Independent Care Guidelines (1533)
Key points below
Independent Care Guidelines
You and your child are almost home! The final step of your teaching is Independent Care. Two caregivers will provide all of the child’s care. Each will do this over a different time. One shift will happen over a several hour period and one will be overnight. You and your Trach/Vent team will agree on the dates and times. You will use your home equipment. Monitors in the room will be turned off, but the nurse (RN) will still respond if you need help. A respiratory therapist will check on the trach collar or ventilator during your shift. Your child’s feeding and medicine schedule will be posted in the hospital room.
Before Starting Independent Care
Before you can start your shift of Independent Care, the following checklist must be complete:
☐ All bedside education completed
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☐ All home equipment teaching completed, and in your child’s room, if used:
☐ Trach CPR training completed |
During Independent Care
At least 2 caregivers must complete a shift of care. One will spend 4 to 8 hours. One will spend an overnight. These are your tasks during your shift
☐ Use all home equipment without help.
☐ Ask for all medicines when they are due.
☐ Ask for all feeds when they are due.
☐ Respond to alarms without nurse help. |
☐ You may take a 30 minute break.
- You must tell the nurse if you plan to leave the room.
- Return within the 30 minute time frame.
- Give and get updates when you leave and come back.
☐ Practice taking a walk with your child.
- You must pack up all emergency supplies and equipment.
- The respiratory therapist will check over your set up before you leave, and when you return.
☐ If you are completing a night shift, please do not try to stay awake. Sleep like you would at home. You do have to wake up when your child needs anything.
After Independent Care
After each caregiver completes their shift, the nurse will talk about how things went. The nurse will ask how you felt. They will write a note in your child’s chart that will look like this:
Date/Time: Caregiver arrived for independent cares. Expectations outlined and home schedule accessible in patients room. Caregiver independently set up home equipment. Independent cares
started at _____________________. Caregiver (did/did not) provide cares to patient independently. Caregiver (did/did not) respond to all alarms appropriately. Caregiver (did/did not) ask for feeds and meds prior to time due. Caregiver interacted with patient by
__________. [RN can provide specific examples related to medical cares and personal interactions]. Independent cares concluded at __________________. [Indicate when switch between caregivers occurs and repeat note format]. RN reviewed report card with Caregiver A and B;
Caregiver A (was/was not) successful and Caregiver B (was/was not) successful.
You need to do Independent Care again if one or more of these happened:
◻ RN needed to remind caregiver to give a medicine or feeding.
◻ RN needed to remind caregiver to suction.
◻ RN needed to answer an alarm.
◻ RN needed to help with cares. This does not include cares like trach or tie changes that do need 2 people.
◻ Caregiver did not know how to do cares.
◻ Caregiver was not able to answer questions about child.