Monday, May 29, 2017

Sentence Starters for Strategic Medication Education

Sometimes when a patient says they understand a new medication, it’s because they’re reluctant to ask a question they think is silly. It’s your job to take the initiative and overcome that resistance.

Consider This

Keep It Simple: talk to them in “everyday” language, not technical terms – it’s so easy to get caught up in technical jargon.
            “This medicine will reduce the swelling in your knee, and help it heal.”
Get The Family in the Room: for many patients, family members serve as care-givers at home. Seat family members close to you for educational sessions. Make sure they digest the information, techniques, and skills that are needed - especially if they are translating for the patient.
“Who would you like to be included in this teaching-session?”
“Who will be your main care-giver at home?”

Be Empathetic: sometimes small, sincere gestures make the biggest impact.
“I can tell you’ve had a tough time.”
“I can see why you would be discouraged.”
“I can tell you’re disappointed.”

Ask Them to Ask You Questions: one thing I know about human nature is: people love to be asked questions. Give them permission to ask (without being embarrassed) by leading the conversation.
“What questions do you have about this medication?”
“What would you like to ask me about this medication?”
“Many patients wonder how this medicine…” or “I’ve had patients express concerns about…  Do you feel that way?”

The Teach-Back Method: politely ask patient to repeat back what you’ve taught him/her. Make the teach-back method a game, make it fun if you can! You don’t want it to be a test that puts stress on patients.
“Mrs. Jones, I want to be really sure that you understand all the important information about this new medicine. May I ask you a few questions?”

If patient’s answers are shaky, ask some questions and clarify.

The Take Away

Cultivate an environment that encourages questions - no concern is foolish in a hospital. We always want our patients to be safe; we have to make absolutely sure that they are understanding what we tell them, rather than just nodding and smiling.
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Monday, May 22, 2017

Communication Confabulation

When it comes to education about medication, there are some people who should pay particular attention: CNOs, DONs, chief medical executives, physicians, nurse managers, nurse supervisors, risk managers, pharmacy directors, and lead pharmacists are all critical leaders in this process. This information is also essential for nurses, hospitalists, pharmacists, mid-levels, PA’s, CNA’s, case managers, and - let’s not forget – IT, who are absolutely vital when it comes to electronic medical records.

I don’t know about you, folks, but everything – groceries, my to-do list, things I need to pack when I travel – are easier to remember when I make a checklist. Why don’t we make a checklist for medication education?

Consider This
First: make sure you have the patient’s full attention when you explain medications, possible side effects, and what to do if the patient experiences them. 

Second: we have to empower patients to ask any questions they have about their medications.

Third: be constantly vigilant for patients who are reluctant to ask questions, rarely complain, and avoid using their call button for help. You’ve got to assure them there’s no such thing as a “false alarm” in reporting what they think is a harmful side effect. Use the phrase “we always want you to be safe.” Remind them that there’s no blame or shame in calling attention to how they feel. 

Urge patients not to put themselves in jeopardy. Potential side effects are a very real concern.

Education Checklist
Here is the checklist for educating a patient about a new medicine.
Explain to patients:
  • the name of the medication.
  • what the medication is for
  • how it works
  • how and when to take the medication
  • what to do if a dose is missed.
The Take Away
In addition to your being healers, all bedside caregivers are also teachers. You educate about meds. But you also, in your time with your patients, share knowledge about diet, nutrition, exercise, stress management and adherence to regimens.
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Monday, May 15, 2017

The D.E.A.T.S. of Medication Education

How competent is your team at engaging a reluctant patient? As a nurse or manager, it’s your job to make sure they have those skills. There’s no substitute for role-playing the skills you want your team to master. It takes five or ten minutes, max, and you’ll know that they’ve got it. Don’t assume they’ve picked it up from watching you. 

Consider This

Arguably one of the most important skills your staff need to master is active listening. Be sincere and empathetic, because your attention validates the patient’s struggle and frustration. Sometimes a friendly smile makes a huge difference.

Make sure that you:
  • are fully present (not thinking about the last patient or the next patient),
  • have open body language (uncrossed arms, leaning forward),
  • are nodding your head and making affirmative noises (“mm-hmm” or “uh-huh”).
When you’re engaged in medication education, remember the handy anagram D.E.A.T.S.

D - Draw Curtain. Partially for privacy, but mostly to block anything that might divert attention from your presentation about a new medicine.

E - Engage Patient. Let your patient hold the pill, or handle the bottle of liquid, and repeat its name. Help them get familiar with what it looks like.

A - Adapt Communication. Use communication methods preferred by the patient. Use everyday language, especially with older folks. Avoid fancy, difficult medical terms.

T - Translate As Necessary. I worked at a hospital in downtown Los Angeles where, on any given day, twenty seven different languages could be spoken. There were caregivers in that hospital able to speak almost every one of those languages. Plus, they had access to phone translators. Get translators involved if necessary!

S - Side Effects. People need to know the potential side effects: how they might feel, what they’ll look like, and what to do if they appear.

The Take Away
Patients that are reluctant to ask questions may be put at ease through active listening. Remember to focus, lean forward, nod, make affirmative noises, smile, and use D.E.A.T.S. to cover all your bases.

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