University of California Irvine, Department of Emergency Medicine, Irvine, California.
West J Emerg Med. 2021 Apr 27;22(3):644-647. doi: 10.5811/westjem.2021.1.48968.
When discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions. However, numerous factors make it difficult to ensure that patients understand their next steps. Our objective was to determine whether patient understanding of ED discharge and aftercare instructions could be improved through instructional videos in addition to standard written discharge instructions.
This was a prospective pre- and post-intervention study conducted at a single-center, academic tertiary care ED. Patients presenting with the five selective chief complaints (closed head injury, vaginal bleeding, laceration care, splint care, and upper respiratory infection) were given questionnaires after their discharge instructions to test comprehension. Once video discharge instructions were implemented, patients received standard discharge instructions in addition to video discharge instructions and were given the same questionnaire. A total of 120 patients were enrolled in each group.
There were significantly better survey scores after video discharge instructions (VDI) vs standard discharge instructions (SDI) for the closed head injury (27% SDI vs 46% VDI, P = 0.003); upper respiratory infection (28% SDI vs 64% VDI; P < 0.0001); and vaginal bleeding in early pregnancy groups (20% SDI vs 60% VDI, P < 0.0001). There were no significant differences in survey scores between the splint care (53% SDI vs 66% VDI; P = 0.08) and suture care groups (29% SDI vs 31% VDI; P = 0.40).
Video discharge instructions supplementing standard written instructions can help improve patient comprehension and information retention. This better understanding of aftercare instructions is essential to patient follow-up and has been shown to improve patient outcomes.
在急诊科(ED)出院时,确保患者了解其处置和后续护理说明至关重要。然而,许多因素使得难以确保患者了解其下一步骤。我们的目标是确定通过除标准书面出院说明之外的教学视频是否可以改善患者对 ED 出院和后续护理说明的理解。
这是一项在单中心学术三级护理 ED 进行的前瞻性预干预研究。在出现五个选择性主要投诉(闭合性头部损伤、阴道出血、裂伤护理、夹板护理和上呼吸道感染)的患者在出院说明后接受了问卷调查,以测试理解能力。一旦实施了视频出院说明,患者除了标准出院说明外还收到了视频出院说明,并收到了相同的问卷。每组共有 120 名患者入组。
与标准出院说明(SDI)相比,视频出院说明(VDI)的调查得分显著更高:闭合性头部损伤(27% SDI 对 46% VDI,P = 0.003);上呼吸道感染(28% SDI 对 64% VDI;P < 0.0001);和早期妊娠组的阴道出血(20% SDI 对 60% VDI,P < 0.0001)。夹板护理(53% SDI 对 66% VDI;P = 0.08)和缝合护理组(29% SDI 对 31% VDI;P = 0.40)之间的调查得分无显著差异。
补充标准书面说明的视频出院说明可以帮助提高患者的理解和信息保留能力。对后续护理说明的更好理解对于患者随访至关重要,并已被证明可以改善患者的结局。