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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

Standard Code Book (SCB)  

Patient Education Protocol

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Code Topic Subtopic Outcome Standards
YEAST-WC   YEAST INFECTION  WOUND CARE  The patient/family will understand proper wound care and infection control measures.  1.Explain the reasons to care appropriately for the wound, e.g., decreased infection rate, improved healing. 2.Emphasize the importance of hand hygiene before and after caring for the wound and the relationship to preventing infection. Explain that the patient/family has the right to request staff members to wash their hands if the staff member does not do so in plain sight. 3.Explain the correct procedure for caring for this patient wound, including the use of personal protective equipment. As appropriate the patient/family will demonstrate the necessary wound care techniques. 4.Detail the supplies necessary for care of this wound (if any) and how/where they might be obtained. Emphasize the proper methods for disposal of used supplies. 5.Explain signs or symptoms that should prompt immediate follow-up: increasing redness, purulent discharge, fever, increased swelling/pain, etc. 6.Discuss any special recommendations or instructions particular to the patient wound. 
YEAST-TX   YEAST INFECTION  TREATMENT  The patient/family will understand the treatment plan.  1.Explain the treatment plan. Emphasize the importance of active participation by the patient/family in the development of and participation with treatment plan. 2.Explain that various treatments have their own inherent risks, side effects, and expected benefits. Explain the risk/benefit of treatment and non-treatment. 3.Explain that compliance with the treatment plan is essential. Explain that treatment of yeast infections varies according to the site, severity and organism causing the yeast infection. Treatment is usually topical but can be oral or IV. 
YEAST-TE   YEAST INFECTION  TESTS  The patient/family will understand the test(s) to be performed, the potential risks, expected benefits, and the risks of non-testing.  1.Explain test(s) that have been ordered (explain as appropriate): a.method of testing b.necessity, benefits, and risks of test(s) to be performed c.any potential risk of refusal of recommended test(s) d.any advance preparation and instructions required for the test(s) e.how the results will be used for future medical decision-making f.how to obtain the results of the test 2.Explain test results: a.meaning of the test results b.follow-up tests may be ordered based on the results c.how results will impact or effect the treatment plan d.recommendations based on the test results 
YEAST-SM   YEAST INFECTION  STRESS MANAGEMENT  The patient will understand the role of stress management in yeast infection.  1.Explain that unmanaged stress can have an adverse effect. 2.Explain the role of effective stress management in yeast infection. 3.Discuss various stress management strategies such as maintaining a healthy lifestyle. Some examples may include: a.Becoming aware of your own reactions to stress b.Recognizing and accepting your limits c.Talking with people you trust about your worries or problems d.Setting realistic goals e.Getting enough sleep f.Maintaining a healthy diet g.Exercising regularly h.Taking vacations i.Practicing meditation, self-hypnosis, and positive imagery j.Practicing physical relaxation methods such as deep breathing or progressive muscular relaxation k.Participating in spiritual or cultural activities 4.Provide referrals as appropriate. 
YEAST-PRO   YEAST INFECTION  PROCEDURES  The patient/family will understand the proposed procedure, including the indications, complications, and alternatives, as well as, possible results of non-treatment.  1.Discuss the indications, risks, and benefits, any significant alternatives, likelihood of success, and common and important complications of the proposed procedure. Discuss the possible results of non-treatment and any potential problems related to recuperation. 2.Explain the process and what is expected after the procedure. 3.Explain the necessary preparation for the procedure. 4.Explain the safety processes that will be applied to prevent errors and encourage reporting of concerns regarding safety, such as: a.Informed consent b.Patient identification c.Marking the surgical site d.Time out for patient identification and procedure review e.Measures to prevent surgical site infections 5.Discuss pain management as appropriate. 
YEAST-PM   YEAST INFECTION  PAIN MANAGEMENT  The patient/family will understand and fully participate in the plan for pain management.  1.Explain the pain scale and how it is used to assess the degree of pain individuals are experiencing. Discuss its use in developing a plan to manage pain. 2.Explain that pain management is specific to the disease process and the patient and may be multifaceted. Refer to "PM-Pain Management". 3.Explain that narcotics and other medications may be helpful to control pain and the symptoms associated with pain or nausea and vomiting. 4.Explain non-pharmacologic measures that may be helpful with pain control. 
YEAST-P   YEAST INFECTION  PREVENTION  The patient/family will understand ways to prevent yeast infections.  1.Explain that keeping skin clean and dry is a major deterrent to the growth of yeast on the skin. 2.Explain that control of blood glucose for diabetics helps prevent yeast infections, as appropriate. 3.Discuss the use of live-culture yogurt or pro-biotics. Refer to "YEAST-N Nutrition". 4.Avoid wearing tight workout clothes and nylon underwear (which traps heat). Remove sweaty clothes and wet swim suits ASAP. 5.Discuss methods to prevent reinfection or transmission: a.To prevent vaginal infections, wear cotton underwear and avoid douches. b.To prevent skin infections, keep the area clean and dry. c.For infants with oral thrush, discuss that all bottle nipples and pacifiers should be washed in hot, soapy water. If the infant is breast-fed, the mother is likely to be treated as well. 
YEAST-N   YEAST INFECTION  NUTRITION  The patient/family will understand nutrition, as it relates to yeast infection.  1.Emphasize that nutritional management includes meal planning, careful shopping, appropriate food preparation, and eating. 2.Describe healthy food preparation methods. Emphasize the importance of appropriate serving sizes and reading food labels. 3.Discuss the importance of regular meals and adequate fluid intake. Explain that oral supplements are beneficial to boost calories if oral intake is less than optimal. 4.Refer to registered dietitian for MNT or other local resources as appropriate. 
YEAST-M   YEAST INFECTION  MEDICATIONS  The patient/family will understand the purpose, proper use, and expected outcomes of prescribed drug therapy.  1.Describe the name, strength, purpose, dosing directions, and storage of the medication. 2.Discuss the risks, benefits, and common or important side effects of the medication and follow up as appropriate. 3.Discuss any significant drug/drug, drug/food, and alcohol interactions, as appropriate. 4.Discuss the importance of full participation with the medication plan and that this is the patient responsibility. Discuss any barriers to full participation. 5.Discuss the importance of keeping a list of all current prescriptions and over-the-counter medicines, vitamins, herbs, traditional remedies, and supplements. Encourage the patient to bring this list and pill bottles to appointments for medication reconciliation. 6.Stress the importance of choosing over-the-counter treatments indicated for the specific site of infection. 
YEAST-L   YEAST INFECTION  LITERATURE  The patient/family will receive literature about yeast infections.  1.Provide patient/family with literature on yeast infections. 2.Discuss the content of the literature. 
YEAST-HY   YEAST INFECTION  HYGIENE  The patient will recognize good personal hygiene as it relates to yeast infections.  1.Review the importance of bathing, paying special attention to face, pubic hair area, skin folds, diaper areas, and feet. Discuss hygiene as part of a positive self image. 2.Review the importance of daily dental hygiene (thrush), with attention to brushing and flossing. Remind patients who use inhaled steroids to rinse the mouth after each use. 3.Review the risks of exposing immunocompromised and high-risk persons (infants and elderly) to communicable diseases. 
YEAST-HPDP   YEAST INFECTION  HEALTH PROMOTION, DISEASE PREVENTION  The patient/family will understand the lifestyle changes necessary to promote and sustain healthy living.  1.Explain that health and wellness refers to whole person (mind, body, and spirit) and is a positive state which results from healthy choices. 2.Explain healthy lifestyle choices (e.g., spirituality, social connections, exercise, and nutrition) and avoidance of high risk behaviors (e.g., smoking, alcohol and substance abuse, sex with multiple partners). Discuss the benefits of a healthy lifestyle. 3.Discuss wellness as an individual responsibility to: a.Learn how to be healthy. b.Be willing to change. c.Practice new knowledge. d.Get help when necessary. 4.Review the community resources available for help in achieving behavior changes. 
YEAST-HM   YEAST INFECTION  HOME MANAGEMENT  The patient/family will understand the home management of yeast infection.  1.Explain the home management techniques. If certain that the infection is a yeast condition, it can be treated with over-the-counter medications. 2.Discuss the implementation of hygiene and infection control measures. 3.Refer to community resources, as appropriate. 
YEAST-HELP   YEAST INFECTION  HELP LINE  The patient/family will understand how to access and benefit from a help line or Internet website regarding Yeast Infections.  1.Explain that support groups and reliable information may assist in answering questions regarding Yeast Infections and dealing with issues. 2.Provide the help line phone number or Internet address (URL). 
YEAST-FU   YEAST INFECTION  FOLLOW-UP  The patient/family will understand the importance of follow-up in the treatment of a yeast infection.  1.Emphasize the importance of follow-up care. 2.Discuss the procedure and process for obtaining follow-up appointments. 3.Emphasize that full participation of the treatment plan is the responsibility of the patient/family. 4.Discuss signs/symptoms that should prompt immediate follow-up. 5.Discuss the availability of community resources and support services and refer as appropriate. 
YEAST-EX   YEAST INFECTION  EXERCISE  The patient/family will understand the role of physical activity in yeast infection.  1.Discuss that vigorous exercise produces more sweat, which means warmer, moist dark places for Candida yeast to thrive. Avoid wearing tight workout clothes and nylon underwear (that traps heat). Remove sweaty clothes and wet swim suits ASAP. 2.Discuss medical clearance issues for new physical activity. Current exercise can be maintained. 3.Discuss the benefits of any physical activity, such as improvement in well being, stress reduction, sleep, bowel regulation, and improved self image. 4.Discuss obstacles to a personal physical activity plan and solutions to those obstacles. Assist the patient in developing a personal physical activity plan. 5.Discuss the appropriate frequency, intensity, time, and type of activity. 6. Refer to community resources as appropriate 
YEAST-DP   YEAST INFECTION  DISEASE PROCESS  The patient/family will understand that candidiasis (yeast infections) is caused by a group of microscopic fungi or yeast.  1.Discuss the signs/symptoms of yeast infections. 2.Explain that yeast infections are caused by a fungus. Candida albicans is the most common cause of genital and oral infections. 3.Explain predisposing factors to yeast infections as appropriate: a.Treatment with antibiotics that kill bacteria that otherwise control fungal growth b.Moisture retention on the skin, e.g., people who frequently have their hands in water, children who suck a thumb, babies who stay in wet diapers, skin folds of the obese c.Uncontrolled diabetes d.Impaired immune response e.Use of spermicidal jellies or creams f.Ill-fitting dentures 4.Discuss that women should see a healthcare provider the first time they suspect a yeast infection. Occasionally yeast infections are mistaken for other similar vaginal infections such as bacterial vaginosis or allergic reactions. Recurrent or uncleared infections should be evaluated by a medical provider. 
YEAST-CUL   YEAST INFECTION  CULTURAL/SPIRITUAL ASPECTS OF HEALTH  The patient/family will understand the impact and influences cultural and spiritual traditions, practices, and beliefs have on health and wellness.  1.Discuss the potential role of cultural/spiritual traditions, practices and beliefs in achieving and maintaining health and wellness. Refer to clergy services, traditional healers, or other culturally appropriate resources. 2.Explain that traditional medicines/treatments should be reviewed with the healthcare provider to determine if there are positive or detrimental interactions with prescribed treatment. Explain that the medical treatment plan must be followed as prescribed to be effective. 
YEAST-C   YEAST INFECTION  COMPLICATIONS  The patient/family will understand the common and important complications of yeast infections.  1.Explain that repeated yeast infections may be a sign of a more serious condition. 2.Describe the common complications of yeast infections: a.Vaginal yeast infections can lead to chronic discharge, itching, pain with urination, pain with intercourse. b.Oral or pharyngeal yeast infections can lead to weight loss, malnutrition, or dehydration. c.Skin yeast infections cause increased susceptibility to bacterial infections, which may become threatening to life or limb. d.Widespread (disseminated) candidiasis may occur in immunocompromised individuals. 3.Explain that devices such as urinary catheters and IV ports provide access for the yeast to enter the body. Persons who are IV drug addicts who use dirty needles may inject yeast directly into their blood stream or deep tissues. 
YEAST-AP   YEAST INFECTION  ANATOMY & PHYSIOLOGY  The patient/family will understand anatomy and physiology as it relates to yeast infections.  1.Explain the normal anatomy and physiology of the affected area (usually skin, mouth and throat, or reproductive organs). 2.Discuss the changes to anatomy and physiology as it relates to yeast infections. 3.Discuss the impact of these changes on the patient's health or well-being. 
XRAY-TE   RADIOLOGY/NUCLEAR MEDICINE  TESTS  The patient/family will understand the test(s) to be performed, the potential risks, the expected benefits, and the risks of non-testing.  1.Explain test(s) that have been ordered and method of imaging. e.g., MRI, CT scan, ultrasound, EKG, etc. Explain as appropriate: a.method of testing b.necessity, benefits, and risks of test(s) to be performed c.any potential risk of refusal of recommended test(s) d.any advance preparation and instructions required for the test(s) , e.g., fasting e.how the results will be used for future medical decision-making f.how to obtain the results of the test 2.Explain test results: a.meaning of the test results b.follow-up tests may be ordered based on the results c.how results will impact or effect the treatment plan d.recommendations based on the test results 
XRAY-S   RADIOLOGY/NUCLEAR MEDICINE  SAFETY  The patient/family will understand the safety procedures used to protect the patient and staff.  1.Discuss the importance of informing the providers of pregnancy status in females of childbearing age prior to procedures. 2.Discuss the importance of informing the providers of any allergies, e.g., latex, iodine dye, and medications. 3.Explain the importance of correctly identifying self before the procedure, e.g., name, birth date. 4. Discuss as appropriate that needles and other infusion equipment are single-patient use and will be discarded. 5. Discuss the procedure of accidental needle-stick of the patient or the staff as appropriate. 
XRAY-PRO   RADIOLOGY/NUCLEAR MEDICINE  PROCEDURES  The patient/family will understand the radiographic/nuclear medicine procedure to be performed.  1.Discuss the indications, risks, and benefits, any significant alternatives, likelihood of success, and common and important complications of the proposed procedure. Discuss the possible results of non-treatment and any potential problems related to recuperation. 2.Explain the process and what is expected after the procedure. 3.Explain the necessary preparation for the procedure. 4.Explain the safety processes that will be applied to prevent errors and encourage reporting of concerns regarding safety, such as: a.Informed consent b.Patient identification c.Marking the surgical site d.Time out for patient identification and procedure review e.Measures to prevent surgical site infections 5.Discuss pain management as appropriate. 6.Explain that some procedures may require chaperones. 
XRAY-PM   RADIOLOGY/NUCLEAR MEDICINE  PAIN MANAGEMENT  The patient/family will understand and fully participate in the plan for pain management.  1.Explain the pain scale and how it is used to assess the degree of pain individuals are experiencing. Discuss its use in developing a plan to manage pain. 2.Explain that pain management is specific to the disease process and the patient and may be multifaceted. Refer to "PM-Pain Managment". 3.Explain that medications may be helpful to control pain and the symptoms associated with pain or nausea and vomiting. 4.Explain that narcotics and other medications may be helpful to control pain and the symptoms associated with pain or nausea and vomiting. 5. Explain non-pharmacologic measures that may be helpful with pain control. 
XRAY-M   RADIOLOGY/NUCLEAR MEDICINE  MEDICATIONS  The patient/family will understand the purpose, proper use, and expected outcomes of the prescribed drug therapy.  1. Describe the name, strength, purpose, dosing directions, and storage of the medication. 2. Discuss the risks, benefits, and common or important side effects of the medication and follow up as appropriate. 3. Discuss any significant drug/drug, drug/food, and alcohol interactions, as appropriate. 4. Discuss the importance of full participation with the medication plan and that this is the patient’s responsibility. Discuss any barriers to full participation. 5. Discuss the importance of keeping a list of all current prescriptions and over-the-counter medicines, vitamins, herbs, traditional remedies, and supplements. Encourage the patient to bring this list, inhalers, and pill bottles to appointments for medication reconciliation. 
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