Pediatric Registered Nurses‘ Perceptions of the Knowledge, Skills, Attitudes, and Resources Required to Care for Adult Congenital Heart Disease Patients in a Pediatric Hospital
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Date
2013-05
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The Ohio State University
Abstract
Background: Advances in medical treatment, management, diagnosis and surgical palliation have improved both the quality and longevity of children born with Congenital Heart Disease (CHD) (Berghammer, Dellborg, & Ekman, 2006; Dearani J. et al., 2007). As these patients‘ age, reach adulthood, there are no data or guidelines available to provide direction to the preparation of pediatric registered nurses to care for adult patients with complex congenital heart problems. Purpose: The purpose of this scholarly project is to describe the care experiences and the knowledge, skills and attitudes (KSA) identified by practicing registered nurses (RNs) in a pediatric hospital as requisite to caring for adult patients with CHD (ACHD). Methods: The project used focus group interviews with a population of Registered Nurses (RN) in The Heart Center at Nationwide Children's Hospital in Columbus, Ohio. This project mirrors a prior study focusing on pediatric acute care advanced practice nurses (APRN) caring for adult patients with congenital heart disease (ACHD) within the same setting (Crumb, 2012). Results: Pediatric bedside RNs caring for ACHD patients acknowledge perceptions of noncompliance on the part of some ACHD patients. Additional topics of concern are the chronic nature of the disease process and alterations in the ACHD patient in assuming independent adult roles. In describing KSA concepts that are essential for caring for the ACHD patient, the need of social work and the direct physician involvement, using direct and assertive communication techniques to promote rapport and review of the assessment differences between adult and pediatric patients in the congenital heart disease population were identified and described. Conclusions: The nursing staff caring for the ACHD patient wants to provide the best experience for their patients regardless of age. Descriptors to articulate care concepts of concern are limited. Communication skills to deal with the adult patient as well as multi-disciplinary team utilization would be seen to improve the quality of care and better meet the needs of the ACHD patient. Additional recommendations would include development of appropriate adult resources, educational programming and evaluation of patient rules related to visitation. Addressing these concerns may help reduce nursing staff frustration and perceptions of lack of knowledge regarding care of the ACHD patient.
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Keywords
Pediatric Registered Nurses, Knowledge, Skills, Attitudes,, Adult Congenital Heart Disease, Pediatric Hospital