Papworth Hospital is is one of five centres nationally that provide ExtraCorporeal Membrane Oxygenation (ECMO). It involves the drainage of venous blood, adding oxygen and removing carbon dioxide before returning it to the patient and is used to support patients with acute respiratory distress syndrome.Jo-anne Fowles, Lead Nurse at Papworth was responsible for devising the robust referral pathways and ensuring safe repatriation of patients back to a hospital nearer their home when appropriate. Clinically, she is the lead practitioner on the team, demonstrating a high level of expertise in ECMO practice which includes trouble shooting the circuit and managing patient care including when weaning off ECMO and post-ECMO support.
Jo-anne developed a programme of study days, annually assessed reflective essays and clinical assessments. As a result, patients’ care is less fragmented and when nurses are supporting relatives they have the knowledge and experience to answer their questions. There are protocols for keeping in touch with the referring unit while the patient is at Papworth and following their repatriation and letters are sent to the patient’s GP.
Recovery
Once the patient is ready, they are repatriated to their hospital but Papworth supports the local team with telephone follow up. ‘After six months we invite all patients to our clinic where we do a quality of life assessment using a modified questionnaire from Canada on how they feel that day,’ says Jo-anne. ‘We also take ex-patients and their families to the ICU and show them an ECMO circuit. It is a very important part of the patient’s recovery – and amazing to see their response.’
Patient satisfaction questionnaires are very positive, as are relative experience questionnaires. Patient/carer information has been made available so relatives can be more informed about the treatment. The nurses that travel with the retrieval team are also trained in family liaison and give families a written leaflet.
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