Adult Care Advice Topics
This past year we developed a set of Adult Care Advice Topics (ACATs) to use along with the Adult Schmitt-Thompson Clinical Content After-Hours and Office-Hours Telehealth Triage Guidelines. They are available with the 2023 annual update.
Each care advice topic can be used as a “handout” to reinforce health information and care advice given during a triage encounter. During the telehealth triage process, “patients are most satisfied with care that is individualized, collaborative, and provides clear communication and problem resolution.” (1)
The care advice topics provide patients and caregivers with Instructive, Directive, Preventive, and Supportive care advice.
We provide an Index of Topics with the annual update. Please read the index and become familiar with the adult care advice topics.
We encourage you to send these topics to patients and their caregivers, especially at the end of lower-acuity telehealth encounters. Care advice topics serve to improve patient satisfaction, safety, compliance, and outcomes.
Care Advice Topics: Telehealth Continuity of Care and Support
There are teachable moments during most telehealth triage encounters. Patients call with questions and concerns. They are seeking information and asking for help and guidance. We should take advantage of these teachable moments to educate and support our patients. The physical and psychosocial wellbeing of a patient can be improved with personalized patient education handouts.(2)
Here are five reasons why patient education is important.
Empowerment
Patients with acute and chronic medical conditions often struggle with a lack of control. When patients are informed about their health condition and treatment options, they feel more empowered. This can help increase their engagement and boost their confidence when making important healthcare decisions. Providing simple, topic-specific care advice fosters a patient’s desire to practice self-care.
Cost Effective Management of Symptoms and Conditions
Education helps patients understand how to manage their disease better, which can lead to improved health outcomes. As health care costs continue to rise, the potential for improved health outcomes through patient education and self-directed care and management is immense.(3) Care advice that supports symptom management can help decrease high-cost emergency department visits.
Improves Compliance
Care advice topics provide targeted health information. Nurses play a major role in delivering self-care advice, teaching strategies for symptom control, and providing people with proper tools to manage minor illness.(4) Providing easy to follow care advice improves patient compliance to treatment. Treatment compliance leads to improved clinical outcomes.
Increases Patient Safety
Patient care advice topics support the patient in their decision-making. Care advice topics clearly define how and what a patient should do when their condition is not improving. Strategies for symptom management and care that is given verbally during a telehealth encounter can be poorly retained by patients and caregivers. Sending a written care advice handout after a telehealth encounter reinforces call back instructions.
Enhances Patient Satisfaction
Patient satisfaction is a valuable part of the patient experience. Patient satisfaction results in fewer lawsuits, better compliance with treatment recommendations, and improved clinical outcomes.(5) Care advice handouts offer the patient a tangible form of continued care and communication when the telehealth encounter is over.
Care Advice Topics: Structured With Care and Consistency
Topic Content
Most topics are symptom-based (such as Cough or Knee Pain) or for injuries (such as Foot Injury or Head Injury). A topic can be diagnosis-based (such as Common Cold and COVID-19). Other types of topics include exposure to infection and health information. There currently are 100 topics, released in June 2023. These topics cover the most common reasons why people call a nurse advice line.
Consistency With Telehealth Triage Guidelines
The care advice and health information is aligned with the care advice in the STCC telehealth triage guidelines. The information in these handouts is consistent and evidence-based. The care advice in each topic has been reorganized, shortened, and simplified to make it easy for patients to read and understand.
Clear Communication Using Health Literacy Principles
Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.(6) Care advice topics are written using the principles of health literacy. These principles will improve your patients’ understanding on how to best care for themselves. In addition to verbal education, handouts improve patient care by using shared treatment and decision making to improve patient satisfaction and health literacy.(2)
The care advice topics are written using plain language at the 5th to 6th grade reading level.(7) The topics are meant to support patients with a home care disposition. Handouts for some topics that do not offer a home care disposition will provide care advice the patient can follow until they are seen.
Adult Care Advice Topics Are Linked to Guidelines
There may be multiple care advice handouts linked to one guideline. This allows the nurse to send a patient more or less information as needed, about a particular symptom or condition. For example, linked to the Toe Injury guideline we currently have the following topics available for the nurse to select to send to a patient:
Cuts and Lacerations
Foot Injury
Foot Pain
Over-The-Counter Pain Medicines
Tetanus Shots - When Are They Needed?
Toe Injury
Toe Pain
Toenail Injury
Sample Use Case and Flow Chart
Here is an example use case scenario.
Julie RN is a telehealth triage nurse working at Pascal Memorial Hospital. At 8 PM she receives a call from Kathy, a 35-year old.
Kathy stubbed her big toe on the sofa while walking briskly to catch-up with her toddler! There is mild pain and swelling. She is not limping.
Julie recommends self-care at home to Kathy. Julie also provides some brief care advice over the phone and clear call back instructions. Right after the call she emails Kathy two care advice handouts: Over-The-Counter Pain Medicines and Toe Injury.
Here is a high-level flow chart of the telehealth encounter.
Organization of Adult Care Advice Topics
Your telehealth triage software vendor will determine how your care advice handouts look and are organized.
Typically, each of the handouts have a similar format and are commonly divided into the following sections:
Overview
This section can include information such as key points, symptoms, causes, and sometimes caution statements.
The goal of this section is to provide the patient with an overall summary of their symptoms or condition.
Care Advice
This section contains targeted care advice for each different symptom addressed within the topic.
This section may also include frequently asked questions about care or symptoms. There may also be information about the expected course of symptoms or illness.
Over-The-Counter (OTC) Medicines
Here, we list OTC medicines that can be used to treat each different symptom or condition.
The most common OTC medicine warnings are also found within this section.
There are also longer, more detailed versions of some OTC medicines (pain, fever, antihistamine, and cough medicines). The nurse can send these as a separate topic to the patient if needed.
Prevention
The prevention care advice is applicable to specific topics.
One example is using eye protection to prevent eye injuries.
When to Call Back or Seek Care
We outline when the patient should call back or seek care.
In some cases, we have listed symptoms or changes in condition that would necessitate emergency care.
Future Adult Care Advice Topic Development
Our editorial team has prioritized future topic development based on frequency of telehealth guideline utilization, patient safety, and clinical partner input. We will continue to expand the number of topics as we work towards the 2024 annual update. These handouts can benefit the patient, the triage nurse, and our software partners.
We welcome your feedback at: AdultEditorialTeam@STCC-triage.com.
Author
Cortney Book RN, MSN, Nurse Editor, Adult Telehealth Triage Guidelines, Schmitt-Thompson Clinical Content
Co-Authors
Jeanine Feirer RN, MSN
Cheryl Patterson RNC, BSN
David Thompson MD
References
(1) Greenberg ME, Rutenberg C. 2012. The Art and Science of Telephone Triage: How to Practice Nursing Over the Phone. Hot Springs: Anthony J. Jannetti, Inc.
(2) Bhattad PB, Pacifico L. Empowering Patients: Promoting Patient Education and Health Literacy. Cureus. 2022 Jul 27;14(7):e27336. doi: 10.7759/cureus.27336. PMID: 36043002.
(3) Paterick TE, Patel N, Tajik AJ, Chandrasekaran K. Improving health outcomes through patient education and partnerships with patients. Proc (Bayl Univ Med Cent). 2017 Jan;30(1):112-113. PMID: 28152110.
(4) Gustafsson, S., Vikman, I., Sävenstedt, S. and Martinsson, J. (2015), Perceptions of needs related to the practice of self-care for minor illness. J Clin Nurs, 24: 3255-3265. https://doi.org/10.1111/jocn.12888
(5) Thompson DA, Yarnold PR, Williams DR, Adams SL. Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department. Ann Emerg Med. 1996 Dec;28(6):657-65.
(6) U.S. Centers for Disease Control and Prevention (CDC): What is health literacy? Available at https://www.cdc.gov/healthliteracy/learn/index.html.
(7) U.S. National Institutes of Health (NIH): Health Literacy. Available at https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/health-literacy.