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Characteristics of Home-Visit Nursing Stations that Accept Children Requiring Long-Term Medical Care after Discharge
Yumi Nomoto1, Toyohiko Kodama1
1University of Occupational and Environmental Health, Japan School of Health Sciences.
Insights
Delayed childbearing increases high-risk births, leading to more children requiring long-term medical care (CLTM). Home-visit nursing stations accepting CLTM are associated with experienced managers and increased nursing visits, highlighting the need for enhanced pediatric training.
Area of Science:
- Pediatric Nursing
- Healthcare Management
- Public Health
Background:
- Delayed childbearing is increasing globally, resulting in more high-risk births.
- Consequently, there is a growing need for pediatric home-care services for children requiring long-term medical care (CLTM).
- Home-visit nursing stations play a crucial role in providing this essential care.
Purpose of the Study:
- To identify factors influencing the acceptance of CLTM by home-visit nursing stations.
- To analyze the characteristics of stations, managers, staff, and patients that impact CLTM acceptance.
- To explore strategies for improving home-based pediatric care capacity.
Main Methods:
- A questionnaire-based cross-sectional survey was conducted with 338 home-visit nursing station managers.
- Chi-squared tests and logistic regressions were used to analyze the determinants of CLTM acceptance.
- Data included station characteristics, manager and staff experience, patient demographics, and home visit volume.
Main Results:
- A higher volume of home visits by nursing staff correlated with increased acceptance of CLTM.
- Nursing stations managed by individuals with 3+ years of pediatric experience accepted more CLTM.
- Managers and staff at accepting stations demonstrated better preparedness for pediatric home care.
Conclusions:
- Increased nursing home visits and experienced management are key factors in accepting CLTM.
- Declining pediatric departments limit nurses' practical experience, necessitating targeted training.
- Enhanced pediatric training, seminars, and interdisciplinary collaboration are vital to support CLTM acceptance in home-visit nursing.
Abstract:
Many cultures are witnessing high-risk births due to the increasing trend of delayed childbearing. This has resulted in a higher proportion of children requiring long-term medical care (CLTM). The number of home-visit nursing stations available for pediatric patients should increase to provide care for CLTM at home. Through a questionnaire-based cross-sectional survey of 338 home-visit nursing station managers, this study aimed to identify the determinants of the acceptance of CLTM by analyzing the characteristics of the stations, managers, staff, and registered children, and the volume of home visits. Chi-squared tests and logistic regressions were applied to determine the independence of the variables of acceptance and analyze their significance, respectively. The response rate was 14.6%, the number of pediatric patients registered in the past was 914, and the average number of registered pediatrics was 2.7. The results indicate a correspondence between the increase in home visits by nursing staff and the number of CLTM accepted for home-visit nursing services after discharge from neonatal intensive care units. Additionally, stations whose managers have three or more years of pediatric care experience accept more CLTM, and their employees are better equipped to facilitate these acceptances. Nonetheless, the number of facilities with pediatric departments has declined; thus, nurses will face increasing difficulty gaining pediatric work experiences. Therefore, enhanced seminars and training on pediatric medical care for managers and nurses, as well as strengthened collaboration/coordination with pediatric wards, clinics, and multidisciplinary occupations should be implemented as countermeasures. Our findings illustrate issues and strategies for acceptance.
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