Our Interprofessional Partnership: The Psychiatric Hospitalization of an LVAD (Left Ventricular Assist Device) Patient

Sunday, 29 October 2017: 4:35 PM

Cathy Peters, MS
Psychiatric Nursing, University of Rochester Medical Center, Rochester, NY, USA

Left ventricular Assist Devices (LVAD) are designed to improve cardiac output in otherwise failing hearts. The device is surgically designed to enhance weakened native circulation (Feldman, D., et al., 2013). The number of patients with end stage heart failure using mechanical circulatory support has increased dramatically over the past decade. This is due in part to increasing numbers of patients waiting for cardiac transplants, while there has been no increase in the number of available donors (Abraham, et al., 2013). There is a high prevalence of psychopathology in patients with LVAD's. A detailed biopsychosocial formulation is required to adequately identify and resolve the medical, psychiatric and social challenges represented among the LVAD population (Caro, M.A., et al. 2016). For most LVAD patients who are hospitalized on a cardiac unit, input from the Psychiatric Consultation-Liaison Team will suffice (Caro, M.A., et al. 2016). However, for our patient, a transfer from the cardiac unit to inpatient psychiatry was necessary due to the severity of his depression and subsequent vivid suicidal ideation. There is a single journal article which addresses the managment of an LVAD patient in inpatient psychiatry (Tylus-Earl, N, 2009). The 2016 transfer of our LVAD patient to psychiatry was/is unique to our university hospital. A series of very successful outcomes were achieved, with global policy implicaitons, through staff education/training and interprofessional collaboration among nursing, medicine, social work in cardiology and psychiatry. There is tremendous value to interprofessional care. From our experience, the collaboration, creativity, and the commitment to the well-being of our patient and his family built solidarity within and among our teams. There was also a perceived increase in confidence to meet future challenges. The Joint Commission reviewed our interprofessional work as an exemplar of innovation and integrated care. Our patient was discharged to home within one month of his transfer to psychiatry. At the 9 month mark, he continues to do well both medically and psychiatrically.