Effect of Multimedia Discharge Instructions on Outcomes for Emergency Department Patients with Acute Lower Extremity Injuries: A Prospective, Experimental Trial

2.50
Hdl Handle:
http://hdl.handle.net/10755/162739
Type:
Presentation
Title:
Effect of Multimedia Discharge Instructions on Outcomes for Emergency Department Patients with Acute Lower Extremity Injuries: A Prospective, Experimental Trial
Abstract:
Effect of Multimedia Discharge Instructions on Outcomes for Emergency Department Patients with Acute Lower Extremity Injuries: A Prospective, Experimental Trial
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:Buraczewski, Michele, RN, MSN, CEN
P.I. Institution Name:Mercy Hospital of Pittsburgh
Contact Address:1400 Locust Street, Pittsburgh, PA, 15219, USA
Contact Telephone:(412) 232-8168
Co-Authors:Susan Rolniak, Pamela Cockley, Gregory L. Larkin, Michael Turturro, and Chris Connor
Purpose: Computer assisted instruction (CAI) has been used effectively in non-emergency patient populations as an adjunct to education. The purpose of this study was to determine the impact of CAI on adherence behavior, satisfaction, and medical outcomes for emergency department (ED) patients.

Design: This was a prospective, experimental trial using short term longitudinal outcomes.

Setting: This study was conducted in an urban, level I trauma center with an annual census of 42,000. Patients were enrolled over a six month period.

Sample: Convenience sample of ED patients (>18 years) with acute (<48 hours) lower extremity injuries discharged home were included.

Methodology: The CAI was created by emergency staff and video/computer consultants using text, graphics, voice, music, and video. Patients were sequentially assigned to control (standard 'of care verbal and written discharge instructions) or intervention (standard of care and CAI). All patients completed a post-test and satisfaction survey (visual analogue scale). Structured telephone interviews were conducted by a registered nurse 2-4 days and 2-3 weeks post discharge. The interview questions asked patients about compliance with prescriptions and follow up instructions, pain management, time lost from work, and satisfaction with care and instructions. Data were analyzed with Chi square, Fisher's Exact Test, and multivariate regression.

Results: A total of 140 patients (n=75 control; n=65 CAI) were enrolled. The mean age was 36 years. Discharge diagnoses included 56.8% sprain, 17.0% contusions, and 23.6% fractures/dislocations. There were no significant demographic or diagnostic differences between groups.

The majority (83%) of intervention patients preferred the CAI over standard discharge instructions. Average time to discharge was not significantly different between groups. Satisfaction with amount of time spent on discharge instructions, ability of discharge instructions to answer questions, and overall quality of discharge instructions was reported as significantly higher by the CAI group (p=.03, p<.001, and p=.02 respectively). Adherence to discharge instructions was significantly improved for the CAI group (medications p=.04; ice p<.00l; elevation p= <.01; other p<.01; follow-up p<.01). There was no significant difference in either perceived pain or recidivism between groups.

Conclusion: CAI was preferred by the majority of patients over standard discharge instructions. CAI significantly improved patient satisfaction and adherence to discharge instructions. CAI is a useful adjunct to patient education in the ED. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffect of Multimedia Discharge Instructions on Outcomes for Emergency Department Patients with Acute Lower Extremity Injuries: A Prospective, Experimental Trialen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162739-
dc.description.abstract<table><tr><td colspan="2" class="item-title"> Effect of Multimedia Discharge Instructions on Outcomes for Emergency Department Patients with Acute Lower Extremity Injuries: A Prospective, Experimental Trial</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Buraczewski, Michele, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mercy Hospital of Pittsburgh</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1400 Locust Street, Pittsburgh, PA, 15219, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(412) 232-8168</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mburaczewski@mercy.pmhs.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Susan Rolniak, Pamela Cockley, Gregory L. Larkin, Michael Turturro, and Chris Connor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Computer assisted instruction (CAI) has been used effectively in non-emergency patient populations as an adjunct to education. The purpose of this study was to determine the impact of CAI on adherence behavior, satisfaction, and medical outcomes for emergency department (ED) patients.<br/><br/>Design: This was a prospective, experimental trial using short term longitudinal outcomes.<br/><br/>Setting: This study was conducted in an urban, level I trauma center with an annual census of 42,000. Patients were enrolled over a six month period.<br/><br/>Sample: Convenience sample of ED patients (&gt;18 years) with acute (&lt;48 hours) lower extremity injuries discharged home were included.<br/><br/>Methodology: The CAI was created by emergency staff and video/computer consultants using text, graphics, voice, music, and video. Patients were sequentially assigned to control (standard 'of care verbal and written discharge instructions) or intervention (standard of care and CAI). All patients completed a post-test and satisfaction survey (visual analogue scale). Structured telephone interviews were conducted by a registered nurse 2-4 days and 2-3 weeks post discharge. The interview questions asked patients about compliance with prescriptions and follow up instructions, pain management, time lost from work, and satisfaction with care and instructions. Data were analyzed with Chi square, Fisher's Exact Test, and multivariate regression.<br/><br/>Results: A total of 140 patients (n=75 control; n=65 CAI) were enrolled. The mean age was 36 years. Discharge diagnoses included 56.8% sprain, 17.0% contusions, and 23.6% fractures/dislocations. There were no significant demographic or diagnostic differences between groups. <br/><br/>The majority (83%) of intervention patients preferred the CAI over standard discharge instructions. Average time to discharge was not significantly different between groups. Satisfaction with amount of time spent on discharge instructions, ability of discharge instructions to answer questions, and overall quality of discharge instructions was reported as significantly higher by the CAI group (p=.03, p&lt;.001, and p=.02 respectively). Adherence to discharge instructions was significantly improved for the CAI group (medications p=.04; ice p&lt;.00l; elevation p= &lt;.01; other p&lt;.01; follow-up p&lt;.01). There was no significant difference in either perceived pain or recidivism between groups.<br/><br/>Conclusion: CAI was preferred by the majority of patients over standard discharge instructions. CAI significantly improved patient satisfaction and adherence to discharge instructions. CAI is a useful adjunct to patient education in the ED. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:20Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:20Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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