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VAD Programs Driving Ahead with the Inclusion of Bioengineering Students


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By Pamela S. Combs, PhD, RN
Seton Medical Center
Austin, Texas
pscombs@seton.org



"The discipline of creation, be it to paint, compose, write, is an effort towards wholeness."
(Reflections on Faith and Art by Madeleine L'Engle) [1]



Due to a significant improvement in survival rates following implantation of ventricular assist devices (VADs), the number of patients with implanted VADs has increased considerably [2]. Considering this increase in implants, the VAD team composition is evolving into a mixture that includes other members besides cardiologists, surgeons, VAD Coordinators, and perfusionists [3]. This brief discussion will describe the three key factors to consider when transitioning a Bioengineering student into the VAD program in order to add to the program's "wholeness."

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VAD Manager Pam Combs reviews VAD equipment with Bioengineering student Connie Zurbuch

  1. Stay within the Lines: The third-year student hired from the University of Texas School of Bioengineering had little knowledge of VADs but was eager to learn. Orientation began with a comprehensive and intensive training period consisting of one-on-one training with the VAD Coordinators, shadowing the surgeons and physicians, and formal training with industry.

    Clear delineation and explanation of scope was explained regarding the role. An explanation of scope of service was provided to the Bioengineering student which was not to provide hands-on care for the patient, since typically the patient believes anyone who is not a physician is a nurse [4]. The duties of the student were listed as the following: 1) Serve as support staff for patients with VADs, 2) Be responsible for the care and maintenance of the VAD equipment, 3) Coordinate VAD equipment care and maintenance activities with VAD procedures/physicians/teaching, and 4) Provide patient teaching regarding equipment.

  2. Add fuel for Motion: Initially, simple learning goals were established and as those goals were achieved, higher goals were set. Each achievement in knowledge goal was a step to a higher knowledge level. This learning process takes time and patience and is crucial to provide mentoring with a continuum of communication. The team's long-term goals were to foster growth and to keep the student in the field of VADs.

    Initially, basic foundational learning was performed with VAD equipment and as confidence and knowledge expanded, the duties broadened to teaching the patient and community.

  3. The Compass remains on the Patient: The primary focus of the VAD team is the patient. One of many attributes the student represented was a strong work ethic with a personable demeanor that worked well with patient interactions. This positive demeanor allowed the building of student-patient relationships. These positive relationships led to extra monitoring of the VAD patient. Many patients provided positive feedback towards the students stating she added energy and time for equipment focus to our care.

In conclusion, the integration of the Bioengineering student has added to the positivity of the dynamic while adding not only a technical "go to" but a chance to mentor young innovators. This experience has allowed the team to foster a newcomer into the field who is now graduated and will forge ahead into the VAD industry. Understanding changes in the composition of the VAD team is imperative in order to proceed towards the destination of positive patient outcomes. Changes like those described above will only add to our own strength in knowledge and deliverance of care to the VAD patient. This experience was particularly rewarding in fostered mentoring, sharing of knowledge, building teamwork, and positive patient outcomes. ■

Disclosure Statement: The author has no conflicts of interest to disclose.


References:

  1. L'Engle, M. (2001). Walking on Water: Reflections on Faith and Art. WaterBrook Press.
  2. Slaughter, M. et al. (2010). Clinical management of continuous-flow left ventricular assist devices in advanced heart failure, Journal of Heart and Lung Transplantation, 29, S1-S39.
  3. Princer, K. (2012). The role of clinical engineer within a mechanical circulatory support device program: A single center's experience. Progress in Transplantation, 20(2), pp. 148-154.
  4. Robinson, B., & Cook, K. (2010). The HCAHPS Handbook: Hardwire your hospital for pay-for-performance success. Fire Starter Publishing: Gulf Breeze, FL.



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