Ann and Robert H. Lurie Children's Hospital of Chicago

Experts Address National Shortage of Home Care Nurses for Children

  • Pediatric home care nursing shortage results in some parents unable to work and children kept in hospital longer, which can amount to millions in excess healthcare spending 
  • Shortage of pediatric home care nurses is largely due to inadequate pay and training, with less than 2 percent of Medicaid spending for children with complex medical needs supporting home care
  • Experts recommend more competitive wages for pediatric home care nurses, better training through partnerships with pediatric hospitals, payment for telemedicine support and alignment with initiatives to improve adult home care

Newswise — Child health experts from Ann & Robert H. Lurie Children’s Hospital of Chicago offer recommendations to address the national shortage of nurses who provide care at home for children with serious chronic health conditions often caused by complications of premature birth. In an article published in the June issue of Health Affairs, Carolyn Foster, MD, MSHS, and colleagues assert that inadequate pay and training for pediatric home care nurses are the major drivers of this shortage, which can cause social, emotional and financial hardship for families. Too often, children cannot be discharged home from the hospital safely because home care nursing support is not available, forcing them to remain in the hospital for weeks or even months until nurses willing and available to do the work can be found.

“Families with children who need medical technologies to survive life-threatening illness are legally entitled to home care services, but frequently they cannot find a nurse to do the work for the long term,” says Dr. Foster, lead author and physician at Lurie Children’s, and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Parents can find themselves exhausted, staying up night after night for weeks or even years, as they try to keep up with the care their children need to stay out of the hospital.”

With less than 2 percent of Medicaid spending on children with medical complexity to support home care, salaries for pediatric home care nurses fall well below nursing jobs of similar skill levels in hospitals and surgical centers.

“Increasing wages for pediatric home care would likely attract more nurses to this field,” says Dr. Foster. “Greater investment in home care for children would be a better use of healthcare dollars than paying for prolonged hospitalizations that can amount to millions in excess health care spending.”

The authors propose that payment for home care nurses should reflect the level of skill required, with higher wages going to nurses who care for children with more complex needs, such as the use of a home breathing machine. Higher wages also should be directed to nurses working in areas of greatest shortage.

Dr. Foster and colleagues also recommend increased partnerships with children’s hospitals, which would result in better coordination between hospital and home care services for children, as well as better training for home care nurses. Children’s hospitals often provide pediatric-specific training, as for example a program at Lurie Children’s that helps nurses improve their skills in home care for children who are medically fragile and technology dependent.

In addition, the authors stress that reimbursement for telemedicine services, which include use of videoconferencing and remote home monitoring technologies, is needed to extend and support home care of children with chronic illnesses.

“Telemedicine initiatives, such as Lurie Children’s Care Connect, are especially important for the medical support of children and youth who live in remote areas or who are difficult to transport,” says Dr. Foster. “Payment for these services is important, especially since telemedicine has been shown to decrease emergency department use in children with medical complexity, which reduces healthcare costs.”

To advance home care for children, the authors maintain, it will be important for pediatric experts and advocates to be included in government efforts to expand and improve adult home care.

“As the Baby Boomer generation ages and increases policy attention to adult home care, we need to make sure that children who need home care and their parents also benefit from future improvements in this arena,” says Dr. Foster.

On June 4, 2019, Dr. Foster will join adult home care experts and provide the pediatric perspective in the Health Affairs forum “Community Care for High-Need Patients” that will take place in Washington D.C.

The writing of the Health Affairs article was supported by the Lucile Packard Foundation for Children’s Health, Palo Alto, California (Grant No. 2017-00219), with co-authors Rishi Agrawal, MD, MPH, and Matthew Davis, MD, MAPP from Lurie Children’s and Northwestern University Feinberg School of Medicine.

Child health research and advocacy at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center at Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 212,000 children from 49 states and 51 countries.

Filters close

Showing results

110 of 5480
Released: 24-Sep-2020 4:05 PM EDT
Trump said he has "a constitutional obligation to put in nine judges — justices.” This claim is false
Newswise

Only since 1869 have there consistently been nine justices appointed to the Supreme Court. The U.S. Constitution is silent about how many justices should sit on the Supreme Court.

Released: 24-Sep-2020 12:50 PM EDT
The claim by Pres. Trump that Nevada voters are not required to sign their mail ballots is false
Newswise

At a rally in Vandalia, Ohio, President Donald Trump falsely claimed that Nevada voters are not required to sign their mail ballots and, if they do sign them, the signatures don’t have to be verified.

access_time Embargo lifts in 2 days
Embargo will expire: 25-Sep-2020 8:00 AM EDT Released to reporters: 24-Sep-2020 11:40 AM EDT

A reporter's PressPass is required to access this story until the embargo expires on 25-Sep-2020 8:00 AM EDT The Newswise PressPass gives verified journalists access to embargoed stories. Please log in to complete a presspass application. If you have not yet registered, please Register. When you fill out the registration form, please identify yourself as a reporter in order to advance to the presspass application form.

Released: 24-Sep-2020 10:10 AM EDT
Rebound or Permanent Slump? Possible Impacts of US COVID-19 Fiscal Policies
University of Virginia Darden School of Business

Fiscal policy is a powerful tool to combat economic downturns, but the results depend on decreasing inequality, an imperative to the efficacy of fiscal multipliers. As COVID-19 cases rise, new research offers insights into which fiscal policies may bolster the economy — and the other options, which may have long-term ramifications.

Released: 23-Sep-2020 1:55 PM EDT
Obama administration implemented several police and prison reforms despite what popular Facebook claim says
Newswise

A Pew Research Center analysis found that Obama granted clemency to more people convicted of federal crimes than any president in 64 years.

Released: 23-Sep-2020 10:00 AM EDT
Lack of Key Considerations in FDA Food Chemical Safety Process Leaves Consumers at Risk of Chronic Diseases
Endocrine Society

Today, a group of health, environmental, and consumer organizations challenged the Food and Drug Administration’s (FDA) practice of not accounting for the cumulative health effect of chemicals in the diet when allowing new chemicals in food. Over 60 years ago, Congress passed a law requiring that FDA and industry do just that. Unfortunately, an Environmental Defense Fund investigation of nearly 900 safety determinations found that only one considered the requirement in a meaningful way.

Released: 22-Sep-2020 4:15 PM EDT
Did Justice Ruth Bader Ginsburg Say Her ‘Most Fervent Wish’ Was Not To Be Replaced until a New President is installed?
Newswise

The quote reads: “My most fervent wish is that I will not be replaced until a new President is installed.” Ginsburg dictated this statement to her granddaughter, Clara Spera, in the days before her death.

Newswise: COVID-19 Opens a Partisan Gap on Voting by Mail
Released: 22-Sep-2020 3:35 PM EDT
COVID-19 Opens a Partisan Gap on Voting by Mail
University of California San Diego

Study by UC’s New Electorate Project documents a growing divide on preferences for absentee ballots. Before the pandemic, there wasn’t any difference in the rates at which Democratic and Republican voters actually cast their ballots by mail or in-person. That may change now.


Showing results

110 of 5480

close
1.74331