Promoting Caregiver Competency and Confidence through Supervised Family Care Prior to Hospital Discharge in Children with Heart Disease
Introduction: Discharging a pediatric patient with heart disease is often challenging. These patients can require the assistance of medical technology, and often depend on timely medications and careful monitoring to stay healthy at home. Many patients have long admissions, and some patients have never been home.
Jessica Farrell, Ariana Powers, Dana Zingo, Melissa Duva, and Deepika Thacker
Methods: A process, called Supervised Family Care (SFC), was instituted for patients with heart disease admitted to the cardiac center between October 1, 2019, and December 31, 2020. During the SFC, we asked the patientís caregiver to assume care of the patient for a period of 12 to 24 hours. SFC was scheduled when the patient was medically cleared for discharge and all caregiver education was completed. Surveys were administered to both caregivers and nurses for evaluation of the new process.
Results: Fifty patients met inclusion criteria for SFC, and 44 patients completed the process, which was deemed satisfactory in 34 instances. Reinforcement was needed in six instances, and SFC was deemed unsatisfactory in four instances. Repeat SFC was performed in four cases, and facility placement was needed in two of those cases.
Conclusion: In 80% of cases, caregivers performed all aspects of care satisfactorily prior to discharge. Additional focused education and support were able to resolve the problem in many cases. Additionally, caregiver surveys demonstrated most caregivers felt more confident caring for their child after completing the SFC. Nursing surveys revealed the SFC process was a crucial step in identifying caregiver ability to ensure safe discharge.