Currently, pediatrics is approximately 20% home healthcare (HHC; The National Association for Home Care and Hospice, 2010). Children are often underrepresented in research on HHC so this number may be inaccurate (Jasem et al., 2020). Because HHC gets little attention in research, there is not much available for guiding practice. Pediatric private duty nursing is understaffed by approximately 20% (The National Survey of Children with Special Healthcare Needs, 2001). This leaves children with substantially unmet needs that families often have to meet. Agencies sometime resort to staffing with undertrained nurses, in part because there are no specific requirements to guide pediatrics or private duty nursing (MI Health and Human Services Agency, 2020). This creates serious safety issues for children. With such few resources, policy may be the only way to bring attention to this serious issue. It should not be acceptable for children with complex needs to be cared for by undertrained individuals. A recent article in Home Healthcare Now on best practices for care of the ventilator-dependent child is a must-read for home care leadership and pediatric nurses (Estrem et al., 2020). I congratulate the team at Pediatric Home Service for setting a high standard for pediatric home care nursing.

Methamphetamine Overdose Deaths Rise Sharply Nationwide

NIH: Deaths involving methamphetamines more than quadrupled among non-Hispanic American Indians and Alaska Natives from 2011-2018 (from 4.5 to 20.9 per 100,000 people) overall, with sharp increases for both men (from 5.6 to 26.4 per 100,000 from 2011-2018) and women (from 3.6 to 15.6 per 100,000 from 2012-2018) in that group. The findings highlight the urgent need to develop culturally tailored, gender-specific prevention and treatment strategies for methamphetamine use disorder to meet the unique needs of those who are most vulnerable to the growing overdose crisis.

The study found markedly high death rates among non-Hispanic American Indians and Alaska Natives, as well as a pattern of higher overdose death rates in men compared to women within each racial/ethnic group. However, non-Hispanic American Indian and Alaska Native women had higher rates than non-Hispanic Black, Asian, or Hispanic men during 2012-2018, underscoring the exceptionally high overdose rates in American Indian and Alaska Native populations. The results also revealed that non-Hispanic Blacks had the sharpest increases in overdose death rates during 2011-2018. This represents a worrying trend in a group that had previously experienced very low rates of methamphetamine overdose deaths.

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