Focus on Pediatrics: Educational program focuses on cardiac patients
Focus on Pediatrics: Educational program focuses on cardiac patients
Checklist follows patient
To address the needs of 35% of its pediatric patients who have heart problems and its cardiac surgeons, Phoenix Children’s Hospital created a comprehensive cardiac program. Education is a key part of this program.
Teaching begins by providing families with a drawing of a normal heart and another of their child’s heart to help them understand the defect. "At some point, they are given a picture of how we have corrected it with the surgery as well," says Vina Holloway, BSN, RN, manager of the pediatric intensive care unit (ICU) and manager of the Children’s Heart Center at Phoenix Children’s Hospital. Parents also are connected with the hospital’s learning center where they can obtain detailed information.
After the procedure, nurses follow a checklist for education beginning with basic information. Nurses use the checklist as a guideline tailoring the education to each family. For example, if the child is going to have a feeding tube at home, parents would receive information on that while other families would not. "Nurses may cover one thing one day, and five days later have to repeat it, but at least they have the checklist that shows what has been covered and how much comprehension there was," says Holloway.
When the children are transferred from the pediatric ICU to the general pediatric area the checklist goes with them. At discharge, a copy is sent to the surgeon’s office so staff know what teaching has been done. The teaching protocols were developed in conjunction with the cardiovascular surgeon to make sure that inpatient and outpatient education is the same.
Prior to the surgery, families are given a comprehensive hospital tour by the child life department when they come in for lab work. At that time, families meet some of the nurses they will be in contact with during their child’s hospital stay. "We always have people available on the cardiac unit to explain to families what is going to happen and to answer all the questions they have," says Holloway.
Families also meet with a social worker who specializes in cardiac patients. At that time, arrangements for any special needs they may have are made. If families are traveling to the medical center from an outlying area, housing is arranged. Links to other families who have gone through the experience and can give support also are made if the family wants the connection. Cab vouchers are given if needed. "We do anything to ease the stress the first few days," explains Holloway.
All nurses who come in contact with the children are educated about the heart defects and how to handle the children and the parents pre-operatively, post-operatively, and to prepare them for discharge.
Multidisciplinary planning
The program was designed by a multidisciplinary group that included nutrition, respiratory, pharmacy, social work, child life, nursing, the medical and nursing directors of the pediatric ICU, a cardiac surgeon, and a parent of a cardiac patient. As the group developed objectives, people were pulled in to help them meet the goals set. For example, the group worked with the education department when it saw the need for more intense education for the nurses who come in contact with cardiac patients.
When the group is working on special projects, it meets twice a month; otherwise, regular meetings are held monthly. Families are given surveys to determine what they liked and disliked about the program to promote ongoing improvement. A patient and family support group run by child life, and social work is provides the committee feedback.
Because families have a great deal of anxiety before their child’s surgery, it is difficult to do much teaching ahead of time. Therefore, a handout was developed with information that families will need to know when they go home. Often, parents ask the same questions over and over or have a blank look on their faces during educational sessions because they are so overwhelmed, says Holloway. Therefore, nurses are encouraged to start education as soon as possible and constantly review what has already been covered.
Source
For more information about the comprehensive cardiac program at Phoenix Children’s Hospital, contact:
- Vina Holloway, BSN, RN, Manager, Pediatric Intensive Care Unit/Manager Children’s Heart Center at Phoenix Children’s Hospital, Phoenix Children’s Hospital, 1111 E. McDowell Road, Phoenix, AZ 85006. Telephone: (602) 239-3949.
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