Barriers to care can have a huge impact on patients’ trust in their healthcare teams and on their recovery.
But nurses help eliminate barriers to care by, for instance, assisting a patient who speaks a different language or helping patients gain a better understanding of their treatment plan.
In doing so, nurses are preventing re-hospitalizations and improving health outcomes.
So, what does it take to break down barriers to care?
It takes good communication skills
Poor communication is one of the top barriers to care. Ronda Hughes, PhD, MHS, RN, FAAN, knows how easily poor communication can interfere with a treatment plan. According to Hughes, misunderstandings between staff and patients can occur because of issues such as low literacy levels and language barriers.
Nurses might think patients understand the instructions they’ve been given, when the reality is patients are too embarrassed to admit they don’t.
“We’ve implemented the teaching vs. telling protocol with our nursing students, new grads and those in residency programs,” said Hughes, who is director of the Center for Nursing Leadership at the University of South Carolina College of Nursing in Columbia, S.C. “A lot of times when a patient isn’t following instructions or taking their medication as directed, it’s not because they’re being difficult, it’s because they don’t understand.”
Hughes said nurses learn how to teach a procedure to a patient or give them instructions and then have the patient verbalize what they’ve learned. Teaching in front of a patient’s family reinforces the messaging.
Referrals to other health professionals
When a patient is discharged from the hospital, they’re given printed instructions with their medications, but sometimes that’s not enough.
“Patients are often discharged with a lot of new medications, and they need help understanding how their prescriptions have changed and how they’re taken,” Hughes said.
“If the medications are complex, having a pharmacist consult with the patient makes sense since inappropriate use of medications is one of the leading causes of readmissions,” he said.
Robin Steaban, MSN, RN, a CNO at Vanderbilt University Medical Center in Nashville, employs patient flow nurses to complement the work of bedside nurses and handle discharge paperwork.
“PFNs are assigned to units and have more time than bedside nurses to teach patients about how to manage their condition after discharge,” Steaban said. “They make sure patients go home with the self-care resources they need and a plan of care.”
PFNs also address barriers to care that patients might face during discharge, such as making sure prescriptions are filled and determining who will care for the patient once they’re home.
“It can be validating for patients and their families to demonstrate an understanding of tasks, such as wound care, that they’ve been taught by nurses,” Steaban said. “If a patient or their family seems to have difficulty due to language differences or low literacy levels, visual aids often work better than written instructions.”
Focus on a patient’s financial woes
Steaban said Vanderbilt’s “Meds to Beds” program helps remove barriers to care by having a pharmacist deliver discharge medications directly to patients …read more
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