Growth & Development -Transitioning to Adult Care

Kaiser Ann Pajulas, USRN

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Outline

Overview

Adolescent patients with the following diagnosis often need assistance with transitioning to adult care.
1. Cystic Fibrosis
2. Asthma
3. Sickle Cell Disease
4. Bleeding disorders

Nursing Points

General
Adolescents are at increased risk for poorly managing illnesses due to
1. Increased risk taking
2. Feelings of invincibility
3. Increased emphasis on peer groups and popularity

Assessment

Assess the adolescent for readiness to transition
1. Currently adhering to treatment plan
2. Disease is stabilized or improved
3. Actively participating in health promotion
4. Maintaining a good quality of life
  1. Meeting developmental milestones
  2. Setting and obtaining personal goals

Therapeutic Management

Nursing Care
1. Effective communication and planning
  1. Encourage the patient to be involved in care
  2. Provide opportunities for the patient to make decisions and be involved in care
  3. Continually assess patient for readiness to transition
2. Provide education to help patient develop skills necessary to manage their illness
  1. Example
    1. Adolescent with diabetes learns to manage an insulin pump

Nursing Concepts

Health Promotion
1. Adolescent patients who are transitioning to adult care require close monitoring and education to ensure success.
Human Development
1. During the adolescent phase, patients are at increased risk for non-compliance with treatment plans.
Patient Centered Care
1. Understanding the developmental milestones associated with adolescence will aid in developing patient specific treatment plans.

Patient Education

Adolescent patients should be educated on the long-term complications associated with poor management of their diagnosis.

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Transcript

Hey everyone! In this lesson we are going to talk about the process of helping our adolescent patients transition from pediatric care to adult care, and we’ll do this by thinking about the developmental needs that are specific to this age group.

So, this process of changing care, leaving pediatric settings and moving to an adult provider can be very stressful for an adolescent patient who has been dealing with a complicated illness. they will have developed a high level of comfort in the peds world.

Now, adolescent patients are already at risk for non-compliance because developmentally, they feel invincible. They don’t fully comprehend the impact their illness could have if not properly managed. In addition to this, our adolescent patients are going to be super concerned about their peer groups. They want to be popular, and cool and normal so they may be less compliant if they think it’s going to affect this.

So, yeah transitioning to adult medicine is difficult and should involve a lot of planning. Nurses play a huge role in this process.

Some diagnoses where this is a common issue are cystic fibrosis, asthma, sickle cell disease, and bleeding disorders

The first thing nurses do is help assess to see if the patient is ready to transition.

The first thing we are looking for is to see that the patient is currently adhering to their management plan- so they are taking their medications, attending appointments, complying with diets, and generally have a solid understanding of the disease process.

Next, we want to see that as a result of their adherence, their disease has stabilized. So they way we measure this will vary with each disease, but we would want to see infrequent hospitalizations, fewer exacerbations of the illness, a lack of infections. All the things that would indicate they are managing the disease well.

We also want to see them stepping up and being involved in the care. So not just adhering to the plan, but also helping to create a plan that works for them. So this could mean scheduling appointments, taking time to read about their illness, things like that

Last but not least, we want to see that they are achieving a good quality of life. They have friends, they can set and attain goals, and that they are meeting milestones as well.

Like I said, nurses are really involved in this process. The encounters you have with these patients, either in hospital or at appointments are perfect times to chat about how they are feeling and also to involve them in the care.

It really boils down to communication, planning and patient education. These are pretty self-explanatory. You really want to make sure you give ample opportunities for the patient to be involved and make decisions from early on so they are ready to make the transition when they need to.

Once the transition has been made, they need to be under close monitoring and someone should be reassessing to make sure they are managing well and remain compliant with their care plan.

Peer groups can be really helpful during this time as they can help build confidence and ultimately help the patient stick with the care plan.

Your priority nursing concepts when helping and adolescent transition to adult care are health promotion, growth and development, and patient centered care.

Okay, I’ve listed some key points for this lesson here- let’s just talk through these really quickly. Transitioning care is just the process that takes place when an adolescent patient transitions to adult care. This will always be a team effort, but nurses play a key role in assessing, planning and helping the teen prepare.

One reason it takes all this planning and effort is because adolescents are at risk for being non-compliant. This is because of a lot of reasons but the main ones are because they feel invincible, will engage in risky behaviours and are very concerned about their peer groups.

Nurses play a huge role in looking for these signs of non-compliance and continually reassessing for readiness. Things to look for are current compliance, stabilization of the disease, active participation and interest and quality of life.

Planning is all about involving the patient and supporting them in their decisions.

Education will focus on giving them skills and knowledge needed to safely care for themselves.

That’s it for our lesson on growth and developmental considerations for transitioning to adult care. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

Growth & Development -Transitioning to Adult Care

You're watching a preview. 300,000+ students are watching the full lesson.

Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Overview

Nursing Points

Assessment

Therapeutic Management

Nursing Concepts

Patient Education

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Used by 300,000+ nursing students. 99.25% NCLEX pass rate.

Transcript

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