Exam 2 - Pt Education and Empowerment

Question 1

Healthcare quality domains: safe

Answer 1

Avoiding harm to patients from the care that is supposed to be helping them

Question 2

What are the 6 domains of healthcare quality?

Answer 2

Safe
Effective
Pt-centered
Timely
Efficient
Equitable

Question 3

Healthcare quality domains: Effective

Answer 3

Providing evidence-based care to those who would benefit

Refraining from providing services to those not likely to benefit (misuse and underuse)

Question 4

Healthcare quality domains: Patient-centered

Answer 4

Respectful and responsive care to individual patient preferences, needs, and values and using these to guide clinical decisions

Question 5

Healthcare quality domains: Timely

Answer 5

Reducing waits and sometimes harmful delays in care both for those receiving and giving care

Question 6

Healthcare quality domains: Efficient

Answer 6

Avoiding waste in:
- equipment
- supplies
- ideas
- energy

Question 7

Healthcare quality domains: Equitable

Answer 7

Providing care that does not vary in quality due to personal characteristics like:
- gender
- ethnicity
- geographic location
- socioeconomic status

Question 8

IOM strategies to improve med safety: patient’s rights regarding safety and equality in healthcare should be…

Answer 8

Formalized at state and/or federal levels

Question 9

IOM strategies to improve med safety: Every patient should maintain…

Answer 9

An active med list that every provider involved in their care can access

Question 10

IOM strategies to improve med safety: Providers should educate patients and/or caregivers about…

Answer 10

Safe and effective use of meds

Question 11

IOM strategies to improve med safety: What should be available at all key points of the pt care process?

Answer 11

Consultations on meds

Question 12

Communication strategies

Answer 12

Meet pts on their level
Roll w/ resistance
Support self-efficacy
Follow up

Question 13

Communication strategies: Meet pts on their level

Answer 13

Use appropriate language

Show compassion

Listen (esp after open ended questions)

Be honest about disease and medications

Question 14

Communication strategies: Roll w/ resistance

Answer 14

Typically avoiding direct confrontation…. But it is needed sometimes

Question 15

Communication strategies: Support self-efficacy

Answer 15

Help patients develop and maintain autonomy

Question 16

What are the AMA’s 6 steps for verbal pt communication?

Answer 16

1. Use plain, non-medical language
2. Create a shame free environment
3. Use the teach back method
4. Slow down
5. Show them w/ pictures and simple diagrams
6. Limit the amount of info given and repeat it

(Use CUSS Language)

Question 17

What should you do if you give a patient instructions over the phone?

Answer 17

Make sure pt has pen and paper to document any dosage change

Write down info as you give it and date it

Read back the info and verify understanding

Have pt keep dated instructions w/ their med bottle for reference

Question 18

What should be done if a prescriber is calling in a verbal?

Answer 18

Ask them to spell the name and what the purpose is

RPh/intern reads back entire rx

E-scripts preferred but faxing is also good to prevent errors

Question 19

In WV who is legally allowed to take verbals?

Answer 19

Pharmacists and interns

Question 20

Common errors involving communication

Answer 20

• Incomplete rx
• Misread rx
• Bad handwriting
• Use of previous drug/dose on pt profile
• Misheard rx
• Poor fax quality
• Intimidation/bad interaction w/ prescriber or agent
• Typing mistake
• Unable to clarify w/ prescriber
• Prescriber error

(I Might BUMP IT UP)

Question 21

You can (and should) always ____ if you are questioning something about pt, care plans, rx, etc

Answer 21

Confirm

Question 22

What is health literacy?

Answer 22

Degree to which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate decisions

(Basically do they have the ability to understand their care enough to make informed decisions)

Question 23

What is health numeracy?

Answer 23

How a pt interprets numbers, values, or math that is associated with their healthcare

Question 24

.

Question 25

What are the individual factors of health literacy?

Answer 25

Communication skills of individuals Accessibility to quality resources Personal & professional knowledge (CAP)

Question 26

What are the systemic factors of health literacy?

Answer 26

Communication skills of healthcare workers Culture Demands of healthcare and public health systems Accessibility to quality resources

Question 27

What does a short assessment of health literacy (SAHL) evaluate?

Answer 27

Comprehension of medical terms and pronunciation

Question 28

What is a rapid estimate of adult literacy in medicine?

Answer 28

7 item list focusing on recognition and pronunciation of medical terms

Question 29

How is a rapid estimate of adult literacy in medicine administered?

Answer 29

Give pt a list of words and have them read them to you If they don’t know the word, they can pass If they pass or take more than 5 seconds, that one is wrong

Question 30

What words are on the REALM-SF

Answer 30

Behavior Exercise Menopause Rectal Antibiotics Anemia Jaundice

Question 31

How is a SAHL administered?

Answer 31

Show them 3 words — have them read the top one out loud, and say which of the other two are more similar to the top word Ask them not to guess if they don’t know

Question 32

What are red flags of low health literacy?

Answer 32

Saying they can’t read it because they forgot their glasses Commonly brings family members to office visits Incomplete/inaccurate intake forms Identifying meds by visual cues rather than names on the bottle (color/size/shape) Didn’t finish high school

Question 33

Patients can still have LHL, even if they are:

Answer 33

Well spoken College educated Say they understand written info Employed in healthcare

Question 34

Assume all pts have ____

Answer 34

Difficulty understanding

Question 35

What do pts with LHL or adequate health literacy prefer?

Answer 35

Medical info that is easy to read & understand

Question 36

What % of people have health literacy TOO LOW to navigate the healthcare system & promote their well-being?

Answer 36

88%

Question 37

___% have intermediate proficiency

Answer 37

55%

Question 38

___% have basic proficiency

Answer 38

22%

Question 39

___% are below basic proficiency

Answer 39

14

Question 40

What % of adults are proficiently health literate?

Answer 40

12%

Question 41

When using the teach back method, who is being tested?

Answer 41

The patient AND the provider Make sure pt understands and that the provider was clear and included everything

Question 42

How can we improve pt safety and aid LHL?

Answer 42

Consumer medication info Rx labels

Question 43

What is consumer medication info (CMI)?

Answer 43

Written info made for pts/caregivers about rx drugs

Question 44

Who is CMI distributed to?

Answer 44

To consumers when rx is filled

Question 45

What info does CMI include?

Answer 45

Info on general issues Medication-specific recommendations

Question 46

Examples of CMI

Answer 46

Med guide Pt handout Pt leaflet

Question 47

What is the average reading level of CMI?

Answer 47

11-12th grade

Question 48

Less than ___ of patients read CMI

Answer 48

1/3

Question 49

CMI should be ____

Answer 49

Standardized

Question 50

CMI should include ___ and ___

Answer 50

Drug fact boxes Clinical pearls

Question 51

A 2014 study evaluated and reconstructed CMI into 3 prototypes to improve comprehension. What are they? Was it effective?

Answer 51

2 columns to organize info Mimicked OTC drug facts labeling Simple table format following health literacy best practices *ALL THREE of these were better understood than the original format

Question 52

Health literacy best practices prototype outperformed all others, but was ____ adopted by the entire profession

Answer 52

NOT adopted