Teaching Video Helps Transplant Patients Learn Central Line Care

INDIANAPOLIS—Transplant patients may maintain a central line for 6 months to a year. At high risk for infection, they must know how to take care of their line. But when do they learn? Teachable moments can be few and far between, according to Indiana University Hospital nurses who made a video to help solve the problem.

Rather than focusing on the patient’s disease or treatment, their video focuses solely on central line care. The nurse researchers presented an evaluation of the project, entitled "Sooo Much to Teach, So Little Time," at a poster session of the Oncology Nursing Society’s 26th Annual Congress in San Diego.

Specifically, the goals of the project were to ensure that central line teaching occurred in a timely manner, to increase compliance and understanding of central line care, and to decrease patient and caregiver anxiety as well as staff frustration.

"We have a patient population that comes in for cyclophosphamide mobilization," said Gerri Wensloff, RN, BSN, OCN, one of the authors of the evaluation of the video project.

Ms. Wensloff is clinical educator at the Adult Cancer Center, Indiana University Hospital, Clarian Health Partners. Her co-author was Linda Hamer, RN, BSN, OCN, at the same location.

"On the day their line is placed, patients get high-dose cyclophosphamide. They’re usually very nauseous and may get a lot of lorazepam, and so there are not many teachable moments," Ms. Wensloff observed.

Caregivers are hard to catch, too. "Often, their family members just bring them in and take them home," she said. "So we found it was very difficult for our staff to get the teaching done and not feel like the patient was hurried through it."

In response to this problem, the nurses made a video containing the necessary information. "Patients can pop in the video and watch it pretransplant, before they even get their line placed. The nurses go back later and reinforce the information," she said.

The education process begins when the patient is first seen in the BMT Clinic before admission. A teaching record is begun along with the pretreatment laboratory workup. A family caregiver is identified, and the patient and caregiver receive written instructions for central line care.

On the first day of admission, the patient and caregiver view the central line care video, and this is recorded in the teaching record, which comes with the patient’s file from the BMT Clinic. The central line is placed, and chemotherapy is begun. A nurse reviews central line care with the patient and/or the family caregiver.

On the second or third day of hospitalization, the patient and/or family caregiver demonstrates competency of central line care. After the patient is discharged, the teaching record is updated and sent to Medical Records.

The evaluation of the video project showed that not everybody was teaching central line care in the same way. The video is now introduced to new RNs at orientation. "Now we can hopefully assure consistency," she said.

They concluded that the majority of patients and nurses surveyed found the video helpful and liked the flexibility of being able to absorb the information on their own.