presented by Deborah Boroughs
This course provides students with an overview of nursing care in the home of infants and toddlers with special health care needs. Important differences between nursing care of children and adults are differentiated. Normal growth and development patterns are described so that the home care nurse may detect pathologic deviations and ‘red flags’ that may indicate abnormal growth and development. Common diagnoses of infant and toddlers who receive in-home nursing care are identified. General assessment home care guidelines for infants and toddlers are outlined. Required skill preparation for pediatric home care nurses to become proficient and safe to deliver autonomous care to an infant or toddler with complex medical needs is presented.
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.
Pediatric home care nurses need to recognize important anatomical and physiological differences in infants and toddlers that put them at risk for harm compared to adults. This chapter identifies normal patterns of pediatric growth and development so that home care nurses may detect pathological deviations.
Advances in technology have led to the rescue of children with complex medical needs who formerly did not survive infancy; however, their survival often requires long-term nursing care at home that is delivered by highly-skilled nurses. Home care guidelines for physical, motor, sensory, cognitive, language and psycho-social assessments of infants and toddlers are unique.
This is part two of our discussion on assessment of infants and toddlers. In this chapter, common diagnoses and proper assessment of infants and toddlers who receive home care are identified.
Nurses who provide care to infants and children and their families at home, especially premature infants, require a special skill set. Minimum requirements for preparing the nurse and determining competency to provide safe, autonomous care to infants and children with complex healthcare needs are listed. Important consideration is given to the role of the pediatric home care nurse in supporting all caregivers in the home. These guidelines are taken from the new “gold standard” of care by home care providers published by the American Thoracic Society (ATS) in 2017.