{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:35:13Z","timestamp":1777361713436,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T00:00:00Z","timestamp":1570406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Home parenteral nutrition (HPN) is a life\u2010sustaining therapy for children and adults suffering with severe digestive diseases, yet complications are commonplace, and predischarge trainings are variable. High\u2010fidelity simulation training provides participants with an immersive experience using realistic equipment, supplies, and scenarios. Simulation training is rapidly becoming a potential gold standard for healthcare but is currently underutilized for families and caregivers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively collected data on pediatric patients managed at a single HPN program from September 1, 2016, to September 30, 2018. Participants in a pilot simulation\u2010based training program (orientation, high\u2010fidelity mannequin, realistic homelike space, standardized clinical scenarios, and structured debriefing) were compared with historical controls. We excluded patients with short\u2010term HPN use and strictly palliative goals of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen (90%) families participated in the pilot initiative with a median (interquartile range) age of 0.9 (3.7) years and diagnosis of short\u2010bowel syndrome in 14 (74%). During teaching scenarios, learning gaps were identified for aseptic needleless changes (53%), HPN equipment setup (84%) with specific difficulty adding multivitamin (32%), and dressing changes (63%). Thirty\u2010day readmission rates in simulation\u2010based training group vs historical cases were 42% vs 63% (<jats:italic>P<\/jats:italic> = not significant). There was no difference in length of stay between groups. All (100%) simulation\u2010based training group participants would recommend this learning experience to others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HPN discharge training is a novel use for high\u2010fidelity simulation to address family\/caregiver satisfaction and to identify learning gaps. Further studies are needed to refine predischarge training materials and examine the impact on postdischarge outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ncp.10421","type":"journal-article","created":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T08:15:01Z","timestamp":1570436101000},"page":"489-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Learning Gaps and Family Experience, Nurse\u2010Facilitated Home Parenteral Nutrition Simulation\u2010Based Discharge Training: Proof\u2010of\u2010Concept Study"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-5974","authenticated-orcid":false,"given":"Bram P.","family":"Raphael","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Takvorian\u2010Ben\u00e9","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Gallotto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Tascione","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"McClelland","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Rosa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nutrition Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Dinan","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Simulator Program Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianna","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Simulator Program Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Child Life Services Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Weinstock","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Boston Children's Hospital Simulator Program Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Department of Anesthesiology Critical Care and Pain Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115586575"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4182"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1158"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116664785"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.188351"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.26007"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002058"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1367493512461459"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533612464888"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.283057"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3928\/01484834-20040401-04"},{"key":"e_1_2_7_13_1","volume-title":"The Modern Practice of Adult Education: From Pedagogy to Andragogy. 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