Nursing-led Home Visits Post-hospitalization for Children with Medical Complexity
| Autor: | Sarah McBride, Sarah Wells, Jayne Rogers, Jay G. Berry, Meghan M. Tschudy, Igor Shumskiy, Margaret O'Neill, Sangeeta Mauskar, Kevin Blaine, Amy J Hoffman |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Patient Transfer Pilot Projects Pediatrics Financial instability Cohort Studies 03 medical and health sciences 0302 clinical medicine Nursing Interquartile range 030225 pediatrics Hospital discharge medicine Humans Prospective Studies 030212 general & internal medicine Child Prospective cohort study Practical implications business.industry Multimorbidity Health technology Hospitals Pediatric medicine.disease Home Care Services Durable medical equipment Disabled Children Patient Discharge United States House Calls Treatment Outcome Home visits Child Preschool Quality of Life Medical emergency business |
| Zdroj: | Journal of Pediatric Nursing. 34:10-16 |
| ISSN: | 0882-5963 |
| Popis: | Purpose Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. Design and Methods A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72 h of discharge. The visit was staffed by a hospital nurse familiar with the child's admission. The home visit goals were to reinforce education of the discharge plan, assess the child's home environment, and identify and address any problems or issues that emerged post-discharge. Results The children's median age was 6 years [interquartile range (IQR) 2–18]. The median distance from hospital to their home was 38 miles (IQR 8–78). All (n = 36) children had multiple chronic conditions; 89% (n = 32) were assisted with medical technology. The nurse identified and helped with a post-discharge problem during every (n = 36) visit. Of the 147 problems identified, 26.5% (n = 39) pertained to social/family issues (e.g., financial instability), 23.8% (n = 35) medications (e.g., wrong dose), 20.4% (n = 30) durable medical equipment (e.g., insufficient supply or faulty function), 20.4% (n = 30) child's home environment (e.g., unsafe sleeping arrangement), and 8.8% (n = 13) child's health (e.g., unresolved health problem). Conclusions Home visits helped identify and address post-discharge issues that occurred for discharged CMC. Practical Implications Hospitals should consider home visits when optimizing discharge care for CMC. |
| Databáze: | OpenAIRE |
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