Background: The safe transition of children with complex medical conditions who are dependent on technology from hospital to home requires that caregivers receive specialized training from qualified health care professionals. Inadequate caregiver training can lead to discharge delays and hospital readmissions, often resulting in caregiver distress. Objective: To determine the effectiveness of a structured boot camp–style predischarge training program for caregivers of pediatric patients with complex medical conditions. Methods: We conducted a quasi-experimental interventional study to compare outcomes before and after implementation of the training program, which involved 34 caregivers. Pre–boot camp data were collected retrospectively from the medical records of 34 control patients. Results: After program implementation, statistically significant decreases were found in mean unit length of stay (92 vs 60 days; P = .02), mean discharge training days (60 vs 16 days; P < .001), and median total parental stress score, expressed as a percentile (49 vs 45; P < .001). More than 90% of caregiver participants were very satisfied with the program. On the basis of minimal length of stay limits, cost savings were estimated at between $53 300 and $69 900 per patient. Conclusion: The results of this study indicate that the training program is a valuable tool to track and verify caregiver education, reduce hospital length of stay, increase caregiver satisfaction, decrease caregiver stress, and reduce medical costs.
The clinical nurse leader (CNL) provides clinical leadership at the point of care, offers staff mentorship, assumes accountability for clinical outcomes within the microsystem, and promotes evidence-based patient care. The CNL has the skills and competencies needed to facilitate improvement science and lead care delivery redesign in the ever-changing world of health care, including in times of crisis. This article aims to detail 1 pediatric medical center's journey in utilizing the CNL to sustain high-quality patient care and promote a positive work environment during the COVID-19 pandemic using an innovative, evidence-based CNL practice model.Note: The views expressed are those of the authors and do not necessarily reflect the views of Cook Children's Medical Center.
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