Elsevier

Journal of Pediatric Health Care

Volume 17, Issue 6, November–December 2003, Pages 284-289
Journal of Pediatric Health Care

Original Article
Individualized daily schedules for hospitalized adolescents with cystic fibrosis

https://doi.org/10.1016/S0891-5245(03)00109-3Get rights and content

Abstract

Introduction

This article describes the effects of an individualized patient schedule on satisfaction and clinical outcomes for patients with cystic fibrosis admitted to an adolescent unit.

Method

Data on airway clearance treatments, physical therapy attendance, and school attendance were collected for patients who used the individualized schedule and for historic controls. Patients who were admitted following implementation of the schedule were asked to complete a brief survey about their inpatient care shortly before or after hospital discharge.

Results

Patients who used the schedule were more likely to report that their care was often or always delivered exactly as they expected and to believe that they were involved in care decisions as much as they wanted to be. Eighty-seven percent believed that using the individualized schedule made their stay a little or much better compared to past hospitalizations. There was no change in physical therapy, airway clearance, and school attendance.

Discussion

Engaging hospitalized adolescents with cystic fibrosis in the design of their individualized daily schedule is a win-win proposition, resulting in improved satisfaction while maintaining clinical outcomes.

Section snippets

Schedule development and implementation

In October 2001, a team was formed to address the concerns of patients with CF hospitalized for a pulmonary exacerbation at Cincinnati Children's Hospital Medical Center. The team included the director of the adolescent unit to which many teens with CF are admitted, the CF Center director, a parent of two children with CF, and the CF clinical nurse specialist. Initially, the team planned to develop a patient pathway that would describe, in general, what happened during an inpatient admission.

Patient characteristics

Data from a total of 22 patients were examined. Seventeen patients completed the survey after using the individualized schedule. These data were compared with the data from five patients who declined to use the individualized schedule during the same period. The patients who chose to use the schedule were older (17.7 ± 3.4 vs 16.3 ± 2.4 years), slightly more likely to have private insurance (47% vs 40%), and less likely to be female (65% vs 100%) than were those who declined. All 22 patients

Discussion

The implementation of the individualized daily schedule for adolescents hospitalized for CF resulted in improved patient satisfaction while maintaining existing levels of therapeutic intervention. Although we had hoped to see a significant improvement in physical therapy, airway clearance, and school attendance, we were pleased that using the individualized daily schedule did not lead to a decline in therapies received.

Adolescents hospitalized for a pulmonary exacerbation face many challenges

Acknowledgements

We thank Jim Lang, Kathy Dressman, Debbie Warden, James Acton, and Terri Schindler for their help in completing this project.

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    1

    Jeanne Weiland, RN, MSN, CPNP, is a Clinical Nurse Specialist at the Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    2

    Pamela J. Schoettker, MS, is a Medical Writer at the Center for Health Policy & Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    3

    Terri Byczkowski, PhD, is a Research Associate at the Center for Health Policy & Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    4

    Maria T. Britto, MD, MPH, is an Associate Professor of Pediatrics and Internal Medicine at the Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    5

    Gerry Pandzik, RN, is an Organizational Development Administrator at the Division of Patient Services, Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    6

    Uma R. Kotagal, MBBS, MSc, is Vice President of Quality and Transformation and the Director of the Center for Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

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