Cover bases with patient education materials
Consider information and presentation
If educating patients was as simple as giving them information, you could loan them an infusion therapy textbook and be on your way.
Such an approach has its obvious shortcomings, which is why Theresa Harper, MSN, patient education specialist for Hamilton Health Sciences Corp., in Hamilton, Ontario, says patient education materials are much more than providing information.
According to Harper, the first step in creating effective patient education materials is to consider the audience. "We try to create information that is patient-centered," she says. For its home infusion patients, this means consulting more than journals and professional sources. Originally we had IV nurses and patient family members help develop prototypes, then we developed a committee of community nurses and nurses from our corporation to expand them."
Families can prove invaluable throughout the development of education materials. Hamilton Health Sciences uses family members to fill out evaluation forms and test material. All such feedback is solicited by the nurses who work with the families in the field.
"The nurses have had a long working relationship with these families," says Harper. "It all goes through the nurses. Some sit down with the family and discuss the materials, and some will write information down and have the families look over it. We really value the patient input because this is for patients."
It wasn’t long ago that the centralized IV team was handwriting instructions.
"We started this project in the early ’90s because we were having pediatrics go home with ports and nurses were handwriting instructions for parents as a supplement to their teaching," says Harper. "They came to me and asked if I could help them develop written materials, and that is how it started."
Families and patients aren’t the only outside sources used. Harper also collects patient education materials from other providers. She says the main difference was in the supplies and equipment of each provider, which would have a dramatic impact on the specific information included in the education tools. But by simply reviewing other’s tools, Harper was able to come up with several pitfalls that were fairly common:
• Too much to read.
• Too much text or type that is too small, making for a "dense" page.
• Too many medical terms and inclusion of complex information.
• Outdated information.
• Difficulty in following the steps provided.
Of course, in addition to patients and other providers, product literature and medical journals were used to reinforce the experience and evidence-based information of the nurses.
It is often stated that first impressions are everything, a cliché that holds true for patient education materials.
"They have to be readable and inviting," says Harper of patient education materials. "They can’t be threatening when you look at it."
There are several ways to make the materials inviting to patients, such as the sample patient education form (see form, above), rather than intimidating:
1. Use plain language.
Avoid giving patients technical excerpts from the latest medical journal.
"Try to avoid jargon, and if we have to use jargon, we define it," says Harper.
2. Liven it up.
There’s no need to lecture a patient or give them dull notes on technique.
"We try to make it conversational," says Harper. "We write for the audience in a personal tone and an active voice."
This is the area that is often most difficult.
"Many nurses realize it’s important to write in simpler terms, but some just don’t know how to do that because it can be a matter of relearning how to write," says Harper.
3. Looks are important.
Illustrations can be an effective way to enhance education materials. But Harper says to use the illustrations for that purpose alone. "We use illustrations to enhance the learning, but we don’t use it for marketing, so we made a distinct decision there," she says.
The use of graphic artists is kept to a minimum, though, due to the added expense of bringing in an outside contractor.
When creating patient education materials, Harper recommends keeping a specific goal in mind. Are you looking to give patients an understanding of their therapy and illness? Do you want to educate them what to do and who to contact in case of an emergency? The goals and intent of your patient education materials will vary their content.
"We try and go the self-management route," says Harper. "We try and give the patient the skills that allow them to manage their line and decrease the need to use a care provider. It makes them feel like they own the line."
More specific than general self-management are the goals of troubleshooting and problem solving, according to Harper. It’s also important to note the tools are not a reference in and of themselves but are meant to be used in conjunction with nurse’s educating the patient.
"This is not a pamphlet you leave and never see the patient again," says Harper. "It is an interactive tool, not a stand-alone tool. We want our nurses to teach every time they work on a line."
The process usually begins when a clinician comes to Harper with written information for patient education. "I’ll ask them questions like, What is the purpose of the material?’ and, Who is the audience?’" she says. "I read it from the patient’s perspective, and then I start editing. I write up a draft and send it back to the IV team."
Harper says the draft will often go back and forth for up to a year while both sides make additions and revisions. Without an open staff, this process can be difficult.
"You have to be open, honest, and accept feedback without worrying about someone being critical of your work," she says.
As tools are completed, Harper avoids putting everything in one home infusion book. This allows for changes and revisions to be made at any time.
"Even when it’s done, we get feedback from patients or nurses on things that need to change," says Harper. "By printing sheets rather than in a book we can make those changes without reprinting everything."
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