Vascular Access: Teaching Strategies and Health Literacy PDF

# Health Care Practices - Professional interpreters are used for patients whose preferred language is not English. - Readiness to learn is dependent upon multiple factors such as physical and intellectual ability, past experiences, motivation, and current comfort level. For example, the patient who...

# Health Care Practices - Professional interpreters are used for patients whose preferred language is not English. - Readiness to learn is dependent upon multiple factors such as physical and intellectual ability, past experiences, motivation, and current comfort level. For example, the patient who is recovering from major surgery or facing a critical diagnosis requiring long-term infusion therapy with a central line may be coping, perhaps with pain, weakness, anxiety, and/or depression. - Recognize that some patients seek and benefit from more information while others cope by avoiding too much information. - For those patients or caregivers expected to provide hands-on care of the CVAD, factors that impact the ability to learn CVAD care might also include cognitive limitations or lack of adequate coordination and dexterity required to maintain aseptic technique with procedures such as catheter locking. - Based upon assessment data, the plan of care, including the teaching plan, must incorporate appropriate interventions. # Attention to Health Literacy - Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. - Health literacy includes the basic ability to read and understand health-related topics. # Teaching Strategies - Based upon results from the assessment, goals and teaching strategies for patient education are planned. - Establish teaching goals and expectations relative to CVAD management. - What is the patient expected to learn, who is expected to be responsible (patient vs. caregiver), and how long will the patient require the CVAD? - Implement teaching strategies used during the patient education process with consideration of health literacy. - Use "plain" language in both written and verbal teaching. - Use the teach-back process. ## Use Plain Language - Healthcare providers are notorious for using health care jargon and acronyms rather than "plain" language. - Plain language is communicating in a way that the patient understands the first time it is read or heard, and it is considered one important strategy in improving health literacy. - Plain language includes: - Organizing information so that the most important points come first. - Breaking complex information into understandable chunks. - Using simple (plain) language and defining technical terms. - Using the active voice. - Some examples of common health care terminology with examples of plain language replacement terms are listed in the table below. | Common Health Care Verbiage | Plain Language | |---|---| | Analgesic | Pain killer | | Contaminated | Dirty/unclean/not clean | | Dose | Amount/number of times | | Immune system | Body's ability to fight germs/illness | | Interventions | Action/treatment | | Monitor | Check/watch | | Outcome | Result | | Physician | Doctor | | Reduce | Lower | | Referral | Send you to another doctor | | Risk | Chance | | Severe | Strong/very bad/harmful | | Inflammation | Swelling or redness | | Utilize | Use | | Recur | Come back | | Exacerbate | Make worse | | Febrile | Feverish | | Culture | Watch | | Medication | Medicine | | Bacteria | Germ | - In the world of vascular access, it is necessary to use terms and acronyms that may not have an easy plain language replacement, so define and describe technical terms and acronyms. ## Use Teach-Back Technique - A well-referenced patient-centered approach in educating patients and families. - Also referred to as "closing the loop" or "show me". - In very simple terms, after providing patient education, the patient is asked to explain the information that was provided. - Recognize that this is not "testing" the patient, rather it is a way to confirm or validate that the information provided, or skills taught to the patient are understood. -The use of teach back is one of 34 endorsed safe practices by the National Quality Forum and is specifically recommended to be part of the informed consent process for any proposed treatments or procedures. - The Agency for Healthcare Quality and Research provides guidance in employing the teach-back technique. A few points include: - Provide information in small amounts and have the patient teach it back rather than waiting until you have completed teaching all of the intended content. - Ask open ended questions and avoid the use of questions that result in "yes" or "no" answers. For example, do not ask "do you have any questions," rather ask "what questions do you have?" - Clarify the information using a different approach and check understanding again when the patient does not understand. As you re-teach, acknowledge to the patient that you must not have done a good job explaining. - Use the show me method when taching psychomotor skills such as CVAD flushing or infusion administration. - Due to safety and infection concerns relative to VADs, aseptic technique and precise skills are necessary." - The use of "return demonstrations" to evaluate the patient or caregiver's competence in the procedure is required. - Make sure the patient is confident in performing the procedure. - When much cuing is required for the patient to perform the task, provide ample opportunity to practice until the patient is both competent and confident. - Use handouts along with teach-back. Help patients remember instructions by writing down key information. Be aware of the patient's literacy level and communication preferences, including health care literacy, and use terminology that is understood. - When patients use their handouts, make sure they use their own words and are not reading the material back verbatim. # Use of Websites and Social Media - It is not uncommon today for patients and families to seek online information, or perhaps query social media contacts for advice. - While many reputable websites are accessible and useful for patient education, there are also those that are less than trustworthy. - Challenges include safety, privacy, and misinformation.