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Children with new tracheostomies: planning for family education and common impediments to discharge.

Publication ,  Journal Article
Graf, JM; Montagnino, BA; Hueckel, R; McPherson, ML
Published in: Pediatric pulmonology
August 2008

To describe an educational program and timeline for the discharge of children with a new tracheostomy and identify common impediments to the education and discharge process.Retrospective pilot case series of 70 children and adolescents undergoing tracheostomy placement over a 24-month period in a large urban academic pediatric hospital.Eleven healthcare providers with expertise with technology dependent children identified the eight most common impediments to education and discharge for children with new tracheostomies. Length of stay, impediments to both education and discharge, and medical equipment needed at the time of discharge were extracted from hospital records. Caregivers of children with new tracheostomies needed a median of 14 days (range 5-110 days) to successfully complete a tracheostomy education program. Discharge occurred a median of 6.5 days (range 0-71 days) after education was completed. Common impediments to completing the education program included social issues (e.g., lack of sibling childcare), inter-current illness of the patient and/or language barriers. Impediments to discharge included patient's inter-current illnesses, social issues (e.g., lack of running water) and unavailability of home nursing. Our cohort of patients had a total median length of stay (LOS) of 46 days. At discharge, 55% of children required two or more medical devices (in addition to their tracheostomy) and 61% had some level of dependency on positive pressure ventilation.Pediatric patients with a new tracheostomy undergo lengthy initial hospitalizations and have complex educational and discharge needs. Multiple factors (both medical and social) can impede the child's transition to the outpatient setting. A structured education and discharge program may result in a shorter LOS for children with new tracheostomies. Impediments to family education and discharge should be anticipated.

Duke Scholars

Published In

Pediatric pulmonology

DOI

EISSN

1099-0496

ISSN

8755-6863

Publication Date

August 2008

Volume

43

Issue

8

Start / End Page

788 / 794

Related Subject Headings

  • Tracheostomy
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Pilot Projects
  • Patient Education as Topic
  • Patient Discharge
  • Male
  • Length of Stay
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Graf, J. M., Montagnino, B. A., Hueckel, R., & McPherson, M. L. (2008). Children with new tracheostomies: planning for family education and common impediments to discharge. Pediatric Pulmonology, 43(8), 788–794. https://doi.org/10.1002/ppul.20867
Graf, Jeanine M., Barbara A. Montagnino, Remí Hueckel, and Mona L. McPherson. “Children with new tracheostomies: planning for family education and common impediments to discharge.Pediatric Pulmonology 43, no. 8 (August 2008): 788–94. https://doi.org/10.1002/ppul.20867.
Graf JM, Montagnino BA, Hueckel R, McPherson ML. Children with new tracheostomies: planning for family education and common impediments to discharge. Pediatric pulmonology. 2008 Aug;43(8):788–94.
Graf, Jeanine M., et al. “Children with new tracheostomies: planning for family education and common impediments to discharge.Pediatric Pulmonology, vol. 43, no. 8, Aug. 2008, pp. 788–94. Epmc, doi:10.1002/ppul.20867.
Graf JM, Montagnino BA, Hueckel R, McPherson ML. Children with new tracheostomies: planning for family education and common impediments to discharge. Pediatric pulmonology. 2008 Aug;43(8):788–794.
Journal cover image

Published In

Pediatric pulmonology

DOI

EISSN

1099-0496

ISSN

8755-6863

Publication Date

August 2008

Volume

43

Issue

8

Start / End Page

788 / 794

Related Subject Headings

  • Tracheostomy
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Pilot Projects
  • Patient Education as Topic
  • Patient Discharge
  • Male
  • Length of Stay
  • Infant