University of Chicago Medicine, Section of Neurosurgery, IL, United States of America; Rush University, Department of Women, Children, and Family Nursing, Rush University College of Nursing, IL, United States of America.
Rush University, Department of Women, Children, and Family Nursing, Rush University College of Nursing, IL, United States of America.
J Pediatr Nurs. 2021 Sep-Oct;60:164-167. doi: 10.1016/j.pedn.2021.05.003. Epub 2021 May 13.
A formal transition program has not been described for neurosurgical adolescent patients with an indwelling shunt device. Transitioning from pediatric neurosurgical care to adult care without transition guidance has caused abrupt transfer of care at this institution. The goal of this pilot transition program was to help patients and caregivers feel informed and prepared for transition.
The Got Transition®, Six Core Elements of Transition, were used to create this program. Both a policy and a registry to track and monitor patients were created. A validated questionnaire for transition readiness was measured. Education was provided based on the results of the questionnaire to prepare the adolescent for transfer of care. A smartphone application was used to promote health care independence. Transfer to adult neurosurgical care included hand-off between the pediatric and adult teams, child life and social work involvement, and scheduled follow up with an adult neurosurgical provider.
All patients 14 to 18 years with indwelling shunts were enrolled in the pilot program. Eight patients completed a baseline transition readiness assessment, received education and anticipatory guidance, and downloaded the smartphone application. At the end of the six month pilot, three patients were successfully transferred to adult care.
The integration of a transition readiness questionnaire and smart phone application during this pilot program was feasible and continues to be used at this institution. Adolescent patients with shunts require gradual and carefully planned transition services.
对于留置分流装置的神经外科青少年患者，尚未描述正式的过渡计划。在没有过渡指导的情况下，从儿科神经外科护理过渡到成人护理，导致在该机构突然进行护理转移。该试点过渡计划的目标是帮助患者和护理人员在过渡时感到知情和准备充分。
使用“Got Transition”®和过渡的六个核心要素来创建该计划。创建了一项政策和一个登记册，以跟踪和监测患者。还测量了用于评估过渡准备情况的经过验证的问卷。根据问卷的结果提供教育，使青少年为护理转移做好准备。使用智能手机应用程序来促进医疗保健独立性。将患者转移至成人神经外科护理包括儿科和成人团队之间的交接、儿童生活和社会工作的参与以及与成人神经外科提供者的预定随访。
所有 14 至 18 岁留置分流装置的患者均参加了试点计划。八名患者完成了基线过渡准备评估，接受了教育和预期指导，并下载了智能手机应用程序。在六个月的试点结束时，有三名患者成功转至成人护理。
在该试点计划中，整合过渡准备问卷和智能手机应用程序是可行的，并且该计划仍在该机构使用。需要渐进式和精心计划的过渡服务的有分流装置的青少年患者。
