Management of Children and Adolescents in Out-of-home Care: Solving the Puzzle

Sunday, 17 November 2013: 11:40 AM

Donna M. Hallas, PhD, PNP-BC, CPNP, PMHS, FAANP
College of Nursing, New York University, New York City, NY

Learning Objective 1: Describe the process for assessment and management of infants, children, and adolescents placed in out-of home care.

Learning Objective 2: Implement and evaluate care management plans for vulnerable children placed in out-of-home care.

Infants, children, and adolescents who enter out-of-home care are a vulnerable population. Most children enter the out-of-home environment (foster care placement) without a known or detailed medical and family history, and most enter without complete immunization records. The nurse practitioner (NP) who performs the initial assessment of these children must astutely begin ‘solving the puzzle’ that surrounds their admission to out-of-home care to establish the best evidence-based care management strategies for the children. The initial physical assessment of infants and young children is often dependent on a few details related to the removal of the children from the home environment. Older children and adolescents may contribute some information to their medical and family history but most often the details are very limited. Thus, the skill of the NP to perform a detailed systematic assessment and establish an initial care management plan is essential to the health and well being of children in out-of-home care. Using a case study format, this presentation will describe the process of performing the assessment without the advantage of a medical and family history, the most appropriate laboratory tests to order, interpretation of the diagnostic tests, and follow-up care management to provide quality health care services for vulnerable children in out-of-home care. The role of the NP and the nurse case manager will be emphasized throughout the presentation.