ABSTRACT
Preparation of ventilator-dependent children, their families, the health care system, and communities for community-based care has presented many challenges over the past two decades. This article reviews some of the challenges that have been resolved by interdisciplinary discharge planning, discharge protocols, case management approaches, and collaborative care. Unresolved challenges continue to prevent children with special health care needs (CSHCN) from being served adequately by the health care system, the legal system and the community in this era of cost containment. Current literature, existing research and clinical observation were used to develop nursing implications and recommendations for continued research.
Subject(s)
Case Management , Child Health Services , Community Health Nursing , Patient Discharge , Patient Education as Topic , Respiration, Artificial/nursing , Child , Humans , United StatesABSTRACT
In response to the rise in pediatric asthma-related deaths and the absence of guidance in the literature for prevention of such deaths, a nurse managed program was designed to prevent death in children at risk for death from asthma. Published guidelines for identification of children with life-threatening asthma were used to develop a comprehensive health care network designed to provide early, aggressive medical attention and rapid access to care for selected children. The program has been successful in assuring more aggressive and timely intervention for asthma attacks and there have been no deaths from lack of access to appropriate care since the program's inception.
Subject(s)
Asthma/nursing , Case Management , Pediatric Nursing/methods , Adolescent , Asthma/mortality , Child , Child, Preschool , Female , Health Education/methods , Humans , Infant , Male , Models, Nursing , Program EvaluationABSTRACT
OBJECTIVE: To design a program to prevent death in children with life-threatening asthma. METHODS: Using published guidelines to identify patients with life-threatening asthma, we developed a comprehensive medical network involving emergency medical services, school workers, extended family members, local physicians, emergency rooms, and a referral center. The network was designed to provide early, aggressive medical attention and rapid access to care for patients enrolled in the program. RESULTS: In 8 years of operation, 75 patients have been enrolled. There have been 270 hospitalizations, with life-threatening asthma occurring in 25 admissions in 15 patients. Three patients have died; of these, two did not use the services provided by the program. CONCLUSIONS: The Red Alert Program has been successful in assuring more aggressive and timely intervention for asthma attacks and seems to have prevented deaths. Patients and their families express a high degree of satisfaction with the services. The Red Alert Program may serve as a model for other programs for children with life-threatening asthma.
Subject(s)
Asthma/therapy , Health Education , Adolescent , Adult , Asthma/mortality , Child , Child, Preschool , Female , Humans , Infant , Male , Patient Education as Topic , Program Evaluation , Severity of Illness IndexABSTRACT
An interdisciplinary pediatric pulmonary team of nurses, pharmacists, and social workers developed an asthma education program for presentation to children with asthma, ages 7-11, in a camp setting. Sound educational principles provide the foundation for this program, which includes a variety of teaching methods including puppet shows, games, crafts, and song. Informal evaluation methods of observation and feedback indicated that children's knowledge of asthma and asthma management increased.