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Inpatient Care

  • Lydia White
  • Malcolm TanEmail author
Chapter

Abstract

The therapeutic relationship between patient and clinician is particularly important during an admission to hospital given the physical and psychological stressors involved. Clinicians must be aware of hospitalisation as a potentially tender time including, of course, the IBD nurse who often has a pre-existing relationship with the patient. However, heavy workloads in outpatient roles, uncertainty around value of visits, a lack of renumeration and activity capture for inpatient activity are all reasons why IBD nurses may find that supporting the inpatient becomes the least priority for a busy day. This chapter seeks to re-address the balance by looking first at the role of the IBD nurse when engaging with the IBD inpatient and secondly at an important clinical scenario from which to extrapolate principles for other acute admissions:
  • The IBD nurse in:
    • Trust/therapeutic relationship

    • Translation and teaching

    • Teamwork and trials

  • Medical considerations for the IBD inpatient
    • General and specific management

    • Salvage therapy

    • Timely colectomy

    • Discharge

Keywords

Inpatient Teaching and learning Teamwork Acute severe ulcerative colitis (ASUC) 

References

  1. Ananthakrishnan AN, McGinley EL, Binion DG (2008) Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease. Gut 57:205–210CrossRefGoogle Scholar
  2. Belling R, Woods L, McLaren S (2008) Stakeholder perceptions of specialist Inflammatory Bowel Disease nurses’ role and personal attributes. Int J Nurs Pract 14:67–73CrossRefGoogle Scholar
  3. Dobson S, Bromley L, Dobson M (2011) How to teach: a handbook for clinicians. Oxford University Press, OxfordCrossRefGoogle Scholar
  4. Dudley-Brown S (2006) Revisiting the blended role of the advanced practice nurse. Gastroenterol Nurs 29(3):249–250CrossRefGoogle Scholar
  5. Grainge MJ, West J, Card TR (2010) Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet 375(9715):657–663.  https://doi.org/10.1016/S0140-6736(09)61963-2. Epub 2010 Feb 8CrossRefPubMedGoogle Scholar
  6. Guler P (2017) Patient experience: a critical indicator of healthcare performance. Front Health Serv Manag 33(3):17–29CrossRefGoogle Scholar
  7. Holloway E, Smith P, Warren J (1998) Patients experience a lack of control over their time in hospital. J Clin Nurs 7:460–466CrossRefGoogle Scholar
  8. IBD Standards (2013 update) www.ibdstandards.org.uk
  9. Kaufman D (2003) Applying educational theory in practice. Br J Med 326:213–217CrossRefGoogle Scholar
  10. Lehman R (2017) Sharing as the future of medicine. JAMA Intern Med 177(9):1237–1238.  https://doi.org/10.1001/jamainternmed.2017.2348 CrossRefPubMedGoogle Scholar
  11. Lennard-Jones JE, Ritchie JK, Hilder W, Spicer CC (1975) Assessment of severity in colitis: a preliminary study. Gut 16:579–584CrossRefGoogle Scholar
  12. Linn A (2013) The value of tailored communication in promoting medication intake behaviour. University of Amsterdam, AmsterdamGoogle Scholar
  13. Locock L, Lehman R, Epstein R (2017) Sharing experience of illness and care. JAMA Intern Med 177(9):1249–1250CrossRefGoogle Scholar
  14. Lotte C, Dinesen Alissa J, Walsh Protic M, Heap G, Cummings F, Warren B, George B, Mortensen N, Travis S (2010) The pattern and outcome of acute severe colitis. J Crohn’s Colitis 4(4):431–437CrossRefGoogle Scholar
  15. Manning M (2004) The advanced practice nurse in gastroenterology serving as patient educator. Gastroenterol Nurs 27(5):220–225CrossRefGoogle Scholar
  16. Maskrey N, Gordon A (2017) Shared understanding with patients. JAMA Intern Med 177(9):1247–1248.  https://doi.org/10.1001/jamainternmed.2017.1932 CrossRefPubMedGoogle Scholar
  17. McCabe C (2004) Nurse-patient communication: an exploration of patients’ experiences. J Clin Nurs 13:41–49CrossRefGoogle Scholar
  18. Nightingale A, Middleton W, Middleton S, Hunter J (2000) Evaluation of the effectiveness of a specialist nurse in the management of inflammatory bowel disease (IBD). Eur J Gastroenterol Hepatol 12:967–973CrossRefGoogle Scholar
  19. O’Connor M et al (2013) N-ECCO Consensus statements on the European nursing roles in caring for patients with Crohn’s disease or ulcerative colitis. J Crohns Colitis 7(9):744–764CrossRefGoogle Scholar
  20. Rokach A, Parvini M (2011) Experience of adults and children in hospitals. Early Child Dev Care 181(5):707–715CrossRefGoogle Scholar
  21. Sobrado CW, Sobrado LF (2016) Management of acute severe ulcerative colitis: a clinical update. Arq Bras Cir Dig 29(3):201–205.  https://doi.org/10.1590/0102-6720201600030017 CrossRefPubMedPubMedCentralGoogle Scholar
  22. Stange EF, Travis SPL, Vermeire S, Geboes K, Reinisch W, Barakauskiene A (2008) European evidence-based Consensus on the diagnosis and management of ulcerative colitis: definitions and diagnosis. J Crohns Colitis 2:1–23CrossRefGoogle Scholar
  23. Travis SPL et al (1996) Predicting the outcome in severe ulcerative colitis. Gut 38:905–910CrossRefGoogle Scholar
  24. Travis SP et al (2012) Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut 61:535–542CrossRefGoogle Scholar
  25. Tulskey J, Beach M, Butow P, Hickman S, Mack J, Morrison S, Street R, Sudore R, White D, Pollak K (2017) A research agenda for communication between health care professionals and patients living with serious illness. JAMA Intern Med 177(9):1361–1366.  https://doi.org/10.1001/jamainternmed.2017.2005 CrossRefGoogle Scholar
  26. van Langenberg D, Andrews J (2012) Satisfaction with patient-doctor relationships in inflammatory bowel disease: examining patient-initiated change of specialist. World J Gastroenterol 18(18):2212–2218CrossRefGoogle Scholar
  27. Williams JG et al (2016) Infliximab versus ciclosporin for steroid-resistant acute severe ulcerative colitis (CONSTRUCT): a mixed methods, open-label, pragmatic randomised trial. Lancet Gastroenterol Hepatol 1(1):15–24CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.John Radcliffe HospitalOxfordUK
  2. 2.Rotorua HospitalRotoruaNew Zealand
  3. 3.Changi General HospitalSingaporeSingapore

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