HINT: How can orders for home care be confirmed?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
HINT: Orders and updates to a child’s plan of care for home
SITUATION:
This QuickHiT comes from Connected Care Resource Nurses who identify it as a potential risk when they receive consults from home care nurses seeking up-to-date orders for a child with medical complexity/technology dependence.
Connected Care Live is a service delivered by SickKids nurses who have expert knowledge and access to high-quality resources, but as Registered Nurses, they cannot give an order to be carried out as part of the child’s medical plan of care.
BACKGROUND:
When a child is discharged from hospital to home all medications and orders for treatments/interventions considered to be part of the medical plan of care are documented in a discharge summary. Examples include prescription and complementary medications, settings for ventilators, enteral tube feeds and oximeter alarm limits. After discharge, when the child is in community/home care, the medical plan is often revised based on new orders obtained from varied providers. Because these orders can come from many sources and the documentation is not easily accessed, Connected Care is not able to confirm if an order is up to date. Such confirmation must come from the child’s hospital Point of Care Team (e.g. Complex Care Team, Transplant Team) or Primary Care Provider (MD/NP).
ASSESSMENT:
After discharge, community/home care nurses and families of children with medical complexity are challenged to keep track and reconcile changes to a child’s medical plan of care for home. When children receive community/home care nursing services, this process of ensuring a care plan is up-to-date is managed differently across employers and Service Provider Organizations.
Connected Care, as part of SickKids, is committed to building capacity in community/home care and reducing preventable harm. A Connected Care Live consult may sometimes, but not always, be informative in the process of establishing what is up to date or not on a child’s medical plan of care for home.
RECOMMENDATION:
If a consult is made to Connected Care about a child’s medical plan of care at community/home we will follow our principles of caring safely by declining to give orders and will seek to help by:
For more information on SickKids commitment and leadership in Caring Safely, see:
http://www.sickkids.ca/patient-family-resources/Patient-Safety/caring-safely/index.html
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