Building on Patient Education in the Medical Library

Kathy Fatkin RN, MLS

[Associate Editor’s note: We’re all “librarians,” but that term covers a great deal of ground; it includes a tremendous variety of job descriptions, patron groups, work environments, colleagues, etc. I am hoping to present a series of articles that focus on various kinds of library settings and librarian positions. Kathy (Nelson) Fatkin has graciously allowed me to tailor an article she wrote regarding her position as Hospital Librarian at Columbia – Eastern Idaho Regional Medical Center (EIRMC) in Idaho Falls for this series.

A librarian in a hospital has quite a different situation to work with than, for instance, a public librarian, but the basic function is the same – providing quality information to her patrons, be they physicians seeking current research vital to the life of a patient, or patients in search of consumer health information, and anything in between. This article helps demonstrate some of the differences as well as some of the similarities between Kathy’s job and the jobs some of us have. –Kristi Austin]

Patient education is an important part of healthcare. When patients and their families are involved in their care and obtain good information, they make better decisions. At Eastern Idaho Regional Medical Center, patients are assessed for educational needs along with other healthcare needs. The nursing assessment considers the patient’s primary language, learning barriers or problems, learning style preference, educational level, reading skills, cultural and spiritual considerations, motivation and readiness to learn, and any emotional or physical impairment. Patients receive education about their health care based on these findings. Instruction may include safe and effective use of medications, drug-food interactions, local resources, personal care, and rehabilitation techniques. A key aspect of formal patient education is planning. Each teaching session has an objective. The hospital staff assesses the outcome of the session by means of the patient’s verbal or behavioral responses.

Numerous barriers can impede the transfer of information from health care professional to patient. A very important constraint is time. Shorter hospital stays require patient education to focus on high priority objectives; consequently, it may often be the case that not all the questions a patient has about his or her illness are answered. Librarians have the knowledge and skills to assist patients in finding health information, thus making the most of the time available. At Eastern Idaho Regional Medical Center, patients can use the medical library for health research, or request assistance from the librarian. Typically the nurse or physician caring for the patient will phone the library and request additional information to supplement the planned patient education. The medical librarian finds information on the topic based on the referral and nursing assessment, and sends it to the nursing unit for the patient. Both healthfinder® and MEDLINEplus® are appropriate for introductory patient materials, as they are written in lay language and include the full text online. PubMed searches can identify topical items in the professional literature; the web site is free, and is useful for patients who have a good understanding of the basic treatment plan and want to gain greater depth of knowledge. The site includes free abstracts, but full text is generally only available from a medical library; if Columbia EIRMC does not own the journal needed, the librarian may request it from another library.

Even after being discharged from the hospital, the patient may still visit the library and use its resources during business hours. Photocopying is available for a small fee. Unlike planned patient education (where the physician, nurse, or other healthcare professional determines what information the patient should receive), the librarian follows the patient’s lead in determining what information is important, matching the resources available to the learning style of the patron and providing authoritative resources to meet the needs of the patient. Librarians can also supply information about alternative treatments for the patient. All this information is delivered without ever giving medical advice. The patient is encouraged to discuss the information with his or her health care providers. The website “Is this health information good for me?” , a valuable resource to encourage thoughtful evaluation of health information, is available in both English and Spanish. The medical librarian at Columbia EIRMC keeps a print copy of this guide to critical thinking at the public computer station.

Online tutorials are another resource that a medical library can provide. The National Library of Medicine’s MEDLINEplus website has several interactive tutorials with excellent graphics. Multimedia presentations can often improve a patient’s understanding of his or her condition. Although computers and Internet access are becoming more readily available, not everyone has this access at home, so libraries with these resources can be of great help to the patient. The library at Columbia EIRMC has paper bookmarks printed with MEDLINEplus information available for patients using the library, to encourage them to return to this Internet resource after they’ve been discharged from the hospital. The library’s collection of videotapes is also a helpful tool for patient education. Patients may view tapes in the library or in their hospital room.

Chronic diseases are common in aging communities, and social support can be an important part of chronic disease management. Libraries may assist by providing information about patient support groups within the community. More information on health organizations can be found on DIRLINE, a resource that lists the toll free numbers of various national help-lines.

By providing patient education, a library can help improve the health of its community. Health information requests are common in all types of libraries. These questions can become routine, but the librarian should carefully consider the emotional state and the physical condition of the patron. Information is a powerful tool for improving health and quality of life for that person. Thoughtful use of resources should answer the majority of health questions. Tools from the National Library of Medicine, particularly the consumer-oriented MEDLINEplus mentioned above, make health resources available for all types of libraries, not just medical libraries, and for their patrons as well.

To help your library provide in depth information to patients, EIRMC will fill interlibrary loan requests from libraries that need professional journal reprints. You can submit the request on a standard ALA interlibrary loan form or by phone (208-529-6077) or fax (208-529-7014). EIRMC’s medical library has reciprocal agreements with many other libraries, and only charges fees to libraries that are not part of this reciprocal arrangement. You can locate holdings online, not only for EIRMC but for all the medical libraries in Idaho, in the Union List of Health Science Journals in Idaho.

Patient education only begins in the hospital; it is an ongoing task for the patient and health care team as long as the patient’s medical condition is present. Libraries can play a vital role in patient education by filling gaps in the patient’s knowledge base with accurate and timely health information.