Looking after patient safety of children with palliative needs at home
Cristina Gutierrez
Hospital Sant Joan de Deu, Spain
: J Nurs Patient Care
Abstract
Background: Professionals of the pediatric palliative care unit (PPCU) work so that the children with serious illnesses can stay and receive assistance wherever they wish. Caring for children with complex needs and/or end of life at home requires specific knowledge and skills of non-professional caregivers and their families. Their training and support is a referring assistance team responsibility. At the hospital level we have many patient safety strategies. However, at home, their motorization can be disrupted.
Aim: To analyze, what factors influence the safety of the patient at home and to establish the demographic-health profile of the patients treated by the PPCU of the Sant Joan de Deu Hospital (HSJD).
Methodology: Descriptive analysis of the characteristics related to patient safety in the children attended at home by the HSJD PPCU during the year 2017. The variables studied were: place of death, support interventions, respiratory/ nutritional devices, polypharmacy and drugs considered of risk.
Results: Of the 135 children attended by the PPCU during the year 2017, a sample of 66 patients with home centered care (49%) was recruited. During 2017, 46 children died (34%), of which 43.5% happened at home. The average calls to PPCU were 63 calls/patient and the urgent home attentions accounted for 21% of the total. Of all amounts of these patients, the 72% had respiratory support devices and 71% had enteral feeding devices. In relation to pharmacological therapy followup, polypharmacy was present in 80% of children and 81% took some drug with complex administration patterns. At the end of life, parenteral medication was administered in 85% of the cases.
Conclusions: The data show a high dependence on care and risk of complications in children treated at home. It is essential to know the vulnerabilities to develop tools that minimize them and guarantee patient safety.
Recent Publications
1. Cady Rhonda G, Anne Kelly and Stanley M Finkelstein (2008) Home telehealth for children with special healthcare needs. Journal of telemedicine and telecare 14(4):173-177.
2. Anam Parand, Giuliana Faiella, Bryony Dean Franklin, Maximilian Johnston, Fabrizio Clemente, Neville A Stanton and Nick Sevdalis (2018) A prospective risk assessment of informal carers medication administration
errors within the domiciliary setting. Ergonomics 61(1):104-121. 3. Haresh L Bhatiaa, Neal R Patela, Catherine H Ivoryd, Phillip W Stewarte, Kim M Unertla and Christoph U Lehmanna (2018) Measuring non-administration of ordered medications in the pediatric inpatient setting. International Journal of Medical Informatics, 110:71-76.
Biography
Cristina Gutierrez has her expertise in pediatric nursing. Since 2016, she is working in pediatric palliative care. This unit consists of a multidisciplinary team that cares for all the dimensions of children and their families, focusing on symptom control, emotional accompaniment and families care empowerment.
E-mail: cgutierrez@sjdhospitalbarcelona.org
