Archive for the ‘Disease Prevention’ Category

Nutrition Web Resources for the School Age Child, comment

November 15, 2010

These websites are great! We have to remember that the generation viewing these websites are very computer “savvy” and pay attention to the information provided. As parents we need to look at the site and make sure it is suitable for our children. Our school nurses and pediatricians in my state also provided good nutrition information. The best education starts at home!

Original Post
April 23, 2009
Title: Nutrition Web Resources for the School Age Child
Nutritional web sites; what a wonderful resource for parents to have at their fingertips. Sites such as HealthLinks (http://www.healthlink.com), and keepkidshealthly (http:www.keepkidshealthy.com) provide useful information on topics such as healthy snacks, slim down plans, food pyramids and daily intake needs based upon the child’s age. Health Promotion (2006) states: “with more school age children accessing the Internet, child-friendly sites(noted above), may help children focus on ways to improve their nutrition and avoid obesity”. This has merit, however, the sites listed in the text are not kid-friendly web sites, rather they are geared toward adult reading levels and comprehension. I endorse kid friendly sites; sites where children can explore on their own the basics of nutrition, its impact on their health, and healthy food choices, all in a fun and engaging method. However, these sites are limited on the web, with the majority of information geared towards the adult population. This would be a great undertaking for a pediatric dietitian to create, as the need exists.

Cardiac Care and Informatics Technology

August 16, 2010

The human heart is an amazing structure.  Serving as a pump for the approximately 5.5 liters of blood, it sends nutrients, oxygen electrolytes, and blood cells throughout the body and removes carbon dioxzide and wastes, beating approximately 60-100 beats per minute, every minute of our lifetime starting at about the fourth week after conception – all this without us ever having to think about it!  Technology has given us insight as to the normal and abnormal function of the heart.  When someone comes into the ER with crushing chest pain, we immediately think IV, O2, monitor – and proceed, if appropriate, with MONA – morphine, oxygen, nitroglycerin and aspirin.  The monitor can give us information on rate and rhythm, conduction, angina or AMI,  indigestion, anxiety or cardiac event. Without the monitor, we would just be guessing and perhaps delay treatment which would increase  progression of cardiac damage (i.e. time=muscle).  Other studies we can expect the physician to order are CBC, CMP, PT/INR, chest xray, possibly CT or prep for cardiac cath.  All these studies are based on technology and informatics with the promise of rapid retrieval of information, therefore preserving cardiac function and life.  Bedside charting via electronics in the ER can also help maintain cardiac function.  While waiting for labs and further orders, the nurse can remain at the bedside and not be fumbling through papers, therefore monitoring the patient and cardiac monitor constantly.  Some technological programs are checklists, which can also serve as cues for the nurse, plus allow easy access to information as needed.   If the MI progresses to Vtach or Vfib, the nurse is at the bedside and can initiate defibrillation immediately.  If it progresses to asystole, the nurse can start CPR without delay.  It is both calming and reassuring to the patient and family to have the nurse present continuously.  Prior to advances in technology, delay in care was a major contributing factor to cardiac loss and death.  While delays in care still occur, medical technology has definitely improved the outcome of cardiac events.  Many patients proceed to rapid cardiac cath with subsequent bypass surgery if appropriate and are discharged within several days with a much more positive prognosis than in the past.  While AMI is still a very serious health problem, informatics and technology have improved the outcome both in the acute phase and the post MI period.

Not all Education is Created Equal, comment

August 6, 2010
Review of Health Assessment for Nursing Practice / Edition 4 by Wilson and Giddens.
Modern health care is indeed a fusion of technology and patient education. The use of computer based education is not only cost effective, but also offers an alternative teaching method to reading, demonstration, or verbal explanation. My concern, however, is that because of its ease, computer based teaching could be used as an inappropriate substitute for traditional nurse-patient teaching.
In chapter two we learn about ethnic and cultural considerations. Based on the needs of the patient or family requiring the education, isolating them to using media as their source of education could impede their ability to take home important, possibly even life saving information. Language, age, and preferred learning style are only a few examples that could potentially be enormous barriers in patient teaching if not properly assessed.
While I agree that in certain situations media can be used as a teaching tool, it is imperative that it be used appropriately and not be seen as an easy replacement for one-on-one teaching. Instead, media could be used to enhance learning in conjunction with personal instruction. This allows the patient to learn while also having the ability to ask questions and clarify concerns. The assessment of the nurse is of the utmost importance when providing education to a patient, family, or community.
Original Post
April 12, 2010
Title: Computer-based Patient-education Program

Given the enormous financial strains on the health care system, and the time constraints of health care providers institutions are seeking to find innovative and cost effective ways of reducing tasks like patient education.  Leading health care centers, many dealing with cancer patients such as Memorial Sloan-Kettering Cancer Center, have taken the first steps by using computer-based learning tools.  They have documented initial success in implementing an extensive computer-based education program. Their program consists of a CD-ROM education program, an internal interactive intranet site that contains education about cancer, has library resources, and Internet links, etc. for patients to access.

The advantages are significant and health institutions everywhere are becoming involved with alternate methods of providing and reinforcing patient education.  Obvious advantages include the quality and consistency of the information provided to the patient, the ability to access education and information independently; provide training in the language of the patient, as well cost savings to the institution.  Disadvantages are the readiness and literacy of the learner, and the inability to interact with the patient at the time questions arise. Some would argue that the disadvantages are fewer than we currently experience, given the lack of caregiver time and consistency and quality of information imparted.

There is no doubt that we will continue to move forward with computer assisted patient education in much the same way as we have with our staff development and training.  Our institution is small compared to the major centers utilizing this resource for patient education.  However, we too, have embraced the practice of CD-ROM and computer based education at our Cancer Center.  Though manned by staff trained to educate patients, we have a resource center with CD’s, interactive patient education videos and an entire resource library for the patients to access.  The union of technology and patient education is upon us and, for the most part, appears to be a win-win situation.  Our challenge, moving forward, will be to find ways to reach and capture all patients, regardless of their status.

Patient Education Matters

May 5, 2010

In researching a request by our hospital staff for a new Coumadin video to be used for patient education, I came across and wonderful website.  It is Patient Education Matters and is found at http://patienteducationmatters.blogspot.com/  . This blog spot was developed to assist healthcare professionals in the development, sharing and use of patient education materials.  The format is a biweekly newsletter, to which I will now subscribe, is totally dedicated to matters of patient education.  Patient education topics and resources are featured with each publication with links to education materials.  In this week’s edition Warfarin or Coumadin is featured as a resource.

In the case of Coumadin education, Patient Education Matters have linked to the Agency for Healthcare Research and Quality (AHRQ) where I found many Coumadin resources for patients and families.  “Your Guide to Coumadin/Warfarin Therapy” is a video available in both English and Spanish.  There were other education resources for patients available including a comprehensive patient handout.  These resources can be downloaded at no cost or in the case of the handout ordered as single copies free of cost. 

In addition to Coumadin education, Patient Education Matters has a topic index for a host of patient education topics.  Links are provided to the actual education source.  If the education topic needed is not listed they also have a Google search engine that searches across multiple patient education websites at once. 

Our organization is fortunate to have a video on demand education system for our patients.  However patient education such as is available from Patient Education Matters could be utilized in some of the outlying clinic areas or by patients once discharged to refresh knowledge. 

Health Promotion/Disease Prevention Online Class

Patient Education & Counseling Online Class

Health Care Informatics Online Certificate Program

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Asthma Patient Education

May 5, 2010

In researching the Internet for asthma education, I came across an excellent patient education website located at http://www.asthmacure.com  that I wish to review.  I feel that it serves as a good example of what patient education can be.  A patient would need to have the ability to read and basic computer skills to utilize this education site independently.  Alternately portions of the material such as the movie could be used for children and non reading adults. 

The education begins with an overview of asthma; discussing what it is and the fundamental information one would need to understand the disease.  The next section contains a movie.  The graphics are colorful and the language easy to understand.  The movie would be suitable for children age 8 or older as well as adults.  The movie is a wonderful option for those patients who learn best visually or have limited reading skills.

The third section deals with understanding asthma’s warning signals.  To teach the concepts they use a colorful picture and concepts of a traffic light.

 The green light is described as Congrats! Stable Asthma zone; symptom free with PEFR > 80% of personal best.  There is a link explaining what PEFR is and how to measure it using a peak flow meter if the patient needs this information.

 The yellow light called the “caution zone”, discusses the signals and symptoms of asthma that indicate varying degrees of airway obstruction with a PEFR of 50-80.  The advice is to avoid triggers and to add medicines in effort to come back again in the green zone. 

The red light is the “crisis zone”.  Patients are encouraged not to delay medications and to seek medical care.  They discuss emergency signals that indicate urgent care needs.

The colorful pictures and analogy using a traffic signal, something most can relate to, as well easy to read language catch the learner’s attention while providing very valuable information.  This is an excellent example of patient education, useful to many.

Health Promotion/Disease Prevention Online Class

Patient Education & Counseling Online Class

Health Care Informatics Online Certificate Program

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Computer-based Patient-education Program

April 12, 2010

Given the enormous financial strains on the health care system, and the time constraints of health care providers institutions are seeking to find innovative and cost effective ways of reducing tasks like patient education.  Leading health care centers, many dealing with cancer patients such as Memorial Sloan-Kettering Cancer Center, have taken the first steps by using computer-based learning tools.  They have documented initial success in implementing an extensive computer-based education program. Their program consists of a CD-ROM education program, an internal interactive intranet site that contains education about cancer, has library resources, and Internet links, etc. for patients to access. 

The advantages are significant and health institutions everywhere are becoming involved with alternate methods of providing and reinforcing patient education.  Obvious advantages include the quality and consistency of the information provided to the patient, the ability to access education and information independently; provide training in the language of the patient, as well cost savings to the institution.  Disadvantages are the readiness and literacy of the learner, and the inability to interact with the patient at the time questions arise. Some would argue that the disadvantages are fewer than we currently experience, given the lack of caregiver time and consistency and quality of information imparted.

There is no doubt that we will continue to move forward with computer assisted patient education in much the same way as we have with our staff development and training.  Our institution is small compared to the major centers utilizing this resource for patient education.  However, we too, have embraced the practice of CD-ROM and computer based education at our Cancer Center.  Though manned by staff trained to educate patients, we have a resource center with CD’s, interactive patient education videos and an entire resource library for the patients to access.  The union of technology and patient education is upon us and, for the most part, appears to be a win-win situation.  Our challenge, moving forward, will be to find ways to reach and capture all patients, regardless of their status.

Health Promotion/Disease Prevention Online Class

Patient Education & Counseling Online Class

Health Care Informatics Online Certificate Program

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Evaluation in Patient Education

April 12, 2010

Chapter 3 of the text, The Practice of Patient Education, A Case Study Approach discusses evaluation in patient education.  The text provides many excellent concepts and tools for the health educator to draw upon when evaluating the effectiveness of the education for the learner.  The importance of evaluating patient education programs cannot be underestimated.  The goals of improving patient outcomes must be evident for education programs to continue exist. 

Certified programs that provide patient education for management of diseases such as diabetes and COPD must collect and document extensive data on an ongoing basis.  The data is used to demonstrate the effectiveness of the program based on the outcomes of the patient over time.  Quality patient data is required for maintaining programs and recertification’s. If the objectives of the program are not met and demonstrated by improved outcomes, the program may not be re-certified.  Certified patient education programs, such as Outpatient Diabetes Education, are often required by Medicare and Insurances in order to be paid for the education.  The incentive for effective teaching is patient outcomes oriented, in part, so that the program can financially sustain itself.

The use of data collection tools and electronic tracking of outcomes is now the standard of practice.  There are many tools available to assist with data collection.  While browsing the intranet I came across the Stanford Patient Education Website, http://patienteducation.stanford.edu/research/.  It contains several patient evaluation tools that, due to a grant, are available for use by interested persons.  Tools for evaluating education regarding diabetes and COPD programs are available in English and in Spanish.  This resource could be very valuable to patient educators who are interested in either validating the tools they currently use or developing others to assess the effectiveness of their patient education.

Health Promotion/Disease Prevention Online Class

Patient Education & Counseling Online Class

Health Care Informatics Online Certificate Program

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Prevention of Obesity in Nevada

June 5, 2009

With regard to the Healthy People 2010 Nutrition Objectives mentioned in our text, I recalled that the state in which I live has developed an obesity prevention plan entitled “Strategic Plan for the Prevention of Obesity in Nevada”. I reviewed this fascinating document, completed in September 2006. This plan, with an overall mission to decrease the burden of chronic diseases by decreasing the prevalence of obesity in Nevada, is the framework our State Health Division utilizes to strengthen obesity prevention efforts within the state. The strategic plan document presents statistical data including; demographic profiling, rapid population growth, health insurance status, prevalence of obesity by gender, age, race/ethnicity and education. It further addresses socioeconomic status, incidence of chronic illness along with associated costs, and exercise and nutrition information for Nevadans. The national target percentages for Healthy People 2010 were compared to recent Nevada statistical data. The comparative data was used in developing the “Strategic Plan for the Prevention of Obesity in Nevada”. The goals focus on the areas of leadership, ongoing data collection and assessment, partnerships and performance. There are identified objectives within each goal. Progress toward the identified goals and objectives is to be reviewed annually. A comprehensive review of the Plan will be conducted in 2010 with realignment of goals at that time as indicated by the review. I am sure most states are using available health information and data to set goals toward improving the health of their citizens. One of the challenges Nevada faces is related to the rapid influx of people, many of whom are undocumented. Many of these same people are uninsured and have chronic illness and health education needs, which may not be realized until they access the healthcare system. Even with the many challenges, there is much more community health information available regarding obesity prevention, both published and in programs, than in years past. It is our goal, with combined efforts of healthcare professionals, to contribute in a positive manner toward both our state and national goals for healthy people.

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What is Health Informatics?

June 4, 2009

With the course Health Promotion/Disease Prevention, I have an opportunity to enhance my knowledge base. This is to explore, as a concept, Health Informatics and how it coincides with health promotion. I have heard the term Health Informatics and have awareness that it is an evolving field. However, since I am unsure I fully understand the term Health Informatics, some research is indicated. It is no surprise to learn that the definition and models of Health Informatics vary widely and have multiple applications. Many Health Informatics models address the processing of data in the healthcare environment in order to analyze healthcare systems. Since much of healthcare is process and systems oriented this is useful. This is especially true for those working in areas where a defined process is helpful in reducing harm to patients. An example would be following a systems process for the administration of medications to decrease the chance of error and potential harm. The text for this course, Health Promotion Throughout the Life Span, discusses the fact that most medical errors are process rather than people oriented. Also Health Informatics address the need to develop algorithms so that vital information needed for the provision of healthcare is available at the time and place healthcare needs to be provided. This makes perfect sense. We find that algorithms based on historical data and evidenced based sciences are very useful for effective patient care. An example of such an algorithm would be those provided by the American Heart Association for the provision of emergency basic or advanced life support. In the broadest sense, Health Informatics could be translated as understanding the skills and tools that enable the sharing and use of information to deliver and promote health. This, for all of us in healthcare, is our goal.

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Nutrition Web Resources for the School Age Child, comment

April 28, 2009

These websites are very helpful if you get on the right one. Some are over the top regarding childhood obesity and the structure of how we should feed our children. Parents must use their common sense but also we as clinicians should assist our parents in getting accurate information. Our state childcare regulatory website has really awesome links that show how to prepare healthly fun meals for kids of all ages and there are also a few websites which allow the kids to play “food” games to learn about the food pyramid and putting together healthly meals and snacks. Again, I love the computer and internet resources but we just have to be aware of the dangers believing everything you read on them.

Original Post:
April 23, 2009
Nutritional web sites; what a wonderful resource for parents to have at their fingertips. Sites such as HealthLinks (http://www.healthlink.com), and keepkidshealthly (http:www.keepkidshealthy.com) provide useful information on topics such as healthy snacks, slim down plans, food pyramids and daily intake needs based upon the child’s age. Health Promotion (2006) states: “with more school age children accessing the Internet, child-friendly sites(noted above), may help children focus on ways to improve their nutrition and avoid obesity”. This has merit, however, the sites listed in the text are not kid-friendly web sites, rather they are geared toward adult reading levels and comprehension. I endorse kid friendly sites; sites where children can explore on their own the basics of nutrition, its impact on their health, and healthy food choices, all in a fun and engaging method. However, these sites are limited on the web, with the majority of information geared towards the adult population. This would be a great undertaking for a pediatric dietitian to create, as the need exists.

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