Faculty Collaboration Database

Transitioning children using home invasive mechanical ventilation from hospital to home: Discharge criteria, disparities, and ethical considerations. Pediatr Pulmonol 2024 Aug;59(8):2113-2130

Date

03/05/2024

Pubmed ID

38441360

DOI

10.1002/ppul.26948

Scopus ID

2-s2.0-85186856575 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

Children using home invasive mechanical ventilation (HIMV), a valuable therapeutic option for chronic respiratory failure, constitute a growing population. Transitioning children using HIMV from hospital to home care is a complex process that requires a multidisciplinary approach involving healthcare professionals, caregivers, and community resources. Medical stability, caregiver competence, and home environment suitability are essential factors in determining discharge readiness. Caregiver education and training play a pivotal role in ensuring safe and effective home care. Simulation training and staged education progression are effective strategies for equipping caregivers with necessary skills. Resource limitations, inadequate home nursing support, and disparities in available community resources are common obstacles to successful HIMV discharge. International perspectives shed light on diverse healthcare systems and challenges faced by caregivers worldwide. While standardizing guidelines for HIMV discharge may be complex, collaboration among healthcare providers and the development of evidence-based regional guidelines can improve outcomes for children using HIMV and their caregivers. This review seeks to synthesize literature, provide expert guidance based on experience, and highlight components to safely discharge children using HIMV. It further assesses disparities and divergences within regional and international healthcare systems while addressing relevant ethical considerations.

Author List

Henningfeld J, Friedrich AB, Flanagan G, Griffith C, Hughes A, Molkentine L, Steuart R, Wilkinson S, Baker CD

Authors

Annie B. Friedrich PhD Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Jennifer Henningfeld MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Rebecca Steuart MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Caregivers
Child
Home Care Services
Humans
Patient Discharge
Respiration, Artificial
Respiratory Insufficiency