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Allied health and nursing practices in pediatric solid organ transplantation: An international survey
Anna Gold1,2, Jo Wray3, Beverly Kosmach-Park4
1The Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Allied Health and Nursing Professionals (AHNP) in pediatric solid organ transplantation (SOT) provide specialized care but face funding and resource challenges. Developing practice guidelines and professional advocacy is crucial for supporting these vital roles.
Area of Science:
- Pediatric Solid Organ Transplantation
- Allied Health and Nursing Professionals
- Clinical Practice Frameworks
Background:
- Improved survival in pediatric solid organ transplantation (SOT) necessitates focus on functional, developmental, and psychosocial outcomes.
- Allied Health and Nursing Professionals (AHNP) are integral to optimizing these outcomes in pediatric SOT.
- A significant gap exists in research regarding established clinical practice frameworks for AHNP in pediatric SOT.
Purpose of the Study:
- To explore the practice issues and roles of AHNP in pediatric SOT.
- To identify challenges faced by AHNP in delivering care within transplant centers.
- To inform the development of practice guidelines and professional support for AHNP.
Main Methods:
- An online survey was developed and disseminated by the International Pediatric Transplant Association AHNP Committee.
- The survey targeted AHNP across global transplant centers as a quality improvement initiative.
- Responses were analyzed using descriptive statistics, thematic analysis of free-text comments, and comparisons across professional groups (Advanced Practice Providers, Nursing, Allied Health).
Main Results:
- 119 AHNP globally completed the survey, with most responses from North America.
- Over two-thirds of AHNP were formally funded, but a notable portion of unfunded respondents were from allied health.
- Resource constraints and the breadth of care (multiple organ programs for allied health) were identified as significant barriers.
Conclusions:
- AHNP deliver specialized clinical care in pediatric SOT, facing challenges related to funding and scope of practice.
- There is a clear need for additional resources and the development of clinical practice guidelines to define and support AHNP roles.
- Professional organizations like the International Pediatric Transplant Association can play a key role in professional advocacy for AHNP.
Introduction:
With improved survival in pediatric solid organ transplantation (SOT) care has focused on optimizing functional, developmental, and psychosocial outcomes, roles often supported by Allied Health and Nursing professionals (AHNP). However, there is a scarcity of research examining frameworks of clinical practice.
Methods:
The International Pediatric Transplant Association AHNP Committee developed and disseminated an online survey to transplant centers as a quality improvement project to explore AHNP practice issues. Participant responses were characterized using descriptive statistics, and free-text comments were thematically analyzed. Responses were compared across professional groups; Group 1: Advanced Practice Providers, Group 2: Nursing, Group 3: Allied Health.
Results:
The survey was completed by 119 AHNP from across the globe, with responses predominantly (78%) from North America. Half of respondents had been working in pediatric transplant for 11+ years. Two-thirds of respondents were formally funded to provide transplant care; however, of these not funded, over half (57%) were allied health, compared to just 6% of advance practice providers. Advanced practice/nursing groups typically provided care to one organ program, with allied health providing care for multiple organ programs. Resource constraints were barriers to practice across all groups and countries.
Conclusion:
In this preliminary survey exploring AHNP roles, professionals provided a range of specialized clinical care. Challenges to practice were funding and breadth of care, highlighting the need for additional resources, alongside the development of clinical practice guidelines for defining, and supporting the role of AHNP within pediatric SOT. Professional organizations, such as IPTA, can offer professional advocacy.
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