Preparing for Discharge in Pediatric Ventricular Assist Device Supported Patients

• Published in: The Journal of heart and lung transplantation Vol. 39; no. 4; p. S220
• Main Authors: Elias, B., Tunuguntla, H.P., Smyth, L., Krack, P., Fields, K., McQueen, M., Brickler, M.M., Mehegan, M., Conway, J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2020.01.858

While the use of durable ventricular assist device (VAD) support with potential for discharge in pediatric patients has increased over time, there is limited knowledge of individual centers’ approach to preparation and education for patients and families around discharge. The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) was surveyed in September 2018 to determine current discharge practices in preparation for a quality improvement project. Surveys were sent to 28 sites, with 22 sites responding (response rate 78.5%). The majority of programs (86.4%, 18/22) reported having a standardized discharge protocol. Discharge teaching was performed in a majority of centers by a VAD coordinator (95.5%). Frequently utilized practices in preparation for discharge included field trips with and without medical chaperones, assessment of home environment (without an actual visit), rooming-in process, establishment of an EMS plan, and education about using a shower bag. The three main topics that patient and families received education on was: dressing change teaching, VAD equipment teaching and emergency planning. In terms of community outreach, programs offered education to EMS (72.7%), school staff (63.6%) and local fire stations (50%). In addition, 50% notified the local utility company in case of an electricity outage. The majority of programs caring for pediatric patients on durable VADs have a standardized approach to discharge with extensive education of patients, families, and community providers. As most programs discharge a small number of patients, a collaborative effort can allow for the development of shared educational materials that best address the needs of patients and their families.