Written materials are a good reminder

Providing written information for the patient with heart failure to use at home is important for reinforcing what was taught, says Eileen Brinker, RN, MSN, heart failure program coordinator at the University of California, San Francisco (UCSF) Medical Center.

Therefore at UCSF Medical Center a binder was created with content written in plain language at the sixth-grade reading level. Because the target population is age 65 and older, the copy is in large font, and lots of clip art and color is used to make it easy to read and understand. The binder is used during teaching sessions on heart failure focusing on the use of the patient's prescribed diuretic, the importance of weighing daily, avoiding foods high in sodium, and signs and symptoms that require medical attention.

Material has been added or removed to improve understanding, Brinker says. For example, during follow-up phone calls to the patients, it was discovered that patients did not seek medical help when they recognized signs and symptoms of their heart failure worsening because they did not know who to call.

To address this problem, a phone card was developed to list the numbers of the medical team, which is completed before discharge. Phone numbers might be provided for the primary care physician, the homecare nurse, and the cardiologist.

Also, four pages covering the main topics were translated into Russian, Chinese, and Spanish to meet the needs of the medical center's highest percentage of non-English speaking patients. Brinker says online resources with similar content for patients who speak other languages are often pulled from www.HealthInfoTranslations.com.

At Lehigh Valley Health Network in Allentown, PA, several types of written materials to reinforce teaching on heart failure are available, says Paula Robinson, RN, BC, MSN, patient, family and consumer education manager.

A book called "Living With Heart Failure Home Advisor" provides details on self-management at home and has such information as the anatomy and physiology of heart failure, diet, and medication. Although it is written at a seventh/eighth-grade reading level, if an individual has literacy issues and does not state that learning by reading is their preferred style, there are other alternatives.

The teach-back questions used during the teaching sessions can be printed electronically from the patient education section of the Intranet and given to patients to use as a worksheet. Also single-page health sheets that convey one concept of heart failure self-management are available through Krames On-Demand. These pages are written at the sixth- to eighth-grade reading level with graphics and are designed for people with poor literacy skills. This variety of written materials helps ensure the right resource is available for patients and families.

Heart Failure Packet

Signs of Heart Failure

Example of Calendar

Teach-Back Guidelines

Teach-Back Questions


For more information about the Krames electronic patient education delivery system used at Lehigh Valley Health Network in Allentown, PA, go to https://www.krames.com. Click on "Products," then "Krames On-Demand."