Video bolsters chronic pulmonary teaching
Identify need for additional teaching
When chronic pulmonary patients were interviewed at Baptist Hospital of Miami to determine the reason for their re-admission, educators discovered that many patients did not fully understand the instructions they were given.
Many patients, for example, said they knew how to use their inhalers, yet when asked to demonstrate the technique could not do so correctly. When asked if they took their full course of antibiotics, patients said they took the medication until they felt better and then quit.
"We found a big knowledge deficit for patients," says Tania Del Rey, MSN, ARNP, assistant nurse manager on the pulmonary unit at Baptist Hospital. There was a lot of information for patients to learn and the health care team did not always have enough time during the hospital stay to go over the instructions again and again with slower learners.
To remedy this problem, the staff made a video to be viewed on the hospital’s closed-circuit television (CCTV) system. Patients can watch the video over and over to learn the information and if they need additional instruction, the appropriate discipline can be notified. For example, if patients need specific instruction on medications, the pharmacist would instruct the patient one-on-one.
A nurse makes sure the patient watches the video at least once during the scheduled viewing times. Following the viewing of the video, a nurse returns to the patient’s room to ask questions about the information to determine if additional teaching is needed in a certain area. Patients have the CCTV schedule and can watch the video again if they want.
A multidisciplinary committee created a video that involved every department that works with pulmonary patients, including social work, respiratory therapy, nutrition, and the chaplain’s office. Staff who were often involved with the pulmonary patients after discharge also were included, such as pulmonary rehabilitation and home health.
The committee determined what information should be included in the video and Del Rey wrote the script. During the video, each discipline goes over the information that pertains to that area of expertise. For example, the nutritionist discusses the importance of a pulmonary diet and the pharmacist explains how to take medications and food and drug interactions. After the instruction in each area, patients are told to tell the nurse if they need more information so the nurse can contact that discipline.
In the beginning of the video, a pulmonary specialist discusses what patients should expect during their hospital stay. A nurse explains the function of the respiratory system, signs and symptoms patients need to report to the doctor after discharge, and the importance of complying with their treatment.
Booklet still to comeThe video was produced by the media services department of another hospital in Miami that is affiliated with Baptist Hospital. This kept the cost down, says Del Rey. In the future, the committee plans to create a booklet to accompany the film.
The booklet will briefly describe the various disciplines that teach in the film and include outpatient phone numbers so patients can call each discipline if they need more information after they are at home.
Follow-up to determine the effectiveness of the video is also planned. Staff will ask patients the same questions they asked before creating the video. "We will also check the readmission rate to see if it has dropped since we implemented the film," says Del Rey.
For more information on creating a film for chronic pulmonary patients to reinforce teaching efforts, contact:
• Tania Del Rey, MSN, ARNP, Assistant Nurse Manager, Pulmonary Unit, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176. Telephone: (305) 596-6561. Fax: (305) 270-3601.