Caregiver and Provider Experiences of Home Healthcare Quality for Children With Medical Complexity.
Carolyn C Foster, Molly M Fuentes, Lauren A Wadlington and 4 others
PMID 32358441WHAT IT FOUND
Caregivers and providers perceived home healthcare as helping medically complex children stay home and minimizing crises.
Nursing shortages, insurance delays, and inadequate airway training were reported to create unsafe gaps and family exhaustion.
Key findings
01Participants said home healthcare helped children take part in home and school activities and perceived higher-quality care as minimizing emergency and hospital use.
02Participants described an interplay of family, insurance, and workforce factors shaping home healthcare quality and access.
03Home healthcare coverage gaps delayed discharge, and interviewees worried home health nurses lacked pediatric airway emergency training.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was done at one hospital in a state with a private duty nursing shortage, so the themes may reflect that local context. Caregivers and providers volunteered, so families with less time or less access may be underrepresented. Caregivers with limited English proficiency and foster children were excluded, so barriers for those families were not captured. The study reports perceptions and experiences, not measured patient outcomes or tested interventions. Questions about therapy services were analyzed separately, so this paper does not report home therapy experiences.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these themes as proof that home healthcare reduces hospital use or that nurse training improves safety. The study reports caregiver and provider perceptions from one institution, and it did not measure outcomes or test an intervention.