Caring for Visually Impaired Patients in the Hospital: A Multidisciplinary Quality Improvement Project.


Journal

The American journal of nursing
ISSN: 1538-7488
Titre abrégé: Am J Nurs
Pays: United States
ID NLM: 0372646

Informations de publication

Date de publication:
05 2020
Historique:
entrez: 26 4 2020
pubmed: 26 4 2020
medline: 2 7 2020
Statut: ppublish

Résumé

People with low vision or blindness may experience anxiety, fear, and depression-sometimes severe-as a result of the challenges encountered when they seek medical care. Such patients deserve, and health care professionals must provide, equal opportunities to participate in and benefit from their health care in a safe environment. A search of the literature yielded information on the needs of visually impaired people but failed to find a comprehensive program that health care facilities could use to meet the needs of this vulnerable population. This gap in the literature on visually impaired patients (VIPs) and implications for their care led us to conduct focused meetings with this population. The specific aims of this quality improvement (QI) project were to determine the needs of hospitalized VIPs, develop educational and other resources that would help clinicians and ancillary hospital staff in their interactions with VIPs, and assemble a toolbox of useful materials for VIPs themselves. A VIP care team identified the needs of VIPs as reported in the literature and in personal meetings with visually impaired people in the community. The team also surveyed interdisciplinary hospital staff members to determine their experience in caring for VIPs as well as their educational needs, and then developed strategies and educational modules to help clinicians and ancillary staff members accommodate the unique needs of VIPs in accordance with the Americans with Disabilities Act of 1990. The team also assembled a VIP toolbox that contained several items useful to VIPs themselves. Supplementary information tailored to the function of each hospital department (such as nursing, admissions, environmental services, dietary, and radiology) was also provided to help staff members improve VIPs' hospital experience. The hospital's interdisciplinary staff members participated in an education program to improve their care of VIPs. Before the program, only 23.6% of 161 staff members reported having received education on caring for VIPs. After the program, however, 56.4% of 140 staff members reported having received such education. Former patients requested bracelets and room identifiers that would alert staff members to VIPs' needs, and the team provided these. The team also introduced a braille version of the hospital menu and provided VIP toolboxes at each nursing station that contained many useful daily care items. VIPs have specific needs when hospitalized. Patients' and staff members' responses to this QI project were overwhelmingly positive; both groups were appreciative of the newly implemented initiatives to meet the special needs of the visually impaired.

Sections du résumé

BACKGROUND
People with low vision or blindness may experience anxiety, fear, and depression-sometimes severe-as a result of the challenges encountered when they seek medical care. Such patients deserve, and health care professionals must provide, equal opportunities to participate in and benefit from their health care in a safe environment. A search of the literature yielded information on the needs of visually impaired people but failed to find a comprehensive program that health care facilities could use to meet the needs of this vulnerable population. This gap in the literature on visually impaired patients (VIPs) and implications for their care led us to conduct focused meetings with this population.
OBJECTIVE
The specific aims of this quality improvement (QI) project were to determine the needs of hospitalized VIPs, develop educational and other resources that would help clinicians and ancillary hospital staff in their interactions with VIPs, and assemble a toolbox of useful materials for VIPs themselves.
METHODS
A VIP care team identified the needs of VIPs as reported in the literature and in personal meetings with visually impaired people in the community. The team also surveyed interdisciplinary hospital staff members to determine their experience in caring for VIPs as well as their educational needs, and then developed strategies and educational modules to help clinicians and ancillary staff members accommodate the unique needs of VIPs in accordance with the Americans with Disabilities Act of 1990. The team also assembled a VIP toolbox that contained several items useful to VIPs themselves. Supplementary information tailored to the function of each hospital department (such as nursing, admissions, environmental services, dietary, and radiology) was also provided to help staff members improve VIPs' hospital experience.
RESULTS
The hospital's interdisciplinary staff members participated in an education program to improve their care of VIPs. Before the program, only 23.6% of 161 staff members reported having received education on caring for VIPs. After the program, however, 56.4% of 140 staff members reported having received such education. Former patients requested bracelets and room identifiers that would alert staff members to VIPs' needs, and the team provided these. The team also introduced a braille version of the hospital menu and provided VIP toolboxes at each nursing station that contained many useful daily care items.
CONCLUSIONS
VIPs have specific needs when hospitalized. Patients' and staff members' responses to this QI project were overwhelmingly positive; both groups were appreciative of the newly implemented initiatives to meet the special needs of the visually impaired.

Identifiants

pubmed: 32332367
doi: 10.1097/01.NAJ.0000662820.87519.52
pii: 00000446-202005000-00028
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

48-55

Références

Rosenberg EA, Sperazza LC. The visually impaired patient. Am Fam Physician 2008;77(10):1431–6.
U.S. Census Bureau. An aging nation: projected number of children and older adults. 2018. https://www.census.gov/library/visualizations/2018/comm/historic-first.html.
Zhang X, et al. Association between depression and functional vision loss in persons 20 years of age or older in the United States, NHANES 2005-2008. JAMA Ophthalmol 2013;131(5):573–81.
Iezzoni LI, et al. Teaching medical students about communicating with patients who have sensory or physical disabilities. Disabil Stud Q 2005;25(1).
Marshall S. ADA checklist: healthcare facilities and service providers. Washington, DC: American Foundation for the Blind, Public Policy Center; 2006 May. https://www.afb.org/blindness-and-low-vision/your-rights/advocacy-resources/ada-checklist-health-care-facilities-and.
Cupples ME, et al. Improving healthcare access for people with visual impairment and blindness. BMJ 2012;344:e542.
Kitching A. Treatment of a visually impaired patient showed me her viewpoint. Nurs Stand 2013;27(46):28.
QIO News. Four tips for communicating with patients with hearing and vision impairments. Washington, DC: Quality Improvement Organizations; 2018 Jul. https://qioprogram.org/qionews/articles/four-tips-communicating-patients-hearing-and-vision-impairments.
Vision Australia. Caring for patients. 2015. https://www.visionaustralia.org/information/family-friends-carers/caring-for-patients.
Beverley CA, et al. Health information needs of visually impaired people: a systematic review of the literature. Health Soc Care Community 2004;12(1):1–24.
Khan A, Simon S. Low-vision education for the health care workforce: strategy to create a vision-friendly hosital. WMJ 2011;110(5):243–6.
Luckowski A, Luckowski M. Caring for a patient with vision loss. Nursing 2015;45(11):55–8.
Rushing J. Helping a patient who's visually impaired. Nursing 2007;37(8):29.
Crossland MD, et al. Smartphone, tablet computer and e-reader use by people with vision impairment. Ophthalmic Physiol Opt 2014;34(5):552–7.
Thomas R, et al. Assistive technology for children and young people with low vision. Cochrane Database Syst Rev 2015(6):CD011350.

Auteurs

Christine Carlson (C)

Christine Carlson is a clinical nurse, Tami Howe is a clinical nurse coordinator, and Chase Pedersen is associate chief nursing officer, all at St. David's North Austin Medical Center in Austin, TX. Linda H. Yoder is a professor at the University of Texas at Austin School of Nursing. Contact author: Christine Carlson, chrisefm@gmail.com. The authors have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com.

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