Using a ventilator to maintain breathing is one of the most complex patient medical needs faced by home health agencies. These patients should benefit from a team of highly qualified nurses with the latest knowledge and experience in medical technology. They must also be able to work with patients and family members who face the challenges associated with using a ventilator. Fortunately, most home care agencies have the expertise and knowledge to make this process as seamless as possible for patients and their families.
Surprisingly, many patients dependent on a home ventilator are children. Children on ventilators present unique challenges, including the need to create an environment conducive to normal growth, development and socialization. Home caregivers play a vital role in facilitating this. It is not uncommon for a home nurse to accompany a child requiring a ventilator to school and other activities to ensure the child’s safety.
Throughout the pandemic, to help prevent admission to heavily impacted hospital intensive care facilities, home care agencies have allowed patients on ventilators to maintain their respiratory health by receiving respiratory treatments and pulmonary physiotherapy. home.
When approaching the care of ventilated patients at home, there are four main areas to consider.
1. Prepare for cleaning
Before a patient on a ventilator can move from hospital to home care, a good amount of preparation must take place. The first step is a safety assessment to ensure the home is ready for the patient’s specialist care. This includes performing an electrical assessment to ensure power is available to operate medical devices, as well as ordering and placing necessary durable medical equipment. This includes, among other things, a bedside ventilator and a travel ventilator that must be kept charged in case of an emergency. Due to the complex nature of ventilation, especially for new patients, it is essential to provide adequate nursing care to support them safely at home.
Family members also need to be prepared for this new venture, which can be overwhelming due to the steep learning curve. In addition to getting acclimated to new equipment and processes within the household, having a professional in the house for much of the day can be a major adjustment. Home care nurses need to be able to manage this change and need to work with families to set clear boundaries and expectations to ensure everyone is comfortable. Family support is critical to patient success, and clinicians are there every step of the way to help ensure the care process goes as smoothly as possible.
2. Preparing Caregivers for Success
Home care agencies also play an important role in preparing their nurses for this important and often daunting responsibility. Unlike an acute care situation, home ventilators are typically used for chronic cases that persist over a long period of time. For this reason, many patients need round-the-clock care from trained individuals, as well as family involvement to maintain a normal home environment.
To prepare for this role, registered nurses and licensed practical nurses must receive detailed clinical training from a home care agency, practicing the process of respiratory care in a simulated home environment to ensure competent care delivery. . Additionally, having new nurses follow seasoned ventilation nurses through their daily duties provides excellent hands-on experience, and setting a standard for minimum training hours creates a real-world foundation of understanding for all caregivers.
Reminding home carers of the many processes in place and offering them ongoing educational support can go a long way in reassuring them that they are never alone, even if they are independent of a facility. From on-call nurse supervisors to an agency’s director of care, make sure there’s always someone to talk to with questions or concerns.
3. Facilitate coordination with the care team
Home care is just one part of a larger interdisciplinary team. However, these nurses often act as the primary facilitator between all entities associated with the care plan due to their unique bedside position. Many other health professionals are involved at one time or another, including pulmonologists; otolaryngologists; respiratory therapists; and the patient’s primary care provider or pediatrician. Home care nurses will often be called upon to interact with these clinicians and provide updates on care, and will also be in touch in the event of an emergency or to discuss changes that may require additional interventions in the care plan. .
4. Recognize and Mitigate Potential Challenges
Ventilators are complex pieces of equipment, and installation and ongoing maintenance can pose challenges for home care teams. In addition to ongoing updates of device settings and care with assistance from respirologists and other specialists, home care providers may be called upon to provide recurring education to families throughout the patient care journey. ‘a patient. For those eligible for weaning from ventilator use, family members may want to take control or speed up this complex and gradual process, which must be overseen by an expert.
Also, as with any medical care, external emergencies can occur and care teams must be prepared to continue to provide support regardless of the circumstances. Events such as power outages can be common, so it is essential to ensure that the secondary portable ventilator is ready and charged at all times. Home care nurses can also talk to families about purchasing a home generator as a backup method for power.
For many ventilator patients and their families, a happy and fulfilling life is achievable with the help of home care agencies. Especially for pediatric patients, the ability to be surrounded by family and to participate in daily activities such as school is essential for development and to be able to thrive in the long term. Although home ventilation may seem overwhelming to patients and new caregivers, the benefits of this service are evident in improving the quality of life for patients who require this level of care.