CF Guidelines - Transition

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CF Guidelines - Transition - Paed's to Adult

Definition of Transitional Care:
		"The purposeful and planned movement of adolescents and young adults from child-centred to adult orientated health care systems." Blum et al (1993)

		Transition involves the patient, their family and their caregivers. Problems relating to transfer can occur for any of these groups.

Problems for the young adult patient:
	-	Will be leaving a team they know well.
	-	May have to accept a new hospital as well as new staff.
	-	Will be expected to meet the professionals without their parents being present.
	-	May find an adult ward a very different environment with more rigid rules (such as visiting) and older patients.

Problems for the parents:
	-	May feel excluded by the adult team.
	-	Loose friendships and support from the paediatric team they have known over many years.
	-	Fear how the child will manage without them.

Problems for the paediatric team:
	-	May feel a sense of loss for the patient that they have cared for and nurtured for many years.

Problems for the adult team:
	-	May feel adversely judged with any differences in approach to treatment.
	-	May be blamed by parents if there is deterioration in health.

What is needed for a successful transition:
	-	A formal transition programme that includes planning care for all involved: patient, family and paediatric and adult teams.
	-	An appropriate place to be transferred to.
	-	Flexible age of transfer – usually somewhere between 16 and 18 years old. Disease stage and progress should be considered when deciding on the right time.
	-	The paediatric team and the adult team need to work together and maintain good communication before, during and after transition.
	-	There should be the opportunity to attend joint clinics between the paediatric team and the adult team.
	-	The young person should have the opportunity to visit the adult service facilities.
	-	In-patients require an appropriate environment and staff to meet their special needs.
	-	Young people need facilities that instil independence and allay boredom.

References:
1,		RCN (2004) Adolescent Transition Care – Guidance for Nursing Staff. London, RCN Publication. Pownceby J. (1996) The Coming of Age Project – A study of the transition from paediatric to adult care and treatment adherence amongst young people with cystic fibrosis. London, Cystic Fibrosis Trust. www.rcn.org.uk/publications/pdf/adolescenttransitioncare.pdf

		Dowloadable PDF File - PDF File
			Document approved - 2011
			Document due for review - December 2013

		Acknowledgements: The Peninsula CF team acknowledges the use of guidelines produced by The CF Trust, Manchester, Papworth, Leeds and Brompton CF teams during development of these local Peninsula protocols and guidelines.

Disclaimer: While efforts have been made to ensure that all the information published on this web site is correct, the authors take no responsibility for the accuracy of information, or for harm arising as a consequence of errors contained within this web site. If you have concerns regarding treatment, drugs or doses then consult your local CF consultant.