Home discharge of technology-dependent children: evaluation of a respiratory-therapist driven family education program.
BACKGROUND
Initial hospital discharge to home of technology-dependent children requires extensive training and education of the family caregivers. Education of adult family members should promote positive interactions in a nonthreatening manner while facilitating the development of the knowledge and skills to competently and independently provide all aspects of the medical care. We utilize a training program for adult family members of children who have undergone tracheostomy to facilitate long-term mechanical ventilatory support and who are being prepared for their initial discharge from the hospital to home. A dedicated respiratory therapist family educator directs this program. Multiple teaching tools, activities, and training sessions, based on adult learning theory, are utilized to develop appropriate clinical skills to manage children with tracheostomies and the associated technological supports.


METHODS
We evaluated the effectiveness of our program by administering a written test to caregivers, at the start and the conclusion of their training. We also surveyed the caregivers about their satisfaction with the educational program and the respiratory therapist family educator's performance. We also surveyed employees of the durable medical equipment companies used by the families, regarding the caregivers' knowledge and competency in the home one month following discharge.


RESULTS
Our program was associated with a statistically significant improvement in caregiver test performance, and the caregivers expressed a high degree of satisfaction with the program. The employees of the durable medical equipment companies perceived a high degree of knowledge and competence on the part of the home caregivers.


CONCLUSIONS
Our training program appears to have a positive impact on the educational preparation of caregivers.
Tearl
Donna K
DK
Department of Respiratory Care Services, Alfred I duPont Hospital for Children, 1600 Rockland Road, PO Box 269, Wilmington, DE 19899, USA. dtearl@nemours.org
Hertzog
James H
JH
D017028:Caregivers / Q000193:education*; D002648:Child; D003625:Data Collection; D006801:Humans; D010351:Patient Discharge; D017060:Patient Satisfaction; D015397:Program Evaluation; D012139:Respiratory Therapy Department, Hospital; D014139:Tracheostomy / Q000193:education*; D012122:Ventilators, Mechanical