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Nurse Practitioner Lead Pediatric Baclofen Pump Program: Impact on Safety and Quality of Care

Kristin Buxton1, Ann Morgan, Jayne Rogers

  • 1Ann Morgan, MS RN CPNP, is Nurse Practitioner, Baclofen Pump Program, Boston Children's Hospital, Boston, MA. Jayne Rogers, MSN RN NEA-BC CPHQ, is Nursing Director, Inpatient Medicine Services, Boston Children's Hospital, Boston, MA.

The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
|August 18, 2017
PubMed

Insights

Intrathecal baclofen (ITB) therapy manages spasticity in children with cerebral palsy. A dedicated nurse practitioner-led program significantly enhances patient safety and care quality for ITB therapy management.

Area of Science:

  • Neurology
  • Pediatrics
  • Rehabilitation Medicine

Background:

  • Children with cerebral palsy often suffer from debilitating spasticity, leading to pain and contractures.
  • Intrathecal baclofen (ITB) therapy offers relief but carries risks, including life-threatening withdrawal from abrupt discontinuation.
  • Regular system maintenance and patient support are crucial for safe ITB therapy.

Purpose of the Study:

  • To describe the development and impact of a nurse practitioner-led program for managing intrathecal baclofen therapy in pediatric patients.
  • To highlight the essential role of the nurse practitioner in ensuring the safety and quality of care for patients on ITB therapy.

Main Methods:

  • Development of a specialized program with a nurse practitioner (NP) leader to manage ITB therapy.
  • Implementation of comprehensive patient and family education programs.
  • Establishment of quality and safety initiatives led by the NP.
  • Leveraging the NP's close patient relationships and clinical knowledge for proactive issue identification.

Main Results:

  • The NP's role evolved to become essential for the safe and effective management of ITB pumps.
  • The program successfully integrated outpatient and inpatient management of baclofen pumps.
  • Enhanced patient and family education improved understanding and adherence to therapy.
  • The NP's unique position facilitated early detection and management of potential ITB-related concerns.
  • Significant improvements in the overall safety and quality of care for patients receiving ITB therapy were observed.

Conclusions:

  • A dedicated nurse practitioner-led program is vital for optimizing safety and care quality in pediatric ITB therapy.
  • The NP's expertise and patient relationships are key assets in managing complex ITB therapy and mitigating risks.
  • This model of care enhances patient outcomes and institutional safety for intrathecal baclofen treatment.

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