Archive for the ‘Healthcare Informatics Internet’ Category

Seasonal Allergies

April 22, 2013

I have two children who suffer from seasonal allergies. Their symptoms are similar, usually characterized by rhinitis and frequent sinus infections. These recurrent problems often lead to frequent trips to the doctor’s office. In the past, I’ve been asked by the doctor to keep a hand written account of their symptoms to take back to the office. I believe that if the information could be sent to the doctor electronically, it would be more convenient for the pt, and the doctor could share the information with other clinicians. The data could also be organized to look for any patterns between patients.

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Impact of Technology on the Teacher and the Learner

June 18, 2012

The section on The Impact of Technology on the Teacher and the Learner has two very interesting points. The idea of encouraging our patients to use technology to seek information and educating them on how to find valid information is great. I have been in the situation where the patient has accessed information on their own and I helped them filter through details, however I had not considered encouraging patient’s to go on the internet to help
better inform themselves. I recently had this discussion with a preceptor of mine and she does encourage her patient’s to use the internet. She does specify to her patients to us either WebMD or E-medicine to help avoid them finding misleading information. I had never thought of encouraging my patients to access the internet, but I have seen the benefits on educating on valid web sites and empowering the patient to research their new diagnosis. This will
become part of my patient education.

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Medication Underuse

May 3, 2012

Medical costs are exploding due to a lack of pricing regulation over the pharmaceutical industry. These high costs of medications are leading patients to seek other means of affordability. Choices that patients are forced into often lead to non-compliance medication regiment. We see the patient not taking their medication due to financial concerns. Some are choosing to skip dosages, cutting pills in half, to go with out food, with hold paying household bills, to not buying them at all so their spouse who is also on medication could buy theirs. This is not an error such as misreading an order, giving the wrong dose or ordering the wrong drug, however it has the same effect in that it is leading to a deterioration of the patient as a whole due to deviation from the plan. Some patients have turned to out of the country purchasing of medications, others to business that buy in gross, over the internet manufactures and some through local grocery store / pharmacy options. There are some warnings that have raised questions whether these medications are tainted, legally accepted by the FDA, are homeopathic substitutions to the prescribed medications which leads to concern and question of side effect they may cause. Resources with in the community and government system are generally available. Unfortunately they often require patients to undertake lengthy processes to get help. Outreach calls to patients usually help identify where social support is needed. Our goal is to aid in giving the patient the best resources so they can have the medication they need. As a nurse I feel we need to be an advocator, a communicator between physician and patient and an educator for the best care for the patient. This includes listening to our patients, hearing if they should choose not to take the treatment ordered and providing them with reasonable options.

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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. 

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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.

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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.

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Autism Today, comment

March 16, 2010

Autism has become one of the biggest issues facing our schools and our insurance companies today. Many people do not understand that there can be differing degrees of autism. Some children diagnosed with autism are considered to be high functioning and will join society as they age if they are given proper diagnosis and therapy throughout. Others with the diagnosis of autism will not function on their own regardless of assistance from schools and doctors. While I was a school nurse, I cared for a family of six children where five of them had differing degrees of autism diagnosis. Two of the children were incapable of performing any care for themselves at the ages of ten and twelve as they were developmentally approximately 18 months. This was a terrible hardship on the family. The children were sent to school as respite for the parents but were incapable of learning and took time away from the other special needs children in their classrooms. Three of the children functioned at the developmental age of four year olds and had some ability to perform their ADL’s and to participate in the classroom. The last child had no autism diagnosis and functioned at the appropriate developmental age. I cannot imagine the difficulties that this family faces on a daily basis.

Original Post
March 10, 2010
Title: Autism Today
Information regarding the disorder of Autism is certainly prevalent in our world today. The “Autism Speaks” organization advertises on television that one in one hundred fifty children are afflicted with the disorder. If correct, these are alarming statistics. It is well documented that all socioeconomic groups and boys more than girls are impacted. The diagnostic process often begins when toddlers do not meet speech and other developmental milestones. The current impact to our schools and other systems as attempts to assimilate the children into society are overwhelming at best. The long-term impact to society and public health resources related to the special needs of this group are yet to be fully realized. The impact on a family is more than those of us not experiencing it can understand. I know well a family in which two out of three children are diagnosed as Autistic. One child is profoundly challenged while the other is able to attend schools, but is clearly socially challenged. The family dynamics were not uncommon. The father enmeshed himself in work. The mother blamed herself for being unable to manage her children. It was a very unhappy home. Health care visits did not readily detect the issues for some time, which allowed denial, frustration and blame to continue. It was interesting to observe the relief when finally having a diagnosis and access to the treatment that would ultimately begin to improve the situation. The state of Arizona recently passed legislation requiring insurance companies to fund advanced therapy for Autistic children. Proponents of the bill contended that the early intervention costs would be offset by costs later in life once the children are able to contribute to society. Those arguing against the bill stated that costs will be passed on to all and that it is unlikely that profoundly Autistic children will ever be emancipated from the health care system. Also of note is the fact that our textbook, Health Promotion Throughout the Lifespan, 6th Edition, by Edelman and Mandle does not directly address Autism, probably because it was last updated in 2006. Certainly upcoming editions will address the disorder along with the role of the nurse in working with the child and family members. This is a good example of how the Internet and other sources can provide real time information.

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Autism Today

March 10, 2010

Information regarding the disorder of Autism is certainly prevalent in our world today. The “Autism Speaks” organization advertises on television that one in one hundred fifty children are afflicted with the disorder. If correct, these are alarming statistics. It is well documented that all socioeconomic groups and boys more than girls are impacted. The diagnostic process often begins when toddlers do not meet speech and other developmental milestones. The current impact to our schools and other systems as attempts to assimilate the children into society are overwhelming at best. The long-term impact to society and public health resources related to the special needs of this group are yet to be fully realized. The impact on a family is more than those of us not experiencing it can understand. I know well a family in which two out of three children are diagnosed as Autistic. One child is profoundly challenged while the other is able to attend schools, but is clearly socially challenged. The family dynamics were not uncommon. The father enmeshed himself in work. The mother blamed herself for being unable to manage her children. It was a very unhappy home. Health care visits did not readily detect the issues for some time, which allowed denial, frustration and blame to continue. It was interesting to observe the relief when finally having a diagnosis and access to the treatment that would ultimately begin to improve the situation. The state of Arizona recently passed legislation requiring insurance companies to fund advanced therapy for Autistic children. Proponents of the bill contended that the early intervention costs would be offset by costs later in life once the children are able to contribute to society. Those arguing against the bill stated that costs will be passed on to all and that it is unlikely that profoundly Autistic children will ever be emancipated from the health care system. Also of note is the fact that our textbook, Health Promotion Throughout the Lifespan, 6th Edition, by Edelman and Mandle does not directly address Autism, probably because it was last updated in 2006. Certainly upcoming editions will address the disorder along with the role of the nurse in working with the child and family members. This is a good example of how the Internet and other sources can provide real time information.

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Internet Access: Changing Rural Nursing

January 5, 2010

Working in a small rural hospital you get used to doing without and making do with what you have. Money is always an issue, and the nursing staff longingly looks at more modern equipment, better forms, and electronic medical records.

While we may be small, we are still held to the same standards of nursing that any nurse is held to. We still need to do patient assessments, carry out doctors orders, and give good, solid patient care. The area that becomes problematic is in the education and discharge instructions that must be given to patients. Without the money to buy programs it has long been a struggle to develop adequate information that can be disseminated to the patient. It is now possible to go on line and take advantage of many free programs that offer patient education materials and discharge instructions.

Our hospital has been able to pick a site that the nurses and providers felt met our needs, and we can go online and print off any education and discharge instructions that will meet each patients needs. We are now able to give disease specific, up to date, instructions. Our patients are now very informed on their disease process, and we passed our Critical Access Hospital survey tag dealing with education and discharge planning.

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Patient Education, Computers, Internet; comment

December 28, 2009

I agree that the medical knowledge is much easier for everyone to obtain. It has made it much easier to provide patient education to our patients in the occupational healthcare setting. We simply go to a program called Dynamed and can quickly obtain the information we need, print the patient education flyers, and even obtain continuing education credit for completing the entire reading on the topic. This has made it very easy to provide concise, complete, and up to date information on a variety of topics. I remember 20 years ago in the ER, we had a "card" file on about 20 diagnoses that we gave to patients for information on their diagnosis. It was very generic and non-specific compared to today’s Internet information.

Original Post
May 27, 2009
Title: Patient Education, Computers, Internet
The Internet has made access to medical knowledge much easier for everyone to obtain. At one time the information was only available through books, available at the Dr.’s office, hospital library, or medical library. The information is now available to patients as well as anyone who wants to find more information on a medical subject.
At the click of the mouse, a nurse can find out if 2 medications are compatible in IV form. Before she would have to look it up in an IV handbook, if one was available, or call the pharmacy.
I find that some patients are more informed about their own health, and can participate in their own healthcare, especially when multiple disciplines are concerned. Patients can also look on the Internet and see if there are any natural treatments to assist in their care and then discuss them with their physician. When you pick up an RX, there is printed information about the drug with it.
The Internet has made it possible for many to obtain medical information to either help them as a patient or health care provider.

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