IBD Patient Care Standards

The following Inflammatory Bowel Disease Patient Care Standards have been developed for the IBD patient care unit at Mount Sinai Hospital. It is the combined effort of the multidisciplinary team that provides the holistic care for patients families coping with Inflammatory Bowel Disease.

Educational strategies and sessions need to be geared towards meeting the outcome standards.

Outcome Standards

• Patient demonstrates manageable level of anxiety as evidenced by verbal and non-verbal indicators (facial expression, body posture, and ability to rest, sleep).

• Patient demonstrates positive self-concept as evidenced by verbal and non-verbal indicators of self-esteem (ability to cope, plans to resume lifestyle and relationships, continued self-care activities, grooming).

• Patient or family demonstrate adaptive grieving as indicated by ability to share feelings, ability to share emotions in a healthy manner, ability to participate in activities of daily living and decision-making.

• Patient or family verbalize understanding of disease process, planned medical/surgical procedure/treatment, alterations in physical appearance and options for management as a result of medical, surgical intervention.

• Patient or family describe anticipated effects of medical, surgical intervention on lifestyle including occupational, school, social and sexual aspects.

• Patient or family verbalize understanding of follow-up and community resources available in order to achieve an ability to cope with the changes, losses as a result of medical, surgical intervention.

Process Standards

Members of the multidisciplinary team become involved with the patient and family either through direct referral from the primary nurse, physician, or other team member; discussion at "bullet rounds"; patient care conferences; pre-admission questionnaire that would identify "at risk" patients or at the pre-admission visit.

• In collaboration with the team, the nurse assesses the patient's and family's level of anxiety and plans interventions aimed at reducing anxiety, as appropriate.

• In collaboration with the team, the nurse assesses the patient's and family's perception of the surgery, medical intervention in relation to effect on self-concept and plans interventions aimed at attaining or maintaining a positive self-concept.

• In collaboration with the team, the nurse assesses the patient's and family's grieving response and plans interventions to facilitate the normal grieving process.

  In collaboration with the team, the nurses assesses the patient's and family's understanding of the diagnosis, prognosis, planned medical/surgical intervention and initiates or reinforces patient and family education based on readiness and ability to learn.

• In collaboration with the team, the nurse assesses the potential effect of medical, surgical intervention on the patient's lifestyle - occupation, school, relationships, social and sexual aspects - and initiates/reinforces patient/family education as well as interventions aimed at providing support.

• In collaboration with the team, the nurse assesses the patient/family with respect to self-care ability, support needs, need for ongoing community resources.

• In collaboration with the team, the nurse provides verbal and written information regarding follow-up care, community resources.

• In collaboration with the team, the nurse initiates or recommends referral to appropriate community resources as indicated.

• In collaboration with the team, the nurse evaluates the effectiveness of interventions and revises the plan of care accordingly.

• The nurse documents relevant information using the appropriate document tool.