Inservice increases use of patient ed. database
Staff education prompted by survey results
By Amy P. Gonzalez, MS
Health Education Coordinator
M.D. Anderson Cancer Center
Houston
In compliance with the Houston-based M.D. Anderson Cancer Center Patient-Family Education Policy, the patient education office receives approval from the pharmacy division on each medication information sheet before it is added to the on-line patient education database and distributed to patients.
While working with clinical pharmacists to develop and receive approval for chemotherapy education sheets, one pharmacist mentioned that not all clinical pharmacists were using the patient education database, which is very discouraging, considering how much work goes into developing documents for the database.
Based on the pharmacist’s statement, I decided to survey 40 pharmacists, including clinical specialists, pharmacy practitioners, and residents to find out what databases they were using for patient education materials. I also wanted to see if they needed or were interested in a patient education inservice. The survey was distributed by Lotus Notes e-mail and interoffice mail. Twenty-three completed surveys were returned.
When asked how often they go to the patient education on-line database for educational materials only 13% of pharmacists said "always," 22% said "most of the time," 35% said "some of the time," and 30% said "never." Reasons for using the on-line database included the following:
• It provides written information regarding chemotherapy for patients to take home.
• It has concise and readable information for patients.
• It has information in Spanish.
Reasons the pharmacists gave for not using the patient education on-line database were:
• They did not know about the database.
• The information is not appropriate for their patient population (i.e., intensive care unit patients and patients receiving high-dose chemotherapy).
• The information is not updated.
• The information is vague.
• Medications not included in the pharmacy formulary are not always included.
• All information is not pertinent for patients.
Clinical pharmacists reportedly use Micromedex, which is available via the M.D. Anderson intranet, more often. They reported using the database always (22%), most of the time (13%), or some of the time (65%).
LexiPals, another database available via the M.D. Anderson intranet, is not widely used (83% of pharmacists reported never using this database).
Pharmacists also said they used information from the Agency for Health Care Policy and Research (AHCPR) web site, from Clinical Pharmacology, and from pharmaceutical companies.
Only 26% of clinical pharmacists said they had received training on the patient education on-line database, although most (74%) said they were familiar with the materials available on the database.
More than half of the responding clinical pharmacists (55%) said they would be interested in attending a patient education inservice.
One pharmacist said he/she appreciates the patient education on-line database very much. Another pharmacist commented that a major problem occurs when the intranet is down, suggesting that there needs to be a backup mechanism to obtain patient education information.
Two pharmacists had content suggestions for the database, with one pharmacist saying that the education information should also be disease-based.
Inservice increases familiarity
Based on the results of the pharmacist survey, an inservice was provided to the clinical pharmacists at one of their monthly staff meetings. The following is a description of what was discussed during the inservice:
• Survey results
The inservice began with a presentation of the results of the survey, with particular attention to the reasons that pharmacists had given for not using the patient education on-line database during the inservice.
• Side Effects Standard Phrasing
Side Effects Standard Phrasing is a document in which standard phrasing is listed for most side effects included in medication information sheets. The Patient Education Office, in conjunction with the Department of Pharmacy, developed this standard of phrasing document to ensure the consistency and quality of side effects information in the patient education medication sheets.
• Process of development and/or revision
When development of a medication sheet is requested, a health education coordinator develops a draft of the medication sheet and sends it to a clinical pharmacist who has been designated as the patient education coordinator for the pharmacy. That pharmacist either makes changes or sends it to a pharmacist who works more with the medication being described. After the pharmacists make any changes that need to be made, the sheet is then sent to the drug use policy director in the Department of Pharmacy for final approval.
Medication sheets are reviewed for revision every three years or by request. When being revised, the sheets are again sent to the designated clinical pharmacist and the drug use policy director for revisions and approval.
• Role of the Patient Education Office
A portion of M.D. Anderson Cancer Center’s Patient-Family Education Policy was read to the group. It says that the Patient Education Office will serve in an advisory capacity and as a resource to patient care staff within the institution and, when appropriate, to its affiliated remote sites.
• Role of the health education coordinator
The role of the health education coordinator position was read, saying that the he or she "coordinates the development of all interdisciplinary patient education programs to promote efficient use of resources, eliminate duplication of effort, and ensure that all clinical information given to patients is in agreement with approved program content."
A list of all health education coordinators was provided to the pharmacists along with their areas of responsibility. As one of those coordinators, I expressed our availability to collaborate and work with the pharmacists to develop new medication sheets, update any sheets that are considered outdated, and to address any concerns communicated to the group. In addition, I informed the pharmacists that it is their responsibility to let the Patient Education Office know when they are aware of changes or additions that need to be made to medication sheets.
• Demonstration of the patient education on-line database
The inservice ended with a step-by-step demonstration of how to locate medication sheets on the new patient education on-line database.
A post-inservice survey was sent to the same 40 pharmacists and 19 completed surveys were returned. In the post-survey, pharmacists who said they never used patient education on-line decreased from 30% to 4%. Pharmacists who said they always used Micromedex fell from 22% to zero.
The inservice proved to be successful by increasing the awareness and usage of the patient education on-line database by clinical pharmacists. Also, communication between the pharmacists and the Patient Education Office has improved with pharmacists requesting new medication sheets and revisions regularly. Furthermore, it has led to pharmacists requesting the inservice be delivered to nurses in both the breast and gynecology centers.
For more information about this survey and the resulting inservice, contact:
• Amy Gonzalez, MS, Health Education Coordinator, Patient Education Office, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 312, Houston, TX 77030-4009. Telephone: (713) 745-8055. E-mail: [email protected].
In compliance with the Houston-based M.D. Anderson Cancer Center Patient-Family Education Policy, the patient education office receives approval from the pharmacy division on each medication information sheet before it is added to the on-line patient education database and distributed to patients.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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