Need a DVD for Ca Patient Education? Make Your Own!

BOSTON—Better, cheaper digital video equipment has brought sophisticated movie-making within the reach of the ordinary person. At the Oncology Nursing Society 31st Annual Congress (abstract 3), a team of oncology nurses led by Ellen Carroll, BSN, RN, demonstrated that this gear can be put to use in cancer patient education.

Ms. Carroll and her colleagues at the National Institutes of Health, Bethesda, used a home video camera to produce a video for patients and caregivers (in English and Spanish) on correct management of central lines. They used their workplace computer to copy the DVDs for patients, and Ms. Carroll said that even patients who have had central lines for a long time have asked for copies.

"If you want to try video instruction, keep it simple," Ms. Carroll advised. "Don't spend a lot of money. Encourage involvement of your staff. And use the video as a supplement to, not instead of, one-to-one teaching."

This project arose from nursing staff concern that oncology patients are being asked to take on more self-care responsibilities, such as central line care, and that the patient population includes more non-English speakers. In addition to the increased responsibilities for patients and caregivers, Ms. Carroll pointed to the decrease in time available for in-depth teaching by nurses and the goal of alleviating patients' fears by having a video "nurse" available at all times to demonstrate correct line care.

Ms. Carroll said the nurses initially considered professional video software but could not afford it, so they turned to a digital camera one of them owned and the software that was included with it. "Basically, we used our own money for this pilot project," she said. "We edited the video on a home computer. The institution did buy us a package of blank DVDs, which we use on our work computer to make copies for patients."

A survey of areas of concern to patients and family found that patients were having difficulty remembering everything they were taught during the standard education sessions, that there was a need for an approach that broke the topic of central line care down into manageable bits, and that line care by patients did not consistently follow hospital protocols.

Ms. Carroll used existing written handouts as the basis for developing the video program. Two staff nurses were the on-camera "talent"—one doing the English, the other the Spanish instruction. Video topics were divided into segments including dressing change, line flushing, and routine and emergency care.

In this pilot project, patients reviewed segments of the DVD and then had the conventional one-on-one nursing instruction. They then were given written materials and copies of the video to take home as a resource. Subsequently, patients and caregivers were surveyed to evaluate the effectiveness of the program.

"Observation of line care by patients and caregivers after using the video program showed consistent adherence to hospital protocols in both the English- and Spanish-speaking patients, and patients reported more confidence and understanding of line care," Ms. Carroll said. "In an informal survey, we also found that nurses reported reduced time required for teaching and were satisfied with the improvement in outcomes."

Ms. Carroll concluded that the approach improves consistency in central line care, provides families with information to review as needed when away from the hospital, and enhances teaching. She said that future video projects are planned on subcutaneous injection technique, intramuscular injection technique, and neutropenic precautions, and in additional languages.