RESUMO
An interdisciplinary review of 16 ventilator-assisted, cervical-cord injured youth, aged 3-19 years, was completed to explore long-term outcomes and develop recommendations for care. Ten youths were younger than 12 years; 6 were adolescents. The mean initial hospital length of stay was 192 days. Discharged youths were followed for 1-73 months after hospitalization. Nursing implications were developed using a systems approach with North American Nursing Diagnosis Association (NANDA) approved diagnoses. Nursing case management was used to coordinate discharge planning and continuity of care. At the time of data collection 13 youths had been successfully reintegrated to home, school and community, the least restrictive environments for all.
Assuntos
Respiração Artificial/enfermagem , Traumatismos da Medula Espinal/enfermagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Exame Neurológico , Avaliação em Enfermagem , Alta do Paciente , Educação de Pacientes como Assunto , Traumatismos da Medula Espinal/mortalidade , Traumatismos da Medula Espinal/reabilitação , Desmame do RespiradorRESUMO
A single case study design was used to explore the nursing process and intervention related to discharge preparation of one family with a child requiring complex care at home. Helping methods described by Orem were used to categorize identified nursing interventions. Discharge readiness was assessed to verify consideration of conditions for discharge. The major study question was "How is discharge preparation conducted?" Collected data provided evidence to support each of three case study propositions: (1) patients and their home caregivers are involved in discharge preparation as planners and as learners, (2) nursing interventions occur in five major helping areas as outlined by Orem, (3) discharge preparation addresses each component of discharge readiness. The case study design was effective as an approach to explore nursing interventions, verify considerations of discharge conditions, and refine the concept of discharge readiness. A decision trail is presented for nurses to replicate the process with questions related to their practice.
Assuntos
Assistência Domiciliar , Hidrocefalia/enfermagem , Enfermeiros Clínicos/normas , Processo de Enfermagem , Alta do Paciente , Comportamento de Ajuda , Humanos , Hidrocefalia/cirurgia , Lactente , Masculino , Pesquisa em Avaliação de Enfermagem/métodos , Projetos de PesquisaRESUMO
Development of emergency systems is essential to ensure a safe home environment for technology-assisted children. Defined as combinations of circumstances or the resulting states that call for immediate action, assistance, or relief, emergencies may arise related to health, equipment, or environmental situations. Based on the philosophy that emergency services should be planned in advance of emergencies for technology-supported individuals, systems for each area of planning are outlined.
Assuntos
Serviços Médicos de Emergência , Tecnologia , Criança , Desastres , Falha de Equipamento , Planejamento em Saúde , Humanos , Respiração ArtificialRESUMO
The Ventilator Assisted Care Program has provided case management services to 36 youths and their families throughout Louisiana. It has served to link tertiary care centers with community-based service systems for the comprehensive care management of children and adolescents who use ventilators. The hospital-based, state-licensed service has been funded by Louisiana's Medicaid and Handicapped Children's Services Programs on a fee for service basis. It was originally funded by a grant from the Bureau of Maternal and Child Health. The service planning, coordination, and monitoring activities for individual families have usually begun predischarge and have been continued throughout the home care experience. The child and family have been considered to be the center of the care matrix, actively directing the service systems as well as service development.
