Week 10.1 - Nursing Care With Young People + Transition to Adult Services

Question 1

What are the three kinds of rights described by the United Nations Conventions on the rights of the Child?

Answer 1

Survival + Developmental
Protection
Participation

Question 2

How do children’s participatory rights translate into them being partners in their care?

Answer 2

Children have the capacity to be included in healthcare decisions - intense understanding of their illness, able to make responsible decisions.

Children’s main goals are to get on their everyday life.

Question 3

What do results show about children’s willingness to be involved in care?

Answer 3

Children want to be included in healthcare decisions and treatment, but are constrained mainly by adults’ actions.

Question 4

What are some steps for the nursing role in collaborative care with patients?

Answer 4

Foundation of Respect

1. Introduce self and set tone
2. Be genuine, take interest, listen
3. Discuss role, goal of interactions and prep for comprehensive assessments
4. Establish confidentiality and its limits
5. HEEADSSS Assessment
6. Give permission to not answer any questions at anytime
7. Carefully consider how you ask questions and their purpose
8. Use open questions
9. Ask for feedback and confirm you understand what has been discussed

Question 5

What is assessed in a HEEADSSS assessment?

Answer 5

H - home + sleep
E - education/Employment
E- eating
A - activities + screens
D - drugs
S - sexuality
S - Suicide/low mood
S - safety

Question 6

What are some strategies for engaging with youth?

Answer 6

Respect privacy, be flexible, encourage choices, foster self-esteem and development.

Recognize and support developmental challenges.

Value family & community connectedness. Support parents to identify & cope with feelings related to being needed differently. Recognize conflict as a positive aspect of growth within relationships.

Develop a critical understanding of the sociocultural pressures which young people endure. Challenge negative stereotypes of young people.

Question 7

At what age range in Canada do provincial/territorial funders mandate the transfer of pediatric patients to adult care services?

Answer 7

Between 16-19
–> Lack of care integration across sectors can negatively impact health engagement and jeopardize health outcomes

Question 8

What are some challenges and barriers to transition to adult care?

Answer 8

Different care models and culture of provisions

Timing - many life transitions happen at this time (school, work, home)

Financial costs

Access to resources to adult services

Lateness in commencing preparation for transition and no clear process for sharing information. No case manager to coordinate transition.

Question 9

What are the four components of a successful transition into adult care?

Answer 9

1. Start early
2. Create an individualized plan
3. Provide support before transition
4. Ensure ongoing support after transition

Question 10

What recommendations does the Canadian Pediatric Association for a successful transition to adult care?

Answer 10

1. Continuous, comprehensive, coordinated, and meets needs of all participants
2. Stepwise plan with individualized age cut-offs
3. Collaboration among care providers with youth, decisions involving parent involvements. Overlaps in pediatricians and primary care providers.
4. Youth should define indicators of improved health outcomes with support to navigate life-course changes
5. National education initiatives to increase capacity to care for youth with complex care needs in diverse clinical settings
6. Adaptable program funding and physician compensation programs.