Participatory Methods to Improve and Develop Pediatric Nursing Practice: A Scoping Review.

Area of Science:

• Nursing Science
• Healthcare Improvement
• Pediatric Care

Background:

• Children's nurses in Africa often lead practice improvements but lack contextually relevant guidance.
• African pediatric nursing is characterized by high family caregiver involvement and participatory cultures.
• Existing practice improvement methods may not be suitable for uncritical adoption in African settings.

Purpose of the Study:

• To identify participatory methods used in pediatric nursing practice improvement.
• To inform the selection of methods for a multi-center African pediatric practice improvement project.

Main Methods:

• A scoping review using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology.
• Searches of five bibliographic databases for English-language articles with no publication date limitations.
• Screening of 7,406 titles and abstracts, with 76 articles meeting inclusion criteria.

Main Results:

• A wide range of participatory methods were identified, including 34 collaborative, unnamed methods and 22 Plan-Do-Study-Act cycles.
• Significant heterogeneity existed in frameworks, tools, and nursing models used, with no clear relationship to method choice.
• Most studies originated from high-income countries, with limited evidence from low-middle-income countries and none from African settings. Family caregiver involvement was reported in less than half of the studies.

Conclusions:

• There is a need for more formalized practice improvement methods with improved reporting rigor and consistency.
• Participatory practice improvement methodologies specifically suited to the African pediatric nursing context need to be developed.
• Context-specific guidance is crucial for effective practice improvement in African pediatric settings.