Prolonged Home Mechanical Ventilation: A Nursing Perspective

Advances in technology offered children with chronic respiratory failure the exciting opportunity to live at home. Accepting this new challenge, nurses took the lead in the developing of hospital discharge practices and policies for home mechanical ventilation (HMV) patients, authoring home care procedures and training caregivers and community colleagues. Guided by the innovative studies of leading nurse researchers, HMV programs were built with an in-depth understanding of parental role attainment, depression, grief, emotional adjustment, and adaptation in the intensive care unit (ICU) setting. Parents were viewed as trusted partners in all phases of the program development. The nursing role has evolved over these last four decades from being just the primary educators to include leading roles in the development of community policies and services. The models of family-centered care and case management were the building blocks in the total integration of all necessary services for HMV patients. This chapter offers the key ingredients of successful HMV experiences from a nursing perspective, highlighting the visionary nursing work in advancing the care of HMV patients by providing a seamless transition from ICU to home. Gaps in care were addressed via research and quality improvement projects.