(71) Adding Life to Days – The Extended Role of the Advanced Practice Nurses in the Community

Ms. Wai-Lin YAM¹, Ms. Po-King MA^1
1United Christian Hospital, Hong Kong SAR

Background
The advancements in medical technology have enabled children with life-limiting medical complexities to spend more days at home and in the special schools. Yet these children still continue to require much professional support and care from the hospital. The Children with medical complexity Community Support Programme (CCSP) is run by a Paediatrics Advanced Practice Nurse (APN) as a coordinator with all the care takers from the hospital and school. We strive to minimize their acute admissions and enhance the children’s quality of life.

Method
Since 2014, 3 special schools have joined the programme in our Kowloon East cluster. Now, a total of 68 primary and secondary school boarders have been eligible and recruited until they are discharged from school. The APN coordinator provides the service of 1) weekly school visits, 2) case meetings 3) enquiry services 4) hospital visits and participation in discharge plannings, 5) post-discharge follow-ups and 6) training programs to the care takers.

Outcome
Through the CCSP, problems and needs were addressed with early intervention and relevant services are referred efficiently. Thus, the continuity of care can be ensured. This results in fewer AED visits and readmissions. Evidently, the students’ hospital stays post-major operations were significantly shortened. Early hospital discharges also lower childrens’ and parents’ levels of anxiety. Furthermore, the regular case meetings and trainings help enhance the caretakers’ understanding about the children’s illness and so increase their confidence in caring for them. Feedback has shown that they all welcome the programme and have expressed great appreciation for the received professional support. 

Conclusion
These children with medical complexities must either stay in hospitals or visit it frequently. Through on site approaching, the Paediatric APN who forefronts this programme benefits them in allowing more time for school and family activities – ultimately, adding life to their days. 

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