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eHomeCare - Setting Boundaries in the Home
Overview
Setting boundaries when caring for children with complex medical conditions is crucial for maintaining the well-being of both the child and the caregivers. Setting boundaries is essential for maintaining physical and emotional health, promoting safety and well-being, respecting personal and family dynamics, supporting developmental needs, facilitating effective communication and collaboration, and providing emotional and psychological support. Caregivers who establish and maintain clear boundaries are better equipped to provide sustainable care and support for the child while maintaining their own well-being.
Practice Gaps and Needs
According to available data, the number of children requiring medically complex care at home is steadily increasing, with estimates suggesting that around 1.6% of children in the United States fall under this category, representing a significant portion of the pediatric population with substantial healthcare needs; this trend is attributed to advancements in medical technology allowing children with previously untreatable conditions to survive and live longer at home, often requiring specialized equipment and ongoing medical support.
With the growing number of children requiring complex medical care at home, there is an urgent need for current and accessible educational resources to enhance the quality and safety of care. The eHomeCare Expansion series addresses this need by offering comprehensive, on-demand training modules that cover essential topics, including central line care, home dialysis, infection control, boundary setting, skin care, range of motion exercises, and daily care activities. These courses are specifically designed to bridge knowledge gaps and enhance caregivers' confidence and competence in managing both routine and emergency situations.
Elements of Competence
This continuing education intervention is designed to change learner competence and focuses on the American Board of Medical Specialties' areas of patient care and procedural skills, medical knowledge, Institute of Medicine areas of employing evidence-based practice and providing patient/person-centered care, the Interprofessional and Nursing area of roles/responsibilities, and UW ICEP's Social Impact and Belonging competency of valuing culturally centered care.
Access after Completion
Upon completion of this course, you will have access to it as a reference until the course expiration date.
Intended Audience
eHomeCare was specifically developed to support home care nurses; however, it is also beneficial for anyone interested in enhancing their understanding of caring for children with complex medical needs at home. This includes physicians, respiratory therapists, other home care providers, family caregivers, and students.
Learning Objectives
After participating in eHomeCare - Setting Boundaries in the Home, attendees will be able to:
- Describe the five types of boundaries.
- Discuss strategies for de-escalation of tense situations.
- Explain the importance of establishing rules for the home between caregivers and family.
~ ~ ~ ~ ~
We acknowledge the support of the University of Illinois Chicago’s Division of Specialized Care for Children (DSCC), whose collaboration and funding have allowed enhancements to the eHomeCare training program. DSCC’s support has enabled the development of this training module.
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eHomeCare is an online training program developed to deliver comprehensive, evidence-based information on the care of children requiring complex medical care at home. The program consists of eight distinct courses aimed at enhancing the knowledge, skills, and confidence of home care providers, including:
- Caring for Children with a Tracheostomy with/without a Ventilator
- Central Line Care
- Dialysis In Home
- Infection Control
- Skin Care
- Range of Motion
- Daily Care Activities for Children
eHomeCare is a partnership between Marquette University College of Nursing, University of Wisconsin-Madison School of Nursing, UW Health, American Family Children’s Hospital, Children’s Wisconsin, and University of Illinois Chicago’s Division of Specialized Care for Children.
Course Outline
- Boundaries: Physical
- How a family contacts you
- Communication Styles
- Assertive
- Aggressive
- Passive
- Passive-Aggressive
- Social Media
- Virtual visits/telehealth
- Safety
- Ergonomic accommodations/expectations
- Neighborhood considerations
- In-Home safety
- De-escalation techniques
- Mandated Reporting
- Ergonomic Safety
- Boundary: Material
- Billing/Insurance
- Accepting/giving gifts
- Boundary: Time
- Personal contact information
- Plan for the next visit
- Cancellation Policy
- Planning for urgent needs/requests
- Crisis plans
- Emotional Boundaries
- Empathy vs. sympathy
- Managing coping mechanisms
- Managing our own emotions
- Ending a therapeutic relationship
- Empathy Versus Sympathy
- Power Dynamics
- Ways boundaries may be crossed
- Oversharing of personal information:
- Use of nicknames and terms of endearment
- Use of touch
- Unprofessional demeanor
- Crossing of Boundaries
- Cultural Diversity
- Family traditions
- Communication needs and addressing language barriers
- Health beliefs
- Religious beliefs and supporting spiritual practices
- Food and dietary considerations
- Gender Identity and Inclusivity
- Cultural Competency
- Religious
- Political
- “Rules” for the Home
- Fire Safety Expectations
- Emergent Evacuation Expectations
- Entrance and Exit access for the healthcare professional
- Preferences: Shoes in the home, lunch breaks, meal storage, breaks
- Identify the designated work area with good lighting
- Daily Routines of Care
- Other children live in home
- Family customs/traditions
- Family pets
AUTHORS
Lori Anderson, PhD, RN, CPNP-PC-Retired, NCSN-E Clinical Professor Emeritus University of Wisconsin - Madison School of Nursing | Althea Denham, RN, COS-C, CCMC Clinical Specialist UW Health Care Direct University of Wisconsin Hospitals and Clinics Authority | Yolanda Rivera, MSN, RN, PCCN Nursing Professional Development Specialist Almost Home Kids Ann & Robert H. Lurie Children's Hospital of Chicago |
PLANNING COMMITTEE MEMBERS
*Kim Whitmore, RN, PhD, CPN Assistant Professor Marquette University, College of Nursing | Tyler Engel, Project Manager Barrier Buster Designs | Courtney Kerfoot , MA Integrated Program Support Specialist University of Illinois Chicago - Division of Specialized Care for Children |
Lori Anderson, PhD, RN, CPNP-PC-Retired, NCSN-E Clinical Professor Emeritus University of Wisconsin - Madison School of Nursing | Abby Hammes, PhD, RN-BC Pediatric Nurse | Nurse Researcher University of Wisconsin Hospital and Clinics | Hara Levy, MD, MMSc Co-director - Pediatric Cystic Fibrosis Center American Family Children’s Hospital |
Tera Bartelt, MS, RN Director of Ambulatory Clinical Practice Children's Wisconsin | Lindsey Hird-McCorry, BSN, RN, CPN Nurse Coordinator Lurie Children's Hospital | Julie Slattery, MS, FNP-C President UW Health Care Direct |
*Course Director
CONTENT REVIEWERS
Sarah Bell | Melissa Lupo |
Amanda Halatek, CCP | Peggy Nied, OT |
| Valerie Hon, RN | Erin Roderick, RN |
Jill Krell, RN | Yolanda Rivera, BSN, RN, CPN |
Hara Levy, MD, MMSc | Tyler Robinson |
EDITOR
Lori Anderson, PhD, RN, CPNP-PC-Retired, NCSN-E
POLICY ON DISCLOSURE
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.
The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.
Name | Role | Financial Relationship Disclosures | Discussion of Unlabeled/Unapproved uses of drugs/devices in presentation? |
Kim Whitmore, RN, PhD, CPN Marquette University, College of Nursing | Course Director | No relevant relationships with ineligible companies to disclose | No |
| Lori Anderson, PhD, RN, CPNP-PC-Retired, NCSN-E University of Wisconsin - Madison School of Nursing | Project Manager | No relevant relationships with ineligible companies to disclose | No |
Tera Bartelt, MS, RN Children's Wisconsin | Committee Member | No relevant relationships with ineligible companies to disclose | No |
| Sarah Bell | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Amanda David, DNP, RN Children’s Wisconsin | Author | No relevant relationships with ineligible companies to disclose | No |
Althea Denham, RN, COS-C, CCMC University of Wisconsin Hospitals and Clinics Authority | Author | No relevant relationships with ineligible companies to disclose | No |
Tyler Engel Barrier Buster Designs | Committee Member | No relevant relationships with ineligible companies to disclose | No |
Nicole Fahley, RN, BSN UW Health Care Direct | Author | No relevant relationships with ineligible companies to disclose | No |
Amy Feller BSN, RN UW Health Care Direct | Author | No relevant relationships with ineligible companies to disclose | No |
| Amanda Halatek, CCP | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Abby Hammes, PhD, RN-BC University of Wisconsin Hospital and Clinics | Committee Member | No relevant relationships with ineligible companies to disclose | No |
Lindsey Hird-McCorry, BSN, RN, CPN Lurie Children's Hospital | Committee Member | No relevant relationships with ineligible companies to disclose | No |
| Valerie Hon, RN | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Courtney Kerfoot , MA University of Illinois Chicago - Division of Specialized Care for Children | Committee Member | No relevant relationships with ineligible companies to disclose | No |
| Jill Krell, RN | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Hara Levy, MD, MMSc American Family Children’s Hospital | Committee Member | No relevant relationships with ineligible companies to disclose | No |
| Melissa Lupo | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Emily Neibauer, MS, RN Children’s Wisconsin | Author | No relevant relationships with ineligible companies to disclose | No |
Peggy Nied, OT | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Yolanda Rivera, MSN, RN, PCCN Ann & Robert H. Lurie Children's Hospital of Chicago | Author | No relevant relationships with ineligible companies to disclose | No |
| Tyler Robinson | Peer reviewer | No relevant relationships with ineligible companies to disclose | No |
Allison Rosen, MS, OTR/L, C/NDT Ann & Robert H. Lurie Children's Hospital of Chicago | Author | No relevant relationships with ineligible companies to disclose | No |
Carrie Sardina, MS, OTR/L Children’s Wisconsin | Author | No relevant relationships with ineligible companies to disclose | No |
Julie Slattery, MS, FNP-C UW Health Care Direct | Committee Member | No relevant relationships with ineligible companies to disclose | No |
Kara Winkler, MSN, RN, CPN Ann & Robert H. Lurie Children’s Hospital of Chicago | Author | No relevant relationships with ineligible companies to disclose | No |
Jessica Whittington, MSN, APRN, CPNP-AC Ann & Robert H. Lurie Children’s Hospital of Chicago | Author | No relevant relationships with ineligible companies to disclose | No |
Brittany Wright, MSN, RN, MBA, CPHON Ann & Robert H. Lurie Children’s Hospital of Chicago | Author | No relevant relationships with ineligible companies to disclose | No |
Accreditation Statement
 | In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the University of Illinois Chicago’s Division of Specialized Care for Children. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. |
Credit Designation Statements
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this enduring material for a maximum of 1.50 ANCC contact hours.
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Education Units
The University of Wisconsin–Madison, as a member of the University Continuing Education Association (UCEA), authorizes this program for .150 continuing education units (CEUs) or 1.50 hours.
Available Credit
- 1.50 AMA PRA Category 1 Credit™
- 1.50 ANCC Contact Hours
- 1.50 University of Wisconsin–Madison Continuing Education Hours
- 1.50 Approved for AMA PRA Category 1 Credit™
Registration for this activity can only be completed through the ICEP Learning Portal. Attendee registrations made through any other sites cannot be honored. UW-Madison ICEP is not able to refund fees paid through unaffiliated registration sites, such as eMedEvents.com, MedConfWorld.com, EventEgg.com, and 10times.com. Please report any unauthorized websites or solicitations for registrations to [email protected].
Accessibility
If you need anything to participate in this program, please contact [email protected].
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