Preparing for Your Child’s Home Care Visit
It’s important for a parent or guardian to be present during your child's scheduled home care appointments. Be prepared to ask any questions you have; some parents find it helpful to write quick notes before their child's home care visit so they remember everything they want to ask the nurse, therapist or technician.
Please have a list of your child’s prescription and over-the-counter medications, the medicine bottles, and a list of your child’s known allergies available at each visit.
If your child receives care from multiple providers or services lines at the Children’s Hospital of Philadelphia, we encourage you to start a Care Binder that can help you organize your child's care for your family's benefit. It's a compact way for you to keep all important documents about your child's care in one place.
Your child’s first home care visit
Prior to your child’s discharge from the hospital, the Children's Hospital Home Care office staff will call you to:
- Introduce our services and your child's home care team
- Discuss the services ordered by your child's physician
- Verify your child’s demographic information
- Schedule your child's first visit and/or delivery of medicine, supplies and equipment from Children's Hospital Home Care
- Let you know how long the visit will take (1 to 4 hours depending on your child’s needs)
A registered nurse (RN) or respiratory therapist (RT) from our Home Care team will arrive at your home at the scheduled time for your child's first visit. They will bring all of the necessary forms, supplies and equipment that will be needed for your child’s care, unless a medical supply delivery has already been arranged.
A goal of the initial home care visit is training parents or guardians to ensure you are confident, competent and independent with your child’s needs and care. Ongoing visits, if needed, are based on additional clinical interventions needed and your comfort in providing care independently for your child.
- Initial respiratory therapy visits usually last from two to four hours, and follow-up visits last from one to two hours.
- Initial nursing visits usually last about two hours, and follow-up visits last approximately one hour.
Depending on the home care services prescribed by your child's physician, our clinician visits may initially be daily, weekly or monthly. Children's Hospital Home Care will work closely with your child’s physician and your insurance provider to ensure your child’s home care needs are met at required intervals for as long as necessary.
During your child's scheduled home care visit, the RN or RT will need a parent or legal guardian to be present while they review and ask you to complete forms that are important to your child’s care and treatment.
The clinician will also explain how to contact the Home Care office with questions about reordering supplies, equipment malfunction, and/or questions about your child’s care between home care visits.
Consents, benefits and responsibilities
The visiting RT or RN will review and explain essential documents such as your Home Care Consent and Assignment of Benefits. This document serves multiple purposes. It:
- Documents your consent for care and treatment to be provided to your child by Children’s Hospital Home Care.
- Serves as an explanation of your rights and responsibilities as a home care client.
- Makes you aware of your financial responsibility for home care services.
- Allows Children's Hospital Home Care to bill your insurance provider for home care services.
Assessments
We perform assessments at our initial visits to establish your child’s baseline status and create a basis for comparison on subsequent visits. If your child’s Home Care services includes a nursing visit, the nurse will conduct:
- A complete physical assessment of your child
- A psychosocial assessment
- A home environmental and safety assessment
This includes a review of your child's living space to make sure there are no safety concerns that would impact your family's ability to safely care for your child. If there are any safety issues, the home care clinician will work with you to correct them or connect you with resources that can help.
As the nurse performs these assessments, they will ask you and your child a series of questions. These same set of questions will be asked during each visit.
Medication reconciliation
On each visit, the nurse or respiratory therapist will also ask to see all of the medications —prescribed and over-the-counter — your child is taking. They will then compare these medications with those ordered by your child's physician to validate your understanding of each medication and ensure that your child is taking each medication as prescribed.
Teaching
The clinician will provide you and your child's primary caregivers all of the training needed, including demonstrating equipment and care required for your child. After the demonstration, they will ask you to perform a return demonstration to ensure you are comfortable and competent in caring for your child safely at home.
During a respiratory therapy visit, you can expect the therapist to complete necessary tasks such as an assessment of your child's airway management, and provide you with valuable information on:
- Effectively and safely managing your child’s care
- Operating and troubleshooting the equipment
- Monitoring compliance with therapy and services
- Managing emergencies
During a nursing visit, you can expect the nurse to complete physician-ordered nursing tasks, such as administering intravenous medications and intramuscular injections, and performing sterile procedures.
Communication with other team members
To promote communication about your child’s home care and treatment among team members from Children’s Hospital Home Care, healthcare partners at CHOP or other hospital systems, our clinicians document information in one electronic medical record. Information from Home Care assessments and notes is available to all medical team members at CHOP. Our Home Care team also holds daily patient rounds to review and coordinate the care we provide for your child.