Life changing accident
At four years old, Katie had an accident which turned her, to date, normal life upside down. She was flown from her local hospital to a tertiary centre in Dublin, where her blocked airway could be treated with the fitting of a tracheostomy to assist with her breathing.
With the tracheostomy requiring constant care, she needed to stay at the tertiary centre, meaning she would be separated from her then pregnant mother and father indefinitely. She was also attending pre-school prior to the accident, so her education and newly formed friendships were to be put on hold.
Four months on, she was unfortunately still at hospital miles away from home. This was creating untold stress on Katie’s mother and father. Added to this, the nature of Katie’s father job meant he was on call 24/7 and had to be available at a moment’s notice.
The massive physical divide the family was forced to endure, Katie’s mothers ensuing due date, plus the hospital not being a suitable long term environment for her, meant a timely and sustainable solution was needed. The HSE then in putting a care package in place, had a strong focus on ensuring that the package would be reliable, considering how much the family would be dependent on it.
Unsustainable: The family circumstances meant Katie needed to get from Dublin to home in a timely manner
Service – A child and family centred plan
Due to already being a preferred partner of the HSE in the region, Resilience Care were engaged with early in the process, once it became clear that Katie could soon be medically fit for discharge (with the right care package in place). Due to the early engagement Resilience was able to quickly and efficiently put a plan in place to get Katie home and her life back to normality.
Early Engagement: Planning the transition early meant getting home early
The initial recommended care package was for night supports seven days a week from a nurse. From Resilience’s consultation with the family during the transition process, this was changed (in agreement with the HSE) to day support as this better met the family’s needs.
A comprehensive assessment was then undertaken by a Resilience Care Nurse Manager, which incorporated examining her medical needs, home environment, required equipment and considering the dynamic/fit of the care team best suited to this family.
Planning For School: We worked with all parties to ensure that Katie could be safe at school
Katie and her family were also very keen on getting back to pre-school, to ensure her personal goals and developmental needs were addressed. With careful planning Resilience was able to get Katie back to school within three weeks of returning home. For this Resilience liaised with pre-school and assessed the environment and staff.
A training plan for staff and emergency was then put in place and delivered by Resilience, including engagement with the National Ambulance Service. A separate care plan was devised for pre-school to ensure her care continued safely in school.
Through ongoing assessment and observation of the care by Resilience, it was highlighted by Resilience that as a day service, this could be delivered by specially trained HCA’s. Following HSE’s own risk assessment, this change was implemented, creating a more cost effective solution for the HSE while still meeting the child’s needs.
Peace of Mind: A suitably experienced Nurse Manager to line manage the staff team
Before the change could be implemented a robust transition was planned with intensive training of the HCAs that would take over her care. All training was overseen by an experienced paediatric Nurse Manager and the care plan was updated to ensure the highest level of care was maintained. The HCA’s worked in tandem with nurses also as part of the training and transition process.
Outcomes – Back with her family and to school
Not only was Katie able to get straight back to school upon arrival home, but with Resilience’s support she was able to attend summer camp and take part in sporting activities when she progressed from pre-school to primary school.
With the progress Katie made, she exited the care plan 19 months later as she no longer required a tracheostomy. She is now able to live a happy and normal (unhindered) life and play soccer with her friends until her heart’s content.
Moving On: The service ended with the skilled staff being retained for further suitable care packages
Challenges along the way
- Ensuring the transition from nursing to carer supports was safe with the correct governance in place
- Ensuring safe care in school; with trained staff, emergency planning, insurance etc. in place
- Being cognisant of having the least amount of upset/upheaval for Katie, as the staff team she had become attached to and reliant upon moved on.