Limitations And Complications Of Patient Education In An ED)

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Discussion
Patient education is vital to ensure patients have the right information following discharge to be able to care for themselves appropriately at home. It has been established through this literature review that many patients do not follow discharge instructions and they can cause themselves further harm from this (Vashi & Rhodes, 2011). Low literacy levels and poor comprehension are major reasons for this (McCarthy et al., 2012). Ministry of Health (2010) established that literacy levels are lower in Maori than non-Maori, so that towns with a high proportion of Maori population are at risk of adverse effects from a large percentage of the ED patient population not complying with discharge instructions. The Maori population have
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All EDs in the literature reviewed were part of a large hospital, whether children’s, adults or women only centres, largely having an annual visit volume of above 20,000. This is well above the number of patients seen in the ED of a small rural hospital where further research is to be conducted. None of the studies found were carried out in a rural ED.

There was no research specifically in New Zealand or Australia, although a large geographical area was researched including America, Finland, France, Taiwan and India. The majority of the studies reviewed had similar findings, although the studies were completed using different methodologies. The main outcomes were that poor understanding of discharge information resulted from low literacy levels, poor patient comprehension and lack of adequate information given when discharged from the ED. These results may be may be generalizable to larger EDs, but further research is needed to test their generalisability to New Zealand and to a small rural
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Numerous articles were found on patients who had been admitted to hospital and discharged from the wards but these were excluded as the ED was the focus.

If physicians and nurses in the studies knew they were being assessed on how adequate their discharge education is to patients, they could have changed their behaviour or actions resulting in them giving better or different discharge instructions to patients than they normally would have if they were not being watched. This could have created an unintentional bias.

Conclusion
Overall patient comprehension of instructions and advice given in the ED setting has been found to be poor from the outcomes of articles reviewed within the literature. There are numerous forms of effective communication and ways for health care professionals to give discharge education used by themselves or in combination. There is a lack of effective communication given to patients prior to discharge from the ED leading to several potential complications. More research is required to accurately establish the discharge education given to patients and their family members before discharge from the ED. This could lead to research on what does the patient need to self-manage their care upon leaving the ED. As the population of Māori in the area where further research is to be conducted is reasonably high other factors that

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