ATS GUIDELINES Bundle

7 Family caregivers must be instructed not to engage in cigarette smoking near the child and respiratory equipment. Smoking cessation should be encouraged. 3. A DME company must be available and able to provide the required equipment and technical support. e DME (or trained personnel from discharge facility) must perform a home inspection to confirm that the home environment and electrical systems are adequate for the necessary medical equipment. e DME company must provide 24-h availability as a resource and to service the equipment, including same-day replacement of malfunctioning equipment. DME respiratory clinicians should visit patients at least monthly and more oen as needed. 4. Professional in-home caregivers (e.g., nurses) as required to support the family must be arranged before discharge. Home professional caregivers must maintain infant/child CPR certification. Professional caregivers must be required to achieve the competencies expected of the child's family-based caregivers. Each professional caregiver must complete ventilator training involving the specific type of ventilator used in the child's home. Professional caregivers must be available to meet the child at home on the day of discharge. An accredited agency must provide professional caregivers with experience in home mechanical ventilation and will maintain training to ensure maintenance of skills. Professional caregivers must be instructed not engage in cigarette smoking while on duty. 5. e home and community environment must be safe and allow access to routine and urgent care as needed. Primary care, pulmonary subspecialty care, and care coordination must be provided in a collaborative manner consistent with the family-centered care and Medical Home models. A formal safety plan should be posted near the patient to include: emergency contact numbers (EMS, primary care provider, specialty providers, DME contact, nursing agency) and any medical information essential to the child's care (allergies, medications, ventilator settings, specific instructions). A functioning phone must remain with the patient in case of emergency. e home should be safe and free from fire/health/safety hazards and provide easy access to the child at all times. Table 2. Proposed Standardized Criteria for Discharge of an Invasively Ventilated Child to Home (cont'd)

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