ENDOSCOPY PATIENT
EDUCATIONYvonne 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 instructionsReview of medications including
patient’s understanding of usageAsk if the patient knows what
procedure they are having and why
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
ASK ME THREE
Health Literate Organization
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
Value of ABCGN Certification
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
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
[email protected], 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
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