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Staff training for LVAD dressings

Posted By Ever-hopeful

"Staff training for LVAD dressings"

About: Royal Victoria Hospital / Cardiology Royal Victoria Hospital / Coronary Care Unit

(as a service user),

First let me say that the care from individual nurses was as always of the very highest standard and I am grateful for that.

I have an LVAD (Left Ventricular Assist Device) implanted. A week ago I was admitted to 5D via casualty with a suspected thrombus in the pump. During my stay in 5D the dressing, on the site where the driveline from the external control/power enters my abdomen, needed changed. This happens every 3 days. This is an important part of infection control. Infection being a significant risk to LVAD patients.

On discussing this with the nurse in charge I  was told that it would not be possible to change it, as they had not been trained. This despite the fact that there are a number of LVAD patients in Northern Ireland all managed by the Royal Hospital.

Under normal circumstances this dressing is replaced by my wife. The nurse asked could my wife come to the hospital and change the dressing? She did.

This leads to some questions.

1. Why has training not been provided given the number of  LVAD patients there are, and the fact that this number will only increase?

2. What would have happened if my wife had not been available, couldn't travel or indeed was self-isolating?

3. Given that visits to patients are currently restricted to once a week, is the fact that my wife would have had to come in twice a week an increased risk to herself, patients and staff in relation to Covid-19? I should note I was transferred to the Freeman Hospital and this did not occur on this occasion. What happens the next time?

I have to be honest, I was surprised that the leading cardiology unit in Northern Ireland was in this situation.

I have some reservations about these comments in that I was probably the only LVAD patient in recently, and therefore could be easily identified. In addition, I again want to emphasise that otherwise care was of the expected high standard.

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Responses

Response from Mary McGeough, Lead Nurse Cardiology, Cardiology, Belfast Health and Social Care Trust 3 years ago
We are preparing to make a change
Mary McGeough
Lead Nurse Cardiology, Cardiology,
Belfast Health and Social Care Trust

Lead Nurse for cardiology services Ward 5B, 5C and 5D.

Submitted on 20/10/2020 at 09:45
Published on Care Opinion at 12:35

Dear Ever-hopeful,

Thank you for taking the time to share the story of your experience on Care Opinion.

I am delighted that your care in the main was of the high standard that we would expect and I thank you for highlighting the shortfall in this care. Please be assured that we welcome comments from all our patients as we are constantly striving to improve the standard of care we deliver.

As you mentioned in your comments you have an implant that is relatively rare in Northern Ireland. Ward 5D in the Royal is a satellite centre for the management of patients with these devices; patients are normally transferred to the Heart Transplant Centre that implanted the device should a problem occur. They are admitted to Ward 5D while the transfer is arranged, this usually happens quite quickly.

The nurses in Ward 5D have been trained in the very specialised skill of changing the dressing on the LVAD site, however it is not a skill that would be commonly used so it is difficult to maintain this expertise to the highest standard. The nurse looking after you recognised that your wife was much more skilled at changing your dressing and she felt that offering for your wife to attend to change the dressing would reduce the risk of infection. This occasionally happens in hospitals as we recognise it is difficult to maintain proficiency in some aspects of the aftercare of some of the highly specialised medical interventions that greatly improves patients’ quality of life.

You mention your concerns if your wife had not been available to change your dressing. In the past, we have contacted the transplant co-ordinator in Freeman’s and they have provided virtual training for the staff on the Ward.

In normal circumstances, we would arrange with the transplant co-ordinators in Freeman’s Hospital to come to Belfast to provide an update training for the management of LVAD patients for the staff, to include changing the dressing. However, due to the ongoing pandemic it will not be possible to have face-to-face training. In the short-term, we propose to arrange further virtual training to include a video that staff can watch to revise the procedure.

We greatly value your feedback and use these comments to improve the care experienced by our patients. We endeavour to maintain the high standards we would like all our patients to experience, and your feedback is an important part of this process. Kind regards Mary

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