Discharge Planning- Who

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Discharge Planning-Whos Role Is It Anyway?

• Andrea Ferns
• Childrens Long Term Ventilation Co-ordinator
• CARA Service

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Childrens Assisted Respiratory Advisory (CARA)
Service

• Andrea Ferns Discharge
• Co-ordinator
• Gillian Halley Consultant Intensivist
• Ruth Wakeman - Physiotherapist

3
PICU/HDU/NICU

• R.B.H.
• G.O.S.H
• Evelina
• St Thomas
• Chelsea Westminster
• St Marys
• St Georges

• Whittington
• Royal London
• Kings
• Cambridge
• Brighton

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PCT Boundaries
London Bedfordshire Hertfordshire Essex Kent Surre
y Sussex
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Aims and Learning Outcomes

• Identify the role of the Community Childrens
  Nurse in relation to discharge planning for
  children on long term ventilation
• Explain the different roles of key workers
• Consider the responsibilities being placed upon
  Community Childrens Nursing Services

6
Guidelines

• Hospital to Home Guidance on discharge
  management and community support for children
  using LTV (2005)
• National Service Framework (2001)
• Together from the Start (2003)

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Key Worker - Definition

• Federal employees who are generally responsible
  for distributing campaign materials

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Key Worker

• Takes responsibility for
• organizing the discharge planning for children
  on long term ventilation

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Hospital Team

• A named nurse/team from PICU/HDU/NICU is
  responsible for co-ordinating discharge
  planning from acute setting

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Community Nursing Team

• A key worker will be allocated and
  responsible for co-ordinating discharge and
  management of child in the community

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Starting the Process

• Key worker from acute setting contacts the Key
  worker from the community
• Key worker (Community) contacts local authority
  commissioners
• Health Needs Assessment carried out/1st MDT
  meeting
• Funding needs to be agreed in principle

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Health Needs Assessment

• Who is responsible for carrying out a health
  needs assessment?

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Housing Assessment

• Who is responsible?

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Equipment List

• Who is responsible?

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Funding Agreed What Happens Now?

• Timescales
• Responsibilities
• Purchase of equipment
• Recruitment of carers/nurses
• 2nd MDT meeting

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Training of Home Carers

• PCT is responsible for training their own carers
• Agency/Care Providers are responsible for
  training their own carers

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Competency Training

• Competency Guidelines
• How often updates required?
• Who is responsible for updating the
  parents/carers?

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Final Discharge Arrangements

• Date and time for discharge are set in agreement
  with family
• Emergency services/utility services informed
• Medical passport

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Discharged Home
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Implications for Community Childrens Nurses

• Training
• Maintaining skills
• Resources
• 24 hour support for carers/parents
• Time

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Aims and Learning Outcomes

• Identify the role of the Community Childrens
  Nurse in relation to discharge planning for
  children on long term ventilation
• Explain the different roles of key workers
• Consider the responsibilities being placed upon
  Community Childrens Nursing Services

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QUESTIONS?
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www.longtermventilation.nhs.uk