Educating Nurses on the Specialty Transplant Care Unit

In 2018, a team of nurses at Cleveland Clinic’s main campus launched an educational program to help clinical nurses on the specialty transplant care unit learn the nuances of caring for patients who have received gastrointestinal organs, including the pancreas, kidney, liver and intestine.

“The Specialty Transplant Education Program (STEP) gives nurses an opportunity to get specialty training and to meet and become comfortable with different members of the transplant team,” says Mikaela Hounshell, BSN, RN, kidney/pancreas transplant coordinator at main campus. “Our goal is to make nurses more confident so they know what to expect, what to do and who to go to for help.”

Bolstering unit-specific nursing education

When Hounshell took on the role of kidney/pancreas transplant coordinator, she set out to create an educational opportunity that would supplement short in-services already utilized on the unit. She partnered with several peers to develop the Specialty Transplant Education Program, including Coriandra Deremer, BS, RN, then assistant nurse manager of the unit; Gretchen Garibaldi, BSN, RN, CCTC, liver transplant coordinator; and Michael Spinner, PharmD, MA, transplant pharmacist. “We put our heads together to find a way to provide more comprehensive education to clinical nurses on the unit,” says Hounshell.

Providing nurses a holistic look at patient care

STEP is a half-day program divided into several morning sessions. During the first hour, clinical nurses meet with the liver transplant coordinator on the unit who explains policies, procedures and processes related to liver transplantation. “She covers everything the liver transplant team feels that nurses should know about their patients and the care they receive,” says Hounshell.

Afterward, the nurses meet Hounshell and the transplant pharmacist to go on rounds with the kidney transplant team. “They see how a transplant team works and how the physicians come up with treatments,” says Hounshell. After rounds, the transplant pharmacist teaches the nurses about common medications for transplant patients, including dosage and possible side effects.

During the last session, Hounshell discusses policies, procedures and processes for kidney transplantation. She also touches on immunology testing. “When you are working on a specialty transplant unit, the immune system and immunology testing is very important,” she says. In addition, a transplant nutritionist shares general rules for food safety after transplant.

The program has been a work in progress, with Hounshell and her peers adding elements and tweaking content based on participant feedback. They are currently working with intestinal transplant teams to involve them in the education, too.

Improving the work environment and patient care

By the end of 2019, 29 nurses had participated in STEP – about half of the nurses on the specialty transplant unit. The team strives to fit the program into nurses’ schedules, sometimes offering STEP to groups of three to four nurses and other times offering one-on-one education.

“The nurses seem to really appreciate the program,” says Hounshell. “Feedback is that every nurse should go through the program.” In a post-program survey ranking STEP between one (would not recommend) and five (would highly recommend), 28 nurses gave the program a five and one nurse rated it a four. Last year, STEP also received a Cleveland Clinic Innovation Inventory Award, which recognizes innovative ideas brought to life by individuals or teams within their units or departments.

Hounshell sees the potential for unit-specific education programs like STEP throughout the healthcare system. “We created this for transplants specifically, but what’s nice about the program is that the concept can be used widely,” she says. “Our goal is to teach nurses everything in one setting rather than as it comes up on the floor. We can’t expect nurses to learn all these important concepts in 10 minutes while they are caring for five patients who are ill.”

STEP has benefited patients, too. Hounshell says nurses on the specialty transplant care unit are more confident in their role and understand the reasons behind the things they do. “The nurses know what’s expected of them, what they need to record and what’s required of the patients when they go home,” she says. “As a transplant team, we are all more consistent and on the same page.”