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Management of Patients During Inpatient Stay and Discharge – Cardiopulmonary Transplant (3.16.2)

Management of Patients During Inpatient Stay and Discharge – Cardiopulmonary Transplant (3.16.2) - Policies, Administrative, UWHC, Department Specific, Transplant, Transplant - Solid Organ

3.16.2



POLICY & PROCEDURE
Effective Date: July 2007
Revised Date: March 2016
Title: Management of Patients During Inpatient
Stay and Discharge – Cardiopulmonary Transplant Policy Number: 3.16

Page 1 of 2
I. PURPOSE

The purpose of this policy is to provide standards of care for the transplant multidisciplinary team to
ensure that heart and lung transplant patients are being managed with a consistent, high level
standard of care, and that discharge criteria are met prior to the patient being discharged from the
hospital. Each transplant patient is under the care of a multidisciplinary patient care team
coordinated by a physician throughout the transplant and discharge phases of transplantation.

II. POLICY

It is the policy of the UW Transplant program to adhere to the University of Wisconsin Hospital &
Clinics (UWHC) standards of patient care, as well as the standards determined by regulatory and
accrediting agencies, such as The Joint Commission, the Organ Procurement and Transplantation
Network ("OPTN"), the United Network of Organ Sharing ("UNOS") and the Centers of Medicare and
Medicaid Services ("CMS") and State and Federal laws.

III. FORMS

The following forms can be found on the “related tab” of this policy:
Lung Transplant Patient Care Plan
Additional forms according to patient needs

IV. PROCEDURE

A. Rounding: Inpatient rounds are conducted daily to assess all heart and lung transplant patients
and to evaluate their current health condition. Rounds are performed and documented by the
multidisciplinary team, as described in Policy 3.39. On the weekends, rounds are performed
daily by advanced practice providers (APPs) and the attending physician.
B. Progress Notes: The physician updates the progress notes in the patient’s electronic medical
record (EMR) daily. Documentation in the EMR includes each team member’s involvement as
well as the patient’s progress through each phase of the transplant process.
C. Coordinated Care/Discharge Records: The Case Manager or Social Worker updates the patient's
electronic medical record to reflect discharge planning progress. The social worker will
participate in the initial assessment, care planning, and discharge planning.
D. Following organ transplantation, each patient is assigned a specific post-transplant coordinator
who is responsible for working with the multidisciplinary team to provide acceptable standards
of care. Prior to discharge, a post-transplant coordinator shall provide and document



POLICY & PROCEDURE
Effective Date: July 2007
Revised Date: March 2016
Title: Management of Patients During Inpatient
Stay and Discharge – Cardiopulmonary Transplant Policy Number: 3.16

Page 2 of 2
supplemental discharge teaching and confirm that the patient has attended the appropriate
educational sessions.
E. Discharge Process: The patient is discharged per UWHC Policy 7.19 “Admission and Discharge
Criteria for ICU Status on the Cardiothoracic Surgery and Transplant Unit”
1. The below discharge criteria must be met:
A. Progression in recovery to a level where the patient can be managed in the
outpatient setting
B. Patient caregiver / support person has demonstrated proficiency with self-
medication
C. No signs of untreated infection or active bleeding
D. Stable or improving allograft function
E. Tolerating diet
F. Appropriate bowel function

V. REFERENCES

UW Transplant Policy 3.39: Multidisciplinary Patient Care Team – Lung and Multidisciplinary Patient
Care Team - Heart
UWHC Nursing Standards of Care are followed for ICU, Intermediate Care (IMC) and General Care
levels of care

VI. COORDINATION

University of Wisconsin Transplant Program

VII. REVIEWED BY

Heart and Lung Transplant Manager
B4/5 Inpatient Unit Manager
Operations Director

VIII. SIGNED BY

________________________________ _________________________________
Jill Ellefson, MBA Dixon Kaufman, M.D., PhD
Director, Organ Donation and Transplant Service Line Chair, UW Transplant Program