Jennifer Labas, APN, on Managing the Hospitalized Patient With IBD

Jennifer Labas, APN, reviews her presentation on caring for patients who require hospitalization for Crohn's disease or ulcerative colitis. 

Jennifer Labas, APN, is a board certified FNP from the Inflammatory Bowel Disease Center at the University of Chicago in Chicago, Illinois.

TRANSCRIPT:

Hi, my name is Jennifer Labis. I'm a nurse practitioner at the University of Chicago Medicine in Chicago, Illinois. I am here at the AIBD APP conference this weekend to present inpatient IBD management for Crohn's and ulcerative colitis.

Key takeaways of the talk today are mainly what requires inpatient admission. Mainly patients that are not responding to outpatient therapies or have failed oral prednisone despite having negative infectious workup leading into admission. Big things, takeaways are when to call surgery, especially when we have patients with moderately to severely active inflammatory bowel disease. Certain imaging that you want to do based on that admission, emergent imaging that you want to do, especially in patients with ulcerative colitis to rule out toxic megacolon before even offering medical therapy options. Patients with Crohn's disease, if they've had multiple obstructions, definitely working on deciding between fibrostenotic disease versus active inflammation. So again, steroids are a key point in that assessment.

And then also identifying the psychosocial factors associated with that, especially if patients require surgery during that admission. We're very fortunate where we have IBD friends, where we've had past patients who have undergone similar surgeries or same surgeries as our patients. They actually are available to talk to our patients so that they go into surgery with much less anxiety than maybe what they started with.

And then also for discharge planning home, our biggest thing is to make the admission the least days as possible, mainly for the patient. And also we want to just expedite whatever care we can to get that patient the care that they need, especially if they've been suffering on an outpatient basis. So definitely getting insurance approvals rolling right away. And then on the outpatient side, deciding what bridging therapy we're using so that we can definitely prevent patients from being readmitted again.