Left Ventricular Assistive Device (LVAD) Teaching Plan GOALS/ASSESSMENT Goal for Teaching Sessions: Inform the patient of what is a LVAD Inform the patient on the purpose(s) for having a LVAD Inform the patients on components of the LVAD system and their maintenance/management Inform patient of potential physiologic problems that can occur after placement of LVAD Inform/Instruct the patient to lifestyle alterations in reference to activities of daily living Inform patient on how to respond to emergencies such as a failed battery or other loss of power to LVADSetting for Teaching: The teaching of the patient was performed in a hospital room with the lights on. The television was turned off and the patient was resting comfortably in his bed and reported as not having any pain or discomfort, nor did he exhibit or report any signs of distress. The teaching was done in the late afternoon upon the patient’s request, reason being that he was most alert and attentive at this time of day. Biographical Data: The patient is a 63 year old Caucasian male.
He currently lives over 100 miles away from the hospital on a small ranch.He is married but his wife is in a long term nursing care facility because he is unable to care for her due to her own health issues. He has no children, but he states as having 2 living brothers that check in on him from time to time. He does have a lady that he has personally hired to help him with maintenance and upkeep of his home and another employee to tend to his animals on the ranch.
He is solely responsible for his own health care and issues in reference to taking meds, knowing what to do in case of an emergency and driving himself and being able to keep his doctors’ appointments.He is currently status post HeartWare LVAD implantation as bridge to transplant on the 4th of November, 2010. Assessment (Patient/Family/Other): 1. Need for information or skill It is absolutely imperative that the patient understand all the information that is being presented to him because he is his own sole caretaker. His housekeeper has a general idea of his health issues but she knows of no specifics and is only there in the daytime therefore in the event of an emergency he must be knowledgeable of his condition.
2. Readiness and Motivation to LearnThe patient was very enthusiastic to listen to all the teaching and was agreeing with all information presented to him. He stated that he knows all this info “both backwards and forward. ” He was then asked to verbalize different aspects of his care of his LVAD and the teaching session then became a question and answer session which was more productive in the assessment and teaching of his knowledge regarding his LVAD 3. Best Mode of Learning The patient did state that he learned best by listening and also by viewing pictures and diagrams.
He stated that he is equally a visual and an auditory learner.In the presence of that statement, I brought a picture of the specific type of LVAD that he has implanted and its different components in addition to the literature and facts being presented. 4. Factors Affecting Learning The only factor affecting his learning is the presence of pain. When the patient is experiencing pain, he asks for pharmacological interventions and states that he “turns the room dark and sleeps it off”. During the teaching session, patient had received his medication approximately one hour before and therefore reported feeling no discomfort and was accepting of the teaching session at that time.
PLAN/EXPECTED OUTCOMES Behavioral Objectives: Patient will verbalize what is a LVAD Patient will verbalize their own specific reason for having an LVAD Patient will demonstrate and recite the name of the different components of an LVAD and what types of maintenance and management they might/will need Patient will verbalize the possible physiological side effects that may occur after placement Patient will verbalize safety precautions for being a LVAD recipient Patient will demonstrate how to properly store controller unit and battery in shower bag so as not to damage the controller or the batteriesMethods/Materials: Patient will be given information via information printed from the manufacturer of the specific LVAD system. He will also be given a picture depicting all the different components of the LVAD system. Furthermore, patient will be given safety precaution and lifestyle altering information verbally with an opportunity to ask any questions or express any concerns. Moreover, the patient will be demonstrated how to properly use the shower bag properly to store the controller unit and battery(s).Lastly, information will be given verbally and per manufacturer’s recommendations on how to respond to emergencies such as a failed battery nor loss of power to LVAD. Outline of Teaching: Gather all teaching materials Give a definition of LVAD and breakdown the meaning of the acronym Present the patient with the type of LVAD they’ll be receiving and state the reason why this patient is receiving a LVAD Label each different component of the LVAD system Give the physiology behind each componentDiscuss any maintenance and management of each part of the LVAD and provide handout with pictures and explanations of each part List/verbalize possible side effects from having a LVAD placed List/verbalize signs and symptoms from side effects List/verbalize patient on modifications that are necessary in doing activities in daily living and any safety precautions that are necessary List/verbalize what to do in an emergency situation such as a failed battery or loss of power to the LVADIMPLEMENTATION: Step by Step Implementation: 1.
A LVAD is a left ventricular assistive device which is a mechanical pump that is used to pump blood to your whole body in the presence of heart failure. 2. Patient are placed on LVAD for 3 reasons: awaiting a heart transplant, during or after a surgery until they can recover, or if a patient is not eligible for a heart transplant (destination therapy). 3.
Heartware LVAD system has 9 components that a patient should become familiar with; the pump which is surgically implanted in the pericardium and above the diaphragm; the controller which provide control signals to the pump and provides feedback and alarms to the patient regarding the device; the battery which powers the pump and entails having 2 batteries or 1 battery with AC adapter or 1 battery with DC adapter at all times. When the battery becomes depleted (approx. hours) the system automatically switches to standby battery only and the depleted battery must be replaced. The battery charger which can simultaneously charge 4 batteries at one time and can also test the batteries as well. The patient pack is a case that holds the controller and 2 battery packs and can be carried over the shoulder or worn around the waist. Controller AC adapter uses power from an electrical outlet to power controller.
A Controller DC adapter uses power from a motor vehicle to power controller.There is also an Alarm Adapter which is a small red adapter inserted into controller when gets powered down. 4. Always put your batteries to charge as soon as you deplete them and rotate them equally so as not to “overuse” one battery more than others. Keep your controller and battery from getting wet or from being “banged” so as to avoid malfunction. 5.
Side effects on your body from having a LVAD implantation are; Pain, renal impairment, bleeding/hemorrhage, collapsed alveoli, embolism, infection, nutritional deficiency and hepatic function impairment. 6.Signs and symptoms from side affects that deem immediate medical attention; severe pain, decreased urine output, swelling of lower extremities, bleeding, shortness of breath, fever, swelling, drainage, or extreme warmth at incision site. 7.
In order for you to shower you must put your controller and two batteries within the shower pack in order to bathe. You must never get in a bathtub or go swimming because they can not get submerged and must stay dry. 8. Patients with LVADS must readily live close a hospital that is equipped to handle such emergencies.Also, it is recommended that patients wear a medical ID and always carry a cell phone with them so that they never find themselves without a way to contact emergency medical services.
Summarization: Patient was then given a summary of all the information that we had discussed back and forth on and was very confident in his knowledge. He expressed his gratitude for me trying to educate him because he feels that through education of his LVAD, he’ll be able to live longer knowing signs and symptoms and some possible complications that can occur. EVALUATION Patient will verbalize what is a LVAD; GOAL METPatient will verbalize their own specific reason for having an LVAD-GOAL MET Patient will demonstrate and recite the name of the different components of an LVAD and what types of maintenance and management they might/will need-GOAL MET Patient will verbalize the possible physiological side effects that may occur after placement-GOAL PARTIALLY MET Patient will verbalize safety precautions for being a LVAD recipient-GOAL MET Patient will demonstrate how to properly store controller unit and battery in shower bag so as not to damage the controller or the batteries-GOAL METPatient was able to only name a few of the side effects of a having an LVAD but stated that he knows his body well and if something doesn’t feel right, he does not hesitate to go to the doctor. Patient will readily available access the information for all his LVAD teaching when he first got his implantation. SELF ANALYSIS I feel that I make a good educator because I’m able to relay the information in a way that does not intimidate the patient but actually empowers them through knowledge to take control of their health by knowing what to do and not letting a condition slow them down in life by living with fear and the “What ifs? ”.As for my patient, he enjoys being around his ranch and he feels very confident in his knowledge about his LVAD.
But we could all use a little improvement, and as for me I would think that I need more reference materials, maybe some videos to have access to or websites that are readily available to patients of a certain class to get information or perhaps maybe grasp the information in a different way to make a patient knowledgeable about their condition. I also noticed that at some times I might have been speaking a little bit too fast for the patient to understand me so I will remember and try to speak at a normal, slower pace.
