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Saturday, 29 October 2011
Learning Objective 1: The learner will be able to describe the hallmark symptom of sickle cell disease for the hospitalized adult with sickle cell disorder
Learning Objective 2: The learner will be able to describe at least three interventions used to help alleviate or reduce pain associated with a vaso-occlusive episode
Sickle cell disease is a chronic, debilitating, genetic disorder that was brought to the awareness of Western Medicine 100 years ago. Dr. Herrick, an attending physician at Chicago’s Presbyterian Hospital, described “peculiar elongated and sickle-shaped red blood corpuscles in a case of severe anemia”. Sickle cell disease is a lifelong, genetic, hematologic disorder in which the body produces abnormally shaped erythrocytes. Normal red blood cells or erythrocytes are traditionally bi-concave discs that move easily through the blood vessels and carry oxygen to all parts of the body. These “sickle cells” are hard and sticky and tend to clump together. The cells then get stuck and block the flow of blood to the organs and limbs of the body; this is the main cause of pain, anemia, and organ damage. The specific purpose of this proposed study is to develop, implement and evaluate standardized clinical practice guidelines for the treatment and care of the hospitalized adult for sickle cell vaso-occlusive pain episodes. This clinical practice change will be guided by the Iowa evidenced based practice model. The design of this proposed clinical practice guide is expected to decrease treatment variations from provider to provider. The implementation of this practice change will follow the IOWA Model and is expected to improve pain management, decrease the average length of stay (ALOS) for hospitalization, decrease costs of care and improve patient and family satisfaction with improvements to overall care. Hospitalized adult patients ages 18-65 admitted with uncomplicated vaso-occlusive crisis pain will be recruited for this pilot study. Pain will be monitored daily using visual analog scales (VAS) while ALOS, and costs for utilization will be analyzed with hospital databases. Patient satisfaction will be evaluated by using Press Ganey surveys. These variables will be assessed pre and post implementation.
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