VIP Care Toolbox used in QI project

“Hello, I’m your nurse, Jane. Are you able to see me clearly?”

I have trouble functioning without a pair of eyeglasses within reach. If I were in the hospital without my glasses, I’d be at a loss—unable to read for pleasure, let alone read menus or instructions or consent forms. How much harder is it for people with moderate vision loss, or those who are totally blind?

Christine Carlson and her colleagues at St. David’s North Austin Medical Center in Austin, Texas, set out to answer this question. They met with visually impaired people in the community, reviewed the literature, and surveyed their own staff in order to learn the best ways to accommodate the unique needs of visually impaired patients, or ‘VIPs.’

In “Caring for Visually Impaired Patients in the Hospital: A Multidisciplinary Quality Improvement Project” in the May issue of AJN, the authors highlight how frightening and frustrating a hospitalization can be for those with limited or no sight, and share simple, practical interventions that can make an enormous difference in the safety and quality of a VIP’s hospital experience.

“I’m always afraid to go to the hospital. They don’t know what I really need.”

In their interviews with the visually impaired, the authors learned about patients’

  • feelings of being unsafe, disrespected, and distrustful when signing documents.
  • challenges that resulted from caregivers not recognizing their needs.
  • difficulty remembering instructions because of a lack of technological aides.
  • wanting staff members to ask permission before turning on lights or moving items in the room.

A QI project to improve care for the visually impaired.

A VIP care team was formed and a QI project implemented in order to improve care for visually impaired patients. Staff education was critical. In addition, the team assembled innovative “VIP Toolboxes” for each nursing unit that included items for use by both patients and staff. The toolbox included braille menus, lighted magnifying glasses, special coasters to place under drinking glasses, raised sticker dots to identify bedside controls, VIP identification bracelets, and other useful items.

Staff in other departments (for example, dietary and housekeeping) received guidance about working with VIPs that were specific to their own patient-related duties.

This practical project is easily replicable. Understanding the needs of VIPs was the essential, initial step in making simple and inexpensive changes that led to significantly improved care. The article will be free until the end of May.