Policy for the Discharge and transfer of children and young people ...

Additional Information for initial visit –Information that could be given and obtained during the initial visit if appropriate;What is the family expectation of the Diana Team, what information have they beengiven?The Diana Team do not provide long term direct/ hands on careSupporting and empowering family to provide care for their childIdentify training needsDiscuss supplies; set up PLUSS, Vygon as necessary.Explain to parents that we will help them to manage their supplies but it is not ourresponsibility to know when they are running out and/or to deliver more at short notice.Help families to understand the services they are accessing and sign post families toother services as necessaryMulti – disciplinary liaison;In the first instance the Diana nurse will speak to other professionals, there after it will beup to the parents to contact professionals as necessary. This will be different during Endof Life!Discuss psychology involvement – if appropriate Amanda could act as the second personComplete nursing assessment and care plans, wishes document if appropriate-Discuss care packages if necessaryEquipment; what have they got, where did it come from, what do they need, assetnumbers, servicingObtain consent – consider age and mental capacityProvide service leafletsRemember some families will be able to absorb more information than others, a secondassessment visit may be necessary.Policy for the discharge and transfer of children and young people from child healthPage 24 of 38