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Case Study: Bridge to Home Program – DiGeorge Syndrome

Patient History

  • 1-year-old male
  • Born with DiGeorge syndrome
  • Hypocalcemia anemia
  • s/p VSD and PDA repair
  • Patient home with family in NY state
  • Admitted to hospital at 9 months following acute respiratory failure due to virus; bronchiolitis complicated by severe subglottic stenosis

Reasons for Admission to Bridge to Home Program

  • Family moved to another state and unable to go back and forth for training
  • Streamline medical care prior to discharge to home
  • Coordination with local medical specialists and hospital
  • Establishing relationships between community services and resources
  • Family training for tracheostomy and G tube dependency
  • Intense inpatient rehabilitation
  • Facilitation of DME equipment and supplies for discharge

Condition Upon Admission

  • NPO-all nutrition through G tube
  • Language delay; does not respond to name; no pointing or gestures
  • Rolls left to prone only; needs assist to maintain sitting position; left torticollis with no rotation to left side
  • No weight-bearing through legs
  • Right-hand dominant; requires cues for bilateral hand play

Condition Upon Discharge

  • Parents both trained and competent on all medical care
  • Accepting PO trials without any signs or symptoms of aspiration or aversion
  • Consistently responds to name, making independent communication attempts via gestures, and shows an improved understanding of language
  • Rolls independently in all positions and into quadruped.
  • Independent pull-to-stand transition; crawling independently for short distance
  • Independent toy play, emerging pincer grasps
  • Independent standing at surface to play
  • Independently taking steps in gait trainer and on treadmill

Alternative Without Bridge to Home Program

  • Continued care in a pediatric long-term care facility with little therapy
  • Decreased interaction/bonding with family
  • Ongoing costs of long-term care facility

For additional information on Good Shepherd PediatricsBridge to Home Program, contact Brenda Early, RN, BSN, at 484-788-5492 or [email protected].