SHARED MODEL OF CARE FOR TRACHEOSTOMY AND VENTILATED PAEDIATRIC PATIENTS RECEIVING TREATMENT IN THE AMBULATORY CARE SETTING
CCCF ePoster library. Kaitlin Ames C. Nov 2, 2016; 150981
Disclosure(s): None to disclose.
Christina Sperling and Kaitlin Ames
Christina Sperling and Kaitlin Ames
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Topic: Education

SHARED MODEL OF CARE FOR TRACHEOSTOMY AND VENTILATED PAEDIATRIC PATIENTS RECEIVING TREATMENT IN THE AMBULATORY CARE SETTING


Kaitlin Ames, RN, BSc, MSc(A)N
Paediatric Intensive Care Unit
The Hospital for Sick Children
Toronto, Ontario

Christina Sperling, RRT, BSc, MBA, Sr. Clinical Manager Respiratory Therapy
The Hospital for Sick Children
Toronto, Ontario, Canada
 
Katherine Karkut, RN, MN, Clinical Manager
4C, Dialysis Unit and the Ambulatory Transplant Centre
The Hospital for Sick Children
Toronto, Ontario, Canada
 
Celine Menezes, RN, MScN, Advanced Nursing Practice Educator
6A Ward - Nephrology/Transplant/Chest/GI/Nutrition
The Hospital for Sick Children
Toronto, Ontario, Canada
 
 Jason Macartney, RT, Clinical Educator, Respiratory Therapy
Critical Care Unit
The Hospital for Sick Children
Toronto, Ontario, Canada
    
Cathy Daniels, RN(EC), NP-Paediatrics
Pediatric Nurse Practitioner, Respirology
Long-Term Ventilation Program & Chronic Lung Disease of Prematurity Clinic
Hospital for Sick Children
Toronto, Ontario, Canada
  
Mary McAllister, RN, PhD
Associate Chief, Nursing Practice
The Hospital for Sick Children
Toronto, Ontario, Canada

 



Abstract:

Introduction: There continues to be a dramatic growth in the number of children living in the community with a tracheostomy and on home mechanical ventilation (HMV). At our institution, this number has doubled between 1991 and 2011. Like many children living with chronic illness, children on long-term HMV may require treatments and/or diagnostic imaging at the hospital. Typically these children have been admitted to the Paediatric Intensive Care Unit (PICU) because of the unfamiliarity with HMV outside the PICU setting. For the child and their family, admission to the PICU is less than desirable, as it leads to increased exposure to nosocomial infections, and disrupts their normal routine. From a hospital perspective, it is also not ideal, as it utilizes PICU resources that could be available for more acute patients. 

Objective: To develop a shared model of care (SMC) which supports children and their families who are tracheostomy and IMV dependent to receive treatments and tests in the ambulatory care setting.

Methods: An inter-professional group came together to develop the SMC that identified and acknowledges the accountabilities of each provider caring for the patient, including the parent/caregiver. This model enables parents/caregivers to remain as the child’s primary care provider, tending to the regular cares and technology associated needs.  Education on tracheostomies and ventilation was delivered to the ambulatory care providers and an infrastructure of support and resources was implemented. 

Results: A pre and post survey was also conducted with the ambulatory care providers to assess their perceived competence with tracheostomies and ventilation (Figure 1).

Conclusion: The SMC clearly delineated the responsibilities of each member of the care team, recognizing their unique abilities and expertise.  It has created a collaborative partnership between the family and health care team, minimizing disruption in child and family care giving patterns. 

 


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