Journal of Children and Young People's Health

Background There is currently limited exploration of how paediatric nurses understand and contextualise health literacy in everyday clinical practice. This study aimed to develop an understanding of health literacy among paediatric nurses in their clinical practice.

Methods A mixed methods cross-sectional survey of nurses at a specialist, state-wide paediatric hospital and health service was undertaken between 28 January – 22 February 2019. Quantitative data were analysed descriptively in Stata, and qualitative data analysed thematically.

Findings In total, 248 nurses completed the survey (15% response rate). Whilst almost all respondents identified the high importance of health literacy in patient outcomes (96%), only 20% of respondents had previous health literacy education and exhibited knowledge of the meaning of health literacy. Conceptually, health literacy definitions were based across the domains of ‘health’ and ‘literacy’, varying between biomedical health, self-management and health systems, and between terminology to consumer informed decision-making and participation. Previous learning was identified predominantly as self-directed or through workplace experience, with face-to-face (82%) and online sessions (65%) reported as the most beneficial education methods.

Discussion Within this novel paediatric nursing population study, limited understanding of health literacy was reported, potentially impacting consumer knowledge requirements for quality care.

Conclusion Although limited by a low response rate, this study demonstrates that most nurses consider health literacy highly important for patient outcomes. The introduction of multi-modal health literacy education programs, predominantly conducted face-to-face, may be beneficial in improving nursing knowledge and skills.

This paper explores the impact of the COVID 19 pandemic (https://covid19.who.int/) on children and examines the extent to which their rights were taken into account compared to the rights of others. Decisions that impact children so significantly need to be proportionate to the impact and weighed against the rest of the population. The primary consideration of authorities needs to be in the best interests of the child, ensuring the voice of children is heard and their experiences considered in future responses to and recovery from such events.

Problem Periods of rapid service change represent significant challenges but also opportunities for service delivery. The aim of this project was to evaluate the successes, challenges and barriers experienced by staff delivering care via videoconference (VC) during the COVID‑19 lockdowns in a child health service (CHS) in Queensland, Australia, and make recommendations to guide ongoing use.

Methods A qualitative and quantitative evaluation was conducted. Participants consisted of child health nurses (CHNs), early intervention clinicians (EIC) (social workers and psychologists), advanced health workers (AHWs) and administration officers (AOs). A six-step thematic analysis approach was applied to generate themes from the qualitative data collected in a staff survey. Quantitative data was also obtained from the staff survey and an audit of the service database to identify staff use of VC over time.

Findings Significant differences in clinical staff use of VC were identified. EICs (86%) used VC more with clients than CHNs (65%). Four key themes identified were: navigating systems; having the right “set up”; having the skills and confidence; and working out where it fits. Changes to VC systems as well as difficulties with appointment scheduling and associated processes all influenced the adoption and ongoing use of VC. Polarised views existed about the suitability of VC for different practice elements, roles and clients. When barriers were encountered, services often defaulted to telephone consultations.

Conclusion This evaluation highlights the challenges of implementing VC to enhance services. Having systems in place that are easy to use, processes that are lean, and peer support networks are all key to embed the use of VC.