Evaluating the effectiveness of a mnemonic to guide staff when providing patient education to autologous hematopoietic stem cell transplant patients

Cheryl Page, Charissa Cordon, Jiahui Wong


Effective patient education can influence cost savings and improve patient outcomes (CCO, 2006). Nursing staff provide education to patients and families through the assessment of learning needs, incorporating the teach-back method to assess comprehension, and documenting the care provided. For this pilot study, an educational intervention was developed incorporating a mnemonic memory aid to support a consistent, standardized approach in delivering effective patient teaching.  Forty-five hematology nurses from Hamilton Health Sciences participated in the study, of which 36 completed the follow-up assessments. The mnemonic aid “CARE”, developed for this study, helped nurses to recall the steps involved in patient education. The improved knowledge and the use of the mnemonic aid in patient education was sustained over the three- to six-weeks follow-up period. While there was an increase in documentation of the patient education after the intervention, the changes did not reach the statistically significant level. Further research on the use of mnemonics in nursing education would complement this pilot study.

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Alton, S. (2016). Learning how to learn: Meta-learning strategies for the challenges of learning pharmacology. Nurse Education Today, 382–4.

Beck, R.S., Daughtridge, R., & Sloane, P.D. (2002). Physician-patient communication in the primary care office: A systematic review. Journal American Board of Family Medicine, 15(1), 25–38.

Bevan, J., & Pecchioni, L. (2008). Understanding the impact of family caregiver cancer literacy on patient health outcomes. Patient Education & Counseling, 71(3), 356–364.

Brega, A.G., Barnard, J., Mabachi, N.M., Weiss, B.D., DeWalt, D.A., Brach, Cifuentes, K., & West, D.R. (2015). AHRQ health literacy universal precautions toolkit (2nd ed.). Retrieved from file:///C:/Users/chery/Documents/Desouza/Fellowship/Articles/healthlittoolkit2_4.pdf

Cancer Care Ontario [CCO] (2008, October). Oncology nursing documentation competencies. Retrieved from https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CCONursingDocumentation.pdf

Cancer Care Ontario [CCO] (2009, December). Effective teaching strategies and methods of delivery for patient education. Retrieved from www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=60065

Cancer Care Ontario [CCO] (2006, August). Establishing comprehensive cancer patient education services, a framework to guide Ontario cancer education services: Evidentiary review. Retrieved from https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/301

Cancer Care Ontario [CCO] (2015, May). Patient centered care. Retrieved from https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId

Canadian Nurses in Oncology [CANO] (2006). Practice standards and competencies for the specialized oncology nurse. Retrieved from https://www.cano-acio.ca/page/SpecializedOncology

Canadian Nurses in Oncology [CANO] (2017, September). Standards and competencies for cancer chemotherapy nursing practice. Retrieved from https://cdn.ymaws.com/www.cano-acio.ca/resource/resmgr/Resources/EN_CANO_Chemotherapy_Standar.pdf

Chapman, A. (2003). Process of personal change. Available online at http://www.businessballs.com/personalchangeprocess.htm

Cox, N., Bowner, C., & Ring, A. (2010). Health literacy and the provision of information to women with breast cancer. The Royal College of Radiologists, 23, 223–227. doi:10.1016/j.clon.2010.11.010

Desme, A., Mendes, N., Perruche, F., Veillard, E., Elie, C., Moulinet, F., ... Claessens, Y. (2013). Nurses’ understanding influences comprehension of patients admitted in the observation unit. Journal of Health Communication, 18(5), 583–593. doi:10.1080/10810730.2012.74362

Dunlosky, J., Rawson, K.A., Marsh, E.J., Nathan, M.J., & Willingham, D.T. (2013). Improving students’ learning with effective learning techniques: Promising directions from cognitive and educational psychology. Psychological Science in the Public Interest, 14(1), 4–58.

Farenga, S.J., Ness, D., & Flynn, G.V. (2007). Strategies for learning and metacognition: Identifying and remembering big ideas. Science Scope, 31(2), 82.

Hertzog, M.A. (2008). Considerations in determining sample size for pilot studies. Research in Nursing & Health, 31(2), 180–191. doi:10.1002/nur.20247

Kirkpatrick, D.L. (2006). Evaluating training programs: The four levels (3rd edition). San Francisco, CA: Berrett-Koehler.

Koutsopoulou, S., Papathanassoglou, E.E., Katapodi, M.C., & Patiraki, E.I. (2010). A critical review of the evidence for nurses as information providers to cancer patients. Journal of Clinical Nursing, 19(5/6), 749. doi:10.1111/j.1365-2702.2009.02954.x

Levin-Zamir, D., & Bertschi, I. (2018). Media health literacy, eHealth literacy, and the role of the social environment in context. International Journal of Environmental Research and Public Health, 15(8), 1643. doi:10.3390/ijerph15081643

Linnard-Palmer, L. (2012). The use of simulation for pediatric oncology nursing safety principles: Ensuring competent practice through the use of a mnemonic, chemotherapy road maps and case-based learning. Journal of Pediatric Nursing, 27(3), 283–286. doi:10.1016/j.pedn.2012.02.001

Mannix, T., Parry, Y., & Roderick, A. (2017). Improving clinical handover in a paediatric ward: implications for nursing management. Journal of Nursing Management, 25(3), 215–222. doi:10.1111/jonm.12462

Marcum, J., Ridenour, M., Shaff, G., Hammons, M., & Taylor, M. (2002). A study of professional nurses’ perceptions of patient education. The Journal of Continuing Education in Nursing, 33(3), 112–8. Retrieved from http://libaccess.mcmaster.ca.libaccess.lib.mcmaster.ca/login?url=https://search-proquest-com.libaccess.lib.mcmaster.ca/docview/223324613?accountid=12347

Newnham, A.L., Hine, C., Rogers, C., & Agwu, J.C. (2015). Improving the quality of documentation of paediatric post-take ward rounds: The impact of an acrostic. Postgraduate Medical Journal, 91(1071), 22–25. doi:10.1136/postgradmedj-2013-132534

Pidala, J., Anasetti, C., & Jim, H. (2009). Health-related quality of life following hematopoietic cell transplantation: Patient education, evaluation, and intervention.

Putman, A.L. (2015). Mnemonics in education: current research and application. American Psychological Association, 1(2), 130–139. http://dx.doi.org/10.1037/tps0000023

Rootman, I., & Gordon-El-Bihbety, D. (2008). A vision for a health literate Canada: Report of the expert panel on health literacy. Canadian Public Health Association. Retrieved from www.cpha.ca

Stenberg, U., Haaland-Øverby, M., Fredriksen, K., Westermann, K.F., & Kvisvik, T. (2016). A scoping review of the literature on benefits and challenges of participating in patient education programs aimed at promoting self-management for people living with chronic illness. Patient Education & Counseling, 99(11), 1759–1771. doi:10.1016/j.pec.2016.07.027

Stenberg, U., Vågan, A., Flink, M., Lynggaard, V., Fredriksen, K., Westermann, K.F., & Gallefoss, F. (2018). Health economic evaluations of patient education interventions a scoping review of the literature. Patient Education & Counseling, 101(6), 1006–1035. doi:10.1016/j.pec.2018.01.006

Tian, Y., & Robinson, J. (2008). Incidental health information use and media complementarity: a comparison of senior and non-senior cancer patients. Patient Education & Counseling, 71(3), 340–344.

Treacy, J.T., & Mayer, D.K. (2000). Perspectives on cancer patient education. Seminars in Oncology Nursing, 16(1), 47–56. https://doi.org/10.1016/S0749-2081(00)80007-8

Wagner, E.A. (2014). Using a kinesthetic learning strategy to engage nursing student thinking, enhance retention, and improve critical thinking. Journal of Nursing Education, 53(6), 348. doi:10.3928/01484834-20140512-02

Wallner, L., & Bäuml, K.T. (2017). Beneficial effects of selective item repetition on the recall of other items. Journal of Memory & Language, 95159–172. doi:10.1016/j.jml.2017.04.006

Watterson, K., Hauck, M.J., Auker, A., Burns, R., Greider, J., Marlin, M., ... Fenimore, E. (2018). S.T.I.C.K.: A Quality Improvement Pediatric IV Infiltration Prevention Bundle. Journal of Pediatric Nursing. doi:10.1016/j.pedn.2018.01.003

Wizowski, L., Harper, T., & Hutchins, T. (2008). Writing health information for patients and families (3rd Ed.). Hamilton Health Sciences. Retrieved from www.hamiltonhealthsciences.ca

Woodfin, K.O., Johnson, C., Parker, R., Mikach, C., Johnson, M., & McMullan, S.P. (2018). Use of a novel memory aid to educate perioperative team members on proper patient positioning technique. AORN Journal, 107(3), 325–332. doi:10.1002/aorn.12075

Yosso, T.J. (2005). Whose culture has capital? A critical race theory discussion of community cultural wealth. Race Ethnicity and Education, 8(5), 69–91. doi:10.1080/1361332052000341006


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