Quality Outcomes of a High Acuity Transplant Unit

Tuesday, 8 July 2008: 11:10 AM
Alma Degracia Cabading, RN, MBA, CCRN , Director Transplant Unit, The Methodist Hospital, Houston, TX
Rizalina M. Bonuel, MSN, RN, CCRN, CNS, APRN-BC , Education Service Line, Michael E. DeBakey Veterans Affair Medical Center, Texas, TX

Learning Objective 1: learn strategies used to improve patient outcomes of a high acuity transplant unit.

Learning Objective 2: learn about the acuity adaptable concept.

In today's healthcare market, healthcare costs continue to rise while reimbursements continue to fall. Nursing leaders must be innovative and resourceful in order to be competitive in the current healthcare industry. By combining the different levels of care, one can create an environment conducive to produce quality patient, nursing, and administrative outcomes. The nurse leader created an evidenced-based nursing environment by adding technology at the bedside and using an acuity-adaptable concept.

During the patient's hospital stay, one could expect to transfer to different units having different levels of care. By keeping the patient in one room throughout the patient's hospital stay, care interruptions were decreased to a minimum, and patient and nursing satisfactions are all time high. By creating a new program called the high-acuity transplant unit, the nurse leader was able to get approval for a higher labor budget. The higher labor budget opened the avenue of titrating the nurse to patient ratio depending on the patients' acuity levels.

In collaboration with the interdisciplinary transplant team, a visionary nurse leader developed protocols for a high acuity transplant unit. And with the help of the nursing education department, nurses were trained to enhance their critical care skills. A transplant core curriculum was formulated to give didactic classroom training to 12 transplant nurses. The nurses also rotated to the different intensive care units.

By using technology, different levels of care such as ambulatory pre-operative care, surgical intensive care, intermediate care, and regular medical/surgical floor care were combined to produce great quality patient outcomes such as decreased in number of falls and medication errors with harm, increase in patient satisfaction with nursing care, increase in nursing autonomy satisfaction, and an average decrease of 2.2 days length of stay, therefore decreasing hospital cost.