Educational materials for transplant patients are often too complex for patients to fully comprehend. That’s why oncology nurses at Cedars- Sinai Medical Center, Los Angeles, California, decided to produce 2 patient-friendly books that have gotten rave reviews from cancer patients and the whole oncology team.
At the 37th Annual Congress of the Oncology Nursing Society (ONS) held in New Orleans, Louisiana, the author of the Patient Education Notebooks, Laura Snoussi, RN, BSN, OCN, described the books, which can be downloaded and customized from the Cedars-Sinai Blood and Marrow Trans - plant Program Web site (http://www.cedars-sinai.edu/Patients/Programs-and-Services/Blood-and-Marrow-Transplant-Program/For-Patients/Patient-Education.aspx).
“The aim of developing these books was to provide a user-friendly and effective tool to educate and empower our patients undergoing blood and marrow transplant,” Snoussi said. “The existing books were from 2005, and the content did not reflect our current standards of practice. They were written in textbook style, were too complex and verbose for the average adult learner (a patient or the caregiver), and had too many contributors, so the style was disjointed.”
In addition, she said nurse coordinators determined patients were not reading the material, and were leaving the books at home; nurses, therefore, could not review the material with them. Compliance with important instructions related to patient care before and after transplant was suboptimal, and patients were being readmitted for preventable problems.
“We were using a textbook geared to nurses. I tried to dial it down and keep the information on a 7th grade level [using an educational software application],” she said. “We used pictures and colors. The format was more like ‘Bone Marrow Transplant for Dummies.’ ”
New, Improved Version
Snoussi, the clinical program coordinator for the Blood and Marrow Transplant Program, authored the 2 books, one with comprehensive pretransplant content and the other a detailed review of the transplant, discharge, and self-care. She incorporated feedback from the coordinator team, transplant physicians, and other staff. The books were written in English and Spanish.
In the new books, pictures and images are interspersed with text that addresses different learning styles. Important safety information is contained within key points boxes and highlighted. There are quizzes at the end of each chapter to test the patient’s knowledge and improve the patient’s confidence in the material. The nursing coordinator reviews the quizzes with the patient or caregiver to reinforce the teaching, evaluate the patient’s mastery of content, and identify needs for further teaching or clarification.
Anne Rosenblatt, RN, MSN, lead clinical program coordinator of the Blood and Marrow Transplant Program, commented on the value of the new educational books. “I had noticed that the original books were not so good. The new books have made a big difference in how we talk to patients. The patients actually read them and like them, and they free up time for floor nurses.”
Snoussi agreed that the impact has been very favorable, “as evidenced by nursing coordinators engaging in comprehensive, interactive discussions earlier in the pretransplant process, and patients stating they feel prepared by the level of education they have received,” she said.
“Patients are utilizing the books in a meaningful way,” she continued, “asking more specific questions, demonstrating a higher level of understanding, and successfully completing quizzes with fewer errors. Caregivers are also included in the discussions, because their purpose is detailed in the books. Some patients arrive at their consults having already read the books, since they are available on the Web site. It has clearly met a need for patients, caregivers, and staff.”
“Other healthcare providers involved in teaching this complex patient population can adapt our process to their setting and likely achieve similar positive outcomes,” she added.
The presentation at ONS was entitled Empowering Blood and Marrow Transplant Patients Through a Comprehensive, Manageable Education Book. In addition to Rosenblatt and Snoussi, contributors to the abstract (1342733) included Carolina Caso, RN, CPON; Sandra Rome, RN, MN, AOCN; Margarita Guerrero, RN, OCN; Patricia Van Strien, RN, OCN, CHTC; and Seda Gharapetian, RN, MSN, NP, AOCN, all members of the team at the Cedars-Sinai Medical Center Blood and Marrow Transplant Program.
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