Ncbi How Can Aprns Educate Patients and Families
J Hosp Librariansh. Writer manuscript; available in PMC 2021 Jan 14.
Published in last edited form equally:
PMCID: PMC7273904
NIHMSID: NIHMS1549837
Validating Effective Interventions in Patient/Family Education Using Tablet Computers
Abstract
Patient teaching at the bedside, with Android tablet computers, has proven to be successful at the University of Southward Alabama Children's & Women'southward Hospital in Mobile, Alabama. Plans to expand the program within the USA Health Organization were made possible with a National Network of Libraries of Medicine Southeastern Atlantic Region Technology Comeback Honour in 2018. This article discusses the implementation of tablet computers in a larger hospital setting inside the USA Health System and discusses the bear upon of the educational interventions used in patient education within this health disparate community.
Keywords: patient education as topic, tablet computers, family unit education, wellness videos, program evaluation, chronic diseases, healthcare disparities
Background
Access to quality wellness information using tablet computers at the bedside at the University of South Alabama (USA) Children'south & Women's Infirmary has greatly assisted parents and their families to locate information on their or their child's condition, medications, and home-based procedures from the National Library of Medicine (NLM) and the National Institutes of Health (NIH) resources (i). The seeds of this project were established from a National Network of Libraries of Medicine Southeastern Atlantic (NNLM Ocean) Technology Improvement Award in 2016 that purchased Android tablet computers and rolling bedside stands for patient teaching within the Pediatric and USS Hope infusion units of the U.s. Children's & Women'due south Hospital. In improver to the resources from NLM and NIH, X-Plainly® health videos from the Patient Didactics Institute were too available on the tablet computers. The project proved to exist very successful and additional funding was sought to expand the program to include all units of the much larger United states of america University Hospital and two additional units of the United states of america Children's & Women's Hospital specifically, the High Take chances OB/GYN and Mother Babe units. This expansion would create a comprehensive patient instruction program throughout the USA Health Organization leading to excellent patient care.
United states Wellness is habitation to the region's most respected physicians and researchers, who practice at various facilities that include the USA Children's & Women'southward Hospital, USA University Hospital, USA Mitchell Cancer Found and USA Physicians Group clinics. The USA University Hospital is an astute level one trauma center that is besides home to the Arnold Luterman Regional Burn Centre, one of the busiest burn centers in the state. Meetings with the The states Academy Infirmary nursing administration were held to discuss the implementation of the tablet computers for patient education at this facility so that patients on all units of infirmary could be served. Nurse managers from each unit were involved in the discussions and after several meetings it was determined that the devices could serve an educational need at the facility. Each floor would have one tablet on a rolling bedside stand up that would be easily attainable to the nurse educator and/or floor nurses. The resources on the tablets included those from the National Library of Medicine such every bit MedlinePlus, LactMed, Health Reach, Genetics Dwelling Reference, Genetic and Rare Diseases Information Middle likewise equally health videos from the Patient Education Institute'due south Ten-Plain® video collection.
The U.s. Children's & Women's Infirmary had 12 tablet computers in identify within the Pediatric, Neonatal Intensive Care Unit (NICU) and the USS Promise Infusion units from the previous NNLM Ocean Engineering science award but saw a need for more in the High Take chances OB/GYN (HROB) and Mother Baby units of the hospital. The HROB unit attempted to expand the educational needs of their patients previously by calculation weekly classes in the use of MedlinePlus in a classroom setting with a librarian, but considering the patients are bedridden, it proved hard to execute. Many of the patients have underlying chronic illnesses such equally diabetes and heart affliction and have extended stays in the hospital, some, up to a month. Education with the tablet computers on rolling stands for this patient population was a perfect solution as patients could read near pre- and postal service-delivery issues and newborn home care procedures at the bedside during the many weeks they are bedridden. Quality data in a format that is easy to use would provide patients with the necessary tools to continue using the resources after discharge.
Community Needs Assessment
The USA Health Arrangement conducts a customs health needs assessment every three years. The 2015–2016 cess identified several chronic health issues that were increasing in numbers inside the community, specifically, respiratory cancers and diabetes (2). They acknowledged the need to focus on ways to gainsay these rising health conditions, most specifically, diabetes. Using tablet computers to access quality health data would allow healthcare professionals to take a proactive role in providing instruction in preventative care procedures and help in the didactics of those already coping with diabetes while addressing the health needs assessment of this community. Nurse educators would have a wealth of information available to aid those learning about insulin administration, diabetic diets and compliance issues, as well equally other conditions which would amend wellness outcomes. With the utilise of the tablets at the patient'due south bedside, focused didactics for the patient and their family members would exist provided. Knowledge nearly the resource could also be included in diabetic education classes conducted on a monthly basis.
Additional facts from the community cess indicated that Mobile Canton had seen a consistent rising in infant mortality over the by five years. In 2010, the infant expiry charge per unit was 7.v but by 2014 the rate rose to 10.2. For the black race, the rate was higher with 11.5 in 2010 to xiv.4 in 2014 (2). By providing prenatal pedagogy with the resources from MedlinePlus and other reputable sources, babe bloodshed rates could potentially be reduced. The educational interventions using tablet computers were seen equally very benign in addressing this and other rising wellness issues of our community.
Institutional Support and Planning
The United states of america Children'southward & Women's Infirmary Assistants continued to be an advocate for the programme and supported the goal of incorporating two additional units. Two clinical nurse educators from HROB and Mother Baby respectively, each having over 25 years of experience, were the lead contacts. They promoted the projection with great enthusiasm, assisted with the coordination of the nursing grooming schedules, and ensured the program was beingness implemented as planned.
The Director of Staff Evolution at the USA University Hospital, who had over forty years of experience in nursing, was the lead contact at this hospital facility. She was instrumental in analogous and promoting the project amid all unit managers. In addition, the master nursing officeholder of the U.s.a. Academy Hospital was in total back up of the project and endorsed the utilize of the tablets amongst the nursing staff. Having this collaboration with both infirmary administrators was cardinal to the success of the project.
In all the preliminary meetings, topics of nurse training, number of tablets needed, storage of tablets and stands, theft issues, promotion of the project and data collection were discussed. From the data gathered, 13 Android tablet computers on rolling stands were purchased from funds through an additional NNLM SEA Applied science Award received in 2018. The tablets were distributed to both infirmary facilities with the University Hospital receiving viii tablets for each floor unit and the Usa Children'southward & Women'due south unit receiving five tablets for the HROB and Mother Infant units. (Figures 1 & ii)
University of S Alabama Academy Infirmary Administration, Nurse Managers and Project Librarian with tablet computers on rolling stands.
University of South Alabama Children's & Women'due south Infirmary Administration, Nurse Managers of Loftier Take a chance OB/GYN and Female parent Baby Units, and Project Librarian with tablet computers on rolling stands.
With the nurse managers' guidance and input, multiple training schedules for day and dark shift nurses were adult and flyers were posted on the unit floors to promote the sessions. Due to the sheer number of nurses at the Usa University Hospital, railroad train the trainer sessions were provided to 22 nurse managers and nurse educators, who in turn, trained their flooring nurses. Since the number of nurses of the HROB and Mother Baby units at United states Children's & Women'southward Hospital were more manageable, training sessions for all nursing staff on these units were provided. Training included use of MedlinePlus, 10-Plain® Patient Educational activity Found videos and survey instruments that would be used to collect data. In all grooming sessions, 78 nurses were reached.
The Usa University Hospital Residents were besides aware of the tablets to augment patient didactics. Information on the tablets too as an article supporting doc/patient relationships through patient education was distributed to stress the importance of this endeavor (3). This proved to be very valuable every bit one resident became heavily involved in a research projection and used the tablet computers extensively with patients.
Benefits of Tablet Computers
Within the outpatient cardiac clinic at the USA University Infirmary, nurse educators and nurse practitioners provide i-on-one instruction to patients. Having access to MedlinePlus and health videos on the tablets allowed them to amend inform the patients of their atmospheric condition, medications and treatment plans. Adherence to treatment plans can exist difficult; nonetheless, these additional resource to encourage and inform patients of the benefits greatly influenced the outcome of patient surgery and long term wellness. The heart failure dispensary began a series of educational sessions that included MedlinePlus as a vital resource for health information.
Access to quality health information has now expanded to include those in our community with high rates of cardiovascular disease, diabetes and cancer. Mixed with these chronic illnesses, Mobile County has a college percentage of residents living at or below the federal poverty level (18.74% in 2014) every bit compared to the land (18.38%) and the nation (fourteen.83%) (2). Additionally, the USA University Hospital operates equally a safety internet hospital providing services to low income patients where many self-pay. Educational interventions addressing health issues during treatment and intendance have assisted wellness care professionals in this health disparate community to address the rising mortality statistics, intertwined with depression poverty levels,.
Patient teaching also plays a key office in reducing readmits. This patient/family unit instruction program assisted clinical staff and physicians address non only the health needs of this customs, but instilled a mechanism whereby patients became enlightened and learned about their wellness conditions from authentic and reliable sources while at the hospital that continue upon discharge.
With the tablets, nurses have been able to greatly aggrandize their current individual patient education with quality of resources from NLM. In addition, patients tin view videos on their weather condition and supplement their cognition by using the tablets at any time during their hospital stay. Patients now take a more agile role in the understanding of their conditions and become engaged in an interdisciplinary team arroyo to their medical care.
Patient education comes in many forms and patients like to refer to printed resources such as brochures or pamphlets. In the previous project using the tablets and print materials, 50% of family members indicated they used the impress brochures and pamphlets that were available to them and 27% indicated they used print wellness magazines (1). A multifariousness of brochures and pamphlets were once again available to distribute to patients describing the resources from NLM and NIH. They included MedlinePlus, Mobile Resources at NLM, Drug Data Portal and Substance Misuse and Addiction Resources trifold brochures. Copies of the NIH MedlinePlus magazine related to diabetes, center disease, COPD, Crohn's, sickle prison cell and other topics relevant to the health weather of this target population were available to the units as appropriate. These materials provided valuable website information of the resource discussed with the nurse educator or project librarian and could be passed on to other family members.
Evaluation
With the increased number of hospital units involved in this project, information was needed to determine if the tablets and resources would be as effective as in the previous report with fewer units. To evaluate the efficacy of the interventions and resources used and the usage patterns of all the units involved, the aforementioned survey instruments were used (1). The survey, even so, would be completed online using a web based awarding called REDCap instead of a paper version. This proposition was made by the nurses for ease of use and a more streamlined process. There were two surveys used to collect the data. The start survey, Initial Educational activity Survey, recorded the demographics of patients, resources consulted, diagnosis and number of people served in each session and was completed by staff who provided the instruction. The second survey, Evaluation of Educational Activities, was completed past the patient upon discharge. This survey determined the efficacy of the resources and indicated which educational interventions helped patients learn more than about their conditions or their newborn health issues. The data from the online surveys was very helpful in monitoring the project. Email messages were sent out periodically to nurse managers to determine how well they liked using the tablets. One unit in particular, indicated that they, also as the patients, liked using the tablets very much, however, there were no usage statistics recorded. When this was pointed out, it was discovered that the nurses had forgotten to complete the surveys afterward each educational session. Monitoring usage throughout the grant catamenia was key to identifying and addressing issues in a timely manner.
Survey Results
The information nerveless and reported from the surveys covered November i, 2018 to May ane, 2019. There were sessions, yet, as explained in the previous paragraph, that were non recorded. This was one obstacle in the project every bit information technology was difficult to get anybody to complete the surveys later each session even with email messages and written reminders labeled on the tablets.
Initial Education Survey Results
At the USA Children's & Women's Hospital, from the surveys completed showed 79 sessions were conducted serving 100 people. At the USA University Hospital, completed surveys indicated that 85 sessions were conducted serving 198 people. Results from the surveys gave valuable data on the number of sessions and patients served, sources used and the efficacy of the video intervention which are described below.
Units served and number of sessions
The usage statistics from the USA Children's & Women'due south Hospital correspond all units of the hospital and non just those of HROB and Female parent Baby since the project was integrating all the units in the patient/family education program. Table ane indicates the unit of measurement and the number of educational sessions conducted.
Tabular array 1.
Units Served and number of sessions – USA Children's & Women's Infirmary
| Children'south & Women'south Infirmary Units | #of sessions |
|---|---|
| USS HOPE | 20 |
| Hematology/Oncology | 6 |
| High Chance OB/GYN | x |
| NICU | five |
| Pediatrics | 2 |
| Surgery | 0 |
| Female parent Baby | 36 |
The value of the tablets for patient education was recognized, but without specific patient educators, the apply of the devices were non beingness maximized at the Usa Children's & Women'south Hospital, especially within the Pediatric and Hematology/Oncology units. Discussions with hospital administrators, nurse managers and child life specialists ensued with a recommendation to integrate hospital volunteers, specifically an undergraduate nursing student volunteer, to assistance the outreach project librarian with patient education rounds once a calendar week. The librarian agreed to expand her services on the pediatric floors equally she saw the importance of the service and how it had helped many of the families in the USS Hope Infusion Unit. Providing patient education on rounds where patients receive data based on their needs in a timely manner enhances the patient educational activity process and helps to ensure they are a partner in the determination making process while having access to quality information (4,5). Having the student volunteer assist on these rounds was seen equally a perfect solution, non but because of the undergraduate nursing educatee status, but the fact that the volunteer assigned was bilingual in Spanish whose population the infirmary too served. The project librarian began training the student volunteer in the resources and developed procedures for integration into this type of service.
Utilizing hospital volunteers to assistance with patient information needs has been successful in empowering patients to learn near their own wellness care so they can brand informed decisions as well every bit fostering the interdisciplinary team model approach to patient care (half-dozen). By creating this new dimension to the project at USA Children's &Women's Hospital, patients received quality wellness information at the time of need, increased the exposure of the devices and their use among flooring nurses, and provided a dandy learning opportunity for the student nursing volunteer.
Unfortunately, the tablet computers were not used within the surgical services unit of measurement at either hospital facilities. When initially discussed with staff in the pre-op surgical expanse, the concept was well received and staff idea the devices would be of great assistance. However, the practicality of patients using them in pre-op surgery was not ideal. Patients were seen very quickly for lab piece of work and one time in pre-op, educational opportunities with the devices were not seen as optimal.
The overall usage of the devices was college at the Usa University Hospital than at USA Children's & Women'southward Infirmary. (Table 2). This is a direct correlation of each unit at Us University Infirmary having a designated nurse educator who was also responsible for patient education. The nurse educators enjoyed using the tablets for education as information technology provided a rich assortment of resources for the patient and comments and statistics indicated that the patients liked using them too.
Table 2.
Units Served and number of sessions – Us University Hospital
| Academy Hospital Units | #of sessions |
|---|---|
| Surgical Services | 0 |
| Gastrointestinal surgery | 2 |
| Cardiology | 7 |
| Burn down Center | 1 |
| Medicine | ten |
| University Hospital Surgery | six |
| Trauma | 8 |
| ICU | 1 |
| MSCU | 9 |
| NSICU | four |
| PCU | 22 |
| Oncology | 0 |
| Cardiac Clinic | 13 |
The usage within the clinic setting, specifically cardiology, was high and was seen as ideal for the tablet computers. Every bit a issue, discussions with physicians and nurses in other clinics within the Us Health System occurred and tablet computers have now been placed in the pediatric sickle prison cell and internal medicine clinics.
Assessment data from the surveys and follow up meetings resulted in the redistribution of the devices to units where they would be used to their greatest potential. In addition to the clinic setting, team members suggested that infirmary dieticians be given a tablet for their specific educational needs. Their use would extend to those patients needing diet and dietary resource, besides equally to advise and educate those needing to comply with dietary changes due to conditions such as diabetes and heart disease. Integrating these tablets inside this specific area will be more effective as the dieticians will have more than resources to use when engaging in patient education. Placing the tablets with staff educators will increase usage of the multitude of reliable and reputable sources available to the patients. This is a positive result of reviewing usage statistics and collaborating on a regular basis with squad members to ensure the best utilize of the tablets.
Sources Used
Information was collected to determine the sources used and the percentage of time each was used. If units did non use the tablets ofttimes, the figures represent usage per source. The figures likewise reflect that a single educational session could have consulted one or more sources. (Tables three & 4)
Table three.
Sources Used at Us Children's & Women's Hospital (C&W)
| C&Westward Unit | MedlinePlus | X-Plain® videos | Clinical Trials | GARD | GHR | NORD | Other |
|---|---|---|---|---|---|---|---|
| USS Promise | 85% | 45% | 5% | 45% | 55% | 10% | x% |
| Pediatrics | 100% | 100% | 50% | ||||
| NICU | 20% | 100% | |||||
| Hematology/Oncology | 100% | 66.7% | 33.3% | ||||
| HROB | 75% | 75% | |||||
| Mother Baby | 5.nine% | 94.ane% |
Table 4.
Sources Used at USA University Hospital Unit
| University Hospital Unit of measurement | MedlinePlus | X-Plain® videos | Clinical Trials | Wellness Reach | Alabama Virtual Library | Other |
|---|---|---|---|---|---|---|
| Gastrointestinal Surgery | 100% | |||||
| Cardiology | 12.55% | 87.5% | ||||
| Burn Heart | 100% | |||||
| Medicine | 22.2% | 88.9% | ||||
| University Hospital Surgery | 80% | 20% | ||||
| Trauma | 83.3% | 16.seven% | ||||
| ICU | 100% | |||||
| MSCU | 100% | 12.v% | ||||
| NSICU | 100% | |||||
| PCU | 91.7% | four.2% | 4.2% | |||
| Cardiac Dispensary | 100% | seven.7% |
It is evident that both hospitals used the video resource more heavily than MedlinePlus which could propose that this learning modality was more appropriate for the low literacy rates of this population, even though MedlinePlus has easy to read materials and was promoted by nurse managers. It was encouraging, nevertheless, to run across the use of Clinical Trials and HealthReach in patient education for this population. The genetic databases, Genetic and Rare Diseases Data Middle (GARD), Genetics Abode Reference (GHR) and the National Organisation for Rare Diseases (NORD) were used quite extensively specially at the USS HOPE unit of measurement at USA Children's & Women's Hospital. Information technology is hither where treatments for babyhood cancer, sickle cell and other rare atmospheric condition are conducted and where the librarian provides extensive education.
The primary resource used by the Mother Baby unit was the breastfeeding videos from the Part on Women's Health (OWH), from the U.S. Department of Wellness and Man Services. This was reflected in the Other category which REDCap allowed to specify the resources used. The OWH has a wealth of videos on this topic which the unit nurses and a resident conducting research used quite extensively. Various organizational websites related to particular diseases were as well noted in this category.
Video efficacy
The X-Plain® videos produced by the Patient Instruction Institute were an added benefit to the educational resource available on the tablets. The video subscription was implemented with the first project and proved to be extremely helpful in patient education (1). The videos are curt in length, use simple language and blitheness and are culturally diverse. To adapt the wider scope of conditions and diseases seen at both hospitals, the number of video titles increased from 356 to over 700. This increase greatly enhanced the collection of resources bachelor to the patients and their families. The efficacy of the videos proved to be a successful ways of education in other unit settings at the Usa Children's & Women's Hospital, but additional data to confirm the validity for this larger patient population was sought.
The survey questions and responses are listed in the post-obit charts. The results are gleaned from a total of 94 responses collected from United states of america Children's & Women'due south Hospital and USA Academy Hospital (Tables v, half-dozen, &vii).
Table 5.
Responses to the onest video survey question.
| Before viewing the X-Plain® video, how much did you know about your (child'due south) condition or procedure? | |
|---|---|
| None | 17.0% |
| A piddling | 46.8% |
| Quite a flake | 29.eight% |
| Completely | 6.4% |
Table 6.
Responses to the iind video survey question.
| After viewing the X-Plain® video, did the data requite you a meliorate understanding of the condition, procedure or intendance? | |
|---|---|
| Strongly Disagree | ane.1% |
| Disagree | 0% |
| No Opinion/ Uncertain | 6.4% |
| Agree | 61.7% |
| Strongly Concur | 30.nine% |
Table vii.
Responses to the iiird video survey question.
| Afterward viewing the X-Plain® video, did the information help you think of questions to ask the md or nurse? | |
|---|---|
| Strongly Disagree | two.ii% |
| Disagree | 5.4% |
| No Opinion/ Uncertain | 14.1% |
| Agree | 59.8% |
| Strongly Agree | eighteen.5% |
Just equally in the previous project, the figures to a higher place show clearly that the videos helped the patients and their family members acquire more near their (or their child's) condition. It is interesting to annotation that those who knew quite a bit or completely about the condition, procedure or care totaled 36% but there was 92.half-dozen% agreement that the videos did help in the comprehension of the topic. The data from the previous project also confirmed that this educational modality is effective and improves comprehension of information and should be incorporated as an effective intervention in patient education (1). This intervention addresses low literacy issues and engages the patient in e-learning. Combined with interactive questions, the patient is engaged in learning complex concepts and self-care skills for themselves and their child. The videos trigger questions from patients seeking more data from their health intendance team, which fosters a patient-medico human relationship and improves communication. Using technology to enhance the educational process is one step toward improving health outcomes. Patients larn more about their status in a way that is engaging and effective.
Evaluation of Educational Activities Survey Results
The second survey, Evaluation of Educational Activities, which was completed by the patients upon discharge, helped decide the effectiveness of all the educational interventions available to patients in this programme. Given the increased number of infirmary units involved, it was discovered that this detail survey was the most difficult to complete. This was due to the timing of discharge and multiple activities associated with it. Nevertheless, there were hospital units that were successful in obtaining data such as the NICU and Mother Babe at USA Children's & Women's Hospital and the Progressive Care Unit (PCU) and Cardiac Dispensary at the USA University Infirmary. The USS Promise infusion unit of measurement did non engage in this survey as they practise not belch patients.
Below are the results to the questions asked on the Evaluation of Educational Activities survey. From the responses, the following activities were selected as those that helped patients and their families learn more about their health issues. (Tables 8 – 12).
Table eight.
Activities that helped patients learn about their wellness issues.
| Q one. What activities helped you learn more than about your health issues? | ||
|---|---|---|
| Activity | Children'due south &Women'southward Hospital (46 responses) | University Hospital (85 responses) |
| Use of MedlinePlus | 69.half-dozen% | eight.2% |
| Viewing the X-Plain®videos | 15.2% | 88.2% |
| Sessions with a librarian | 6.5% | 2.iv% |
| Print brochures | 23.nine% | eight.two% |
| Impress health magazines | 13.0% | 0% |
Table 12.
Connected use of resources
| Q5. I volition continue to employ the resource learned. | ||
|---|---|---|
| Children'due south &Women's Hospital (53 responses) | University Hospital (85 responses) | |
| Strongly Disagree | 1.9% | 10.6% |
| Disagree | 0% | 0% |
| No Opinion/Uncertain | 18.nine% | 0% |
| Concord | 18.nine% | 61.2% |
| Strongly Concord | lx.four% | 28.2% |
Overall, patients liked using the tablet computers to locate health data whether it was using MedlinePlus, NIH resources or watching various wellness videos. The devices were easy to use and enabled the nursing staff to provide a means of patient instruction that was reliable and current. Nursing staff could leave the tablets in the patient's room where they and their families could scan and gather more information using a variety of sources for an extended length of time.
What resonated with both projects is that patients liked having print materials available fifty-fifty when an electronic means of obtaining medical information was presented. This is consequent with conversations with parents in the USS Promise unit and data from the previous projection which indicated 46% percent of the families used print brochures equally an action that helped them learn nigh their or their child's weather condition (1). Parents and family members like to have reminders of various websites, in the form of bookmarks and brochures, likewise as print magazine articles that discuss the conditions they are coping with. Although the USS HOPE unit of measurement did not engage in this survey, the value of the impress materials is axiomatic based on the interactions with this patient population. Parents want reputable and reliable resource textile they can provide other family members as inconsistent, conflicting and inaccurate information can be generated amongst various family members causing greater confusion, fear and unnecessary stress. The brochures on MedlinePlus, GHR, GARD and Mobile Resources at NLM have been profoundly appreciated.
Having patients exposed to a variety of resources and learning styles is central for effective education. In populations where depression literacy rates are prevalent, the video intervention worked extremely well. When providing patient education in the USS HOPE unit of measurement, fourth dimension spent on resources such every bit GHR and GARD greatly benefitted the parents. Links to patient advancement and back up groups accept been life-irresolute. Many families travel long distances multiple times a twelvemonth to receive treatments or to take part in a clinical trial. The financial aid, travel and lodging back up resource from GARD have provided otherwise unknown assistance to these families
It is reassuring that patients will continue to use the resources exterior the hospital setting to help them make improve decisions about their or their child'southward health. Many parents indicated that they like knowing where to get for quality health information instead of using Google®. Bookmarking MedlinePlus on patient and parents phones has provided quick access to quality information. When a kid is diagnosed with cancer or other rare and debilitating diseases, the family structure becomes unraveled and trying to cope with the condition and handling plans becomes overwhelming. Having the ability to directly parents to like shooting fish in a barrel to read resources that can aid in the comprehension of new concepts, aid with financial and travel costs, and provide data on support groups at a time when they tin can mentally grasp the information has been beneficial to all involved. Patient didactics is a powerful and needed aspect of healthcare and using technology to assist in this role has been quite successful.
Word
The tablet computers benefitted not but the various units of both hospitals, but extended to the clinics that serve the United states of america Children's & Women's Mother Baby population due to the piece of work of ii proactive lactation consultants in the Mother Baby unit. The devices were brought to the neighboring USA clinic to provide instruction using the Role on Women'due south Wellness videos on breastfeeding. This was one area that was not envisioned in the original implementation every bit the new clinic setting was existence built. The expanded use of the resources to this patient population has been very well received. The nurses feel that the technology, ease of use of the devices and the resources take been very helpful to the patients in the clinical setting which has resonated multiple times when assessing the projection.
What was non expected was the low utilize in the surgical pre- and post-op units. Upon initial consultation with the nursing staff in these units, it was thought to be a perfect location for patient education. However, information technology was discovered that the rate at which patients are seen and prepped for surgery did not allow for this type of educational intervention. Although the nurse educators encouraged its utilise, the tablets did not serve this patient population. Equally a result, the tablets were reassigned to areas that had a greater need.
The method of information collection was improved from a print grade to an electronic ways using the REDCap web application. The surveys were very easy to complete and could be done chop-chop. Notwithstanding, throughout the projection period, it was a challenge to become the nurses and patients to complete them. Email messages encouraging the completion helped with this upshot, but there were some that resisted the activity. This resistance was only from a small number of staff and did non represent all from both hospitals. Despite these obstacles, at that place was data to determine the usefulness of the interventions.
Since the completion of the surveys was an issue, this is one area that will be reassessed. The surveys were very short, so the length of the survey was not the issue. Investigation of software programs to track usage of non-subscription resources is an artery that could be used to gather statistics.
Theft of the tablet accuse cords and chargers was also a claiming. Unfortunately, the new feature of having the charger built into the rolling bedside stand was not an efficient ways of charging the tablets. This method was extremely boring and equally a result the devices had to be charged with the original cord and charger. It was difficult to monitor the security of the cords and chargers, but ane solution that worked, was to continue the tablets and stands in the nurse director'due south office rather than at the nurses' station. All nurses on the floor had admission to this part. Securing the cords on the arm of the rolling stand with plastic ties was another solution that kept the string with the tablet. When the tablet was in use, the charge cube would be kept in the nurse manager'due south role. Units that had shut monitoring and used the tablets oft did non meet theft issues.
One effective strategy used throughout the project was communicating with cardinal players on a regular basis. Emailing nurse managers of issues that needed to be addressed with unit of measurement flooring nurses worked well in the absenteeism of regularly scheduled meetings. Keeping the number of key players to those essential to the project made for constructive communication management. Meeting constituencies on a regular ground kept the project on the forefront.
For this type of educational intervention to succeed, a nurse/patient educator on each floor is imperative. The motivation of the nurse/patient educator fostered the use of the tablets and resources and became an advocate of the tool. With this advancement, credence of the new educational interventions improving patient care and health decisions was common. Its use and demonstrated effectiveness by the nurse educator enticed other nurses to engage in the intervention which saved time and benefitted the patient. Nursing staff had a means of supplementing their educational protocols with free resource from the NLM and NIH which can result in better wellness outcomes for the community.
The tablets were available to patients and their families at any time during their hospital stay which incited them to ask their wellness intendance providers more directly meaningful questions. Exposing patients and families to reputable resources that encompassed a diversity of learning styles was core to effective patient education. Multiple learning modalities addressed the low literacy rates within the community and the ease and administrative dimensions of MedlinePlus and Genetics Dwelling house Reference enabled patients and their families to become improve informed with quality data. Using assessment techniques to identify and confirm usage was invaluable as it ensured the best placement of tablets for patient pedagogy. Reallocating devices to clinics and specialized departments enabled more effective employ of the resources.
The program is still in its infancy and changing behaviors to employ new materials and new devices takes time that must exist factored when cultivating acceptance and adoption. New target populations were identified to increase usage within the USA Children's & Women'southward Hospital and statistics and feedback provided evidence that the dispensary setting was very conducive for patient education.
Continuation Plans
The tablet computers volition proceed to be used for patient instruction at both hospitals. The funding from this laurels allowed the creation of a patient/family educational activity programme that at present provides access to NLM and NIH resources, also every bit subscription based health videos, on tablet computers for all units of both U.s.a. Hospitals. This has been a very effective project that both infirmary administrations take embraced and supported. The connected cooperation and enthusiasm for the program, as well as the unparalleled support by the nursing staff of both hospital administrations, accept made this projection then successful. Meeting with nurse managers and team members volition go on in society to monitor and update tablets and to keep abreast of their use and concerns that arise. Working side by side with staff in the USS Hope unit, the projection librarian has continued to provide access to valuable resources to patients, parents and family members who are coping with rare and chronic diseases. This work, initiated from the original projection funded through the NNLM SEA Engineering Improvement Award in 2016, will keep indefinitely.
Working alongside physicians and nurses has provided other opportunities for patient education and exposure to quality wellness resources. Meetings with the Ronald McDonald House Manager resulted in the integration of NLM resources on computer terminals in their family resource room along with the distribution of NLM brochures and pamphlets. Invitations to speak at family meetings were extended to the project librarian which provided an opportunity to make parents aware of the resources and remind them of the availability of the tablet computers on each unit of the hospital.
Conclusion
This project was extremely of import to this health disparate community as it allowed a greater number of patients and their families to locate quality medical information free of medical jargon, in their native linguistic communication, and at a time when they could mentally absorb the material. Valuable consumer health information is now being provided in a customs where didactics is so vital for positive health outcomes. Data from surveys and comments from patients and nurses indicate that tablet computers and the resource from NLM made a positive impact on patient didactics. Enabling patients and their families to obtain quality health information in collaboration with a wellness sciences librarian or nurse educator at the bedside using tablet computers has consistently proven to be a very effective and engaging intervention. Easy to read information from reputable resources has bridged a gap between the multitude of complex information patients receive from physicians and wellness intendance professionals. This sensation has provided a wealth of resources for patients and family unit members that tin be used long after discharge.
Health services and medical librarians have a vital role in the multidisciplinary approach to the care of patients. Assisting in the patient pedagogy process within the infirmary setting has resulted in an innovative and artistic means that has helped the overall health of a community. This program tin be seen equally a model for patient teaching that integrates applied science and various learning styles to provide accurate, current and easy to understand health data adjustable in a variety of hospital and health care settings.
Table ix.
Likeability of computer tablets
| Q2. I liked using the reckoner tablets to find health information. | ||
|---|---|---|
| Children'due south &Women'southward Hospital (54 responses) | University Hospital (85 responses) | |
| Strongly Disagree | 1.9% | eleven.eight% |
| Disagree | 0% | 0% |
| No Opinion/Uncertain | ane.nine% | 3.v% |
| Agree | 29.half-dozen% | 52.9% |
| Strongly Agree | 66.vii% | 31.8% |
Table 10.
Confidence levels using MedlinePlus
| Q3. Searching MedlinePlus has given me more conviction locating quality health data on my (child's) health problems. | ||
|---|---|---|
| Children'south &Women's Hospital (52 responses) | University Hospital (84 responses) | |
| Strongly Disagree | one.9% | 7.1% |
| Disagree | 0% | 0% |
| No Opinion/Uncertain | 42.3% | 22.6% |
| Agree | 21.2% | 51.2% |
| Strongly Agree | 34.6% | nineteen.0% |
Table 11.
X-Apparently® video effectiveness
| Q4. Viewing X-Plain® videos gave me a better agreement of my (child'southward) health issues. | ||
|---|---|---|
| Children'south &Women's Hospital (52 responses) | University Hospital (85 responses) | |
| Strongly Disagree | ane.nine% | 10.vi% |
| Disagree | 0% | 0% |
| No Opinion/Uncertain | 42.3% | 4.seven% |
| Agree | 21.two% | 54.1% |
| Strongly Agree | 34.6% | thirty.6% |
Funding
Adult resources reported in this publication are supported past the National Library of Medicine (NLM), National Institutes of Health (NIH) under cooperative agreement number UG4LM012340 with the University of Maryland, Wellness Sciences and Human Services Library. The content is solely the responsibility of the writer and does not necessarily stand for the official views of the National Institutes of Health.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273904/
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