Nurse practitioner Loretta Colvin figured out a way to provide patients with extra sleep apnea therapy support, even when her in-person time with them may be limited.
Sleep clinics often see the same problems come up again and again. When a patient starts continuous positive airway pressure (CPAP) therapy, dry air might irritate their airways. If there is not a good enough seal on the CPAP mask, air could leak, leading to less effective treatment.
These issues often have simple fixes, but with limited in-person time and more appointments being administered though telemedicine, patients sometimes don’t get the right level of hands-on support, explains Loretta Colvin, APN, RN, CRNP, an acute care nurse practitioner who specializes in the treatment of sleep disorders with the SSM Health Medical Group in St. Louis.
When Colvin started treating telehealth patients, she wished she had more communication tools. “Some of the things that I would have done in the clinic when we meet face-to-face, I can’t do remotely. I can’t give quite the same level of education as I could in the clinic, in terms of being able to give them handouts or being able to walk them through some of the adjustments I might make,” explains Colvin, who is also a clinical assistant professor of nursing at Maryville University.
This all changed when in early 2019 the health care system where Colvin works announced a contest for innovation to advance patient care. Colvin immediately wondered if the contest would approve a video education project for sleep patients who receive care via telemedicine. The videos would serve as a resource for patients to learn about the anatomy of obstructive sleep apnea, to understand why and how to use CPAP therapy, and what to do when something goes wrong during treatment. SSM Health approved her idea and Colvin got to work recording and editing videos before uploading them onto a public YouTube channel called Sleep Apnea Education, which now features six educational recordings. The videos cover everything from how to adjust humidification on Respironics DreamStation to how to monitor for leaks on the ResMed AirSense.
The most viewed video is the “Intro to PAP,” which gives a simple overview of obstructive sleep apnea and the PAP therapies available to treat it. The video touches on ways to make the therapy more comfortable, including the use of smaller masks and humidifiers. The videos cover the most common issues patients might face when using CPAP, including how to recognize a leak and how to tell if you need more humidification.
“Having the videos allows us to give them some support during that time when they are waiting for their appointment with us or to give them support to follow the recommendations that I have given them after their visit,” says Colvin.
The videos also offer suggestion for tracking progress and tips for getting used to the air pressure.
“It’s nice to have other ways to educate patients besides saying the same thing over and over for each patient that comes in when we are limited for time,” says Colvin.
Initially, the clinic launched a six-week pilot project to evaluate patient’s responses. Medical assistants would pull the videos up on a desktop or provide the patient with a tablet in the minutes before a clinician would visit with a patient. The project used YouTube’s playlist function, so when one video ended, the next would automatically start playing.
Surveys were sent to patients to measure the program’s success. Many patients reported that the videos improved their knowledge and bumped up their confidence when using the devices.
After the successful trial run, the clinic continues to use the videos to support patients. They have created a Google document that contains links to the educational videos that can be easily emailed or shared with patients through electronic medical records.
“What’s nice is you introduce them to questions that they didn’t even think to ask and you give them the answers,” she says.
Lisa Spear is associate editor of Sleep Review.
Photo: Loretta Colvin, APN, RN, CRNP, records a CPAP therapy educational video. Photo courtesy of Dan Donovan