Utilization of a second caregiver in the care of a child with a tracheostomy in the homecare setting

Abstract

Objective: To safely discharge a child with a tracheostomy tube to home, we require two legal guardians/parents to complete a special training program. However, there are times when two parents/guardians are unavailable or unwilling to be trained. Therefore, the purpose of this study was to evaluate the role of the second caregiver of a child with a tracheostomy tube in the home setting. Methods: A retrospective, descriptive, qualitative, pilot study of a convenience sample of parents of 16 children who were discharged from the hospital with a tracheostomy tube between September 2004 and December 2008 was conducted. Data were obtained from the unit's discharge database and from the primary and/or secondary caregivers. Univariate analyses were used to determine the frequency of primary and secondary caregiver participation at home. Themes were generated from caregiver responses regarding utilization of a second caregiver in the home. Results: A majority (93.8%, n=15) reported primary caregivers participating very often in the care of the infant at home; less than half (31.3%, n=5) reported comparable secondary caregiver participation. Fifty percent (n=8) said they would not be able to care for the infant at home without another trained caregiver. Analysis of the caregiver responses revealed three major themes: confidence, safety, and respite/support. Conclusion: Findings support the importance of training two caregivers in the care of a child being discharged with a tracheostomy tube. Training should include the medical/nursing care of the child as well as anticipatory guidance regarding what to expect and the need for respite services. © 2010 Wiley-Liss, Inc.