Part 1 in a series discussing the challenges and opportunities in patient/family education

By Paula Erwin-Toth, MSN, RN, CWOCN, CNS

Mr. Gillan is a 72 year old man with venous insufficiency. He presents with a venous ulcer on his left lower leg. He has several co-morbid conditions including hypertension, cataracts, and osteoarthritis which includes his hands. His primary caregiver is his 74 year old wife who suffers from diabetes and mild dementia. They do not have any family living nearby. He is being discharged to his home with a primary wound dressing and compression wraps. His discharge instructions include requests for Home Care nursing and follow up with vascular medicine and a pedorthist.

Does this situation sound all too familiar? Though Mr. Gillan’s case is fictitious, his case is based on the reality of many patients’ circumstances when leaving a treatment facility and left with discharge instructions. Here is a patient who may struggle with day-to-day activities even without a wound to manage, who is without adequate family support to assist in adhering to their discharge instructions, and is left with an expectation to follow-through on multiple appointments to manage their condition, in addition to prescribed therapies and dressings changes at home.

All of us have been taught that the cornerstone of effective patient education is learner readiness. How often have we been compelled to accelerate this process only to find (not surprisingly) our efforts have been in vain? No matter what health care setting you work in the pressures we are facing are immense. Regulatory and legal standards and requirements (e.g. JCAHO, CMS, professional practice acts), length of stay, prospective payment, staffing and level of experience all affect clinical care.

For the next several months I will discuss the challenges and opportunities relating to patient/family education that need to be considered by the interdisciplinary team following Mr. Gillan in a variety of settings including acute care, home care, ambulatory care, subacute care and long term care.

About The Author
Paula Erwin-Toth has over 30 years of experience in wound, ostomy and continence care. She is a well-known author, lecturer and patient advocate who is dedicated to improving the care of people with wounds, ostomies and incontinence in the US and abroad.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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