Paediatric community home nursing: A model of acute care

Aims and objectives: The aim of this pilot service development was to determine if the community children's nursing outreach team (CCNOT) service, as a model of care, was effective and efficient in its delivery of reducing unscheduled care and admissions to hospital, and improving patient satisfaction. Background: CCNOT was developed to manage acutely ill children at home and to reduce the demand for unscheduled care. Design: This is a pilot prospective study within a dual-site integrated care organisation. Methods: The CCNOT service was developed with the aim of determining the effectiveness of the CCNOT model of care and service delivery in the following outcomes: 1) reducing length of hospital stay (LOS) 2) reducing A&E admissions 3) reducing non-elective admissions 4) reducing readmissions and 5) improving patient satisfaction. Data were obtained from hospital episode statistics (HES) and patient satisfaction questionnaires. Results: The data indicate that, after the implementation of the CCNOT service, A&E attendances fell by 5% per month, non-elective admissions by 15.8% and readmissions by 17.3%. Overall, LOS rose by 2.3%-0.88 days compared with 0.9 days-but the difference was not significant. The results of the patient satisfaction survey show high overall satisfaction with the service. Conclusion: A paediatric CCNOT as a model of service delivery in acute paediatric care is effective in reducing hospital admissions. It also increases patient and carer satisfaction with care provision for sick children in the home environment.