presented by Deborah Boroughs
This course provides students with an overview of nursing care in the home of children and adolescents with complex health care needs. The three most common diagnoses of children and adolescents who receive home care nursing are identified. Normal growth and development patterns are described so that the home care nurse may detect pathologic deviations. General physical assessment home care guidelines for children and adolescents are outlined. Required skill preparation for the pediatric home care nurse to autonomously provide proficient, safe care to a child or adolescent with complex medical needs is presented. The role of the home care nurse in fostering independence and self-care in the child or adolescent with special health care needs is described.
Deborah Boroughs, RN, MSN, has extensive professional and personal experience in the management of medically complex children. As an advanced practice nurse, she led a professional team of nurses and social workers as the director of the Pennsylvania Ventilator Assisted Children’s Home Program (VACHP), a Pennsylvania Department of Health program with offices at Children’s Hospital of Philadelphia and Pittsburgh Children’s Hospital. She is a much-published author of professional journal articles and textbook chapters, and a lecturer about care of the complex pediatric patient. She has taught pediatric and community health nursing at two universities. She currently serves as a consultant to home care agencies, an expert witness for legal cases, and a nurse educator of home care nurses. Personally, she is the mother of eight children, six of whom are adopted and have complex health care needs, including two ventilator-dependent children.
The three most common diagnostic categories of children and adolescents who receive nursing care in the home are chronic lung disease, congenital anomaly and syndrome, and nervous system/neuromuscular disorders. This chapter identifies statistics and specific diagnoses in each category common to pediatric home care.
In this chapter, the student will understand the importance of accurate developmental assessment of the child and adolescent by the home care nurse to develop an appropriate approach to care and safety for the child.
Knowing the patient’s unique baseline is the first step in recognizing and successfully responding to a change in status. In this chapter, understanding baselines and responding to status changes will be discussed.
The steps for physical assessment of the child or adolescent with special health care needs are outlined in this chapter.
Nurses who provide home care to children and adolescents with complex health care needs require a special skill set. This chapter identifies the nursing skills required for a nurse to provide proficient, safe care autonomously. The unique role of the home care nurse in fostering independence in the child and adolescent with complex needs is highlighted.