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Unit Based Approach to Caring for Pulmonary Hypertension Patients

Chanel Etty

Kelsey Johnson

Sarah Joy

Allison Lynn

Megan Smakulski


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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1021

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, MD on October 5-7, 2017


Through a collaborative approach, the Transitional Medical Unit (TMU) has developed and implemented a streamlined process for the care of pulmonary hypertension patient receiving intravenous or inhaled prostacyclins.


To reduce patient harm and improve quality care, all pulmonary hypertension patients on intravenous or inhaled medications are admitted to TMU. Nurses on TMU specialize in the administration of pulmonary hypertension medications and are well versed in the disease process.


TMU has developed a strategic approach to caring for the pulmonary hypertension patient. TMU nurses receive extensive training on the pathology of PAH, pharmacodynamic/kinetics of intravenous/inhaled medications, and administration/monitoring of PAH therapies. All nurses are required to pass hands on bi-annual competency testing. Through an electronic medical alert system all patients on intravenous or inhaled prostacyclins are recognized immediately once they enter our healthcare system. This alert message is sent via page to the TMU charge nurse and the PAH on call team. TMU partnered with the emergency department to develop a process to communicate all PAH line and drug infusion issues to the TMU charge nurse in the moment. This process includes bringing TMU PAH trained RN down to the emergency department to directly troubleshoot central line or infusion complications. A Clinical Management Guideline (CMG) available on the system portal provides guidance and promotes patient safety during initiation, titration and monitoring of these complex patients. In addition, members of the PAH team work closely with the TMU staff and order entry for these medications are restricted to the PAH team providers.


Cohorting patients to the TMU and training of specialized staff have resulted in a decrease in patient harm. In addition, patients are familiar to the staff and patient hand offs are minimized.


TMU has successfully set a standard of care for the PH patient. By recognizing the specific needs of the PH patient and closely monitoring their care, TMU has implemented safety standards to optimize patient outcomes. TMU continues to increase the awareness about the specialized management of the PH patient and PH standards of care.