Equal Partners in Pediatric Skin and Wound Care: multidisciplinary best practice project

Transcription

1 Equal Partners in Pediatric Skin and Wound Care: multidisciplinary best practice project Schlüer Anna-Barbara, PhD, MScN, Advanced Practioner Nurse for Skin- and Wound care Rotterdam 29 th August 2019

2 Disclosure All photographs used with permission of families and patients (where applicable)

3 Children's Hospital Zurich, Switzerland highly specialized medicine needs highly specialized nursing care 3

4 App. 250 beds incl. pediatric burn center incl. pediatric rehabilitation center 4

5 Start searching a team Hard work

6 Pediatric burn and plastic surgery Skin and wound care Ichthyosis Atopic dermatitis Chronic and complex wounds Vascular anomalies, Hemangioma ulcer Congenital melanocyte Naevii Steven Johnson / TEN Epidermolysis bullosa Pediatric dermatology 6

7 Working in the team 7

8 Plastic surgery and pediatric burn surgery team since 1977 Dr. med. Rok Krajik Dr. med. Johannes Adams Med pract. Julia Elrod Team TBRU PD Dr. med. C. Schiestl Dr. med. Kathrin Neuhaus PD Dr. med. Sophie Böttcher 8

9 Pediatric dermatology team since 2002 PD Dr. med Lisa Weibel Dr. med. Martin Theiler Dr. med. Agnes Schwieger-Briel* Dr. med. Isabelle Luchsinger Dr. med. Regula Wälchli* *mit FMH Dermatologie und FMH Pädiatrie 9

10 Situation NP/ APN in Switzerland today No regulation by government for NP/APN roles Successful development and implementation of APN role models in practice since 2002 Innovation and development of NP/ APN roles needs leadership, experience, education..and a passion for patients and health care 10

11 Its all about the skin 11

12 ANP Wound care ANP Wound, Skin and Ostomy Care ANP Skin and Wound care since 2015 Karin Willi Münch (Focus Pediatric Burns) Dania Strobel (Vascular Anomalies & Laserinternevtion) Edith Angelico (RN, acute Wounds) Dr. Anna-Barbara Schlüer (Head) Corinne Brunner APN Skin Care Started with 40%, today a Nurseled service with 320% Bettina Hafner acute wound care 12

13 Team work not always an easy mission 13

14 Good teamwork is about not only working together, but respect each other trust each other honor each other believe in every one within the mission stay together listen to each other know your own part within the mission define goals together keep up and communicate to every one 14

15 On the way.. 15

16 Our Patients..care and cure together. 16

17 Our Patients..care and cure together. Hand in hand. Hand in hand with FD 17

18 Our Patients..care and cure together. 18

19 Equal partners at Zentrum Kinderhaut since PD Dr. med. C. Schiestl, Dr. Anna-Barbara Schlüer, PD Dr. med. Lisa Weibel 19

20 Low term neonate 32 gga, with aplasia cutis and multiple erosions at whole body 20

21 Priorities and goals: Excellent wound management Pain treatment Nutrition and fluid management DIAGNOSE! 21

22 Working in the team Baby and Family Lead by pediatric dermatologist APN/ clinical nurse specialists PICU Nurses PICU Doctors Anesthesiologist Psychologist Genetic team Plastic surgeon Gastroenterologist Nutritionist Physiotherapist Occupational therapist Social worker. And.. 22

23 à Septicemia (Pseudomonas) with multiorgan failure and à Ecthyma gangraenosum 23

24 Who takes a decision? Together in the team What are the new goals? How far to go? Where to start with treatment? Lead by? 24

25 Who takes a decision? Together in the team What are the new goals? How far to go? Where to start with treatment? Lead by? APN/ Wound care Specialists Team even more excellent wound care no further escalation. Handing over after 8 weeks to. 25

26 Who takes a decision? Together in the team What are the new goals? next steps Lead by? Plastic surgeon team maternal split thickness skin graft.. 26

27 It's all about her skin Lead by: APN Skin and Wound Care Discharge after 4 month Define an outpatient team including: local Nurses Family doctor local Physiotherapist APN/ wound care team Orthopedist and Orthopedist technician 27

28 Good teamwork is about caring for patients and family not only working together, but respect each other trust each other honor each other believe in every one within the mission stay together listen to each other know your own part within the mission define goals together keep up and communicate to every one 28

29 Titel / Autor / Ort / dd.mm.yyyy 29

30 Thank you Contact: 30