Transplanting Trauma With Interprofessional Collaboration

Friday, March 27, 2020

Rachel Bentley, MSN, RN, RHIA
Nursing Staff Development, UK Healthcare, Lexington, KY, USA
Jennifer Forman, MSN, RN-BC, CNML
Nursing Professional Practice and Excellence, UK Healthcare, Lexington, KY, USA

Purpose: In order to meet Hospital Infection Prevention and Control (IPAC) standards for immunocompromised care, patient rooms must have a private bath/shower and a minimum number of air exchanges per hour. After completing an environmental assessment of a 10-bed progressive care unit where abdominal solid-organ transplant patients were cohorted, it was determined the unit needed to transition to a different area of the hospital to meet IPAC requirements, and create a multidisciplinary, collaborative team to develop an education plan and expedite the move. A 14-bed acute care trauma/surgical unit was identified as the new home for abdominal transplant patients. This required the trauma/surgical and abdominal transplant units to swap locations.

Methods: This was a qualitative description of the experience and lessons learned transitioning and merging care areas of trauma/surgical and transplant populations. This exchange presented several challenges, including transferring distinctly different patient populations and levels of care/acuity, change in staffing patterns and management, and in-depth disease-specific education for 19 nurses and 6 nursing care technicians in 10 weeks. During this short transition period, progressive care transplant nurses received trauma-focused education and orientation to the new unit. The acute care trauma/surgical nurses who chose to stay and care for transplant patients were trained to progressive level, received dedicated transplant training, and were mentored by experienced transplant nurses. These interventions were possible with use of interprofessional collaboration. Preparations and training ethnographical observations were made and recorded.

Results: With the collaboration of all team members, the transition was successfully completed with all staff meeting assigned training requirements. The trauma/surgical nurse demonstrated competence in caring for the transplant patient with completion of progressive level training, including essentials of critical care orientation modules, EKG interpretation, and ACLS certification, and dedicated classroom and hands-on transplant training. The trauma/surgical nursing care technician demonstrated competence in caring for the transplant patient with completion of educational handout review and in-service transplant training. The transplant nurse and nursing care technician demonstrated competence in caring for the trauma/surgical patient with completion of trauma-focused education and orientation to the new unit. The new care environment meets IPAC standards, providing patients with a private room and bath/shower, and improved air exchanges per hour to prevent risk of infection to this unique population.

Conclusion: Reassessment of successes and concerns were conducted through focus groups and transition team meetings with continuous implementation of on-unit modifications to enhance future acclimation to the new work environment. Previously there was a distinct lack of sufficient collaboration between groups of the trauma/surgical service line. The transplant transition encouraged a cohesiveness between all teams, creating a strong relationship to successfully carry out the education plan and complete the move, and pursue future projects.