The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [149]
Information should be ratified according to local trust policy. Where a trust does not produce patient information materials to meet specific patient needs, suitable alternative sources of information should be sought.
Other sources of information
Patients and their families may benefit from information and support available in the wider community, away from the environment of statutory health services. Sources of additional information include:
disease-specific national charities, for example the Multiple Sclerosis Society or the British Heart Foundation: these organizations produce written material in booklet and fact sheet format, as well as having websites
the ‘illness memoir’ and internet blogs: personal accounts are easily accessible online and through bookstores. It may help patients to hear other people’s stories as this can reduce the sense of isolation and powerlessness and promote hope (Chelf et al. 2001). It must be borne in mind that not everyone will benefit from these sources of information
peer support: the therapeutic benefits of groups are extensively documented (NICE 2004) and most of the support charities will have a directory of local and national groups available.
Principles table 5.2 Provision of information
Principle Rationale
Review the changing context of the patient’s situation. What may have been relevant before may now not be the same. People’s circumstances and needs change. E
Prepare for discussion, ensuring you are familiar with the procedure, disease process, medication or other aspect of care to be discussed. Accurate information giving is an essential part of nursing care. E
If possible, discuss the procedure some time before it is to be carried out for the first time. Provide the patient with leaflets, DVDs or video if available so the patient has time to review the information at their own pace. Give patients the opportunity to digest information in their own time (Lowry 1995, E). In certain groups it can be demonstrated to improve clinical outcomes, satisfaction, chances of meeting the targeted discharge date and return to prior functional status sooner (Lookinland and Pool 1998, R2b).
Introduce yourself. Ensure the patient understands who you are and your role and specific aim. Promote patient satisfaction (Delvaux et al. 2004, R1b).
Maintain a warm and approachable demeanour. Do not rush. Promote patient satisfaction (Delvaux et al. 2004, R1b).
Explain that you have a procedure to carry out, considering privacy in giving information. Promote dignity/preserve confidentiality (NMC 2008a, C).
Name the procedure. Elicit, clarify and check the information received by the patient. Promote understanding and patient satisfaction.
Explain the procedure, avoiding the use of medical jargon. Be prepared to repeat information or rephrase until the patient understands. (If the patient doesn’t understand, they haven’t consented.) Establish mutual understanding. Gain compliance with procedure: minimize risk (NMC 2008a, C). Improve outcome (Fellowes et al. 2004, R1a). Help patients manage side-effects and adhere to care and treatment (Chelf et al. 2001, R3a).
Confirm consent: ensure that the patient is happy for you to proceed. Allow the patient an opportunity to ask further questions or say no to the procedure. (If the patient fully understands what is involved, they may decide that they are not ready to proceed.) Respecting the rights of the individual (NMC 2008a, C). Obtaining consent correctly (NMC 2008c, C; see also Appendix 1).
Start the procedure, reiterating the main issues as you go along and keeping the patient updated on progress. To maintain open dialogue and address issues and questions, as they arise. E
Make it clear when the procedure has finished and what has been achieved. Offer opportunity for discussion of implications, disclosing as much information as the patient wishes. So that the patient is aware and has the information they need and want (Jenkins et al. 2001, R2b).