Consultation Needs for Young Adults with Intellectual and Developmental Disabilities Admitted to an Adult Tertiary Care Hospital: Implications for Inpatient Practice.


Journal

Journal of pediatric nursing
ISSN: 1532-8449
Titre abrégé: J Pediatr Nurs
Pays: United States
ID NLM: 8607529

Informations de publication

Date de publication:
Historique:
received: 04 01 2021
revised: 31 07 2021
accepted: 31 07 2021
pubmed: 16 8 2021
medline: 6 10 2021
entrez: 15 8 2021
Statut: ppublish

Résumé

Children with intellectual and developmental disabilities (IDD), particularly those with medical complexity, account for a large proportion of pediatric inpatients and are increasingly surviving to adulthood. However, few studies have evaluated the inpatient care of this population after transition to adult hospitals. This paper describes a Med-Peds Hospitalist service providing inpatient consultation for young adults with childhood conditions and offers a window into issues likely to be faced by young adults with IDD as they face increased admissions to adult hospitals. A single center retrospective chart review was performed of adults with intellectual and developmental disabilities referred to the Med-Peds consult service at a large urban adult academic medical center. The most common medical recommendations provided focused on diagnosis and management of gastrointestinal, neurologic, and respiratory issues. Coordination between pediatric and adult caregivers, disposition planning, communication and family support, and guidance on weight-based dosing were also commonly provided services. Young adults with IDD face new challenges when admitted to adult hospitals. In this single-center study, several areas were identified where expert consultation could be helpful. The need for structured coordination of care for this vulnerable patient population was highlighted. Knowledgeable consultative services may be an effective intervention to address the unique needs of hospitalized young adults with IDD. Hospitals should consider structured inpatient programs, care-paths, or consultation from providers knowledgeable in the care of young adults with intellectual disabilities in order to improve the inpatient care of this population.

Sections du résumé

BACKGROUND BACKGROUND
Children with intellectual and developmental disabilities (IDD), particularly those with medical complexity, account for a large proportion of pediatric inpatients and are increasingly surviving to adulthood. However, few studies have evaluated the inpatient care of this population after transition to adult hospitals. This paper describes a Med-Peds Hospitalist service providing inpatient consultation for young adults with childhood conditions and offers a window into issues likely to be faced by young adults with IDD as they face increased admissions to adult hospitals.
METHODS METHODS
A single center retrospective chart review was performed of adults with intellectual and developmental disabilities referred to the Med-Peds consult service at a large urban adult academic medical center.
FINDINGS RESULTS
The most common medical recommendations provided focused on diagnosis and management of gastrointestinal, neurologic, and respiratory issues. Coordination between pediatric and adult caregivers, disposition planning, communication and family support, and guidance on weight-based dosing were also commonly provided services.
DISCUSSION CONCLUSIONS
Young adults with IDD face new challenges when admitted to adult hospitals. In this single-center study, several areas were identified where expert consultation could be helpful. The need for structured coordination of care for this vulnerable patient population was highlighted. Knowledgeable consultative services may be an effective intervention to address the unique needs of hospitalized young adults with IDD.
APPLICATION TO PRACTICE CONCLUSIONS
Hospitals should consider structured inpatient programs, care-paths, or consultation from providers knowledgeable in the care of young adults with intellectual disabilities in order to improve the inpatient care of this population.

Identifiants

pubmed: 34392020
pii: S0882-5963(21)00233-5
doi: 10.1016/j.pedn.2021.07.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

288-292

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Nathan Stehouwer (N)

Departments of Medicine and Pediatrics, University Hospitals Cleveland Medical Center and Rainbow Babies & Children's Hospital, OH, United States of America; Case Western Reserve University School of Medicine, Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106, United States of America. Electronic address: nathan.stehouwer@uhhospitals.org.

Angeline Sawaya (A)

Departments of Medicine and Pediatrics, University Hospitals Cleveland Medical Center and Rainbow Babies & Children's Hospital, OH, United States of America; Case Western Reserve University School of Medicine, Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106, United States of America.

Paul Shaniuk (P)

Case Western Reserve University School of Medicine, Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106, United States of America; Louis Stokes Cleveland VA Medical Center, OH, United States of America.

Patience White (P)

Got Transition/The National Alliance to Advance Adolescent Health, DC, United States of America.

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