ENDOSCOPY
PATIENT
EDUCATION
Yvonne Pumphrey, RN, SCNI, CGRN
UMMC Endoscopy Patient and Endoscopy Education Coordinator
Objectives



Review Health Literacy Facts
Discuss Guidelines for Clear Communication
Discuss Endoscopy Patient Education
Health Literacy

Health Literacy is defined as the ability to read,
understand and effectively use health care information

Research has shown that literacy skills are a stronger
predictor of a patient’s health status than:






Age
Education Level
Employment
Income
Race
Ethnicity
Patients with Low Health Literacy
Are Less Likely
■
■
■
■
■
■
To seek medical care
To comply with prescribed treatments and
follow up
To take medications properly
To keep appointments
To complete medical forms correctly
To admit they don’t understand
Patient’s With Low Health Literacy
Are More Likely




To require hospitalization
↑ hospital length of stay
↑ mortality
↑ hospitalizations ↑ annual health care costs
4
times higher than for patient’s with higher health
literacy skills
Assessing for Health Literacy Skills
in Endoscopy Patients

Begin with first encounter and establish
Primary
language
 If patient read and understood pre procedure
instructions
Review of medications including patient’s
understanding of usage
Ask if the patient knows what procedure they are
having and why
ASK ME THREE
TEACHING PATIENTS TO ASK 3 EVERY TIME THEY
TALK TO THEIR DOCTOR, NURSE OR PHARMACIST
1. WHAT IS MY MAIN
PROBLEM ?
2. WHAT DO I NEED
TO DO ?
3. WHY IS IT
IMPORTANT FOR
ME TO DO THIS ?
ASK ME 3 is an educational program provided by the
Partnership for Clear Health Communication at the
National Patient Safety Foundation
Health Literate Organization
Clearly Explains Health Care Coverage
Includes Patient’s Out of Pocket Expense for Services
Creates Easy to Use Materials
Design Team Includes Patients to be Served
Meets Needs of All
MultiLingual
CLEAR COMMUNICATION
WITH PATIENTS




Ask for and use correct pronunciation of
patient’s name
Encourage patients to bring a list of their
current medications and health concerns
Use short words and sentences
Explain all medical terminology in layman’s
terms
Non-Verbal Communication
■ Use direct eye contact
■ Nodding indicates that you are listening to the patient
■ Use affirmative statements , then confirm your
understanding with patient’s
■ Don’t interrupt the patient, allow them to finish their
statement
Health Literacy Facts



Almost 9 out of 10 adults in the US have some level of
difficulty understanding the health information that is
common in hospitals, medical offices, media, and
communities
The average adult in the US reads at an 8th grade level,
although 20% of our population read at the 5th grade level
or lower. (may include elderly, those with chronic disease,
uneducated, and recent immigrants)
Medical terminology is most often written at an 11th or
12th grade level creating the gap for low health literacy
Unit Level Education









Pre Procedure Phone Call
Review of Instructions
Npo Status
Adult Accompaniment if Sedation or Anesthesia
to be used
Specific Prep Instructions
Review of Medications
Sleep Apnea and Use of CPAP
Review Directions to Facility and Endoscopy Unit
Review Procedure Time and Expected Time of Arrival
Unit Level Education
Begin Patient Education with Endoscopy Unit
Orientation
 Perform Intake Assessment
 Explain Safety Precautions
 Explain Pre, Intra and Post Procedure
 Initiate Plan of Care with Patient’s Goals,
Education Needs, and Interventions
 Explain Anesthetics/Sedation Plan

Discharge and Follow Up
Education
Provide Discharge Instructions
Written, Verbal, Multilingual
To include :
■ Physician’s impressions and recommendations
■ Medication Reconciliation
■ Follow up treatments/appointment dates
and time
Post Procedure Calls
Fever, Pain or Bleeding
 Other Problems
 Is a physician, physician’s assistant, or nurse
practitioner call back necessary
 Patient Satisfaction

Community Outreach Education






Health Fairs
Colon Cancer Awareness
Parish Nurse programs
County Homeless Education Support
Educational Fund Raisers
GI Nurses and Associates Day




Founded in 1823 as one of the nation’s oldest academic
medical centers. All physicians are faculty at the University
of Maryland’s School of Medicine. The medical center
treats over 32,000 inpatients and more than 300,000
outpatients each year. The Shock Trauma unit provides
treatment for more than 7,500 patients yearly with greater
than 97% survival rate.
Magnet Designation
Leap Frog Top Hospital award for quality and safety from
2001-2011
Listed Among Nation’s Top Hospitals by US News and
World Report
UMMC Endoscopy





Case Load – 75% Outpatient 25% Inpatient
Apx 30 procedures daily
Two Procedural Units
Four procedure room / nine bed recovery unit
with moderate sedation and anesthesia support
Two procedure room/PACU unit with
anesthesia support (SECU-surgical endoscopy
care unit)
UMMC Endoscopy





Clinical Staff : 13 Medical and Surgical
Endoscopists
5 Hepatologists
17 Fellows /3 yr program
17 Nurses
16 Technicians
Endoscopy Procedures











EGD
Balloon Enteroscopy
ERCP
Endoscopic Ultrasound
Capsule Endoscopy
Bravo
Cryotherapy
Radio Frequency Ablation
Laser Therapy
Colonoscopy
Flexible Sigmoidoscopy
Value of ABCGN Certification
Study and Review:
 Stimulates your recall
 Increases your knowledge
base
 Improves your organization
and study skills
 Promotes networking with
colleagues
ABCGN Certification:
 Instills a professional sense
of pride and accomplishment
 Validates your advanced
knowledge, competence, and
skills
 Improves patient care
 Improves patient satisfaction
 Improves job satisfaction
 Increases potential for higher
salary and career
advancement
References













New Federal Policy Initiatives To Boost Health Literacy Can Help The Nation Move
the Cycle of Costly Crisis Care (2012)
www.health Literacy.Health.gov A Guide to Writing and Designing Easy to Use
Websites
www.health Quick Guide to Health Literacy and Older Adults
www.health National Action Plan to Improve Health Literacy
National Patient Safety Foundation Partnership for Clear Health Communication
www.AskMe3.org
The Center for Healthcare Communication
infor@communicatingWithPatients.com, www.Communicating WithPatients.com
Institute of Medicine of the National Academies Roundtable on Health Literacy
University of Maryland Health Sciences and Human Services Library
The Newest Vital Sign: A Health Literacy Assessment Tool for Healthcare Providers,
http://www.pfizerhealthliteracy.com/public-policy-researchers/NewestVitalSign.aspx
Improving Health Literacy
http://www.plainlanguage.gov/populartopics/healthliteracy/index.cfm
University of Maryland Patient and Family Education Council
Planning Your Patient’s care Delivery and Education 2008
University of Maryland Endoscopy Practices and Procedures 2012
Bey
Health