Introduction: Children post-heart transplant (HTx) undergo coronary angiography (CA) under general anesthetic (GA) every 2-5 y but this is done without GA in adult centers.  Historically, there has been a lack of formal preparation to introduce teens to adult-like procedures while still under the care of their pediatric team. Applying an interprofessional (IP) approach, HTx nurse practitioners (NPs) and child life specialists collaborated with the catheter lab team to create a virtual information session for teens to prepare them for the procedure.  Here we review the experience implementing this novel IP information session.
Methods: HTx patients aged 14-18 y who were due for routine CA were invited to participate in a session either synchronously (group) or asynchronously (individual) based on scheduling convenience within 4 mos of their CA.  Pre-CA knowledge was assessed via a Kahoot game for the synchronous participants including self-reported anxiety (scale 1-5). Post-CA surveys were used to assess patient knowledge/coping post procedure.
Results: All 18 patients (50% identified as female, mean age 16.3+1.8y, mean time post-HTx 11± 3y) eligible to participate in a session agreed; 14 (78%) participated - virtual synchronous (n=8), virtual asynchronous (n=3), in person asynchronous (n=3).  Reasons for not participating (n=4) included: scheduling conflict due to work, fear of the procedure, CA date change and psychosocial barrier. Pre-session knowledge revealed 7/8 (88%) knew the reason for the CA however only 2/8 (25%) had some baseline knowledge about the procedure itself.  The average self-reported pre-procedural anxiety was 2.8/5 (n=8). Since implementation of this initiative, all session participants (n=14) have undergone CA.  A total of 13/14 (92%) had a coping plan in place organized prior to the procedure date (i.e., child life support and/or anxiolytic available on arrival) and 12/14 (85%) successfully completed the procedure without GA.  Six post-procedure surveys were returned and 5/6 (83%) had improved their knowledge about CA.  Participants felt the sessions were useful in their procedural preparation with average score of 8.4/10;  the synchronous sessions were reported to create a safe space for shared learning, where teens asked questions related to their procedure, general HTx care and topics related to transition.
Conclusion: Our review of the implementation of this IP virtual session notes teens had limited pre-session knowledge or preparation for CA without GA.  Post-session, knowledge and coping support improved with a high level of procedural success without GA. The teens found the sessions beneficial as part of their transition preparation.  Barriers to participation included fear, work/procedure schedule and psychosocial barriers.  The synchronous experience fostered new relationships amongst teens with a shared lived heart transplant experience while creating a safe and supported space for learning.  This experience has informed future initiatives for procedure and transition preparation for adolescents.