Coordinating a Multidisciplinary Discharge for the Technology-Dependent Child Based on Parental Needs

Abstract

Primary nurses, case managers, and clinical nurse specialists in pediatric settings are continually providing care for chronically ill children. With our advancing medical knowledge and technology, the concept of chronically ill children has taken on an added dimension: technology-assisted living. Technology-dependent children pose the greatest challenge for discharge into the home environment. This article identifies the chronically ill technology-dependent child and family and their needs in order to develop a chronologic plan for a successful multidisciplinary discharge.

Effect of an intervention on performance regarding change of tracheostomy tube among the caregivers of the patient

“…Ideally, the training of the caregivers in the hospital should be started as early as possible so that they are skilled enough to take care of their patients at home. Hill [15] and Lewarski [9] noted the importance of an early training phase in the discharge plan. Bakewell-Sachs and Porth noted the importance of the family's confidence and competence in the care of their patients prior to discharge and the need for early and progressive training.…”

Substantive Areas of Clinical Nurse Specialist Practice

“…[166][167][168][169][170] Clinical nurse specialists are also active in discharge planning, which prepares patients and families for the next phase of care and assists in making arrangements for that transition. 128,[171][172][173][174][175][176][177][178][179] Last, CNSs coordinate care by providing direct community follow-up by way of home visits or through telephone management. 172,[180][181][182][183][184][185] This latter aspect of CNS practice emerged in the literature over the past 2 decades, with the trend in healthcare of early discharge from acute care settings.…”

“…[113][114][115][116][117][118][119][120][121] Another prominent example is the effort by CNSs to assess the needs of and to teach, support, and advocate for family members who assume caregiving roles. 118,[122][123][124][125][126][127][128][129][130][131][132] A major feature of coordination of care is the facilitation of patients and families through and across healthcare settings, ensuring ''seamless'' provision of care. In addition to facilitating system access and proactively identifying high-risk patients and families, providing case management is frequently discussed as an integral part of CNS clinical practice.…”

Extended Hospitalization of Medically Stable Children Dependent on Technology: A Focus on Mutable Family Factors

“…Advancing medical knowledge and technology has made home care for children dependent on technology possible (Hill, 1993). However, families are expected to acquire medical knowledge, learn sophisticated medical equipment, and provide medical care to their special needs child in addition to maintaining their normal family roles and activities.…”

“…Several discharge protocols and teaching guidelines have been developed for the care of the technologydependent child and the successful transition to home (Haas, Gray, & McConnell, 1992;Huddleston & Ferrano, 1991;Lawrence, 1994;Nissim & Sten, 1991, Hill 1993.…”