergraduate training. It enhances the continuous development of skills, facilitates early intervention, and optimizes training resources. Constructive feedback provided to the student fosters continuous improvement in preparedness for professional practice and has implications for the development of a learning culture characterized by student activity. This indeed ensures that a smooth transition will be made toward clinical application of skills. The aim of the study was to evaluate examiner`s reliabilities while applying two different assessment methods: a Glance and Grade assessment method and a Checklist and Criteria assessment method. A total of 100 class I amalgam cavity preparations were assessed by three independent examiners to evaluate Class I amalgam cavity preparations on artificial first mandibular molar teeth prepared by second-year undergraduate dental students in a preclinical laboratory setting. Statistical analysis for inter-examiner and intra-examiner variability was tested using one-way ANOVA test and a paired t-test, respectively. Results of this study showed that intra-examiner variability was significantly reduced with Checklist and Criteria assessment method. The inter-examiner variability was present in a Glance and Grade assessment method while with the Checklist and Criteria assessment method, there was an extremely high level of agreement among the examiners. The study's findings indicated considerable variability among examiners using the Glance and Grade assessment method. However, the Checklist and Criteria assessment method demonstrated remarkable consistency among examiners, indicating that it may offer a more standardized and reliable approach to evaluation.

Postoperative bleeding outcome of fresh frozen plasma prime in pediatric cardiac surgery: A systematic review & meta-analysis.

Bleeding after cardiac surgeries holds risk of mortality and morbidity in pediatrics. This systematic review aimed to evaluate postoperative blood loss and blood transfusion requirements for pediatric patients undergoing cardiac surgery with fresh frozen plasma (FFP) priming. In 2024, the search reviewed four databases on randomized trials (RCTs) examining the impact of FFP prime intervention on 24-h postoperative blood loss and transfusion requirements in pediatric cardiac surgeries. The journals were appraised using Grading of Recommendation Assessment, Development, and Evaluation checklists, and random effects models estimated the effect size with a 95% confidence interval. Significance and study heterogeneity were indicated by p-values and I2. Of the screened 2070 articles, one high-quality and four moderate-quality RCTs involving 354 children were identified. No significant reduction in 24-h mean postoperative blood loss was found following FFP priming (mean difference MD: -0.78, 95% CI [-3.3 to 1.75], p = .55) in general pediatric cardiac surgeries. However, subgroup analysis showed significant decrease in blood loss for younger children (<7 months) or those with lower body weight (<6kg). There was no significant difference between groups in FFP (MD: -0.19, 95% CI [-0.42 to 0.05], p = .13) or red blood cell transfusion (MD: -0.25, 95% CI [-0.51 to 0.02], p = .07). Administering FFP as prime fluid in cardiac surgery did not reduce postoperative bleeding in general pediatric patients, but younger children (<7 months) and those with lower weight (<6kg) were the subjects who benefited from the FFP priming before surgery.

Predicting hospital readmission in multimorbid patients with the use of AI: A systematic review

Abstract Background Multimorbid patients are at higher risk of hospital readmission due to the complex nature of their conditions. Identifying those who may be at particularly high risk would allow us to intervene early and potentially delay or prevent such readmissions occurring, thus reducing healthcare costs. We conducted a systematic review investigating the use of machine learning models in predicting 30-days unplanned hospital readmission of multimorbid patients. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines, and was registered with PROSPERO (CRD42022373937). We searched MEDLINE, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Included studies developed an AI model for prediction of 30-days hospital readmission for adult patients with two or more health conditions. The CHARM and PROBAST checklists for data extraction and bias assessment were used. The quality of included studies was assessed with the CASP checklist. Results Eighteen papers were eligible for inclusion. A total of 669 predictors were reported with an average of 37 used per model. Predictors were classified as modifiable and non-modifiable with the most common modifiable predictors being hospital length of stay, hypertension, anaemia and obesity. Average sensitivity and specificity of the models was reported to be 72% in 13 studies and 79.2 in 11 studies, respectively. Area under the curve (AUC) was reported in 13 studies, five of which were considered to have good discrimination power (AUC&amp;gt;0.8). Conclusions Machine learning models are capable of accurately predicting 30-days hospital readmission of multimorbid patients. Identifying modifiable predictors with highest weight allows for better planning and resource allocation to potentially reduce the risk of 30-days readmissions. An important area for future work would be the implementation of these high performance models in practice. Key messages • Hospital readmissions are preventable and identifying those at higher risk allows us to intervene early. • Machine learning models are capable of predicting 30-days readmission of multimorbid patients.

Development of a Cognitive Assessment Checklist for First-Grade Mathematics: Utilizing Hierarchical Cognitive Diagnostic Modeling in Elementary Education

This study aimed to address the need for a comprehensive assessment tool to evaluate the mathematical abilities of first-grade students through cognitive diagnostic assessment (CDA). The primary challenge involved in this endeavor was to delineate the specific cognitive skills and sub-skills pertinent to first-grade mathematics (FG-M) and to determine the most suitable model for assessment. Employing a mixed-methods approach, the research identified nine cognitive attributes essential for FG-M and developed a Q-matrix delineating the relationship between these attributes. A preliminary version of the FG-M checklist comprising 74 items was formulated. Subsequently, the assessment tool was administered to 1018 first-grade students, with their teachers utilizing the FG-M checklist for evaluation. Results indicated a commendable accuracy in classifying the nine cognitive attributes, ranging from 0.68 to 0.92, with an average accuracy of 0.76. Furthermore, the validity of the scores was corroborated by a substantial correlation (r = 0.78) between scores from the FG-M checklist and the arithmetic subtest of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Overall, the study concluded that the scores from the FG-M checklist are reliable for assessing the mathematical skills of first-grade students. The findings underscored the students’ proficiency in fundamental mathematical concepts such as cardinality, addition, subtraction, weight, and statistics. However, areas of weakness were identified in concepts related to multiplication, time, symmetry, and geometry. This research contributes significantly to the advancement of CDA in educational contexts, providing educators with a valuable tool for identifying students’ strengths and weaknesses in mathematical cognition.

Serviced Housing for Older People and Prevention of Functional Decline: A One-year Follow-up Study in Japan.

Serviced Housing for Older People (SHOP) is a community-based housing model in Japan that provides barrier-free apartments and support services for residents. Whether the SHOP model has positive effects on residents' health remains unclear. This follow-up study examines the association between living in SHOPs and functional decline. Using data from the Japan Gerontological Evaluation Study, we compared functional decline risks at one-year follow-up between older adults living in conventional housing (n = 2202) and SHOP residents (n = 160). Functional decline risk was assessed using the Kihon Checklist (KCL) and Care-Need Risk Assessment Scale (CNRAS). SHOPs residents had lower KCL and CNRAS scores than older adults living in conventional housing. In sensitivity analyses, these associations remained unchanged. The results, thus, showed that residing in SHOPs was associated with reduced functional decline; therefore, SHOPs designed to support residents' physical and social health could be important for supporting aging in place.

Effect of telenursing on self-efficacy among diabetic patients: A systematic review

This systematic review aimed to investigate the impact of telenursing on self-efficacy among patients who have experienced myocardial infarctions. The study conducted a comprehensive search of international electronic databases, including Scopus, PubMed, and Web of Science, spanning from the earliest available records to September 15, 2023. The search used keywords derived from Medical Subject Headings, specifically "telenursing", "self-efficacy", and "myocardial infarction". Additionally, Iranian databases such as Iranmedex and Scientific Information Database were consulted. The quality assessment of included studies, which consisted of randomized controlled trials (RCTs) and quasi-experimental studies, was performed using the Joanna Briggs Institute's (JBI) critical assessment checklist. The review included a total of five studies involving 478 diabetic patients. Among these patients, 74.32% were female, and 52.00% were allocated to the intervention group. The average age of the participants was 48.76 (SD=7.48) years. The mean duration of the studies and their respective follow-up periods were 32.80 and 12.80 weeks, respectively. Furthermore, the average duration of the telenursing intervention was 23.33 minutes. The findings of this review indicated that telenursing can be an effective method for enhancing self-efficacy among patients. The study suggests that healthcare managers and policymakers should consider establishing a platform that not only incorporates telenursing via phone calls but also incorporates alternative methods like video calls. This approach should aim to balance the costs associated with these different methods to ensure accessibility for all individuals. Consequently, alongside traditional telephone-based telenursing, other modalities can be integrated to promote self-efficacy.

Evaluation of Measure Dx, a Resource to Accelerate Diagnostic Safety Learning and Improvement.

Several strategies have been developed to detect diagnostic errors for organizational learning and improvement. However, few health care organizations (HCOs) have integrated these strategies into routine operations. To address this gap, the Agency for Healthcare Research and Quality released "Measure Dx: A Resource To Identify, Analyze, and Learn From Diagnostic Safety Events" in 2022. We conducted an evaluation of Measure Dx to measure feasibility of implementation and effects on short-term and intermediate outcomes related to diagnostic safety. Prospective observational study. Teams from 11 HCOs, primarily academic medical centers. Participants were asked to use Measure Dx over approximately 6months and attend monthly virtual learning collaborative sessions to share and discuss approaches to measuring diagnostic safety. Descriptive outcomes were gathered at the HCO level and included uptake of different case-finding strategies and the number of cases reviewed and confirmed to have diagnostic safety improvement opportunities. We collected information on organizational practices related to diagnostic safety at each HCO at baseline and at the conclusion of the project. The 11 HCOs completed all requirements for the evaluation. Each of the four diagnostic safety case finding strategies outlined in Measure Dx were used by at least three HCOs. Across the cohort, participants reviewed 703 cases using a standardized data collection instrument. Of those cases, 224 (31.8%) were identified as diagnostic safety events with improvement opportunities. Unexpectedly, self-ratings on the checklist assessment declined for several organizations. Use of Measure Dx can help accelerate implementation of systematic approaches to diagnostic error measurement and learning across a variety of HCOs, while potentially enabling HCOs to identify opportunities to improve diagnostic safety practices.

Natural history of otitis media with effusion without hearing loss in children under 12 years: a systematic review

ObjectiveThis study aimed to evaluate the natural history of otitis media with effusion (OME) without hearing loss in children under 12 years.MethodsWe performed a systematic search in Embase, CINAHL, MEDLINE,...

Comparison of the effects of medication error encouragement training and problem-based scenario on the medication safety competence and knowledge of nursing students: A quasi-experimental study

BackgroundMedication errors among nursing students pose a threat to medication safety. Medication Error Encouragement Training and Problem Based Scenario are two innovative educational methods used in medication education. AimCompare the effects of Medication Error Encouragement Training and Problem Based Scenario on the knowledge and competency of medication safety among nursing students. DesignQuasi -experimental, double-blind, two-group pretest-posttest study. MethodThis study was conducted in 2023. Participants were randomly assigned to two groups: one group received the Medication Error Encouragement Training method, while the other group was taught using the Problem-Based Scenario method. Data collection was performed using the Medication Safety Critical Element Checklist and Medication Safety Knowledge Assessment before and four weeks after the intervention. Data analysis was conducted using SPSS version 16. ResultsThe Pair t-test demonstrated that the change in competency and knowledge scores of medication safety before and after the intervention was significant in both groups (P< 0.05). The results of the Mancova test indicated a significant increase in medication safety competency scores in the Medication Error Encouragement Training group compared with the Problem Based Scenario group after the intervention (P< 0.05), while there was no significant difference in medication safety knowledge scores between the two groups after the intervention (P> 0.05). ConclusionThe Medication Error Encouragement and Problem Based Scenario methods were effective in increasing the knowledge and competency of medication safety among students, but the effectiveness of the Medication Error Encouragement method was more pronounced in achieving safe medication administration.

Reliability and Validity Evidences of Tej Emotional and Behavioral Problem Checklist (TEJ-CL) for Child Mental Health Assessment in Nepal

Introduction: The Tej Emotional and Behavioral Problem Checklist (TEJ-CL) was developed in Nepalese context to aid assessment of childhood emotional and problems of children. This study aimed to evaluate TEJ-CL's factor structure, reliability, and validity evidences as an add-on and symptom monitoring test.Methods: This cross-sectional validation study included guardians of 320 children (age 5 – 17 years) from tertiary mental health centers in Kathmandu as referred group, along with 601 children from two schools (private and community) in Kathmandu as non-referred group.Study was conducted after obtaining ethical approval (ref: 183 (6-11-E)2/073/074 and ref: 776). TEJ-CL, an 89-item parent-reported questionnaire, served as the index test, while referral status acted as the reference standard. Factor structure, internal consistency, test-retest/ cross-informant correlations and criterion validity evidence was assessed using principal component analysis, coefficient alpha, spearman's rank correlation and linear regression models, respectively.Results: Analysis was done using 179 referred and 412 non-referred individuals based on non-missing data. Principal component analysis in referred sample reduced the number of items of questionnaire to 65 from 89 and indicated six factors: externalizing behavioral issues, anxiety/worries, upset/sadness, somatic concern, miscellaneous syndrome, and severe issues with coefficient alpha ranging from .62 to .95. As criterion validity evidence, referred children showed significantly higher scores than non-referred children across composite and factor scores, except for anxiety/worries factor. Similarly, regression analyses within the referred group demonstrated significant associations between factor scores and specific diagnoses.Conclusions: Reliability and validity estimate of questionnaire is comparable to similar empirically based scales. Future research should focus on assessing the tool's generalizability and improving discriminatory indexes.

Effect of telenursing on self-efficacy among myocardial infarction patients: A systematic review

A systematic review was conducted to investigate the impact of telenursing on self-efficacy in patients who have experienced Myocardial infarction (MI). We systematically searched international electronic databases, including Scopus, PubMed, and Web of Science, from their inception to September 1, 2023, using keywords derived from Medical Subject Headings such as "telenursing", "self-efficacy", and "myocardial infarction". Furthermore, we explored Iranian databases like Iranmedex and Scientific Information Database. The quality of randomized controlled trials (RCTs) and quasi-experimental studies was assessed using the critical assessment checklist from the Joanna Briggs Institute (JBI). A total of 220 MI patients were enrolled in four studies. Of the MI patients, 67.29% were male and 50.00% were in the intervention group. The mean age of participants was 57.25 (SD=7.34) years. Of the included studies, four were quasi-experimental studies, three studies were conducted in Iran, and one study was conducted in Egypt. The mean study follow-up was 6 weeks. Also, the mean duration of the intervention was 11.67 minutes. In all studies, interventions were effective in increasing MI patients' self-efficacy. In sum, the findings demonstrated that telenursing can be effectively utilized by nurses to enhance the self-efficacy of patients. We recommend that healthcare managers and policymakers establish a platform that not only incorporates telenursing via telephone calls but also integrates other methods, such as video calls. This approach should aim to balance the costs associated with different telenursing methods, ensuring accessibility for all individuals. Consequently, in addition to traditional telephone calls, alternative telenursing modalities can be employed to enhance self-efficacy.

Effect of acupressure on anxiety in hemodialysis patients: A systematic review

This systematic review was conducted to investigate the impact of acupressure on anxiety levels among patients undergoing hemodialysis. International electronic databases, including Scopus, PubMed, and Web of Science, were meticulously searched from the inception of the databases to January 8, 2024, employing keywords derived from Medical Subject Headings such as "Acupressure", "Anxiety", and "Hemodialysis". Additionally, Iranian databases such as Iranmedex were scrutinized. The quality of randomized controlled trials was assessed using the Joanna Briggs Institute's (JBI) critical assessment checklist. A total of four studies, encompassing 496 participants, were included in the analysis. Among the participants, 51.00% were female, with 67.34% allocated to the intervention group. The mean age of the participants was 40.48 (SD=8.75) years. The average study duration and follow-up period were approximately 28 and 4 weeks, respectively. The average intervention duration was 8.33 minutes. The findings underscored the efficacy of acupressure administered by healthcare professionals, such as nurses, in mitigating anxiety levels. This underscores the recommendation for healthcare managers and policymakers to create an environment conducive to the utilization of acupressure by healthcare professionals within hospital settings. Such measures can contribute to the alleviation of anxiety among patients undergoing hemodialysis.

Effects of reflexology on pain in patients with rheumatoid arthritis: A systematic review

This systematic review was conducted to investigate the impact of reflexology on pain management in individuals diagnosed with rheumatoid arthritis. A comprehensive search was executed on international electronic databases, including Scopus, PubMed, Web of Science, and Iranian electronic library including Iranmedex and Scientific Information Database, covering the earliest available data up to January 25, 2024. The search employed keywords derived from Medical Subject Headings such as "reflexology", "pain", and "rheumatoid arthritis". The quality assessment of randomized controlled trials (RCTs) was conducted using the Joanna Briggs Institute's (JBI) critical assessment checklist. A total of four studies, encompassing 206 participants, were included in the review. Notably, 70.97% of the enrolled patients were female, with 61.17% assigned to the intervention group. The mean age of participants was 50.06 (standard deviation [SD]=8.48) years. The average study duration and follow-up period were approximately 25 and 5 weeks, respectively, with an intervention duration averaging 40 minutes. In three studies interventions were effective in decreasing pain of patients with rheumatoid arthritis. However, in one study, the intervention was not effective in decreasing pain of patients with rheumatoid arthritis. The findings indicated that health professionals, including nurses, can effectively employ reflexology as a means to alleviate pain in individuals with rheumatoid arthritis. Consequently, it is recommended that healthcare managers and policymakers create an enabling environment within hospitals, facilitating the integration of reflexology into patient care protocols. This strategic approach holds the potential for reducing the pain experienced by patients afflicted with rheumatoid arthritis.

Checklist of Aquatic Macrophytes and Water Quality Assessment of Kakarikata Beel, Jorhat District, Assam

Checklist of Aquatic Macrophytes and Water Quality Assessment of Kakarikata Beel, Jorhat District, Assam

Good Intentions, Risky Inventions: A Method for Assessing the Risks and Benefits of AI in Mobile and Wearable Uses

Integrating Artificial Intelligence (AI) into mobile and wearables offers numerous benefits at individual, societal, and environmental levels. Yet, it also spotlights concerns over emerging risks. Traditional assessments of risks and benefits have been sporadic, and often require costly expert analysis. We developed a semi-automatic method that leverages Large Language Models (LLMs) to identify AI uses in mobile and wearables, classify their risks based on the EU AI Act, and determine their benefits that align with globally recognized long-term sustainable development goals; a manual validation of our method by two experts in mobile and wearable technologies, a legal and compliance expert, and a cohort of nine individuals with legal backgrounds who were recruited from Prolific, confirmed its accuracy to be over 85%. We uncovered that specific applications of mobile computing hold significant potential in improving well-being, safety, and social equality. However, these promising uses are linked to risks involving sensitive data, vulnerable groups, and automated decision-making. To avoid rejecting these risky yet impactful mobile and wearable uses, we propose a risk assessment checklist for the Mobile HCI community.

Development of theoretical framework and digital competence assessment checklist (DCAC) for nursing students

BackgroundThe rapid development of digital technology impacts all aspects, including nursing education. Nursing programs are tasked with equipping graduates with both clinical skills and digital competence. However, inconsistencies in the conceptual understanding of digital competence in nursing literature, underscore the need to refine the concept. DesignThis study involved two phases including a modified Delphi approach and psychometric testing. In Phase 1, the panel of experts in nursing was invited to evaluate the theoretical framework, domain, and item of assessment checklist. In Phase 2, the psychometric properties of the assessment checklist were tested using a quantitative survey. SettingThe study was conducted in Taiwan, Indonesia, and Vietnam. ParticipantParticipants included 12 nursing experts from Taiwan, Indonesia, and Vietnam during the development phase and 417 nursing students from these countries in the validation phase. MethodsPhase 1 utilized a modified Delphi approach establishing a theoretical framework and assessment checklist. Experts provided feedback on a Likert scale, aiming for consensus. Phase 2 involved a quantitative survey where graduate nursing students rated the DCAC. The analysis process following the recommendation of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). ResultsThe theoretical framework defined digital competence across four domains. In the first Delphi round, all items were rated above the consensus threshold. After two rounds, the CVI ranged from .8 to 1.0, suggesting strong agreement among experts. The second phase revealed high discriminant validity among survey items, with Cronbach's alpha indicating high internal consistency. The refined 22-item DCAC showed improved fit indices, confirming the assessment checklist's structure. ConclusionThe developed 22-item DCAC is a valid and reliable tool for measuring digital competence among nursing students. Integration of digital competence into nursing education is essential for preparing students to excel in the healthcare environment.

Wasting and its associated factors among under-two years children in Ethiopia: a systematic review and meta-analysis

IntroductionGlobally, about 45 million under-five children have suffered from wasting where Asian and African countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia.MethodsThe search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research repositories from June 19–22/2023. The review included articles published between January 2013 and December 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies was evaluated using Cochrane Q-test and the I2 statistics. Publication bias was checked through graphical and statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight.ResultsThe pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97–12.85; I2 = 86.36%). Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20–5.26), no exclusive breast feeding until six months (OR; 5.30; 95%CI: 1.17–9.43), current illness of the child (OR; 2.58: 95%CI: 1.78–3.37), large family size (OR; 12.38; 95%CI: 1.37–26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting among under-two children.ConclusionsThis study disclosed that the pooled prevalence of wasting among under- two children were high in Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households, large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of malnutrition. This review registered at PROSPERO with registration number CRD42023414914 (https://www.crd.york.ac.uk/prospero/#myprospero).

Evaluation of Home Safety Assessment Checklists for the Aging Population: A Scoping Review

This systematic review aimed to evaluate the checklists available for assessing home safety among older adults in their home. We conducted a comprehensive search on PubMed, Scopus, SafetyLit, and Web of Science, covering the period from 2000 to December 2022. We identified 22 articles or documents were included in the review. The acquired documents encompassed a diverse range of checklists/tools, featuring evaluations from seniors, nonprofessionals, and experts. Additionally, the quantity of items in each was accurately determined. The findings of this study can inform the development of a checklist for evaluating the safety of older adults’ homes in diverse societies.

EP465 - Transfusion Associated Circulatory Overload (TACO) Audit - A prospective analysis of adherence to standards ensuring safe transfusions

Abstract Aims TACO is defined as acute or worsening respiratory compromise during or up to 12 hours of transfusion, with additional features including cardiovascular system changes not explained by the patient’s underlying medical condition. In the UK, TACO remains a major cause of Morbidity in surgical post operative patients. The aim of this audit was to assess whether the current trust transfusion practices are synchronous with the NICE guidelines and SHOT recommendations. Methods We reviewed 27 incidences of transfusion during the whole month in acute general surgical ward. Patient’s notes, trust intranet and EPMA were used for data collection. The adherence to Ng24 as well as latest SHOT recommendations was checked. Following standards were taken into account: A formal pre-transfusion risk assessment for transfusion-associated circulatory overload (TACO) should be undertaken for all patients receiving blood transfusion and mitigating actions taken. (Serious hazards of transfusion SHOT recommendation) Patients who develop respiratory distress during or up to 24 hours following transfusion where transfusion is suspected to be the cause must be reported to SHOT. A structured incident review should be undertaken for every case of TACO. Weight-adjusted red cell dosing should be used. (NICE Guidelines Ng24) Result TACO assessment checklist was only completed for 15% of transfusions (compared to 35% nationally) while mitigation actions were only considered for 4% of patients. There appeared discordance among junior doctors regarding TACO Management. Conclusions Interventions like teaching sessions, information leaflets and posters, presentation for induction pack and liaison with Transfusion practitioner team to modify transfusion pathway significantly reduced inconsistencies regarding safe transfusions and immensely improved patient management.

Integrating Emotional Health Assessments into Pediatric Care: Initial Learnings from an MOC Part 4 Activity

Introduction: Living with a chronic condition often impacts the emotional health of children. Pediatricians frequently feel unprepared to address these concerns. The American Board of Pediatrics Roadmap Project aims to support these clinicians. We describe the results from the initial cohort of pediatricians who completed the American Board of Pediatrics Maintenance of Certification (MOC) Roadmap Part 4 activity. Methods: The Roadmap MOC activity uses a standardized improvement template with accompanying resources to guide participants. Physicians self-assess their ability to provide emotional health support by completing a Roadmap Readiness Checklist and creating a personal project relevant to their practice. They collect data at three time points: baseline, midpoint, and completion for two measures (the Readiness Checklist and a participant-selected measure). Physicians also reflect on their experience. Results: Of the initial cohort of 29 physicians, 22 submitted three sequential checklist assessments. Scores increased for “developing a family resource list” (by 90%), “confidence to address emotional health” (79%), “having a family crisis plan” (78%), and “staff awareness” (34%). Twenty-four physicians who measured whether clinical encounters addressed emotional health documented an increase from 21% to 77%. Physician feedback was positive, for example, “This project has had a profound impact on our care of children.” Conclusions: This initial cohort of participants improved on the Readiness Checklist and emotional health assessment. Both generalist and subspecialty pediatricians found the activity useful and relevant, suggesting that this MOC Part 4 activity is a feasible resource for supporting physicians in addressing emotional health.