Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Principles of Effective Transition Promotion

Transition is a term used to describe the movement from the pediatric healthcare system into the adult healthcare system. It is defined as “the purposeful, planned movement of adolescents with chronic medical conditions from child-oriented to adult oriented health care” (Blum, 2002, p.1320).

  1. Transition preparation should begin early in childhood, with the healthcare system encouraging families to be informed participants in their child’s care, e.g. young children and their families can be taught developmentally appropriate self-management skills which, with continued encouragement, will grow into increased abilities and responsibilities as they move into their adolescent and youth adult years.
  2. As children enter adolescence, they require support and encouragement, as well as opportunities to practice increased levels of responsibility and information regarding their condition and how to best manage it.
  3. Adolescents, their families and care providers must work together to develop transition care that is effective in fostering health-promoting behaviours and in enhancing the long-term quality of the young adult’s life.
  4. Adolescents and their supports (e.g. family) must have a thorough understanding of the condition and its impact on various aspects of life at different developmental stages, e.g. adolescents require accurate and honest information regarding relationships, pregnancy, parenting and vocation options, and any limitations that may be imposed.
  5. Transition efforts should be based on concepts central to positive youth development.
  6. Collaboration among healthcare providers – including pediatric and adult specialists – is essential for successful transition from pediatric to adult care.