Specialist home-based nursing services for children with acute and chronic illnesses

Abstract

Current research does not provide supporting evidence for a reduction in access to hospital services or a reduction in hospital readmission rate for children with acute and chronic illnesses using specialist home-based nursing services; however, the only summary finding across a few studies was that there is a significant decrease in length of hospitalisation. The preliminary results show no adverse impact on physical health outcomes and a number of papers reported improved satisfaction with home-based care. Further trials are required, measuring health, satisfaction, service utilisation and long-term costs.

A possibility for strengthening family life and health: Family members’ lived experience when a sick child receives home care in Sweden

“…Home‐care service (HCS) for children is described as care that “substitutes for acute hospital review and/or admission by providing clinical review, support, education and management of the acutely or chronically unwell child in their own home” (Parab, Cooper, Woolfenden, & Piper, , p. 3). Internationally, there are different models for financing and organising HCS.…”

Integrating primary and secondary care for children and young people: sharing practice

“…There is some evidence that families prefer services, which bring specialist care out of hospital and into their home or the community,10 11 19 that health outcomes might be maintained when care is provided closer to home,10 11 13 19 but that they are not necessarily efficient for the NHS 10 11 17–19. Other reviews of integrated care initiatives in adults have also highlighted the potential for these initiatives to increase demand and/or cost despite ambitions to the contrary 1.…”

Outcomes in systematic reviews of complex interventions never reached “high” GRADE ratings when compared with those of simple interventions

“…From 24 reviews in this group, 16 only included randomized trials (10 of these restricted the study design to the RCTs in the inclusion criteria), whereas the rest contained a mixture of randomized, quasi-randomized, and/or nonrandomized studies, such as controlled before-after designs [47,50,51], interrupted time series analysis [50], and cross-sectional studies with controls and matched historical controls [8,48]. In this group, three reviews opted out entirely from quantitative synthesis of the effect estimates [42,50,51], whereas six reviews partially meta-analyzed data for several outcomes [35,42e44,47e49].…”

“…None of the reviews that did not adopt GRADE gave a reason for that decision. In comparison with GRADEendorsed reviews, a higher proportion of those not endorsing GRADE in both complex and simple intervention review groups reported either the narrative synthesis of the data [42,50,51,61,62] or the quantitative synthesis applied to only part of the included outcomes [8,35,43,44,47e49,68].…”

“…X X X Bennett[46] X X X X X X Bisson[31] X X X X X Churchill[32] X X X X X Cooney[33] X X X X Coren[47] X X X X X X X X Dangour[48] X X X X X X X X Fellmeth[34] X X X X X X X Fletcher-Watson[35] X X X X X Hunot[36] X X X X James[37] X X X X X Langford[49] X X X X X X X X X Livingstone[38] X X X X X X Martin[39] X X X X X X X Mayo-Wilson[40] X X X X X Oono[41] X X X X X X Parab[42] X X X X X Pega[50] X X X X X X X Petrosino[43] X X X X X Rosendal[44] X X X X Shinohara[45] X X X X Thomson[8] X X X X X X X Turley[51] X X X X X X X Winokur[52] X X X X X X ''Simple'' intervention reviews Brown[53] Cipriani[54] Guaiana[55] …”