Packard Nurses Lead Research, Advance Care
July 12 was a big day for the Ho family of Cupertino. That morning, Cassie Ho, 13, and her father, Simon, both went in for surgery. Due to a condition called biliary atresia, Cassie was facing end-stage liver failure. At Stanford Hospital, a portion of Simon’s liver was removed, then rushed next door to Packard Children’s and transplanted into his daughter. Just weeks later, both Cassie and Simon are doing well.
Still, some big questions remain. Receiving an organ donation from a parent is a dramatic, life-changing event. Living-related liver transplants occur more often in infants too young to remember what happened. But for older patients like Cassie, how might it affect their physical, emotional, social, and family life in the long term?
Annette Nasr, RN, PhD, is determined to find out. “We need to better understand the experiences of adolescents who have undergone a living-related liver transplant,” she says. “But little about the child’s perspective is currently documented in transplant literature.”
As Simon Ho notes, his family would have benefited from hearing about the experiences of other families that had gone through similar situations. Through surveys and interviews with patients ages 11-18, Nasr is now gathering valuable insights. She hopes to translate her findings into educational materials for youth and families, and to help healthcare professionals understand and address the issues that families face throughout the living donation process.
Nurses as Researchers
Nasr is one of a growing number of nurses who are developing new solutions to unmet challenges. Already recognized as compassionate caregivers, Packard’s forward-thinking nurses are now emerging as leaders in pediatric research as well.
“Nurses are in a special position to understand and address patient needs,” says Amy Nichols, RN, EdD, director of Packard’s Center for Nursing Excellence. “Through their own research, they can produce evidence-based recommendations for better healthcare delivery.”
Such creative thinking is being awarded with research grants from the Innovations in Patient Care (IPC) program, which is supported entirely by the Lucile Packard Children’s Fund. Available on a competitive basis to all clinicians at the Hospital, IPC grants give nurses like Nasr the opportunity to lead innovative studies that will translate directly into more effective care.
Finding a Better Way
Another nurse-led study is under way in the cardiovascular intensive care unit (CVICU), where Sandra Staveski, RN, MS, CPNP-AC, cares for children who have undergone heart surgery. While comfort medications are routinely used to minimize patients’ pain and anxiety, they come with drawbacks—the drugs can lead to complications and longer hospital stays.
Staveski is now studying the use of massage therapy, which may reduce the need for medications and minimize their side effects, facilitate lung rehabilitation, reduce the length and cost of hospital stays, and promote patient and family satisfaction. “Massage therapy is currently available only on a limited basis in the CVICU,” explains Staveski. “If we can document its effectiveness, we may be able to offer this therapy routinely so that more children can benefit from it.”
In the coming years, says Pam Wells, vice president of patient care services, studies like Nasr’s and Staveski’s will become even more important. “Nurse-led research allows us to translate innovative practices into better patient outcomes. It can transform our understanding of how medical therapies and care practices benefit patients and their families.”