Skin care is critical for the population of end stage organ failure patients and transplant recipients, all of whom are immunocompromised. As the Wound Care Resource Nurse, one of my directives was to educate the North 11 staff about skin assessment using the Braden Scale. This led to 100% Braden Scale completion in a recent, hospital-wide, skin care audit.
This education about skin care and its documentation continually promotes positive patient outcomes that lead to prevention of skin breakdown. The results of the audit provided evidence upon which a change and improvement in practice are based.
It is the success of this program that gives me pleasure and pride to be part of the Wound Care Team for North 11.
Becky Joiner, RN
Self Medication Program (SMP) -- Transplant Patients Learn About Their New Lifestyle and Medications
The transplant population exhibits a unique set of learning needs after surgery. Increasing morbidity prior to transplantation has resulted in the patient focus being solely that of survival. Often patients experience frequent hospitalizations involving procedures and new medications just to maintain a level of functional stability.
Once patients receive the transplanted organ, they are presented with a new challenge, to maintain wellness. If things go smoothly, patients can be out of bed, and on the road to recovery the very next day. Many patients often travel this path. However, with others, the transformation from a life of chronic illness toward a life of improved wellness can be overwhelming. The nursing staff on N11 is cognizant of this difficult transformation. Because of this awareness and expertise, the staff has put into place support systems to assist a patient through this challenging time.
One such support system on North 11 is the Self Medication Program (SMP). It is a program developed to provide a concrete, universal approach to teaching all transplant patients information about their new medications. Here is how is works. Initially, all transplant medications are given intravenously for 24—48 hours post op. By day three, most medications are administered orally. It is on day three that patients become active participants. A medication card is created with a picture of the medications: type, dose, and times of administration such as for breakfast, lunch, dinner and bedtime. A box that holds all the medications for 24 hours is presented with the medication card. The expectation is for the patient to place the corresponding medications with the pictures on the medication card. The nurse checks the medications that have been placed by the patient in individual slots of the plastic box. It requires a lot of time and energy on the nurse’s part to educate the patients and their family/friends to the new medications. In addition, patients are given transplant manuals with key information about medications and care of their new organs. An expectation is that patients will start reviewing the information, and asking pertinent questions while learning about their new lifestyle and medications.
The SMP is a support system put into place that assists our transplant population to lead an improved way of life. Strong relationships and bonds are formed with the patient and our team ensuring success with the new lifestyle.