Parents were satisfied and team able to prevent re-admissions in some cases.


Nurse-led home visits for children with medical complexities can be beneficial to reduce the amount of emergency room visits and re-hospitalizations.  Wells et al. (2016) conducted a pilot study with 36 children with medical complexities (CMC) who had a home nurse visit within 72-96 hours post discharge. Each visit lasted between 60-90 minutes which allowed the nurse the opportunity to address different aspects of patients’ home care. The visit reinforced discharge teaching started in the hospital, reviewed and addressed problems associated with medications and medical supplies, and assessed safety in the home environment. By establishing care continuity the nurse acted as a liaison between the hospital’s medical team and the patients’ families. Children with new medical technologies or changes in health require individualized assessments to help reduce the likelihood of hospital re-admission. Having a home nurse perform customized teaching without interruptions is beneficial to families who will have more time to ask questions in their own environment. While the article is well written and details the benefits of a home visit from a skilled nurse, the financial aspects should be considered in future studies.

As a registered nurse who works with children in both the inpatient and outpatient setting I believe that a minimum of 1 home visit should be the standard of care when discharging CMC. Home care can be complicated by lags in education and misunderstanding instructions given in the hospital. The home care nurse acts a bridge for care coordination that can identify potential problems and implement the necessary interventions to diminish the possibility of avoidable hospital visits.

Jennifer Gomez, RN

Wells et al. Nursing-led Home Visits Post-hospitalizations for Children with Medical Complexity. J Pediatr Nurs. 2017 Mar 23. PMID: 28342694