Liver Transplant Intensive Care Unit Team

Case Study: Liver Transplant Intensive Care Unit Team

Mr. Taylor is a 57-year-old liver transplant patient. The team that receives the transplant patients in the intensive care unit (ICU) consists of the nurse assigned to the patient, a pharmacist, a surgical resident, a resident from the internal medicine team, a respiratory therapist, and the ICU head nurse; the family is often involved, especially at the beginning when history is being collected and as discharge approaches. The postoperative transplant team meets every morning to discuss the day’s plan for the patients. The day after Mr. Taylor’s transplant, the team meets, and the nurse assigned to him reports that he seems restless and anxious. After the team reviews the chart, the pharmacist notes that Mr. Taylor had been receiving the immunosuppressant medication intravenously for more than 24 hours and that he should have been switched already to the oral medication. She explains that “shakiness” is a common side effect of the intravenous (IV) version of the medication. The surgical resident suggests a consultation with the psychiatry department for an anxiolytic, but the ICU head nurse recommends switching the patient to the oral immunosuppressant medication and orienting him to lower the “anxiety” before getting the consultation. The assigned nurse offers to engage Mr. Taylor’s adult daughter because she is able to calm him and make him feel less uneasy. The team agrees on the plan.

Discussion Questions

1. What actions in this case study demonstrate proficiency in Interprofessional Collaborative Practice? Identify at least two actions and explain your rationale using the Sub-competencies of any of the four Core Competencies.
2. What are some of the advantages of working as an interprofessional collaborative team, as demonstrated in this case study?
3. Who should be the leader of this team and why?
4. Who should present the case to the group and why?

. Actions Demonstrating Proficiency in Interprofessional Collaborative Practice:

Sub-competency: Values/Ethics for Interprofessional Practice

• Pharmacist’s Identification of Medication Issue: The pharmacist’s recognition of the medication error and explanation of its side effects aligns with the sub-competency of recognizing and respecting the unique cultures, values, roles/responsibilities, and expertise of other professions. This contributes to patient safety and care.

Sub-competency: Roles/Responsibilities

• ICU Head Nurse’s Decision-Making: The ICU head nurse’s decision to prioritize the change to oral medication and addressing the patient’s anxiety aligns with understanding one’s own role and the roles of other professions. By making this decision, the nurse effectively coordinates the team’s efforts to address the patient’s needs without overreaching into other professional domains.

2. Advantages of Interprofessional Collaboration:

• Holistic Patient Care: In this scenario, the collaborative effort allows for a comprehensive approach to patient care. Each professional’s unique expertise contributes to addressing different aspects of the patient’s condition, ensuring a holistic treatment plan.
• Enhanced Communication: Interprofessional collaboration fosters open communication among team members. This facilitates sharing information, addressing concerns, and making informed decisions to optimize patient care.
• Improved Patient Outcomes: By leveraging the diverse expertise of the team, patient outcomes can improve as issues are identified and addressed promptly through collective decision-making.

3. Leadership in the Team:

The ICU head nurse or a designated healthcare professional experienced in coordinating care within the ICU setting could lead the team. Leadership in this scenario should focus on facilitating communication, coordinating care plans, and ensuring the team operates smoothly towards the common goal of patient recovery.

4. Presenter of the Case:

The nurse assigned to Mr. Taylor could present the case to the group. Given their direct interaction and observation of the patient’s condition, they possess firsthand knowledge crucial for an accurate and comprehensive case presentation. However, it’s important that all pertinent information from each team member is considered and included in the discussion.

In essence, this case highlights the significance of interprofessional collaboration in providing comprehensive and patient-centered care in the ICU setting, emphasizing the importance of recognizing and utilizing each team member’s expertise.