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Development of an Electronic Sign-Out Tool to Improve Communication and Patient Safety During Handoffs in Care
CCCN Abstracts
myocardium, usually leading to heart failure. Although there are different causes and classifications of cardiomyopathy, many symptoms and treatments are similar. Females requiring hospital admission are typically beyond child bearing years. The purpose of this presentation is to describe a case study of a young female, with a previous diagnosis of idiopathic cardiomyopathy, admitted to a tertiary care cardiology inpatient unit while in her second trimester of pregnancy. The patient was cared for on the cardiology inpatient unit until the birth of the baby. This unique clinical encounter required the coordination and collaboration from several disciplines including cardiology and obstetrics. The case study will highlight the management and treatment plan, review the considerations in the management of complications such as heart failure and arrhythmias and describe some of the challenges cardiac nurses faced in caring for an individual with a unique clinical situation over an extended period of time. This case study illustrates the considerations in the management and treatment of patients with a diagnosis of cardiomyopathy with complications while pregnant. It is hoped that the knowledge gained from our local experience will be helpful to cardiac nurses to successfully care for similar patients elsewhere. N034 PUMP UP YOUR KNOWLEDGE: HOW TO CARE FOR PATIENTS WITH VENTRICULAR ASSIST DEVICES (VADS) IN CARDIAC REHAB W Chiu, A Kaan, J Kealy, E Laquer, D Cuff St. Paul's Hospital, Vancouver, BC
Patients who undergo VAD implantation in British Columbia (BC), generally live at home while waiting for a heart transplant. Seventy five percent of patients come from outside of the implanting health authority. Following implantation, VAD recipients are often de-conditioned from symptoms of advanced heart failure prior to surgery. In 2013, the International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: recommended that “all patients who are able should be enrolled in cardiac rehabilitation (CR) after surgical placement of a mechanical circulatory support device”. With a growing population of patients living outside of the local area, we encountered resistance when referring patients to local CR due largely to lack of knowledge about VADs and their management, especially during exercise. To that end, we devised an education training program for community CR staff to become familiar and comfortable with accepting and caring for VAD patients. The training program involves a goal oriented learning plan along with buddy shifts at our hospital's cardiac rehab program and access to a 24/7 emergency hotline for advice and support. This paper will describe the challenges encountered during the development of this program, present the details of the program and provide information about feedback and proposed modifications.
S403
Empowering outlying hospitals’ CR programs with VAD education and hands-on experience will allow these patients to attend CR closer to home with the aim of improving attendance, quality of life and long-term outcomes. N035 DEVELOPMENT OF AN ELECTRONIC SIGN-OUT TOOL TO IMPROVE COMMUNICATION AND PATIENT SAFETY DURING HANDOFFS IN CARE M Rodger Toronto General, Toronto, ON
Throughout their hospitalization, patients will be cared for by many different health care providers. This creates opportunities for error when clinical information is not accurately transferred between providers during handoffs in care. The primary objective of sign-out is the accurate transfer of information about a patient's state and plan of care from one set of health care providers to another (Patterson et al., 2004). Sign-out processes vary from hospital to hospital and unit to unit. In order to create a structured and effective exchange of information during sign-out, the cardiovascular surgical team at University Health Network implemented an electronic sign-out tool. In this presentation, the components of the electronic sign-out tool and the structured handoff and sign-out protocols will be summarized. Lessons learned regarding design and implementation of an electronic sign-out tool will be discussed. Emphasis will be placed on how the sign-out tool improved work flow of nursing and medical staff and continuity of care for our patients. N036 SELF-CARE IN HEART FAILURE INDEX- DO SCORES CHANGE OVER TIME? K Harkness1,2, G Heckman2,3, L Jewett2, R McKelvie1,2 1 Hamilton Health Sciences, Hamilton, ON, 2 McMaster University, Hamilton, ON, 3 University of Waterloo, Waterloo, ON
The self-care in heart failure index (SCHFI) is a validated instrument comprised of three subscales measuring self-care maintenance, self-care management and self-care confidence in patients with heart failure (HF). Based on studies comparing scores between patient groups, SCHFI authors state that a subscale change score of 8 points is clinically significant; however, longitudinal studies measuring SCHFI scores within individuals are lacking. The purpose of this longitudinal, descriptive pilot study was to determine if there is a change in scores for each of the SCHFI subscales in HF patients who completed the SCHFI at entry to a HF clinic and again in 6 months. From the 23 participants who completed baseline testing, 17 participants completed follow up testing. Participants’ (n¼17) mean age was 72 SD 9 years and 71% had NYHA class III symptoms at baseline. The SCHFI self-care management mean scores at baseline and 6-months were 45.6 (SD 21) and 63.2 (SD 23)
myocardium, usually leading to heart failure. Although there are different causes and classifications of cardiomyopathy, many symptoms and treatments are similar. Females requiring hospital admission are typically beyond child bearing years. The purpose of this presentation is to describe a case study of a young female, with a previous diagnosis of idiopathic cardiomyopathy, admitted to a tertiary care cardiology inpatient unit while in her second trimester of pregnancy. The patient was cared for on the cardiology inpatient unit until the birth of the baby. This unique clinical encounter required the coordination and collaboration from several disciplines including cardiology and obstetrics. The case study will highlight the management and treatment plan, review the considerations in the management of complications such as heart failure and arrhythmias and describe some of the challenges cardiac nurses faced in caring for an individual with a unique clinical situation over an extended period of time. This case study illustrates the considerations in the management and treatment of patients with a diagnosis of cardiomyopathy with complications while pregnant. It is hoped that the knowledge gained from our local experience will be helpful to cardiac nurses to successfully care for similar patients elsewhere. N034 PUMP UP YOUR KNOWLEDGE: HOW TO CARE FOR PATIENTS WITH VENTRICULAR ASSIST DEVICES (VADS) IN CARDIAC REHAB W Chiu, A Kaan, J Kealy, E Laquer, D Cuff St. Paul's Hospital, Vancouver, BC
Patients who undergo VAD implantation in British Columbia (BC), generally live at home while waiting for a heart transplant. Seventy five percent of patients come from outside of the implanting health authority. Following implantation, VAD recipients are often de-conditioned from symptoms of advanced heart failure prior to surgery. In 2013, the International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: recommended that “all patients who are able should be enrolled in cardiac rehabilitation (CR) after surgical placement of a mechanical circulatory support device”. With a growing population of patients living outside of the local area, we encountered resistance when referring patients to local CR due largely to lack of knowledge about VADs and their management, especially during exercise. To that end, we devised an education training program for community CR staff to become familiar and comfortable with accepting and caring for VAD patients. The training program involves a goal oriented learning plan along with buddy shifts at our hospital's cardiac rehab program and access to a 24/7 emergency hotline for advice and support. This paper will describe the challenges encountered during the development of this program, present the details of the program and provide information about feedback and proposed modifications.
S403
Empowering outlying hospitals’ CR programs with VAD education and hands-on experience will allow these patients to attend CR closer to home with the aim of improving attendance, quality of life and long-term outcomes. N035 DEVELOPMENT OF AN ELECTRONIC SIGN-OUT TOOL TO IMPROVE COMMUNICATION AND PATIENT SAFETY DURING HANDOFFS IN CARE M Rodger Toronto General, Toronto, ON
Throughout their hospitalization, patients will be cared for by many different health care providers. This creates opportunities for error when clinical information is not accurately transferred between providers during handoffs in care. The primary objective of sign-out is the accurate transfer of information about a patient's state and plan of care from one set of health care providers to another (Patterson et al., 2004). Sign-out processes vary from hospital to hospital and unit to unit. In order to create a structured and effective exchange of information during sign-out, the cardiovascular surgical team at University Health Network implemented an electronic sign-out tool. In this presentation, the components of the electronic sign-out tool and the structured handoff and sign-out protocols will be summarized. Lessons learned regarding design and implementation of an electronic sign-out tool will be discussed. Emphasis will be placed on how the sign-out tool improved work flow of nursing and medical staff and continuity of care for our patients. N036 SELF-CARE IN HEART FAILURE INDEX- DO SCORES CHANGE OVER TIME? K Harkness1,2, G Heckman2,3, L Jewett2, R McKelvie1,2 1 Hamilton Health Sciences, Hamilton, ON, 2 McMaster University, Hamilton, ON, 3 University of Waterloo, Waterloo, ON
The self-care in heart failure index (SCHFI) is a validated instrument comprised of three subscales measuring self-care maintenance, self-care management and self-care confidence in patients with heart failure (HF). Based on studies comparing scores between patient groups, SCHFI authors state that a subscale change score of 8 points is clinically significant; however, longitudinal studies measuring SCHFI scores within individuals are lacking. The purpose of this longitudinal, descriptive pilot study was to determine if there is a change in scores for each of the SCHFI subscales in HF patients who completed the SCHFI at entry to a HF clinic and again in 6 months. From the 23 participants who completed baseline testing, 17 participants completed follow up testing. Participants’ (n¼17) mean age was 72 SD 9 years and 71% had NYHA class III symptoms at baseline. The SCHFI self-care management mean scores at baseline and 6-months were 45.6 (SD 21) and 63.2 (SD 23)