The impact of the early introduction of a Transplant Nurse Specialist in the management of patients on early return from the regional center to the local center.

E Harrison, S Bhandari

Hull Royal Infirmary

Problem - Previously renal transplant recipients returned from the regional center after 5-10 days post transplant and required a period of inpatient assessment and monitoring before out patient follow up.

Purpose – We assessed the impact of the introduction of the transplant nurse practitioner (TPN) and associated specialist clinic for early transplant management and follow-up.

Design- Current and prior practice was retrospectively evaluated by examining the documentation on the transfer of patients and documentation of patient management.

Findings – Previously less than 10% of the patients on return from the regional center had written documentation of events(only a copy of the medications and biochemical profile was present no details of surgery, donor or complications). However telephone information was routinely given. Follow up as ward attendees was sporadic and unstructured and prone to confusion. The introduction of the TPN has lead to a structured approach. All patients now have a structured transfer sheet with all essential relevant details included. Key duties include co-ordinating the post transplant care. Education and follow up of all patients in particular review of wounds, monitoring biochemistry, support and close liaisons with clinicians and all other members of the multidisciplinary team. The TPN ensures that current local transplant protocols are followed e.g. arranging removal of ureteric stents at six weeks with post ultrasound scanning checks. Detailed written plans are in place allowing close follow up and early investigations as necessary. The patients are seen separately by the TPN who allows time to educate these patients with regards to their new treatment regimes.

Conclusion – the role of the TPN is central to the success of early transplant management.

Relevance – The TPN ensures that early return to the local center is safe and ensures that patient care is holistic and has continuity of care.