Transcript Document
A Program for Asthma Education in an Urban Level I Trauma Center Christine A. Kletti, MD FACEP Hennepin County Medical Center Program #2078 Asthma Education in an ED • ED’s provide asthma care to an increasing number of patients • Asthma exacerbations often result of… – Lack of understanding about disease – Poor asthma management skills – Lack of consistent primary care – Lack of access to primary care Program # 2078 Asthma Education in an ED Goal • Develop asthma education program for patients seen in the ED for asthma symptoms that will improve patients’ asthma self-management skills Program # 2078 Asthma Education in an ED Asthma self-management requires – Understanding of disease process – Ability to identify symptoms – Knowledge of medications and indications – Appropriate technique for medication administration – Understanding of importance of consistent primary care Program # 2078 Asthma Education in an ED Opportunities for Education in the ED – “Teachable Moment” • Patients may be more receptive to education during an exacerbation – Time to teach • during treatments • while being observed for response Program # 2078 Asthma Education in an ED Barriers to Education in our ED – Lack of time by ED staff due to • High acuity of patients – Inner city Level I Trauma Center • Lack of predictability of patient arrival – Language barriers – Lack of patient receptiveness Program #2078 Asthma Education in an ED Curriculum characteristics for success – Limited number of messages – Simple, concise teaching points – Varied methods of disseminating information – Limited additional requirement of staff time Program # 2078 Asthma Education in an ED Program characteristics for success – Well developed curriculum – Delivered throughout patient stay – Initiated with RN or medical provider order in electronic health record – Frequent reminders/refreshers for staff Program # 2078 Asthma Education in an ED Program Development • Multidisciplinary team – EM physician – Pulmonologist – Nurses – Asthma education specialists Program # 2078 Asthma Education in an ED Components of Asthma Curriculum 1. Face to Face teaching 2. Video 3. Asthma Education Booklet 4. Written Discharge Instructions Program #2078 Asthma Education in an ED 1. Face to Face Teaching • Explain indication for medications • Difference between “controllers” and “relievers” • Medication administration technique • Demonstrate spacer/ inhaler technique • Request teach back • Interpreters to facilitate as needed Program #2078 Asthma Education in an ED 2. Video • Describes symptom recognition • Demonstrates asthma self-management skills • Available in – – – – English Spanish Somali Hmong • Suggest playing video during treatment Program #2078 Asthma Education in an ED 3. Take Home Asthma Booklet – More thorough coverage of asthma – Available in English and Spanish 4. Written Discharge Instructions – Emphasis on importance of follow up with a primary care provider Program # 2078 Asthma Education in an ED Review of the program • Retrospective chart review reveals – 30% of asthma patients are receiving asthma education in our ED • Post discharge survey reveals – Patients satisfied with program – Patients felt it was useful Program #2078 Asthma Education in an ED Asthma education can be successfully delivered in a busy ED 1. Curriculum should • consist of limited, concise messages • be available in multiple languages 2. Deliver education throughout the ED visit 3. An order to initiate the education may increase rate of delivery 4. Frequent reminders/refreshers required Asthma Education in an ED Special Thanks to Gail Brottman, MD Angie Carlson, PhD Sherry Murphy, RN Cherylee Sherry, MPH, CHES Program #2078