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

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