1. Patient and Family Education
Documentation
Nelia B. Perez RN, MSN
PCU-MJCN
2. Factors Necessary for
Effective Health Education
• Provide a hospitable learning
environment.
• Help your patients decide who
should be involved in the learning
process.
• Establish a baseline of
knowledge.
3. • Ask your client what they think
they need to know.
-What do they need to know to
go home safely?
• cultural, religious or beliefs and
practices
• Assess a patient’s motivation
prior to embarking on a teaching
plan.
4. • Establish special needs of your
patient.
Keep in mind that we as people tend
to remember only
• 10% of what we read
• 20% of what we hear
• 30% of what we read & hear
• 50% of what we hear and see
• 70% of what we say
• 90% of what we say and do
5. • Leave your judgments at the
door.
• Be open to conversation when
caring for your patient.
• Break up the time you spend
educating
• Adults speed of learning changes
over time.
6. • Utilize your resources.
• Evaluate the success of your
teaching.
• Be sure to document your
teaching properly
7. Patient and Family
Education
• Throughout the process of treating
cancer with cytotoxic drugs, nurses and
other health care professionals must
work closely with patients and families to
help them understand how cytotoxic
drugs work, what side effects might
occur, and what to do about them should
they occur. The following are realistic
goals for patient and family education.
8. • The patient and family are able to describe the
chemotherapy protocol, including the name of
the cytotoxic drugs, route, method, schedule of
administration, and schedule for routine
laboratory and physical exam follow up visits.
• The patient and family can list potential
immediate and long-term side effects of the
drugs used.
• The patient and family can describe self-care
measures to decrease the incidence and
severity of complications of therapy.
9. • The patient and family can list symptoms that
should be reported immediately to the health
care team. Education about symptom
recognition should focus on signs and symptoms
of infection, e.g., temperature greater than 101,
pain, swelling, redness, or pus, nausea or
vomiting that persists and is unrelieved by usual
methods, unusual bleeding or bruising, acute
changes in mental or emotional status, and
diarrhea or constipation unrelieved by usual
control methods.
10.
11. • Clinicians generally agree on the value of
providing information to caregivers. Information
tailored to a caregiver’s situation provides
guidance for implementing care. Information
may also help reduce the stress of caregiving
and associated feelings of inadequacy and
helplessness.[2] Information about the patient's
disease trajectory, anticipated course of
disease, and the range of emotions experienced
by families helps normalize the experience and
enhances a caregiver’s sense of control.
12. • The patient and family can identify
community resources to meet
potential demands of treatment and
rehabilitation.
• The patient and family demonstrate
competence in self-care skills
required by the treatment, e.g., care
of venous access devices,
implanted ports, or intracavity
catheters.
13. • Caregivers need to be trained in
managing the side effects of
treatment because the experience
of side effects can cause cancer
patients to abandon their treatment
regimens.
14. Caregivers have been shown to benefit from training in
nonpharmacologic strategies for symptom management,
including the following:
• Massage.
• Use of heat and cold compresses.
• Energy conservation.
• Rest and restoration strategies.
• Relaxation.
• Distraction.
15. • Skills in positioning the patient with
pillows, mobilizing the patient, and
assisting the patient with ambulation
in an effort to promote pain relief
and reduce fatigue can also be
taught.
17. Prior to the first administration of a new
chemotherapy regimen, chart
documentation available to the
practice/institution includes:
• Pathologic confirmation or
verification of initial diagnosis. If
original pathology report is
unobtainable, note of explanation is
in chart or a reference to primary
source pathology. This standard
does not imply the need to rebiopsy
if not clinically necessary.
18. • Initial cancer stage or current cancer status.
Cancer stage is defined at diagnosis. Cancer
status includes a current description of the
patient’s disease since diagnosis/staging, if
relevant (e.g., recurrence, metastases).
• Complete medical history and physical
examination that includes, at minimum, height,
weight, and assessment of organ-specific
function as appropriate for the planned
regimen. Example of assessment of organ-
specific function as appropriate for the planned
regimen: patient plan for cisplatin requires pre-
treatment assessment of kidney function.
• Presence or absence of allergies and history of
other hypersensitivity reactions.
19. • Documentation of patient’s comprehension
regarding chemotherapy regimens (and
associated medications), including information
regarding disease.
• Assessment regarding psychosocial concerns
and need for support, with action taken when
indicated.
Documentation of psychosocial concerns may
include: copy of distress, depression, or anxiety
screening form in the chart; patient self-report of
distress, depression, or anxiety; or chart
documentation regarding patient coping,
adjustment, depression, distress, anxiety,
emotional status, family support and care giving,
coping style, cultural background, and
socioeconomic status.
20. • The chemotherapy treatment plan,
including, at minimum,
chemotherapy drugs, doses,
anticipated duration, and goals of
therapy.
• For oral chemotherapy, the
frequency of office visits and
monitoring that is appropriate for the
individual and the antineoplastic
agent and is defined in the
treatment plan.
21. • Informed consent of the patient who
is to go on Chemotherapy.
• Pertinent Baseline data which may
include VS, Labs/Diagnotics, BSA
22. There's no thrill in easy sailing ...
but there IS satisfaction that's
mighty sweet to take, when you
reach a destination that you
thought you'd never make.
— Spirella
