|Continuing Nursing Education
Evaluation of a PNP Care Coordinator Model for Hospitalized Children, Adolescents, and Young Adults with Cystic Fibrosis
Purpose: The purpose of this study was to evaluate a new model for delivery of care to hospitalized children, adolescents, and young adults with cystic fibrosis (CF) admitted to the adolescent unit at Golisano's Children's Hospital at Strong.
Specific Aim/Hypothesis: The specific aim of this study was to test the hypothesis that children, adolescents, and young adults with CF who were hospitalized under the new model for care delivery would have better experiences and clinical outcomes than they had during previous hospitalizations prior to the implementation of the new model.
Methods: A pre-post design included all children, adolescents, and young adults with CF admitted to the hospital for treatment of a pulmonary exacerbation during the six-month study period. Each patient's experience was compared with his or her most recent previous hospitalization. Outcomes measured included timeliness of inpatient consultations, change in forced experitory volume in first second (FEV1), weight gain, length of hospital stay (LOS), and patient/parent and nursing/medical staff satisfaction.
Results: A total of 21 patients completed the study. Compared to the patient's previous admission, there was a significant reduction in the time to complete consultations by ancillary services. The differences between predicted LOS and actual LOS was reduced by 2.47 days (p=.06). Actual LOS was decreased by 1.35 days. Parent/patient satisfaction with new model remained high and health care provider satisfaction was overwhelmingly positive.
Conclusions: An inpatient Pediatric Nurse Practitioner Care Coordinator (PNP-CC) for CF patients admitted to the hospital can reduce the time for ancillary service consultations, reduce LOS, and improve patient and health care provider satisfaction. This model also can be applied to the treatment of hospitalized children with other chronic illnesses.