Abstract • Medical technology is enabling many high-risk infants and toddlers to be cared for at home. However, techniques for evaluation of home-care and discharge-planning outcomes have not been well documented. Using 60 subjects, we performed telephone assessment of home-care givers' knowledge base in basic knowledge of treatment, operation and maintenance of supplies and equipment, and vendor Information, using standard questions, 48 hours following discharge from the hospital. Families giving apnea monitoring or Broviac catheter care as a single treatment scored 100% in all three areas. However, the scores for care givers providing gastrostomy care (54%, 100%, and 91%), tracheostomy care (80%, 70%, and 50%), or total parenteral nutrition (88%, 50%, and 100%) as single treatments were lower. Care givers providing multiple home-care treatments had the lowest scores (65%, 65%, and 76%). However, care givers of patients who were subsequently readmitted scored well (80%, 85%, and 85%), and none of the readmissions were due to a failure of home-care management. Telephone assessment 48 hours after discharge can be used to document home-care and discharge-planning outcomes for highrisk infants and toddlers. (AJDC 1987;141:888-892) References 1. Burr BH, Guyer B, Todres ID, et al: Home care for children on respirators . N Engl J Med 1983;309:1319-1323.Crossref 2. Frates RC, Splaingard ML, Smith EO, et al: Outcome of home mechanical ventilation in children . J Pediatr 1985;106:850-856.Crossref 3. Greentrel LB: Home oxygen therapy: A proposal . Am Rev Resp Dis 1985;131:932-933. 4. Aradine C: Home care for young children with long-term trachs . Matern-Child Nurs J 1980;5:121-125. 5. Ruben RJ, Newton L, Chambers H, et al: Home care of the pediatric patient with a tracheostomy . Ann Otol Rhinol Laryngol 1982;91: 633-640. 6. Paarlberg J, Balint JP: Gastrostomy tubes: Practical guidelines for home care . Pediatr Nurs 1985;11:99-102. 7. McLean DL: Observations on premixed bronchodilator solutions . Respir Ther 1985;15: 49-52. 8. Byrne WJ, Halpin TC, Asch MJ, et al: Home total parenteral nutrition: An alternative approach to the management of children with severe chronic small-bowel disease . J Pediatr Surg 1977;12:359-366.Crossref 9. Duffty P, Bryan MH: Home monitoring in 'near-miss' sudden infant death syndrome (SIDS) and in siblings of SIDS victims . Pediatrics 1982; 70:69-74. 10. Grimaldi PL: Third-year medicare PPS regulations proposed . Nurs Manage 1985;16:47-52. 11. Kun S: Pediatric discharge planning: Challenges and rewards . Caring 1985;4:37-38. 12. Gilsth BE: Incentives for planned patien education . Qual Rev Bull 1985;11:295-301. 13. Alogna M: CDC diabetes control programs Overview of diabetes patient education . Diabete Educ 1985;10:32-37.Crossref 14. Miller L, Goldstein J: More efficient care [ill] diabetic patients in a country hospital setting . Engl J Med 1972;286:1388-1391.Crossref 15. Morisky DE, Levine DW, Greene LW, et al Five-year blood pressure control and mortality following health education in hypertensive pa tients . Am J Public Health 1983;73:153-162.Crossref 16. Dudeffant P, Manier G, Gbikpi-Benissan G[ill] et al: Outcome of patients with chronic respira[ill] tory insufficiency treated at home with tracheos[ill] tomy and assisted ventilation . Rev Mal Respi[ill] 1985;2:145-150. 17. Longo DR, Laubenthal R, Redman R[ill] JCAH Forum: Hospital compliance with JCAH nursing standards: Findings from 1982 surveys . Qual Rev Bull 1984;10:243-247. 18. Donaldson M, Keith K: Planning for program effectiveness in quality assurance . Eval Health Prof 1983;6:233-244.Crossref 19. McVotava K, Cleveland J, Hiltunen K: Home care of the patient dependent on mechanical ventilation: Home care policy development and goal setting using outcome criteria for quality assurance . Home Health Care Nurse 1985; 3:18-25. 20. Mazzuca SA: Does patient education in chronic disease have therapeutic value? J Chron Dis 1982;35:521-529.Crossref 21. Becker MH, Drachman RH, Kirscht JP: Predicting mother's compliance with pediatric medical regimens . J Pediatr 1972;8:843-854. 22. Korsch BM, Fine RN, Negrele VF: Noncompliance in children with renal transplants . J Pediatr 1978;61:872-876. 23. Home care growth statistics , in: Blue Cross/Blue Shield Association and Health Care Financing Administration Data: American Hospital Association Home Care Information Packet . Chicago, American Hospital Association, Health Administrative Services/Data Center, 1984. 24. Koren MJ: Home care: Who cares? N Engl J Med 1986;314:917-920.Crossref
American Journal of Diseases of Children – American Medical Association
Published: Aug 1, 1987
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