[Nursing and medical delegable measures for children and adolescents with cancer as outpatient outreach care - The pilot project KIK HomeCare].

Abstract

Background: In the period from 2019 to 2022, pediatric hemato-oncological patients were cared for in a pilot project in North Rhine-Westphalia (NRW). The project delivered care at the homes of the patients as opposed to care at the clinics and included both general nursing as well as specific treatments that were delegated from physicians. Patients were admitted to this form of care upon referral by a physician.

Objectives: The project objective was to test the feasibility of such a method of care in the context of pediatric hemato-oncologic disease.

Method: For the evaluation, a documentation system was designed and applied, which made it possible to evaluate relevant health care data. The evaluation was carried out by means of descriptive statistics and content-analytical categorization.

Results: From 11/2019 to 12/2022, a total of N=475 hemato-oncological patients were enrolled in the care project and n=4005 home visits were performed in 242 different zip code areas in NRW. The majority of activities that could be delegated to physicians consisted of blood sampling (79.2%). Assessment of general condition (96.5%) represented the largest proportion of care services. Complications related to the method of care did not occur.

Conclusion: The nurse-led outpatient care of pediatric, hemato-oncological patients was shown to be a patient- and team-oriented form of care and seems to be an alternative to purely clinic based care. Presumably, transfer to other pediatric specialties is possible. In the next step, a prospective multicenter randomized study is needed to draw relevant conclusions about the actual possibilities and limitations.