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The discharge process for a child with complex healthcare needs dependent on respiratory technology: A scoping review
Cora O'Leary1, Rachel Flynn1, Serena FitzGerald1
1School of Nursing and Midwifery, University College Cork, Cork, Ireland.
Insights
Discharging children with complex healthcare needs who require respiratory technology is challenging. This review identifies barriers and facilitators to improve hospital-to-home transitions for these vulnerable children.
Area of Science:
- Pediatric Healthcare
- Respiratory Care
- Health Services Research
Background:
- Children with complex healthcare needs (CHN) experience prolonged hospital stays and discharge delays.
- Discharge is complicated by fluctuating health, carer training, social factors, housing, and community resources.
- Effective discharge processes are crucial for timely, coordinated, family-centered transitions for technology-dependent children.
Purpose of the Study:
- To conduct a scoping review of the discharge process for children with complex healthcare needs dependent on respiratory technology.
- To understand the multifaceted barriers and facilitators impacting these transitions.
Main Methods:
- Comprehensive literature search of CINAHL, Medline, PsycINFO, and Embase databases.
- Inclusion of peer-reviewed, English-language articles from 2015 onwards.
- Systematic review of titles, abstracts, and full texts by two independent reviewers.
Main Results:
- Synthesis of existing literature on discharge processes for respiratory technology-dependent children.
- Evidence organized by micro (child/family), meso (healthcare team/institution), and macro (policy/system) levels.
- Identification of key barriers and facilitators influencing hospital-to-home transitions.
Conclusions:
- The review will identify current evidence on discharge processes for this population.
- It will detail essential components and contextual factors for effective discharge planning.
- Findings will inform clinical practice, policy development, and future research.
Background:
Children with complex healthcare needs spend a long time in hospital with frequent delays in discharge. This may be due to fluctuating health status, or contextual factors such as training carers, social circumstances, suitable housing, and community resources such as homecare nurses. Understanding the process for an effective discharge for children with complex healthcare needs who are respiratory technology dependent is essential to guide clinical practice, and shape policy that supports timely, coordinated, and family-centered transitions from hospital to home and inform evidenced-based research.
Objective:
The aim of this scoping review is to gain an understanding of the discharge process for children with complex healthcare needs who are dependent on respiratory technology.
Methods:
CINAHL, Medline, PsycINFO and Embase databases will be used for the literature search. Articles will be considered from peer reviews sources and English language text from 2015 owing to the increase in children with complex healthcare needs requiring respiratory technology and advances in complex care. Title and abstracts followed by full-text articles will be reviewed to determine which papers meet the inclusion criteria. Two reviewers will review each stage with further discussion as required for exclusion and inclusion. Data extracted will include information on key findings related to the aim and objectives of the scoping review and will be summarized and presented in tables and charts with a narrative summary.
Expected Results:
International guidelines on care closer to home and caring for children with tracheostomies state the need for discharge pathways. This review will synthesis existing literature regarding the discharge processes of children with complex healthcare needs dependent on respiratory technology. Evidence will be organised across micro-level (child and family), meso-level (healthcare team and institutional processes), and macro-level (policy and system) influences. This scoping review will identify the multifaceted barriers and facilitator that impact the transition from hospital to home for children dependent on respiratory technology.
Conclusion:
This review will identify current evidence from relevant studies in relation to discharge processes and provide detail on components and context.
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