title: Utilization of a second caregiver in the care of a child with a tracheostomy in the homecare setting.
abstract: OBJECTIVE
  To safely discharge a child with a tracheostomy tube to home, we require two legal guardians/parents to complete a special training program. However, there are times when two parents/guardians are unavailable or unwilling to be trained. Therefore, the purpose of this study was to evaluate the role of the second caregiver of a child with a tracheostomy tube in the home setting.
  
  
  METHODS
  A retrospective, descriptive, qualitative, pilot study of a convenience sample of parents of 16 children who were discharged from the hospital with a tracheostomy tube between September 2004 and December 2008 was conducted. Data were obtained from the unit's discharge database and from the primary and/or secondary caregivers. Univariate analyses were used to determine the frequency of primary and secondary caregiver participation at home. Themes were generated from caregiver responses regarding utilization of a second caregiver in the home.
  
  
  RESULTS
  A majority (93.8%, n = 15) reported primary caregivers participating very often in the care of the infant at home; less than half (31.3%, n = 5) reported comparable secondary caregiver participation. Fifty percent (n = 8) said they would not be able to care for the infant at home without another trained caregiver. Analysis of the caregiver responses revealed three major themes: confidence, safety, and respite/support.
  
  
  CONCLUSIONS
  Findings support the importance of training two caregivers in the care of a child being discharged with a tracheostomy tube. Training should include the medical/nursing care of the child as well as anticipatory guidance regarding what to expect and the need for respite services.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA. tina.tolomeo@yale.edu
authors.forename: Concettina ' Tina '
authors.initials: C'
authors.lastname: Tolomeo
authors.forename: Alia
authors.initials: A
authors.lastname: Bazzy-Asaad
mesh_terms: D017028:Caregivers / Q000193:education* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006701:Home Nursing / Q000193:education* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012144:Respite Care; D012189:Retrospective Studies; D014139:Tracheostomy / Q000534:rehabilitation*