Discharge management for children with complex needs.

There is now an expectation that children with complex (often technology-dependent) care needs will be cared for at home by parents who assume 24-hour responsibility following extensive training to nurse, care for and parent their child. A variety of models of discharge planning exist but the planning and process of discharge are persistently reported to be problematic from the perspective of families, professionals and commissioners. A consultation exercise with both parents and professionals indicated that nurses, doctors and social workers would benefit from some practical help and specific knowledge relating to complex discharge management. This article summarises best practice and, where possible, evidence-based principles and procedures with the intention of contributing to the establishment of effective models of discharge management and ongoing homecare, and improved outcomes for children and families. Guidance on putting together and costing a care package proposal, and applying risk management and clinical governance procedures in home-based settings will be published in the June issue of Paediatric Nursing.