title: Transition to adult care in pediatric solid-organ transplant: development of a practice guideline.
abstract: BACKGROUND
  Transition to adult-centered care is becoming an increasingly important area of practice in pediatric organ transplant. Standardized, best-practice guidelines are needed to assist transplant practitioners in providing optimal transitional care for this population of patients.
  
  
  OBJECTIVE
  To describe the development and implementation of a practice guideline for the transitional care of pediatric transplant recipients.
  
  
  METHODS
  A quality improvement project was undertaken in a pediatric multiorgan transplant program setting. Strategies employed included (1) creation of an interdisciplinary working group, (2) survey of transition-related practices and learning needs of transplant practitioners, (3) review of the literature and existing transition-related materials, and (4) creation of transition guidelines.
  
  
  RESULTS
  An interdisciplinary survey of transplant practitioners at our institution identified practice strengths related to transitional care and learning needs. Review of relevant literature and other materials revealed limited but emerging research related to the transition of pediatric transplant recipients from pediatric to adult care. Existing transition tools were examined and applicable items identified. A practice guideline for use with pediatric transplant recipients transitioning to adult care was developed. Strategies to educate staff about the guideline and promote ongoing guideline use were implemented.
  
  
  CONCLUSIONS
  Preparing pediatric transplant recipients and their families for transition to adult-centered care is an emerging challenge for transplant teams. These guidelines provide practitioners with a developmentally sensitive overview of important transition-related domains and strategies directed toward patients and their caregivers, who may experience the process of transition differently. Dissemination of the pediatric transplant transition guideline will make transition information more widely available to transplant practitioners.
authors.affiliation: The Hospital for Sick Children (AG, KM, KB, YA, MK), University of Toronto (YA, MK), Toronto, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Gold
authors.affiliation: The Hospital for Sick Children (AG, KM, KB, YA, MK), University of Toronto (YA, MK), Toronto, Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Martin
authors.affiliation: The Hospital for Sick Children (AG, KM, KB, YA, MK), University of Toronto (YA, MK), Toronto, Canada.
authors.forename: Katie
authors.initials: K
authors.lastname: Breckbill
authors.affiliation: The Hospital for Sick Children (AG, KM, KB, YA, MK), University of Toronto (YA, MK), Toronto, Canada.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Avitzur
authors.affiliation: The Hospital for Sick Children (AG, KM, KB, YA, MK), University of Toronto (YA, MK), Toronto, Canada.
authors.forename: Miriam
authors.initials: M
authors.lastname: Kaufman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D009732:Nursing Care / Q000592:standards*; D016377:Organ Transplantation / Q000451:nursing*; D010371:Pediatric Nursing / Q000592:standards*; D017410:Practice Guidelines as Topic; D060305:Transition to Adult Care / Q000592:standards*; D066027:Transplant Recipients; D055815:Young Adult