Instruc(onalToolsfor,BaclofenPumpEducaon - …onalToolsfor,BaclofenPumpEducaon ... •...
Transcript of Instruc(onalToolsfor,BaclofenPumpEducaon - …onalToolsfor,BaclofenPumpEducaon ... •...
Authors: Mary Kautto, MA, BSN, RN; Rhonda Cady, PhD; Alejandra Eppinger, RN Instruc(onal Tools for Baclofen Pump Educa(on
Background • Many consumers living with an Intrathecal Baclofen Pump (ITB) live in rural areas and informa=on about ITB care and complica=ons is limited.
• Call centers triage numerous calls about alarms and how to care for someone with a pump.
• As inclusion con=nues to evolve along with advancements in healthcare technologies, there are situa=ons in which “just in =me” type training is needed for caregivers.
• With a new Personal Care AGendant (PCA), a consumer moving, or staff turnover in group homes, hand-‐off communica=on may be incomplete.
• An evidence based easy to access educa=onal tool is needed.
Poster # 1958470
Proposed Educa(onal Tool • Develop a mul=faceted tool that can cater to mul=ple learning styles.
! Video for auditory learners, such as a barcode on educa=onal tools to allow it to be accessed electronically.
! Laminated card with trouble shoo=ng =ps as visual reference
Competency Tool • Competency Tool will be developed to measure understanding for nursing/care-‐giving staff before beginning care of pa=ents with Baclofen pumps. Facili=es may be encouraged to incorporate this as an annual competency.
• Self-‐test to assess knowledge level about ITB and learning completed or need for remedia=on.
• The following ques=ons will be assessed using a teach-‐back technique (having caregiver verbalize understanding):
! What are some indica=ons for a Baclofen pump?
! What are common signs and symptoms of withdrawal?
! What are appropriate ac=ons to take when pump alarm sounds?
Conclusion • Through implementa=on of these tools and resources, we hope to improve the safety and quality of life for those who u=lize Baclofen pumps.
• By increasing provider and caregiver awareness and educa=on, clients will be beGer managed regarding maintenance, troubleshoo=ng, and handling emergencies pertaining to ITB therapy.
The Next Steps U(lize Plan Do Study Act Model of Change: • PLAN-‐Discuss implementa=on of educa=onal tool with the following stakeholders: Hospital that ins=lled pump, group home, on-‐call nurse triage line, and educators for staff at both sites.
• DO-‐Try tool out for 6 months with group home and a assess knowledge gained by group home staff through a small ques=onnaire given by educators.
• STUDY-‐Assess efficacy through ques=onnaire assessment before and aXer tool implementa=on as well as through measurement of calls to nurse triage line. Seek input from both hospital and group home staff about response to tool and sugges=ons for improvement.
• ACT-‐If tool proves effec=ve incorporate use into statewide policy for group home and hospital. Make adjustments to tool based on feedback.
References • Boast, P., & PoGs, C. (2011). Connec=ng cost and quality through automated discharge instruc=ons. Healthcare Financial Management, 65(8), 114-‐118.
• Borowski, A., LiGleton, A., Borkhuu, B., Presedo, A., Shah, S., Dabney, K. Lyons, S., McMannus, M., & Miller, F. (2010). Complica=ons of intrathecal baclofen pump therapy in pediatric pa=ents. Pediatric Orthopaedics, 30(1), 76-‐81.
• Cleghorn, G. D., & Headrick, L. A. (1996). The PDSA cycle at the core of learning in health professions educa=on. Joint Commission Journal on Quality Improvement, 22(3), 206-‐212.
• GilleGe Children's Specialty Healthcare. (2013). Intrathecal Baclofen Pump Implanta=on. Retrieved from hGp://www.gilleGechildrens.org/default.cfm?pid=1.17.4.7.1.4#ITB%20-‐%20Intrathecal%20Baclofen%20Pump
• Mullarkey, T. (2009). Considera=ons in the treatment of spas=city with intrathecal baclofen. American Journal of Health-‐System Pharmacy, 66(1), S14-‐22. doi:10.2146/ajhp0108c
• Nakayama, D. K., Bushey, T. N., Hubbard, I., Cole, D., Brown, A., Grant, T. M., & Shaker, I. J. (2010). Using a plan-‐do-‐study-‐act cycle to introduce a new or service line. AORN Journal, 92(3), 335-‐343.
• Ridley, B., & Rawlins, K. (2006). Intrathecal baclofen therapy: Ten steps toward best prac=ce. Journal of Neuroscience Nursing, 38(2), 72-‐82.
For more informa(on… Mary E. KauUo, MA, BSN, RN Clinical and Marke(ng Outreach GilleGe Children’s Specialty Healthcare 200 University Ave. East | St. Paul, MN 55101 Ph. 651.325.2157 C 651.302.4118 [email protected]
(Reference Pocket Card) (QR Code)
Quick Reference Card Complica(ons: • Redness, drainage/pus, fever, need for dosage adjustment. • Baclofen adds to effects of alcohol and other depressant
medica=ons (i.e. an=histamines, sleep medica=ons, pain medica=ons).
Common causes of temporary tone changes: • Illness, pain, PMS, cons=pa=on/gastri=s, fracture, stress
Emergency Management/Troubleshoo(ng: • Check if oral Baclofen or Valium are available for pa=ent. • Record date/=me alarm sounded, contact provider/24hr.
Nurse line. • Signs of withdrawal get worse hourly: itching,
twitching, “pins & needles”
Ac(vity limita(ons: • Keep cell phones/magnets at least 1 X. away. • No hot tubs, scuba diving • Cau=on with transferring pa=ent.
! Use abdominal binder if needed. • Air travel is allowed. • MRI/CT scans are safe. • Contact provider if therapeu=c ultrasound is indicated. Consumers with ITB