New Healthcare Technology

Explore strategies for using it, instructing patients about it, and keeping up with changes.

To view the Course Outline and take the test online, click here.

For a printer-friendly version of the exam you can print out, complete and mail in to ADVANCE click here.

Learning Scope #362
1 contact hour
Expires July 4, 2013

You can earn 1 contact hour of continuing education credit in three ways: 1) For immediate results and certificate; take the test online; grade and certificate are available immediately after taking the test. 2) Mail your completed exam (or a photocopy) along with the $8 fee (check or credit card) to ADVANCE for Nurses, Learning Scope, 2900 Horizon Dr., King of Prussia, PA 19406. 3) Fax the completed exam to 610-278-1426. If faxing or mailing, allow 30 days to receive certificate or notice of failure. A certificate of credit will be awarded to participants who achieve a passing grade of 70 percent or better.

Merion Matters, Inc. is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association (No. 221-3-O-09), an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Merion Matters Inc. is also approved as a provider by the California Board of Registered Nursing (No. 13230) and by the Florida Board of Nursing (No. 3298).

The goal of this continuing education offering is to provide nurses with strategies to help them educate themselves and patients about new healthcare technologies. After reading this article, you will be able to:

1. Describe the "learn together" method for instructing patients about their new healthcare appliances.
2. Describe how to use the "teach back" method to assure the patient learned how to use the healthcare appliance properly.
3. List ways to obtain information about new healthcare technologies.

CHANGE is constant, especially in the world of healthcare technology. Nurses, who are proven experts in consumer health education, want to feel confident using the latest healthcare technology. They also want to be assured their patients are using any high-tech appliances or equipment given to them correctly.

So, how do we keep up when things keep changing and new appliances for patient care seem to be rolled out every day? How do we know if our patients are correctly using the appliances or equipment given to them to support a healthier lifestyle? What do we do if we have never seen a certain appliance before? This article will provide you with strategies to help deal with the constant influx of change related to new healthcare technologies, appliances and equipment given to patients.

Never Make Assumptions

The appliance the patient left with may not be the appliance the patient brings back.

• Jack Smith, RN, who works in a diabetes clinic, taught Sally Carpenter, who is newly diagnosed with diabetes, how to use a glucometer to test her blood sugar. On her next visit, Jack asked her how she is doing with her glucometer and she removed a different one from her purse. Sally told Jack she saw a commercial on TV about this one that uses less blood, talked with a friend who uses it and decided she wanted one too. She then asked her family nurse practitioner for a prescription for it.

• John Winter, a patient admitted to the local Veterans Health Administration (VHA) hospital brought in a different continuous positive airway pressure (CPAP) machine than the one issued to him by the VHA after a sleep study revealed he was having sleep apnea. He told the admitting RN this mask fits him better and he has better results with it. He wants to use his "own machine" while an inpatient.

It does not matter what appliance you gave the patient, or which one you think he is using, the rule of thumb is: never make assumptions. Always ask the patient to bring in any healthcare appliance he is using along with instructions if he still has them. And be prepared for the unexpected. Always have any appliances brought into the facility checked out for safety.

Lack of Information

What if there are no instructions and you have never seen the appliance before? Don't panic. Ask the patient to show you how to use it - if she seems capable and the process makes sense, you may not need to go any further.

However, you might suspect what the patient is showing you is not accurate. In this case, look for the manufacturer's contact information on the appliance and contact the company for information. Many are happy to fax the information to you or give you an Internet address where the information can be found. As a last resort, use your favorite Internet search engine to see if you can find any information about the particular piece of equipment.

'Learn Together'

In many healthcare facilities, the nurses provide patient teaching for all new equipment. If the nurse is not the primary patient educator, the nurse usually is still expected to reinforce what has been taught and ascertain the patient understands what is expected of him.

Don't forget, however, that you have resources available to help you. Hospitals often set up times for nurses to learn how to use new equipment directly from the manufacturer's representatives. Always begin your teaching early - avoid the temptation to wait until just before discharge. You and the patient deserve enough time to practice and make sure the information has been adequately absorbed.

Keeping up with new models of equipment can be challenging. However, nurses and patients working together can get the job done. For example, you may need to teach a patient about a new glucometer you have not given out before. The strategy here would be to review the instructions yourself first, then set a time with the patient to "learn together."

It is OK to tell the patient you are learning about the differences in this specific glucometer along with him. If the patient has previously used a different glucometer, first review the similarities with his previous one. This gives the patient a context by which to learn the new material. Then, together with the patient, review the differences.

Ask the patient how he wants to note the changes. Many adults like to sketch out a new appliance and/or make notes. If the patient seems unsure how to proceed, get an index card and write out how to use the appliance step by step, if needed, noting the differences from his previous one. Some patients also like to have a family member or friend with them during the teaching session so they have backup just in case they get confused about its use.

During the "learning together" session - make it enjoyable, laugh at any mistakes and keep things light - this creates a more relaxed teaching session, and people learn better when they are relaxed.

What if this is the first glucometer the patient has ever used? The same strategies still apply. However, this patient most likely will have more questions, take longer to grasp the information, and may stumble more in handling it. If you are teaching the patient in an ambulatory care area, ask him to come in on 2-3 consecutive days if needed to review the new appliance.

During your teaching session you are wise to use the instructional materials provided by the manufacturer. These are often of high quality and may be available in more than one language. Follow the step-by-step directions with the patient. Use sticky notes that can be attached to the manufacturer's instructions to add additional comments or to write out alternate wording if needed.

Assessing Patient Learning

Once you have competed the session or a portion of the session, use the "teach back" method to determine what the patient can recall. You may be familiar with this strategy under another name: demonstration and return demonstration. However, "teach back" takes demonstration and return demonstration a step further: Can the patient in her own words teach you what she has just learned?1,2

Proponents of the "teach-back" method stress the importance of recognizing that it is not only important for patients to be able to read and understand, they must be able to follow instructions. Evidence indicates the "teach back" technique is effective, not just for improving patients' understanding but also for improving healthcare outcomes.

To use the "teach back" method, ask your patient to teach you as if she were teaching a family member or friend. You can say something like, "I want to see if you have the steps down in the correct order - let's review it together. Teach me how to use this blood pressure cuff; explain how it works the way you would to your husband or friend."

The "teach back" method is simple and can be applied to any teaching situation. It provides the nurse with information about where the teaching techniques used were effective or ineffective. If the patient cannot "teach back," the nurse needs to reteach using different methods. Ask the patient what might help her better understand the directions.

One of the important components to use during the "teach back" method is to restate and summarize the information the patient gives you, asking for clarification. It takes time. But it has many positives. As you repeat to the patient what you heard, you show you really want to help her to learn this new technique. Patience in the process is very important - never give the impression you are rushed, annoyed or bored. As you work with the patient, correct any misunderstandings and continue to ask her to "teach back" until you are sure she has it down.

Be patient with yourself as you try the "teach back" method with your patients. Make sure you have adequate time. Avoid rushing yourself or the patient. Like anything else, it will take longer the first few times you use it. It's time well spent if the patient truly understands operation of the appliance and has achieved the anticipated results from its use.

Staying Current

How do you keep up with all the new technology? There are websites that post descriptions of new healthcare technology. These sites come in many varieties: blogs, online communities, healthcare system sites, manufacturers' descriptions and news sites.

Not all websites found are unbiased or accurate in their descriptions. So look for professional endorsements, or other safeguards for accuracy and completeness. They usually are found at the bottom of the home page. Professional safeguards include certifications such as Health on the Net Foundation (HON) certification (www.hon.ch). HON is a nonprofit, non-governmental organization that focuses on protecting citizens from misleading health information. Another is URAC (www.urac.org), an independent, nonprofit organization, well-known as a leader in promoting healthcare quality through its accreditation, education and measurement programs.

A rule of thumb is to not rely solely on Internet search engine searches for your information. But they are a good place to start. On a recent Internet search for "new medical technology," these were some of the online resources found.

Medgadget

This site (http://medgadget.com) is an independent weblog of the latest medical gadgets, technologies and discoveries. Medgadget states its website "is written, edited and published by a group of MDs and biomed engineers." Medgaget is HON-certified. On Medgaget there was information on:

• A standalone device produced by PositiveID Corp. for relaying portable glucose meter readings to an online database that does not require a phone or a computer. Patients can simply forward their blood glucose data via wireless technology to an online database at their healthcare provider's office.3

ScienceDaily

This site (www.sciencedaily.com/news/matter_energy/medical_technology) describes itself as "one of the Internet's most popular science news websites . with more than 3 million monthly visitors." From the home page, choose "Matter & Energy," then "Medical Technology." This site offers discussion on technological advances in healthcare practice, rather than focusing on products that healthcare consumers might use. On the website some of the postings include information on:

• A Michigan State University report about a smart laser that can replace tissue biopsy, thus providing for a painless and noninvasive way to make a definitive diagnoses.4

• A University of California at Berkeley report about a breakthrough in magnetic resonance imaging (MRI) that produces brain scans more than seven times faster than currently possible.5

Latest Medical Technology

This site (http://latestmedicaltechnology.net) is a blog of new developments in medical technology. Its producers call it a "resource on the latest about diagnostic methods and devices, pharmacology, and other updates on science and technology." Located on this website is information about:

• The Scout, a tool to detect diabetes before symptoms occur. It is a device that measures levels of blood sugar by projecting light on the person's skin.6

High Touch, High Tech

In this ever-changing healthcare environment, with new and different healthcare technologies being introduced every day, nurses need strategies to help keep themselves current. They need methods of discovery that are easy to use, quick to respond and virtually at their fingertips. Nurses also need a way to make sure their patients understand how to use the appliances given to them.

Making sure patients understand how to use their healthcare appliances can be as easy as using high-touch strategies like "learning together" and "teach back." Keeping up with all the new healthcare technological advances might be as easy as using high tech - that is, the Internet - to stay current with high tech.

To view the Course Outline and take the test online, click here.

For a printer-friendly version of the exam you can print out, complete and mail in to ADVANCE click here.

References for this article can be accessed here.

Joan M. Lorenz is president of Clearly Stated, Gainesville, FL. The author has completed a disclosure form and reports no relationships relevant to the content of this article.




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