Christine Carlson is a clinical nurse, Tami Howe is a clinical nurse coordinator, and Chase Pedersen is associate chief nursing officer, all at St. David's North Austin Medical Center in Austin, TX. Linda H. Yoder is a professor at the University of Texas at Austin School of Nursing. Contact author: Christine Carlson,
Am J Nurs. 2020 May;120(5):48-55. doi: 10.1097/01.NAJ.0000662820.87519.52.
People with low vision or blindness may experience anxiety, fear, and depression-sometimes severe-as a result of the challenges encountered when they seek medical care. Such patients deserve, and health care professionals must provide, equal opportunities to participate in and benefit from their health care in a safe environment. A search of the literature yielded information on the needs of visually impaired people but failed to find a comprehensive program that health care facilities could use to meet the needs of this vulnerable population. This gap in the literature on visually impaired patients (VIPs) and implications for their care led us to conduct focused meetings with this population.
The specific aims of this quality improvement (QI) project were to determine the needs of hospitalized VIPs, develop educational and other resources that would help clinicians and ancillary hospital staff in their interactions with VIPs, and assemble a toolbox of useful materials for VIPs themselves.
A VIP care team identified the needs of VIPs as reported in the literature and in personal meetings with visually impaired people in the community. The team also surveyed interdisciplinary hospital staff members to determine their experience in caring for VIPs as well as their educational needs, and then developed strategies and educational modules to help clinicians and ancillary staff members accommodate the unique needs of VIPs in accordance with the Americans with Disabilities Act of 1990. The team also assembled a VIP toolbox that contained several items useful to VIPs themselves. Supplementary information tailored to the function of each hospital department (such as nursing, admissions, environmental services, dietary, and radiology) was also provided to help staff members improve VIPs' hospital experience.
The hospital's interdisciplinary staff members participated in an education program to improve their care of VIPs. Before the program, only 23.6% of 161 staff members reported having received education on caring for VIPs. After the program, however, 56.4% of 140 staff members reported having received such education. Former patients requested bracelets and room identifiers that would alert staff members to VIPs' needs, and the team provided these. The team also introduced a braille version of the hospital menu and provided VIP toolboxes at each nursing station that contained many useful daily care items.
VIPs have specific needs when hospitalized. Patients' and staff members' responses to this QI project were overwhelmingly positive; both groups were appreciative of the newly implemented initiatives to meet the special needs of the visually impaired.
由于在寻求医疗护理时遇到的挑战，低视力或失明患者可能会感到焦虑、恐惧和抑郁——有时甚至非常严重。这些患者应该得到机会，并且医疗保健专业人员必须在安全的环境中为他们提供平等的机会，让他们参与并受益于他们的医疗保健。文献检索提供了有关视障人士需求的信息，但未能找到医疗保健机构可以用来满足这一弱势群体需求的综合方案。这是视障患者（VIP）文献中的一个空白，对他们的护理产生了影响，这促使我们与这一人群进行了重点会议。
本质量改进（QI）项目的具体目标是确定住院 VIP 的需求，开发教育和其他资源，帮助临床医生和辅助医院工作人员与 VIP 互动，并为 VIP 自己组装一个有用材料工具包。
VIP 护理团队根据文献和与社区视障人士的个人会议中报告的需求，确定了 VIP 的需求。该团队还调查了跨学科医院工作人员，以确定他们在照顾 VIP 方面的经验以及他们的教育需求，然后制定了策略和教育模块，以帮助临床医生和辅助工作人员根据 1990 年《美国残疾人法案》满足 VIP 的独特需求。该团队还组装了一个 VIP 工具包，其中包含了几件对 VIP 本身有用的物品。还提供了针对每个医院部门（如护理、入院、环境服务、饮食和放射科）功能定制的补充信息，以帮助工作人员改善 VIP 的住院体验。
医院的跨学科工作人员参加了一项教育计划，以改善他们对 VIP 的护理。在该计划之前，161 名工作人员中只有 23.6%报告接受过照顾 VIP 的教育。然而，在该计划之后，140 名工作人员中有 56.4%报告接受过此类教育。前患者要求提供手镯和房间标识符，以提醒工作人员 VIP 的需求，团队提供了这些。该团队还引入了医院菜单的盲文版本，并在每个护理站提供 VIP 工具包，其中包含许多有用的日常护理用品。
住院的 VIP 有特定的需求。患者和工作人员对这个 QI 项目的反应非常积极；双方都对新实施的举措表示赞赏，这些举措满足了视障人士的特殊需求。
