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ENDOSCOPY PATIENT EDUCATION. Yvonne Pumphrey, RN, SCNI, CGRN UMMC Endoscopy Patient and Endoscopy Education Coordinator. Objectives. Review Health Literacy Facts Discuss Guidelines for Clear Communication Discuss Endoscopy Patient Education. Health Literacy.
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ENDOSCOPY PATIENT EDUCATION Yvonne Pumphrey, RN, SCNI, CGRN UMMC Endoscopy Patient and Endoscopy Education Coordinator
Objectives • Review Health Literacy Facts • Discuss Guidelines for Clear Communication • Discuss Endoscopy Patient Education
Health Literacy • Health Literacy is defined as the ability to read, understand and effectively use health care information • Research has shown that literacy skills are a stronger predictor of a patient’s health status than: • Age • Education Level • Employment • Income • Race • Ethnicity
Patients with Low Health Literacy Are Less Likely • To seek medical care • To comply with prescribed treatments and follow up • To take medications properly • To keep appointments • To complete medical forms correctly • To admit they don’t understand
Patient’s With Low Health Literacy Are More Likely • To require hospitalization • ↑ hospital length of stay • ↑ mortality • ↑ hospitalizations ↑ annual health care costs • 4 times higher than for patient’s with higher health literacy skills
Assessing for Health Literacy Skills in Endoscopy Patients • Begin with first encounter and establish • Primary language • If patient read and understood pre procedure instructions • Review of medications including patient’s understanding of usage • Ask if the patient knows what procedure they are having and why
ASK ME THREE TEACHING PATIENTS TO ASK 3 EVERY TIME THEY TALK TO THEIR DOCTOR, NURSE OR PHARMACIST 1. WHAT IS MY MAIN PROBLEM ? 2. WHAT DO I NEED TO DO ? 3. WHY IS IT IMPORTANT FOR ME TO DO THIS ? ASK ME 3 is an educational program provided by the Partnership for Clear Health Communication at the National Patient Safety Foundation
CLEAR COMMUNICATION WITH PATIENTS Ask for and use correct pronunciation of patient’s name Encourage patients to bring a list of their current medications and health concerns Use short words and sentences Explain all medical terminology in layman’s terms
Non-Verbal Communication • Use direct eye contact • Nodding indicates that you are listening to the patient • Use affirmative statements , then confirm your understanding with patient’s • Don’t interrupt the patient, allow them to finish their statement
Health Literacy Facts Almost 9 out of 10 adults in the US have some level of difficulty understanding the health information that is common in hospitals, medical offices, media, and communities The average adult in the US reads at an 8th grade level, although 20% of our population read at the 5th grade level or lower. (may include elderly, those with chronic disease, uneducated, and recent immigrants) Medical terminology is most often written at an 11th or 12th grade level creating the gap for low health literacy
Unit Level Education • Pre Procedure Phone Call • Review of Instructions • Npo Status • Adult Accompaniment if Sedation or Anesthesia to be used • Specific Prep Instructions • Review of Medications • Sleep Apnea and Use of CPAP • Review Directions to Facility and Endoscopy Unit • Review Procedure Time and Expected Time of Arrival
Unit Level Education • Begin Patient Education with Endoscopy Unit Orientation • Perform Intake Assessment • Explain Safety Precautions • Explain Pre, Intra and Post Procedure • Initiate Plan of Care with Patient’s Goals, Education Needs, and Interventions • Explain Anesthetics/Sedation Plan
Discharge and Follow Up Education Provide Discharge Instructions Written, Verbal, Multilingual To include : ■ Physician’s impressions and recommendations ■ Medication Reconciliation ■ Follow up treatments/appointment dates and time
Post Procedure Calls • Fever, Pain or Bleeding • Other Problems • Is a physician, physician’s assistant, or nurse practitioner call back necessary • Patient Satisfaction
Community Outreach Education • Health Fairs • Colon Cancer Awareness • Parish Nurse programs • County Homeless Education Support • Educational Fund Raisers • GI Nurses and Associates Day
Founded in 1823 as one of the nation’s oldest academic medical centers. All physicians are faculty at the University of Maryland’s School of Medicine. The medical center treats over 32,000 inpatients and more than 300,000 outpatients each year. The Shock Trauma unit provides treatment for more than 7,500 patients yearly with greater than 97% survival rate. • Magnet Designation • Leap Frog Top Hospital award for quality and safety from 2001-2011 • Listed Among Nation’s Top Hospitals by US News and World Report
UMMC Endoscopy • Case Load – 75% Outpatient 25% Inpatient • Apx 30 procedures daily • Two Procedural Units • Four procedure room / nine bed recovery unit with moderate sedation and anesthesia support • Two procedure room/PACU unit with anesthesia support (SECU-surgical endoscopy care unit)
UMMC Endoscopy • Clinical Staff : 13 Medical and Surgical Endoscopists • 5 Hepatologists • 17 Fellows /3 yr program • 17 Nurses • 16 Technicians
Endoscopy Procedures • EGD • Balloon Enteroscopy • ERCP • Endoscopic Ultrasound • Capsule Endoscopy • Bravo • Cryotherapy • Radio Frequency Ablation • Laser Therapy • Colonoscopy • Flexible Sigmoidoscopy
Study and Review: Stimulates your recall Increases your knowledge base Improves your organization and study skills Promotes networking with colleagues ABCGN Certification: Instills a professional sense of pride and accomplishment Validates your advanced knowledge, competence, and skills Improves patient care Improves patient satisfaction Improves job satisfaction Increases potential for higher salary and career advancement Value of ABCGN Certification
References • New Federal Policy Initiatives To Boost Health Literacy Can Help The Nation Move Beyond the Cycle of Costly Crisis Care (2012) • www.health Literacy.Health.gov A Guide to Writing and Designing Easy to Use Health Websites • www.health Quick Guide to Health Literacy and Older Adults • www.health National Action Plan to Improve Health Literacy • National Patient Safety Foundation Partnership for Clear Health Communication • www.AskMe3.org • The Center for Healthcare Communication infor@communicatingWithPatients.com, www.Communicating WithPatients.com • Institute of Medicine of the National Academies Roundtable on Health Literacy • University of Maryland Health Sciences and Human Services Library • The Newest Vital Sign: A Health Literacy Assessment Tool for Healthcare Providers, http://www.pfizerhealthliteracy.com/public-policy-researchers/NewestVitalSign.aspx • Improving Health Literacy http://www.plainlanguage.gov/populartopics/healthliteracy/index.cfm • University of Maryland Patient and Family Education Council Planning Your Patient’s care Delivery and Education 2008 • University of Maryland Endoscopy Practices and Procedures 2012