Post MI Education

I have a couple of questions that I would like some feedback on just to see what everyone overseas is doing.

1) What do you cover as far as patient education with your post MI patients prior to discharge?

2) how do you document your education?

3) What resources (esp. videos) do you use to help with education?

We are considering changing the docuementation for cardiac education and at present are toying with the idea of a likhert scale to indicate the patients knowledge level before and after each education session.

All responses gratefully accepted

[gwenith, BSN, RN]

Doesn't anyone do patient education on the cardiac unit? Is all your post MI education done in cardiac rehab? Just wondering?

[jessjoy]

Hi! I am a new grad on our tele unit. We have pre-printed discharge instructions that we give to pts. upon discharge. We do teaching prior to dischg also. We have videos that pts watch about living with heart disease and also one on cardiac medications. We also have an "MI folder" which has many teaching sheeets that pts can read and take home regarding when to call the doctor, diet, exercise, meds, etc. Since this info is mandatory to give to the MI pt we have a teaching sheet which includes all this info and we must check it off as we go through it to verify that it has been done. If we go over some of the onfo again it is marked in the "reinforcement" column. Hope this helps! Jess :)

[healingtouchRN]

My patients are in CCU, fresh AMI, post procedure. I begin with what the new meds are used for, side effects (such as bleeding when brushing the teeth-warfarin). I expain the cineangiograms, showing the opening of the arteries, placement of the stent, etc. We consult cardiac rehab & dietician who presents the pt with packet of learning materials in 6th-8th grade level reading. We have a cardiac rehab facility on site they can tour upon discharge if they chose to use it. It has Phase 1-4 rehab with excercise physiologists & nurses their to assist them. our staff is encouraged to join membership there to work out with them. (personally, if I am going to be around the patients on hospital property, I want to be on the payroll).....on our telemetry unit where the patients are discharged home, they continue what I start in CCU. I also have some brochures about living with heart failure that I found outside the hospital & I provide. it's well written & it has lots of pictures, which the older people like. I hope this helps...

[zambezi, BSN, RN]

We have a book specific to our unit. It covers "the heart": arteries, atria, ventricles, the course of blood flow, etc. The next chapter talks about narrowing of the arteries, blockages, chest pain, heart attack warning signs, what to do, etc. Next chapter talks about heart procedures: ptca, stents, ekg, cxr, treadmill tests, etc; it covers about everything that can typically be done. There is a chapter of diet, meds (anything that is "normal" for heart stuff, discusses side effects, class, tips to remember) , our unit, the cardiac surgery procedures; pre/during/post, after surgery care, lifestyle changes, etc. The book is pretty inclusive and specific to our program. Prior to surgery there is a video and we have a cardiac educator. The bedside rn also does continuous teaching, of course. We have videos for everything, diet, stents, mi's smoking cessation, etc. We are just now in the process of making all new updated videos. We also have a mended hearts program that the patients follow up in after their heart surgeries/heart attacks. We have voluenteer that can follow up with them as well. There are some other things in place as well, we are pretty big on education.

[gwenith, BSN, RN]

Thnk-you everyone We have a lot of information that we use most if it from the "Heart Foundation"

What I am specifically looking for is a good low level easy to understand video on A&P of the heart and causes of MI. We have an excellent video called Coronary Disease 2 http://www.rkm.com.au/chd.html but it is a little "discovery channel" and too much for some of our elderly patients.

I am also in the process of designing a form to track the education we give pre-discharge. What I am considering is using a simple Lickert scale 0-5 to assess the patients knowledge and mark pre and post session ( session can be anything from 2 - 20 mins depending on time and patient). Is anyone using anything similar??

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

Hi Gwenith,

On you education tracking, we use what is called an IPER. Interdisciplinary Patient Education Record. We have a general IPER for things like admission, hospital stay, discharge etc. Then we have some that are condition specific i.e MI, arrythmias, pneumonia, renal, etc. We assess patient preferred style of learning and current level of understanding/acceptance of educational material presented. 1-4 scale. 1 being someone incapable of learning, 4 being someone able to completely comprehend. A little hard to explain and tends to make a lot of paperwork but if you want I can email you a copy of what something like it looks like. Hope this helps.

[nowplayingEDRN]

Gwenith,

We have patient education videos from the American Heart Association on didfferent cardiac disease processes and procedures as well as on healthy life styles.....the videos come with a leaflet that documents that patient teaching has been addressed, it is also documented in the patient chart. Currently 90% of all cardiac teaching is done in rehab because our facility does not have enough support services to keep AMIs....they all get shipped out to surrounding facilities. However, I do heavy patient teaching with rule out patients.......obtaining educational material off the internet so that they have something concrete in hand after I have gone through it with them, explained medications, recommended tests, life style modifications and such.....that way they can read after I have gone over it with them, ask questions as they arise. I also provide them with a piece of paper and a pencil so tha tthey can write the questions down as they come to mind so that they do not get forgotten and can be addressed. I always encourage the patients to ask questions......I do not know if this helps you any but I did make an attempt to try.