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813 Pallieterburght: Development of a High Dependence Transitional Care Unit
  1. M Smit-van den Berg1,
  2. C Joosen1,
  3. D Tibboel2,
  4. E Ista1,
  5. S Gischler2
  1. 1PICU
  2. 2PICU and Department of Pediatric Surgery, Erasmus MC - Sophia Children’s Hospital, Rotterdam, The Netherlands

Abstract

Background Ongoing advances in paediatric intensive care led to increased survival, with increased morbidity and long-lasting sequelae. This increases parental burden and impedes quality of life of both child and parents. A poll amongst parents of children with congenital anatomical anomalies showed a need to better prepare parents for hospital discharge with their chronically ill child. Besides, parents needed a ward providing a more structured environment for child and parents rather than the hectic PICU.

Aim Evaluation of a high dependence transitional care unit (HDTCU) as part of PICU care.

Methods A 6 bedded HDTCU for chronically ill children in need of intensive nursing care was built, managed under full (medical and nursing) responsibility of our PICU. Increasingly during admission, parents take responsibility of caring for the child. We calculated duration of admission and bed occupancy rate. Furthermore a survey was held evaluating satisfaction among parents.

Results Pallieterburght is an extramural HDTCU providing care between PICU and home for children dependent on medical appliances. From January 2010 until April 2012, 33 children were admitted with a median length of stay of 50 days (range 4–345). Bed occupancy was 67%. Main appliances were: tracheal cannula 16 (48%), mechanical home-ventilation 3 (1%) and home parenteral nutrition 12 (36%). Parental satisfaction and parental confidence at discharge were high.

Conclusions Although the number of patients is too small to draw definitive conclusions, occupancy rates are high and parents seemed better prepared to accept full responsibility in home-care for their child.

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