Plan ahead to meet patient education needs
Pre-op info in doctors’ offices, web sites helpful
The patient arrives at 7 a.m., and you have 30 minutes to gather information for the medical history, make sure the patient understands the procedure to be performed, and answer any questions about what the patient should expect following surgery. Oh, by the way, be sure you present all of this information in such a way that the patient understands now as well as after discharge, when he or she is miles away at home.
Patient education in a same-day surgery program is a challenge because the only contact most patients have with the staff prior to the day of surgery is a brief telephone call a day or so before surgery, says Nancy Voelker, RN, MSN, nurse manager of recovery, pre-op, and outpatient recovery for Southeast Missouri Hospital in Cape Girardeau.
Because patients are anxious the morning of surgery, Voelker’s program uses a pre-op booklet that discusses some general pre-op instructions and pain management tips, she says. "We make the booklets available in the physicians’ offices, and we hand it to patients if they need to come to us for lab work prior to the day of surgery," she says.
Giving information prior to the day of surgery is helpful because patients have time to think about questions to ask the nurse, says Ka Russum, RN, BSN, director of the Lowery A. Woodall Outpatient Surgery Facility at Forrest General Hospital in Hattiesburg, MS. In addition to providing pre-op information booklets to physicians’ staffs, her program also takes physician office staff members out to lunch once a month, she says. "We use the lunches as an informal way to share information in a positive manner," she explains.
For example, if a particular physician’s office is having patients arrive too close to surgery times, Russum’s staff will bring up the problem as something they need the office staffs’ help to resolve, rather than accusing them of sending patients at the wrong time, she says.
Give patients specific info
Almost all same-day surgery programs call patients at least one to two days prior to scheduled surgery, but the telephone calls are most effective if the nurse has specific information about the patient’s procedure to offer, Russum says. "Our nurses give instructions about arrival times, NPO, and skin care prior to surgery that are specific to the patient’s procedure," she says. This increases the likelihood of compliance and reduces the risk of delayed surgery, she adds.
Printed instruction sheets also are valuable teaching tools, Voelker says. Her facility has a wide range of patient education/instruction sheets on almost every type of procedure, she says. The instructions were developed in-house with input from physicians and staff members, she says. The handouts are available on an internal database, so there is no need to store stacks of instructions or dig through dozens of papers when a specific one is needed, she points out. "We just print out the one we need," she explains. (See sample postoperative instruction sheet for tonsillectomy and/or adenoidectomy on our web site: www.same-daysurgery.com. Click on "toolbox" and look under "patient documentation/patient education.")
"We start our teaching within the first hour of recovery so that the patient and the family members have time to absorb the information and come up with questions," Voelker says. "You do not teach well if you give patients and their families instructions five minutes before they walk out the door."
Even if you spend as much time educating patients as possible while they are with you, there are always questions and misunderstandings as soon as they get home, so it is important to give patients access to information, says Mary Ellen Bowers, RN, MSN, clinical nurse at the Ambulatory Surgical Center at Beth Israel Deaconess Medical Center in Boston. Bowers’ facility has had a same-day surgery web site (www.bidmc.harvard.edu/ambsurg) for four years. "We include information patients need ahead of time, such as location, parking, arrival times, and what to bring or not to bring," she says. "We also include pain management information that is helpful to patients after surgery."
No matter what techniques you use to streamline patient education and provide comprehensive information, it is important to teach at the patient’s level of understanding, Voelker says. Don’t use complicated medical terms, and be willing to offer down-to-earth advice, she says. "For example, we tell parents whose child has difficulty urinating after surgery that the child can be set in a tub of warm water to make urination less difficult," she explains.
The best advice for nurses feeling the pressure of more patient education to present and less time in which to do it is to relax, says Voelker. "It’s an important part of your job, and we should all have a good time with it," she says.
Sources
For more information about patient education within a same-day surgery program, contact:
• Mary Ellen Bowers, RN, MSN, Clinical Nurse, Ambulatory Surgical Center, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA. Telephone: (617) 667-0300.
• Ka Russum, RN, BSN, Director of Lowery A. Woodall Outpatient Surgery Facility, 105 S. 28th Ave., Hattiesburg, MS 39402. Telephone: (601) 288-3131. E-mail: [email protected].
• Nancy Voelker, RN, BSN, Nurse Manager of Recovery, Pre-op, and Outpatient Recovery, Southeast Missouri Hospital, 1701 Lucey St., Cape Girardeau, MO 63701. Telephone: (573) 334-4822.
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