Nurse Practitioner Lead Pediatric Baclofen Pump Program: Impact on Safety and Quality of Care.

Abstract

Children with cerebral palsy experience spasticity that can be debilitating and cause significant pain and contractures. Intrathecal baclofen (ITB) therapy can help relieve this spasticity and improve the quality of life for these patients, but it comes with risk. Withdrawal from the medication in case of abrupt discontinuation of delivery can be life-threatening. Regular maintenance of the system is mandatory. Having a program in place to manage the device and support patients helps to ensure their safety. Toward this end, we developed a program with a nurse practitioner (NP) leader to secure the safety and quality of care for patients using ITB therapy. As the program grew, the NP role as an expert in the care and management of ITB pumps became essential to the safety and care of these patients. In addition to the basic outpatient and inpatient management of the baclofen pump, the NP developed a detailed educational program for the patients and leads the quality and safety initiative for the program. The NP is also in a unique position to have intimate knowledge of the patient's condition and build a strong relationship with the patient/family. The NP is able to use this knowledge and relationship as concerns arise that could be related to the ITB therapy. This has greatly improved the safety and quality of care for patients using ITB therapy at our institution.