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Kaiser Permanente, Northern California
Caritas Consortium 2013

Comfort as Medicine: Integration of CAM into Bedside Care
...
Comfort as Medicine: Integration of CAM into Bedside Care

Intent to Contribute Statement:
Abstract: Numerous studies vali...
Comfort as Medicine: Integration of CAM into Bedside Care
… Continued
Methodology: Inservice education on elements with th...
Comfort as Medicine: Integration of CAM into Bedside Care
… Continued
Data Collection: The measures used to determine effi...
Comfort as Medicine: Integration of CAM into Bedside Care
Inspired Contributor(s) 1 :
 Tracy Trail-Mahan
 Karen Finnie
-...
Comfort as Medicine: Integration of CAM into Bedside Care

Page 6
Complementary and Alternative Medicine (CAM)
• Numerous studies validate the use of Complementary and
Alternative Medicine...
Complementary and Alternative Medicine (CAM):
Bringing it to the Bedside
• The integration of CAM into bedside care is als...
Elements within the Caring Cart
• TV channel guides: distraction, music therapy (care channel)
• Movie list: distraction, ...
CAM Patient Handout
•

Page 10
SMART Goal
• Specific - Promote caring science behaviors and provide comfort
measures consistent with caritas factor #8 cr...
Project Measurables
• Caring Factors Survey to pts pre and post
Caring Cart

• HCAHPS Caritas Factors
• HCAHPS potentially...
Caring Cart
• TV channel guides: distraction, music therapy (care channel),
guided imagery channel
• Movie list: distracti...
Distraction

• TV Channel Guides
• Movie Listings
• Playing Cards
• Coloring pages and crayons

Page 14
C.A.R.E. Channel Guided Imagery
• Nursing education
• Pt brochure

• Nursing Policy
• Signage "therapy in progress: do not...
C.A.R.E. Channel Guided Imagery

Page 16
Aromatherapy
• Nursing Education
• Pt Education/Brochure

• Nursing Policy, documentation
• Limited Scope
• Lavender indic...
Aromatherapy Diffuser Options

Page 18
Lavender
What Lavender Is Used For

What the Science Says

• Historically, lavender was used as
an antiseptic and for ment...
Peppermint
What Peppermint Is Used For

What the Science Says

• Peppermint oil has been used for
a variety of health cond...
Ginger
What Ginger Is Used For
• Ginger is used in Asian medicine to
treat stomach aches, nausea,
and diarrhea.
• Many dig...
Insomnia Resources
• Sound Spa
• Sleep Mask

• Ear Plugs
• Sleepy Time Herbal

Page 22
Music Resources
• Listening to music does wonders to
alleviate stress. Please note that
everyone has different tastes in m...
Caring Factors Survey

Page 24
AVATAR Caritas Factors

Page 25
Possible other metrics to examine

Page 26
Cost of Components per Cart
• Cart

$63

• Essential oils (Lavender & Peppermint)

$20

• CD Player

$20

• Herbal teas

$...
Page 28
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Comfort as Medicine: Integration of CAM into Bedside Care

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Research Question: Will nursing education, and readily available Complementary and Alternative Medicine (CAM) resources increase patient perception of a healing environment and caring behaviors consistent with Watson’s Theory of Caring Science?

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Transcript of "Comfort as Medicine: Integration of CAM into Bedside Care"

  1. 1. Kaiser Permanente, Northern California Caritas Consortium 2013 Comfort as Medicine: Integration of CAM into Bedside Care Caritas in Action How Caring Science informs and inspires KP caregivers and affirms our commitment to provide our patients and their families exceptional care
  2. 2. Comfort as Medicine: Integration of CAM into Bedside Care Intent to Contribute Statement: Abstract: Numerous studies validate the use of Complementary and Alternative Medicine (CAM) for a variety of health issues and symptoms. Complementary therapies offer nurses the opportunity to provide holistic care and empower patients to actively participate in their care and recovery (Fountouki & Theofanidis, 2009). Holistic care seeks to treat the whole individual as opposed to treating symptoms exclusively and recognizes the role of mind, body, and spirit in the healing process. The White House Commission on Complementary and Alternative Medicine Policy (2002) recognized the need for increased education and training of health practitioners in CAM. The California BRN identifies that nurses can help provide the missing link between conventional Western medicine and CAM therapies (BRN, 2009). The integration of CAM into bedside care is also consistent with Watson’s theory of Caring Science. Watson uses the term carative instead of curative to distinguish between nursing and medicine. Watson’s theory focuses on 10 caritas factors that contribute to caring, healing relationships and can be characterized by caring moments or caring occasions. A caring occasion occurs whenever the nurse and another come together with their unique life histories and phenomenal fields in a human-to-human transaction. Our project seeks to enhance nurse patient relationships, enable holistic, individualized by providing nurses resources and education to incorporate simple CAM modalities and caring behaviors into their everyday practice. Research Question: Will nursing education, and readily available resources increase patient perception of a healing environment and caring behaviors consistent with Watson’s Theory of Caring Science? Page 2
  3. 3. Comfort as Medicine: Integration of CAM into Bedside Care … Continued Methodology: Inservice education on elements with the ‘caring cart’ will be provided to staff nurses in 2 nursing units, medical neurology Unit 430 and general surgery Unit 235 of Kaiser Santa Clara Medical center. The carts will be provided for nursing use after the educational inservices. Elements within the Caring Cart: • TV channel guides: distraction, music therapy (care channel) • Movie list: distraction, humor • Aromatherapy: CAM (lavender, peppermint) • Herbal Teas: CAM (mint, lemon, ginger, etc.) • Guided Imagery Channel Guide & Brochure: CAM • Lip Balm: comfort • Playing Cards: distraction • Insomnia Management: ear plugs, white noise machine, sleepy time tea • Mind/Body Medicine KP patient resources handout: podcast, downloads info sheet for depression, anxiety, pain, insomnia etc. Page 3
  4. 4. Comfort as Medicine: Integration of CAM into Bedside Care … Continued Data Collection: The measures used to determine efficacy will be the Caring Factors Survey, this reliable and validated tool measures caring behaviors based on Watson’s 10 Caritas Processes (DiNaploi, Nelson, Turkel, & Watson, 2010). In addition specific HCAHPS and AVATAR data that also measure patients’ perception of caring behaviors and comfort measures provided by nursing staff will also be evaluated. All of these data points will be evaluated pre and post education and implementation of the ‘caring cart’. We hope that these measures will support a healing environment, further our integration of Caring Science into practice, and improve patient satisfaction with caring behaviors and ultimately contribute to our organizational goals of providing world-class care every patient, every time. Page 4
  5. 5. Comfort as Medicine: Integration of CAM into Bedside Care Inspired Contributor(s) 1 :  Tracy Trail-Mahan  Karen Finnie -----Service Area: Santa Clara Medical Center: SCL Affiliation: PCS -----Year Shared: 2013 Venue: Caritas Consortium Format: PowerPoint, Poster ID #: Q01 Page 5 Keyword TAGs: Identifier  Consortium2013-July, Santa Clara, Podium, Poster, Patient Care Services  Healing Environments, Healing Modalities, Patients/Families Descriptor  Aromatherapy, Complimentary & Alt Medicine, Music, Self-Care, Total Health, Research and Metrics
  6. 6. Comfort as Medicine: Integration of CAM into Bedside Care Page 6
  7. 7. Complementary and Alternative Medicine (CAM) • Numerous studies validate the use of Complementary and Alternative Medicine (CAM) for a variety of health issues and symptoms. Complementary therapies offer nurses the opportunity to provide holistic care and empower patients to actively participate in their care and recovery (Fountouki & Theofanidis, 2009). • Holistic care seeks to treat the whole individual as opposed to treating symptoms exclusively and recognizes the role of mind, body, and spirit in the healing process. • The White House Commission on Complementary and Alternative Medicine Policy (2002) recognized the need for increased education and training of health practitioners in CAM. • The California BRN identifies that nurses can help provide the missing link between conventional Western medicine and CAM therapies (BRN, 2009). Page 7
  8. 8. Complementary and Alternative Medicine (CAM): Bringing it to the Bedside • The integration of CAM into bedside care is also consistent with Watson’s theory of Caring Science. • Watson uses the term carative instead of curative to distinguish between nursing and medicine. Watson’s theory focuses on 10 caritas factors that contribute to caring, healing relationships and can be characterized by caring moments or caring occasions. • A caring occasion occurs whenever the nurse and another come together with their unique life histories and phenomenal fields in a human-to-human transaction. • Our project seeks to enhance nurse patient relationships, enable holistic, individualized by providing nurses resources and education to incorporate simple CAM modalities and caring behaviors into their everyday practice. Page 8
  9. 9. Elements within the Caring Cart • TV channel guides: distraction, music therapy (care channel) • Movie list: distraction, humor • Aromatherapy: CAM (lavender, peppermint) • Herbal Teas: CAM (mint, lemon, ginger, etc) • Guided Imagery Channel Guide & Brochure: CAM • Lip Balm: comfort • Playing Cards: distraction • Insomnia Management: ear plugs, white noise machine, sleepy time tea • Mind/Body Medicine KP patient resources handout: podcast, downloads info sheet for depression, anxiety, pain, insomnia etc Page 9
  10. 10. CAM Patient Handout • Page 10
  11. 11. SMART Goal • Specific - Promote caring science behaviors and provide comfort measures consistent with caritas factor #8 create a healing environment by use of a Caring Cart • Measurable - Caring Factors pt survey pre and post Caring Cart introduction, HCAHPS evaluate Caritas Factors data per & post intervention • Achievable - resources available to provide Caring Carts, statistical support for evaluation of outcomes • Realistic - will start in 2 units as a pilot and evaluate, using PDAS methodology, effectiveness of cart, elements of cart, education of nursing • Time-bound - collect pre-intervention data, educate RNs, implement Caring Carts, collect post-intervention data x 2 months Page 11
  12. 12. Project Measurables • Caring Factors Survey to pts pre and post Caring Cart • HCAHPS Caritas Factors • HCAHPS potentially look at Pain Management data • Nursing survey component NrCAM K & A?? Page 12
  13. 13. Caring Cart • TV channel guides: distraction, music therapy (care channel), guided imagery channel • Movie list: distraction, humor • Aromatherapy: CAM • Herbal Teas: CAM • Guided Imagery Channel Guide & Brochure: CAM • Lip Balm: comfort • Playing Cards: distraction • Insomnia Management: ear plugs, white noise machine, sleepy time tea • Mind/Body Medicine KP resources handout: podcast, downloads info sheet for depression, anxiety, pain, insomnia etc Page 13
  14. 14. Distraction • TV Channel Guides • Movie Listings • Playing Cards • Coloring pages and crayons Page 14
  15. 15. C.A.R.E. Channel Guided Imagery • Nursing education • Pt brochure • Nursing Policy • Signage "therapy in progress: do not disturb until____" Page 15
  16. 16. C.A.R.E. Channel Guided Imagery Page 16
  17. 17. Aromatherapy • Nursing Education • Pt Education/Brochure • Nursing Policy, documentation • Limited Scope • Lavender indications anxiety, relaxation • Peppermint indications nausea • Ginger nausea Page 17
  18. 18. Aromatherapy Diffuser Options Page 18
  19. 19. Lavender What Lavender Is Used For What the Science Says • Historically, lavender was used as an antiseptic and for mental health purposes. • There is little scientific evidence of lavender's effectiveness for most health uses. • Today, the herb is used for conditions such as anxiety, restlessness, insomnia, and depression. • Small studies on lavender for anxiety show mixed results. • Lavender is also used for headache, upset stomach, and hair loss. Page 19 • Some preliminary results indicate that lavender oil, combined with oils from other herbs, may help with hair loss from a condition called alopecia areata.
  20. 20. Peppermint What Peppermint Is Used For What the Science Says • Peppermint oil has been used for a variety of health conditions, including nausea, indigestion, and cold symptoms. • Results from several studies suggest that peppermint oil may improve symptoms of irritable bowel syndrome. • Peppermint oil is also used for headaches, muscle and nerve pain, and stomach and bowel conditions such as irritable bowel syndrome. • A few studies have found that peppermint oil, in combination with caraway oil, may help relieve indigestion, but this evidence is preliminary. Page 20
  21. 21. Ginger What Ginger Is Used For • Ginger is used in Asian medicine to treat stomach aches, nausea, and diarrhea. • Many digestive, antinausea, and cold and flu dietary supplements sold in the United States contain ginger extract as an ingredient. • Ginger is used to alleviate postsurgery nausea as well as nausea caused by motion, chemotherapy, and pregnancy. • Ginger has been used for rheumatoid arthritis, osteoarthritis, and joint and muscle pain. Page 21 What the Science Says • Studies suggest that the short-term use of ginger can safely relieve pregnancy-related nausea and vomiting. • Studies are mixed on whether ginger is effective for nausea caused by motion, chemotherapy, or surgery. • It is unclear whether ginger is effective in treating rheumatoid arthritis, osteoarthritis, or joint and muscle pain.
  22. 22. Insomnia Resources • Sound Spa • Sleep Mask • Ear Plugs • Sleepy Time Herbal Page 22
  23. 23. Music Resources • Listening to music does wonders to alleviate stress. Please note that everyone has different tastes in music. Listen to the music that you feel comfortable. • Music is a significant mood-changer and reliever of stress, working on many levels at once. (http://www.holistic-online.com/Stress/stress_music-therapy.htm, 2009) Page 23
  24. 24. Caring Factors Survey Page 24
  25. 25. AVATAR Caritas Factors Page 25
  26. 26. Possible other metrics to examine Page 26
  27. 27. Cost of Components per Cart • Cart $63 • Essential oils (Lavender & Peppermint) $20 • CD Player $20 • Herbal teas $xx • Sound Spa $xx • Ear plugs $xx • Lip Balm (KP Brand Store) $xx • Playing Cards (KP Brand Store) $xx • Channel Guides (TV & Guided Imagery) $xx • Aromatherapy Diffuser $10 • Aromatherapy cotton discs, plastic med cup $xx • KP resources for podcasts Page 27 $0
  28. 28. Page 28
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