Videos provide teaching on demand
July 1, 1999
Videos provide teaching on demand
CCTV and take-home options add convenience
Question: "What are your experiences with your in-house patient education TV system? Have you found it to be a useful tool in light of the shortness of stay and reduction of teachable moments — and if so, how? Are you complementing the system by giving or loaning patients educational videos to take home? If so, what distribution system do you have in place? If using both an in-house TV system and take-home videos, which do you find to be the most effective?
Answer: The On Demand Closed Circuit Tele vision system at St. Joseph’s Hospital of Atlanta is a useful adjunct in teaching patients and families during hospitalization, says Joyce Dittmer, RN, MSN, director of educational services.
With decreasing length of stay for patients who have had open heart surgery, it has become more and more difficult for them to attend a 45-minute class on home instructions and diet prior to discharge. It is also difficult for the patient’s family members to attend the class because it is held Sunday through Friday at 1:30 p.m. Therefore, hospital staff videotaped the class and put it on the CCTV system. Now patients and family members are able to view the video at their convenience.
"Not only is the video one approach to [having fewer] teachable moments; staffing levels are such that nurses may not be able to spend as much time on a one-to-one basis with the patient. The video offers consistent information to the patient that the nurse can either reinforce or evaluate the patient’s learning," says Dittmer.
Having just switched from prescheduled programming to an on-demand system, Northwes tern Memorial Hospital in Chicago has no track record from which to evaluate the technology. Yet, Magdalyn Patyk, MS, RN, expects it to be a much better tool for patient education. "The on-demand system gives staff a little bit more flexibility in regard to meeting the patient’s needs," she says.
It also will complement the teaching for the cardiac clinical paths a little better than the old system. The programming for the cardiac channel was selected in accordance with the teaching prompted by the clinical paths.
The on-demand system currently can handle nine concurrent viewers, but because the system tracks usage, Patyk will be able to evaluate its ability to handle the patient load. The system can be upgraded if viewers are waiting to watch videos.
Technology shapes effectiveness
It seems that CCTV as is only as valuable an educational tool as its technological capabilities. The on-demand system at Provena Mercy Center in Aurora, IL, is run by a volunteer staff. When a patient selects a video from the CCTV guide, he or she dials an extension that connects to a station with a volunteer who manually puts the tape in the VCR and instructs the patient to turn the television to channel three. When the volunteers are not managing the information desk, the patient can’t watch a video.
A second drawback of the system is that only one tape can be viewed at a time. If a patient is watching an educational video when other patients call, they have to wait for their selection. "Originally, we had the tapes on a time schedule, but with the shorter length of stay, patients would miss the video," says Rita Smith, MSN, RN, education coordinator for Provena Mercy.
Even with a limited system, Smith finds that CCTV is a valuable aid to teaching, especially in an era when nurses don’t have a lot of time to devote to teaching. That’s because they can have the patient watch the video while they perform other duties and return to reinforce the education, she says.
CCTV is a valuable teaching tool, agrees Laura Carey, RNC, nurse clinician on the cardiac telemetry unit at South Miami Hospital. Patients view pre-procedure and post-procedure videos on such topics as nutrition and exercise following open heart surgery. Yet many nurses do not take advantage of this teaching tool because the system is too hard to operate. "It takes 10 steps to access the system, and that’s its biggest drawback," says Carey. As a result, patients who are sick don’t exert the effort either.
To make the system less intimidating for both patients and nurses, Carey grouped the instructions into 10 steps and has them available in both Spanish and English.
Northwestern is just beginning to complement its CCTV system with take-home videos. The hip and knee joint replacement video distributed to patients in the physician’s office is now on CCTV and is available at the health learning center. "We are hoping this will be a great piece for patients and their families who don’t always attend the joint replacement classes preoperatively," says Patyk. (For more information on using take-home videos as a teaching tool, see article, p. 78.)
Hospital staff also are experimenting with video on the Intranet, an in-house version of the Internet. A collaborative effort between information services, physical therapy, and nursing development produced a crutch walking demonstration video. Now staff just have to find a way to give patients access to a computer so they can watch the video.
Patient need dictates whether CCTV or the take-home video is the most effective teaching tool, says Paytk. However, with CCTV, a clinician can speak with patients as their questions arise after watching a video.
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