Emergency Planning as Part of Healthcare Transition Preparation for Patients with Duchenne Muscular Dystrophy.


Journal

Journal of pediatric nursing
ISSN: 1532-8449
Titre abrégé: J Pediatr Nurs
Pays: United States
ID NLM: 8607529

Informations de publication

Date de publication:
Historique:
received: 11 12 2020
revised: 04 08 2021
accepted: 04 08 2021
pubmed: 28 8 2021
medline: 15 12 2021
entrez: 27 8 2021
Statut: ppublish

Résumé

Emergency care planning is an important component of healthcare transition, particularly for patients with medical complexity. Duchenne muscular dystrophy (DMD) is a complex, progressive pediatric-onset disease affecting multiple organ systems including impairment of cardiac and pulmonary function, high risk for fractures, fat embolism, adrenal crisis and malignant hyperthermia. Appropriate interdisciplinary emergency management is critical for survival for these patients. The purpose of this quality improvement project was to develop a process to reliably share an individualized emergency care plan (ECP) with patients and their families as part of a larger plan to develop an integrated transition program. An interdisciplinary team of nurses and clinicians used the principles of quality improvement to develop a reliable process to assure patients with DMD received an individualized, multidisciplinary ECP at routine interdisciplinary clinic visits. Additionally, the project used surveys to assess patient and family satisfaction with the letter and whether it improved their knowledge of emergency care. Sixty-two patients were seen during the study timeframe. All received an ECP. Sixty-two surveys were sent and twenty-three surveys were returned. Of those that responded, the majority stated the ECP increased their knowledge of emergency care. ECPs can be developed and disseminated to patients with DMD and their caregivers. This tool can potentially promote timely and appropriate emergency care for these patients with unique and complex medical needs.

Sections du résumé

BACKGROUND BACKGROUND
Emergency care planning is an important component of healthcare transition, particularly for patients with medical complexity. Duchenne muscular dystrophy (DMD) is a complex, progressive pediatric-onset disease affecting multiple organ systems including impairment of cardiac and pulmonary function, high risk for fractures, fat embolism, adrenal crisis and malignant hyperthermia. Appropriate interdisciplinary emergency management is critical for survival for these patients. The purpose of this quality improvement project was to develop a process to reliably share an individualized emergency care plan (ECP) with patients and their families as part of a larger plan to develop an integrated transition program.
METHODS METHODS
An interdisciplinary team of nurses and clinicians used the principles of quality improvement to develop a reliable process to assure patients with DMD received an individualized, multidisciplinary ECP at routine interdisciplinary clinic visits. Additionally, the project used surveys to assess patient and family satisfaction with the letter and whether it improved their knowledge of emergency care.
RESULTS RESULTS
Sixty-two patients were seen during the study timeframe. All received an ECP. Sixty-two surveys were sent and twenty-three surveys were returned. Of those that responded, the majority stated the ECP increased their knowledge of emergency care.
CONCLUSION CONCLUSIONS
ECPs can be developed and disseminated to patients with DMD and their caregivers. This tool can potentially promote timely and appropriate emergency care for these patients with unique and complex medical needs.

Identifiants

pubmed: 34450470
pii: S0882-5963(21)00236-0
doi: 10.1016/j.pedn.2021.08.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

298-304

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors have no potential conflicts of interest.

Auteurs

Wendy A Chouteau (WA)

Neurology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: WChouteau@icloud.com.

Carolyn Burrows (C)

Pulmonary Medicine, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Carolyn.Burrows@cchmc.org.

Samuel G Wittekind (SG)

Cardiology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Samuel.Wittekind@cchmc.org.

Meilan M Rutter (MM)

Endocrinology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Meilan.Rutter@cchmc.org.

Jean E Bange (JE)

Neurology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Jean.Bange@cchmc.org.

Gregg E Sabla (GE)

Pulmonary Medicine, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Gregg.Sabla@cchmc.org.

Irina Rybalsky (I)

Neurology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Irina.Rybalsky@cchmc.org.

Cuixia Tian (C)

Neurology, Cincinnati Children's Hospital, OH, United States of America. Electronic address: Cuixia.Tian@cchmc.org.

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