In this May 12 CardioConnect webinar, Marc A. Priest, BSN, RN, CCRN, discussed his hospital's effective long-term pediatric VAD therapy program. Marc is the Nemours Cardiac Center at Alfred I. duPont Hospital for Children Extracorporeal Life Support (ECLS) and Ventricular Assist Device (VAD) Coordinator.
For severe forms of heart failure, VAD therapy may enable patients' longevity and a higher quality of life. VADs are often utilized to keep patients alive until a donor organ is available. Increasingly, they may be used as a permanent solution for heart failure patients who do not qualify for heart transplantation. Marc covered the internal organizational structure, community relationships and outreach vital to building a comprehensive outpatient pediatric VAD program, and how his hospital's program improves patients' quality of life.
Marc began his career as a critical care registered nurse in The Children's Hospital of Philadelphia's Pediatric Intensive Care Unit. He specialized in all aspects of critical care, including neonatal and cardiac, and this experience sparked his passion for working with ECLS and MCS devices. In 2011, Marc took a position with Nemours Cardiac Center, located within the Nemours/Alfred I. duPont Hospital for Children, to help build and expand a comprehensive ECLS and MCS program.
Learn more about how Marc built and coordinates his hospital's long-term pediatric VAD therapy program.
How does your hospital identify pediatric patients eligible for VAD therapy?
We utilize the New York Heart Association (NYHA) Functional Classification system. Heart failure patients in class III-IV qualify for VAD therapy.
What are some of the biggest challenges associated with long-term pediatric VAD therapy? How does your hospital address these challenges?
There are several challenges specific to long-term pediatric VAD therapy. Therapy compliance can be particularly challenging, especially among teenagers. Patient and family re-education must occur regularly. There are also complications that may occur among VAD patients, such as strokes and gastrointestinal bleeding. Finally, psychological challenges, such as depression and anxiety, may affect patients. We address these challenges through comprehensive, multidisciplinary medical oversight, including palliative care and psychological treatment.
How does your hospital measure a pediatric VAD therapy patient's quality of life?
Our hospital is a member of Pedimacs, the pediatric portion of Intermacs. Pedimacs was developed to focus on capturing data elements unique to pediatric patients receiving mechanical circulatory support device (MCSD) therapy and specific pediatric populations whom therapy may be most effective. We also monitor Pediatric Quality of Life Inventory and VAD Quality of Life (QOL) questionnaires completed by patients and their families.
What are you goals for the future of your long-term pediatric VAD therapy program?
We do not view VAD therapy as merely a bridge for transplant patients. The goals of our long-term pediaric VAD therapy program are to treat heart failure and improve quality of life regardless of transplant status. We aim to minimize complications while optimizing quality of care.
About the Webinar Series
This was the Battelle Healthcare Colloquium's second CardioConnect webinar. The Alfred I. duPont Hospital for Children, a Colloquium member hospital, is a division of Nemours, one of the nation’s largest children’s health systems devoted to patient care, teaching and research.
The CardioConnect webinar series is designed specifically with Colloquium members in mind. Each month, members are invited to join us to collaborate and discuss the latest in enabling their healthcare organization to meet their heart failure care goals.
Battelle Healthcare Colloquium transforms healthcare organizations by using process improvement methodology to advance operational efficiencies and patient outcomes through Heart Failure Accreditation. If your healthcare organization is interested in Heart Failure Accreditation, as well as gaining access to our monthly CardioConnect webinar series, contact the Battelle Healthcare Colloquium team. Visit battelle.org/heart for more information.