The acuity-adaptable patient room concept is an emerging care model in which a patient is cared for in the same room through discharge regardless of the patient level of acuity. Such transfer contributes to errors in communication, patient disorientation, dissatisfaction, and falls. In the acuity-adaptable patient room model, the varying levels of care are brought to the patient to eliminate or minimize these adverse outcomes. Comprehensive literature search was conducted through search engines, web pages of regulatory bodies, institution of authority and other disciplines, research, abstract presentations, and anecdotal reports as well as hand searches focusing on the outcomes of the acuity-adaptable patient room on patients. Forty eight articles were written presenting evidence of positive impact of the acuity-adaptable patient room on patients.
This article describes transplant nurses' experiences in caring for renal transplant patients in the acuity-adaptable patient room using Husserl's descriptive phenomenology. The setting was a twice-redesignated magnet urban tertiary center in the Southwest United States with 14 acuity-adaptable patient rooms. Audiotaped interviews were analyzed using Colaizzi's method and a purposive sample of 10 transplant nurses. Three theme clusters emerged that described the essence of the transplant nurses' experiences in caring for renal transplant patients in the acuity-adaptable patient room: Patient and family comfort: "...I think their anxiety of just not knowing what's going on-that need is being met." Nurse empowerment: "...Her urine output was going down to the 40s and so I had to call the surgeon recommending that we maybe change the normal saline to half normal for replacement." Acuity-adaptable patient room future potential: "I wish that all patients had this kind of access." The nurses felt empowered in caring for renal transplant patients in the acuity-adaptable patient room thereby creating a healing environment for the patient and the family.
Transplant cardiologists in our hospital have performed the percutaneously placed axillary-subclavian intra-aortic balloon pump procedure since 2007. This procedure allows patients to mobilize and walk while they wait for a heart transplant, rather than remaining on bed rest as they would with a traditional femoral intra-aortic balloon pump. This procedure has presented challenges to the nursing staff. A 2007 literature search revealed no precedent or published nursing articles on this subject. This article reviews heart failure, medical treatments, complications of bed rest associated with the femoral intra-aortic balloon pump, the nursing challenges and unique problems of caring for patients with percutaneously placed axillary-subclavian intra-aortic balloon pumps, and our solutions for those challenges.
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