Nurse Practitioner–Led Telehealth to Improve Outpatient Pediatric Tracheostomy Management in South Texas

Moreno, Laura; Peck, Jessica L.

doi:10.1016/j.pedhc.2019.11.008

Cited by 18 publications

(22 citation statements)

References 13 publications

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“…These patients could be seen on an alternating schedule: in-office and telehealth to ensure their current management is optimal for their respiratory function. A study was done evaluating nurse practitioner-led telehealth visits with outpatient pediatric tracheostomy patients in South Texas (Moreno & Peck, 2020). Telehealth was offered to patients who lived more than 241.4 km from the primary clinic site.…”

Section: Resultsmentioning

confidence: 99%

Patient Satisfaction with Telehealth During the COVID-19 Pandemic in a Pediatric Pulmonary Clinic

Capusan¹,

Fenster²

2021

Journal of Pediatric Health Care

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has drastically impacted health care delivery systems and has resulted in the rapid implementation of telehealth services across many health care specialties. As the COVID-19 pandemic highlighted the need to leverage digital mediums to increase patient access to health care, our pediatric pulmonary division sought to measure patient satisfaction with a new telehealth platform. Method: A survey was sent to 281 pediatric pulmonary patients from March 2020 to April 2020. Parents were asked to rate their overall experience with telemedicine. Results: Fifty surveys were completed, and results indicated that overall initial satisfaction with care was high. Eighty-two percent of participants either strongly agreed or agreed that they would use telehealth services again. Discussion: The positive outcome measures may reflect increased patient comfort with integrating telehealth into routine pediatric pulmonary care services. Given high patient satisfaction ratings, we believe that the telehealth platform should be considered for use in routine practice after the COVID-19 pandemic has resolved.

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Section: Resultsmentioning

confidence: 99%

Patient Satisfaction with Telehealth During the COVID-19 Pandemic in a Pediatric Pulmonary Clinic

Capusan¹,

Fenster²

2021

Journal of Pediatric Health Care

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“…21 Thus, after discharge from hospital, querying caregivers with intermittent telephone calls may help reduce their anxiety. 22 COVID-19 may be of particular concern to mothers of children with tracheostomy and chronic diseases, as it is known to cause pneumonia and other severe symptoms in children with chronic diseases. Therefore, informing mothers of children with tracheostomy, who are naturally worried about lower respiratory tract infections, about COVID-19 may help reduce their anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…21 Thus, after discharge from hospital, querying caregivers with intermittent telephone calls may help reduce their anxiety. 22…”

Section: Discussionmentioning

confidence: 99%

Anxiety Levels of Primary Caregivers of Children With Tracheostomy During the COVID-19 Pandemic

Onay

Gürsoy

Eyüboğlu

et al. 2021

Clin Pediatr (Phila)

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We aim to evaluate the anxiety levels of caregivers of children with tracheostomy during the COVID-19 (coronavirus disease 2019) pandemic. Caregivers of 31 children with tracheostomy and 105 healthy children (control group) were included. The State-Trait Anxiety Inventory was administered via teleconference in order to investigate how participants describe how they feel at a particular moment (State) and how they generally feel (Trait). The trait anxiety levels of caregivers of children with tracheostomy were significantly higher ( P = .02). Their state anxiety levels were similar. The state and trait anxiety levels of caregivers of children with tracheostomy correlated ( r = 0.70, P < .001). At the end of the teleconference, caregivers of children with tracheostomy experienced greater anxiety relief than controls ( P < .001). Trait anxiety scores were higher among caregivers of children with tracheostomy, but their state anxiety levels were comparable to those of controls. Caregivers with high trait anxiety also exhibited high state anxiety. Informing caregivers of children with tracheostomy about COVID-19 via teleconference can reduce their anxiety during such stressful times.

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“…Some family compositions and circumstances may be not be solved by discharge-planning changes (single parenthood, caregiver health); however, other more purely logistical barriers may be improved by adapting training methods for individual patient and family needs. Studies have demonstrated evidence in this population of successfully training parent caregivers on medical technology competencies through remote learning (34,35).…”

Section: Original Researchmentioning

confidence: 99%

Discharge Practices for Children with Home Mechanical Ventilation across the United States. Key-Informant Perspectives

Sobotka

Dholakia

Agrawal³

et al. 2020

Annals ATS

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Rationale: In 2016, the American Thoracic Society released clinical practice guidelines for pediatric chronic home invasive ventilation pertaining to discharge practices and subsequent management for patients with invasive ventilation using a tracheostomy. It is not known to what extent current U.S. practices adhere to these recommendations.Objectives: Hospital discharge practices and home health services are not standardized for children with invasive home mechanical ventilation (HMV). We assessed discharge practices for U.S. children with HMV.Methods: A survey of key-informant U.S. clinical providers of children with HMV, identified with purposeful and snowball sampling, was conducted. Topics included medical stability, family caregiver training, and discharge guidelines. Close-ended responses were analyzed using descriptive statistics. Responses to open-ended questions were analyzed using open coding with iterative modification for major theme agreement.Results: Eighty-eight responses were received from 157 invitations. Eligible survey responses from 59 providers, representing 44 U.S. states, included 49.2% physicians, 37.3% nurses, 10.2% respiratory therapists, and 3.4% case managers. A minority, 22 (39%) reported that their institution had a standard definition of medical stability; the dominant theme was no ventilator changes 1-2 weeks before discharge. Nearly all respondents' institutions (94%) required that caregivers demonstrate independent care; the majority (78.4%) required two trained HMV caregivers. Three-fourths described codified discharge guidelines, including the use of a discharge checklist, assurance of home care, and caregiver training. Respondents described variable difficulty with obtaining durable medical equipment, either because of insurance or durable-medical-equipment company barriers.Conclusions: This national U.S. survey of providers for HMV highlights heterogeneity in practice realities of discharging pediatric patients with HMV. Although no consensus exists, defining medical stability as no ventilator changes 1-2 weeks before discharge was common, as was having an institutional requirement for training two caregivers. Identification of factors driving heterogeneity, data to inform standards, and barriers to implementation are needed to improve outcomes.

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Nurse Practitioner–Led Telehealth to Improve Outpatient Pediatric Tracheostomy Management in South Texas

Cited by 18 publications

References 13 publications

Patient Satisfaction with Telehealth During the COVID-19 Pandemic in a Pediatric Pulmonary Clinic

Patient Satisfaction with Telehealth During the COVID-19 Pandemic in a Pediatric Pulmonary Clinic

Anxiety Levels of Primary Caregivers of Children With Tracheostomy During the COVID-19 Pandemic

Discharge Practices for Children with Home Mechanical Ventilation across the United States. Key-Informant Perspectives

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