Intestinal Rehab Simulation Prepares Families for At-Home Care

The first week of a child’s life is often a whirlwind of emotions and adjustments. When a baby is born with medical complexities, that whirlwind can feel like a tornado. That’s why Children’s Hospital Colorado is helping prepare parents to care for their child’s specific medical needs at home.

Our new Intestinal Rehab Simulation (IR-SIM) Center trains caregivers to care for children who need parenteral nutrition (PN), which is often necessary for children with short bowel syndrome, bowel obstructions, diarrheal disorders and many other conditions.

“There’s lots of anxiety and fear surrounding PN,” says pediatric gastroenterologist Lindsey Gumer, MD. “It’s unfortunately something that you have to learn how to do.”

The IR-SIM Center is a part of Children’s Colorado’s larger Intestinal Rehabilitation Program. The educational programming lays out a roadmap, showing families what they need to complete before heading home.

The hands-on training begins once the patient leaves the neonatal intensive care unit and is transferred to the medical floor for continued care. Our team takes a proactive approach and educates parents and caregivers on central line management. This includes hand hygiene, dressing changes, site inspection and monitoring. Parents work together with bedside nurses — first observing proper central line care, then doing it themselves under close supervision. After meeting this goal, families continue developing their skills at the IR-SIM Center.

During the simulation, participants work through potential central line complications in a safe, guided environment.

The infusion pump is beeping. There’s an occlusion. What’s your next step?

A break appears in the central line. Where should you place the clamp?

These scenarios are designed to support caregivers at home in handling similar situations.

After completing the IR-SIM Center training, the team asks families to do a 24-to-48-hour independent stay. This allows families to practice caring for their child for an extended period of time. They’ll give medicine, PN, g-tube feeding, site care, central line care, etc. If there is an emergency, the nurses and medical team will quickly respond. If families are still struggling at the 24-hour mark, they may continue training. This ensures that we’re sending families home properly prepared to safely care for their child.

 "We try to do this to empower our caregivers,” Dr. Gumer says. “We’re hoping to reduce readmission rates from either infections or broken lines and keep our patients safe at home."

The creation of the IR-SIM Center marks an important step forward in supporting families who must provide central line care at home. While the program is just getting started, its impact will extend far into the future, helping countless families become confident in caring for their kids.