Event Management In Health Care and Nursing Education To Assist

Education of Gynae Patient Assist With Event Management

    Patient education associated with event management is common.
Although there are few new approaches to this area of patient education, a
cluster of studies document new health areas where education for event
management should be routine and new, frequently theory based, ways to meet
goals.

    Three studies of educational needs not routinely being met in all
cases within women’s health. Women who during the second stage of labor had an
operational delivery felt unprepared for this event. 

    Many expressed
difficulties fully understanding why they’d needed an operative delivery and
suggested that either they or the baby had failed to achieve a normal delivery,
short comings in the postnatal review were not expressed immediately but
emerged after discharge (Murphy, Pope, Frost, & Darling, 2003).

    A second example occurred with women whose confirmed pregnancies
ended in miscarriage. Again, these women had poor recall and understanding of
the event, needed and de sired formal follow-up plans, and suffered from guilt
and false assumptions, with significant anxiety symptoms (Wong, Crawford, Gask,
& Grinyer. 2003). 

    A final example is need for education to control anxiety
before an event. In women under-going cervical screening, 7% are diagnosed with
an abnormality that requires follow up examination with a colposcope, a large
magnifying glass with a light source that allows detailed examination of the
cervix. 

    In the United Kingdom, many of these women had to wait for colposcopy
and during this time were very distressed, assuming they had cancer because the
physician did not explain dyskaryosis. PR colposcopy educational sessions were
established to deal with fears about the procedure itself and fears of cervical
cancer (Neale, Pitts, Dunn, Hughes, & Redman, 2003).

Pre and Post Surgery Procedure and Event Management In Nursing

    Education during the pre-procedure period was also used in
Canadians waiting to undergo an elective coronary artery bypass graft (CABG).
During this time the patient’s functional and psychological status can
deteriorate. 

    A randomized controlled trial of 8 weeks of twice-a-week
individualized physical training in a supervised setting, education, and
reinforcement, as well as monthly nurse-initiated phone calls to answer
questions and provide reassurance were compared with usual care. Median length
of hospital stay after the surgery for patients in the intervention group was 1
day shorter than for those in the control condition (Arthur, Daniels, McKelvie,
Hirsh, & Rush, 2000).

    Preoperative preparation among first time cardiac surgery patients
used social learning theory, introducing vicarious experience with former
patients exemplifying the active lives they were leading. The former patients
were trained in how to provide this intervention. 

    In this randomized controlled
trial, patients receiving the experimental intervention had decreased anxiety,
increased self efficacy, and more self reported activity of walking and
climbing stairs than did patients in the usual care group (Parent & Fortin,
2000).

    The literature is filled with other examples of needs for patient
education associated with critical events. Hupcey and Zimmerman (2000) found
significant need to know among critically ill patients during the
event information to help them grasp what was going on and a continual need to
be oriented. 

    Once extubated or in stable condition, most patients wanted
information about what happened during “the time I lost.” Critically ill
patients should be provided with continual reassurance and reorientation and asked
what information they need about the intensive care unit (ICU) experience,
repeated as often as they need it. 

    The majority of patients undergoing first
elective percutaneous coronary revascularization had unrealistic expectations
about long term benefits and were not aware of potential risks such as arterial
injury, stroke, myocardial infarction, and death (Holmboe, Fiellin, Cusanelli,
Remetz, & Krumholz, 2000).

At Risk Old Age Patient and event Management Education of Patient

    Finally, older patients are at special risk of not understanding
aftercare instructions. Those managing their pain at home after outpatient
surgery consistently under treated it and dealt with it by remaining immobile,
which of course set them up for complications, more than a third did not
remember receiving instructions, many said they’d had written instructions but
had not read them, and even those who recalled instructions did not follow them
to manage the pain (Kemper, 2002). 

    And elderly postsurgical cancer patients
transitioning from hospital to home had extensive information needs, ranging
from concrete instructions about how to care for a surgical wound, to complex
information about options for cancer treatment. In addition to instructions for
self care, patients and families needed clarification of the illness experience
(Hughes, Hodson, Muller, Robinson, & Mc Corkle, 2000). 

Patient Education for Event Management and Lack of Resources

    Patients and families have been expected to give care without
adequate resources including educational preparation for these roles. A 1998
survey of more than a thousand informal caregivers found more than half who
helped with an activity of daily living such as feeding, hatching, using the
toilet, or lifting said that they received no formal instruction for how to
perform these tasks. 

    Eighteen percent of caregivers who helped with medications
reported that they received no instruction about how to do so, approximately
12% reported they were aware of a mistake they had made in the administration
of a medication. One third reported receiving no instruction on changing
dressings or bandages or on the use of equipment. 

    For years, we have
conceptualized the caregiving experience as something that is inherently
difficult and stressful, in part because of the lack of educational support for
such roles. The Family Caregiver Support Act, implemented in 2001, may expand
assistance for these individuals (Donelan et al., 2002).

    The needs of these patient groups should be expected. What is
starting is that these recent studies should find so many of the needs unmet.

    To date, patient education has been seen as supportive to medical
treatment and not as an independent function, with of the medical
establishment. Most other cultural institutions, each of which has an
educational component parallel to patient education, have successfully made
this transition to client centeredness but continue to struggle with it.

    Viewed through this new set of lenses, patient education can be
seen as a central component of an exciting set of developments that promise to
redefine health care and better serve patients, with a clear potential for
increased efficiencies.