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The purpose of this paper is to share lessons learned from a quality improvement (QI) project that studied pediatric pain assessment scores after implementing additional evidence-based pain mitigation strategies into practice. Most nurses will acknowledge they implement some practices to mitigate pain during injections. Addressing pain during vaccination is important to prevent needle fear, vaccine hesitancy and health care avoidance. The aim of this project was to reduce pain as evidenced by pain scores at the time of vaccination at the North Bay Nurse Practitioner-Led Clinic (NBNPLC).

The design for this study was quasi-experimental utilizing descriptive statistics and QI tools. The NBNPLC utilized the model for improvement to test change ideas. A validated observation tool to assess pain during vaccination with the pediatric population (revised Face Legs Activity Cry and Consolability) was used to test changes. The team deliberately planned improvements according to best practice guidelines to optimize use of strategies to mitigate pain during injections. QI tools and leadership skills were utilized to improve the pediatric experience of pain during vaccinations. Parents and clinicians provided qualitative and quantitative feedback to the project.

Nurses tested pain assessment tools and agreed to use a validated tool to assess pain during vaccinations. Parents agreed to use of topical anesthetic during vaccinations. Improved pain scores during vaccinations were demonstrated with the use of topical anesthetic. Parents agreed to use of standardized sucrose solution during vaccination. Reduced pain scores were observed with the use of standardized sucrose water. To sustain implementation of the guideline, a nursing documentation form was devised with nurses agreeing to ongoing use of the form.

This is a QI project that examined the intricacies of moving clinical practice guidelines into clinical practice. The project validates guidelines for pain management during vaccinations. Leaders within clinics who want to improve pediatric pain during vaccinations will find this paper helpful as a guide.

Pain management in the pediatric population will be touched on in the context of parental expectations of pain. QI tools, lessons learned and suggestions for nurses will be outlined. Leadership plays an influential role in translating practice guidelines into practice.

This paper outlines how organizational supports were instrumental to give clinicians time to deliberately challenge practice to improve quality of care of children during vaccinations.

The aim of this study is to undertake a systemic literature review (SLR) of horticultural therapy and to explore whether its inclusion in a healthcare programme can enhance hospitalised children's well-being.

An empirical study was developed using a mixed methods approach to monitor stakeholders' perceptions of horticultural therapy. Specifically, hospitalised children (N = 31) and their families (N = 21), as well as medical and nursing staff (N = 3), were engaged in the empirical study. Qualitative and quantitative surveys were developed, involving two paediatric units in an Italian hospital.

The authors’ findings show a significant improvement of children's mood and psycho-physical well-being following horticultural therapy. The authors found positive effects of interactive horticultural therapy on hospitalised paediatric patients and their parents. Parents perceived a positive influence on their mood and found the therapy very beneficial for their children. Qualitative analyses of children's and parents' comments (and related rankings) revealed the helpful support role of horticultural therapy in dealing with the hospitalisation period. There is a very limited number of studies that have inspected co-therapy implementation in paediatric hospitals, and to the best of the authors' knowledge, no study has yet examined the effect of horticultural therapy in such a context. The practice of horticultural therapy with children in health settings has been documented in some Italian hospitals, but its effectiveness has not yet been well established in the literature.

The authors’ findings could provide useful insights to clinicians, health managers and directors in creating and sustaining a successful group co-therapy programme under the managed healthcare system.

Knowledge management is very useful to the most departments and sectors of the economy, and the healthcare sector is no exception. Thus, this paper aims to explore how healthcare professionals share knowledge in the Ghanaian healthcare sector. It also ascertains challenges faced by healthcare professionals in Ghana with regards to knowledge sharing.

The study used a case study research design. Data were collected from some healthcare professions working in the Ejisu-Juaben Municipality in Ghana using face-to-face interview. Data were analysed using thematic analysis technique.

The results show that the healthcare facilities studied do not have any formal knowledge management systems, and therefore healthcare professionals rely on informal conversations and seminars to share knowledge. Again, it was found that lack of trust, lack of technological facilities, lack of organizational policy regarding, fear of getting extra task or responsibility, network failure (both mobile phone and internet) and culture are some of the challenge healthcare professionals face in sharing knowledge.

This study contributes to the knowledge sharing literature especially in the healthcare sector in Ghana, as limited studies have been conducted in this area.

Complaints are an integral element of the quality control and clinical governance process of UK ambulance services, and form a valid and reliable way of identifying areas of practice that require improvement. The purpose of this paper is to assess to what extent such complaints and their possible causes are researched; to identify any possible areas of practice requiring further investigation.

A computerised literature search was conducted using the online databases Science Direct, Cochrane library, and Web of Science, as well as specific searches of the Journal of Paramedic Practice and the International Journal of Paramedic Practice database. Online databases were searched for peer-reviewed full research articles between January 2012 and May 2016.

A total of 125 papers were identified and after further screening 90 articles were excluded. Additional screening using the critical appraisal skills programme (2014) criterions excluded a further 21 papers, leaving 14 studies for inclusion within the review.

This review found no specific research focussing on any causes of complaints made to UK ambulance services. Moreover, no research was identified specifically investigating the top three cited themes of complaints made in the last three years. More research is required both in researching those themes of complaints already known but also determining any other possible causes of complaints made. This review has evidenced that studies investigating response times improvement strategies, ambulance staff attitudes, and educational assessments of errors, all have findings which are meaningful and valid to determining the possible causes of complaints and possible improvement strategies. Ambulance services, commissioners, practitioners, and clinical academics should endeavour to research and share causes of complaints made to improve the quality of patient care.

Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.

Legal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.

Organisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.

There is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.

This study aims to determine whether it is possible to use information and communication technology (ICT) tools to share tacit knowledge. Few studies have considered this subject, and they have reported both the ineffectiveness and effectiveness of ICT tools for sharing tacit knowledge.

In this study, the participants comprised 217 knowledge workers from New Zealand and researchers who attended a knowledge management conference in the UK. In all, 59% of the sample was men and 41% women. The research model compared the scores of knowledge workers in two categories of ICT, those that allow dialogue and those that do not, in relation to knowledge sharing in organizations. The instrument used a Likert scale with five levels of response.

It was found that not all ICT technologies let tacit knowledge to be shared, but those ICT that facilitate dialogue, for example, text messaging and video conferences. Emails did not facilitate the exchange of tacit knowledge.

It is suggested to replicate the study with different countries to evaluate the role of culture in the communication of tacit knowledge.

An implication for practitioners based on this study is that email should not be the preferred mode for transferring knowledge between an organization and their workers. This mode is adequate for the exchange of explicit knowledge, but it has a limited capacity for transferring tacit knowledge. Thus, organizations may increase the use of audio and video tools to transfer electronically tacit knowledge. Interaction or socialization may facilitate the understanding and internalization of tacit knowledge by workers.

This study contributed to understand the reason for contradictory results from previous research. ICT tools are effective to share tacit knowledge when they facilitate dialogue. Results also support practitioners about how to obtain more effective exchange of tacit knowledge in organizations.

This paper reviews the role of two significant smart technologies, artificial intelligence (AI) and blockchain technology (BT) in achieving sustainable tourism success. Such changes will maintain consistent tourism growth in the Middle East and North Africa (MENA) region by improving environmental, social and economic sustainability.

This study uses a qualitative approach focusing on AI and blockchain-based adaptations towards sustainability in technology-driven platforms, particularly in the tourism sector. However, this study is conceptualized with Day's (1989) IMRAD (introduction, methods, results and discussion) framework and Hall's (2012) suggestions. This reinforced the structure of this article by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) concept. In addition, the entire study proceeds by way of accentuating the research question.

The potential of these technologies (AI and blockchain) can internalize a win-win situation for economic prosperity and sustainable conservation of environmental resources. Even though, apathy among potential tourists (of traditional mass tourism) can be revived under sustainable tourism in the region through smart technology. Replacing traditional practices and policies with innovative technologies can reduce the adverse effect on environmental and cultural resources.

This research justifies the potential for AI and blockchain to balance economy-oriented tourism and sustainability-prone technologically advanced tourism as a caustic issue for the MENA region. Indeed, this study has revitalized and transformed the less eventful margins of leading cultural-heritage-based tourism into sustainable profitability with concerns over diversity, socio-economic conditions, economic recession and burgeoning geopolitical instability.

The purpose of this paper was to develop a predictor model for an online nutrition course on sugar reduction. The proposed model is based on health knowledge, healthy behavior, social support, self-efficacy, attitude and the health belief model in relation to people’s behavior within a Facebook group. Subsequently, the model can be used to design a robust online training course for human resources, thereby reducing the training costs which managers have experienced as being expensive.

A single pre-post experimental group design was used. Pre and post data were collected from 100 Facebook users using an online questionnaire, within a three-week intervention.

The results show a significant difference between pre- and post-test scores of health knowledge and healthy behavior, indicating an effective intervention. In addition, perceived barriers, attitude, self-efficacy and emotional support were significant predictors of the healthy behavior model, predicting 70 percent of healthy behavior. However, knowledge had no significant relationship with any of the three dependent variables (self-efficacy, attitude and healthy behavior) proposed.

This model has proved to be an effective intervention which can be used in online training of human resources, because the content of the training is known from the predictor model, thereby greatly reducing the training cost, since everything is done online. Moreover, the provided model and predictors show that the content to be delivered in the training program is not knowledge but perceived barriers, attitude, self-efficacy and emotional support.

This study is one of the first to propose an integrative model that suggests attitude and self-efficacy as key predictors of healthy behavior whereas knowledge is not.

The paper's purpose is to document a clinical study of children with Henoch‐Schonlein Purpura that facilitated decision‐making with regard to investigations, follow up and timely referral to a nephrologist.

A retrospective analysis of clinical records of 33 children diagnosed with Henoch‐Schonlein purpura who attended the Whiston Hospital Paediatric unit over a 60‐month period between January 2001 and December 2005 was performed.

In the study 53 per cent (n 17) of the patients were boys. The commonest age group affected was between five to ten years (n 17), with mean age of 7.2 years (range 1 to 17 years). Of the cases , 71 per cent (n 22) presented between July and December. Four patients (13 per cent) had haematuria on dipstick examination at presentation. Eight patients (25 per cent) had neither blood pressure measurement on admission nor a documented plan for urine dipstick or blood pressure measurement on discharge. Daily urine dipstick was performed in 47 per cent (n 15) patients with one patient having checks twice a week. Information to parents was not documented in 72 per cent (n 23) of case notes.

The need to provide better parental education and support in the form of an information leaflet was identified.

This study highlights the importance of follow up of children with HSP with emphasis on regular urine dipstick examination and measurement of blood pressure even if they remain asymptomatic to ensure that they do not develop long‐term renal impairment.