An Institutional Approach to Enhance Caregiver Discharge Education on a High Acuity Pediatric Bone Marrow Transplant Care Unit

Abstract

Topic Significance & Study Purpose/Background/Rationale Preparing patients and families for transition from hospital based care to home care is crucial. This transition has a variety of implications for pediatric bone marrow transplant patients and their caregivers. These patients experience lengthy hospitalizations due to the complexity of their care which creates a challenging and stressful environment for the role of the caregiver. There has been a movement toward shorter lengths of hospital stay to reduce healthcare costs which result in patients being discharged home in increasingly short periods of time (Heine, Kock, & Goldie, 2004; Weiss et al., 2017). Nurses play a key role in providing education and are responsible for detailed, concise discharge teaching. Due to patients being discharged earlier post-transplant, our institution recognized the need to develop standardized focused discharge teaching classes offered in English and Spanish. Our goal is to help decrease hospital readmission rates and increase patient satisfaction in the area of nursing education. Methods, Intervention, & Analysis The BMT clinical educator and colleague consulted with the leadership team. A collaborated approach was used to develop family-oriented BMT discharge teaching classes. Classes began weekly in February 2019. If families could not attend the scheduled classes, tailored individual classes were provided to the caregivers. Attendees were asked to complete an evaluation form. This form is used to demonstrate parental satisfaction with the discharge education provided by the Bone Marrow Transplant nursing staff. Findings & Interpretation Overall, the impact of discharge classes has demonstrated a positive effect on pediatric BMT caregivers and their families. Our BMT unit patient experience scores have increased by 13.2% in fiscal year 2019. Discussion & Implications One implication noted is that our classes have not measured the caregiver's perspective on readiness for discharge. In the future, we aim to measure this by using the Readiness for Hospital Discharge Scale (RHDS). According to literature review, studies suggest evidence that parent perception of readiness for hospital discharge is influenced by predischarge hospital care processes including care coordination and discharge teaching for parents (Lerret, et al., 2015). By providing structured discharge teaching classes and future use of validated scales, our institution will be one step further in providing successful nursing discharge education.