Nichole Halliburton: The Roles of Patient Education, Caregivers, and Technology in Improving Dermatology Care

Nichole Halliburton, APRN, CNP, a family nurse practitioner at Cincinnati Children's Hospital Medical Center (CCHMC), highlights how patient education efforts and telemedicine can be used to improve the quality of care in pediatric patients with skin conditions. Halliburton presented at the Society of Pediatric Dermatology annual conference in Toronto, Canada in a presentation entitled, "Facilitating improvements in health care access for patients with dermatologic needs."

Halliburton also worked on a study assessing the impact and effectiveness of inpatient management of epidermolysis bullosa (EB). The study enabled the development of a consensus-derived resource targeting health care professionals to improve the quality of inpatient care for patients with EB.

This transcript has been lightly edited for clarity.

Transcript

How can patient education and outreach programs be tailored to empower patients to take proactive steps in managing their dermatologic health?

Patient education has to start with the primary care provider. It's imperative for us to build relationships with our primary care colleagues who treat these patients and are typically the first line the patient utilizes for skin concerns. The primary care providers have developed a trusting relationship with their patients and are in the best position to educate them and provide them the first-line treatment.

However, community outreach can also be used to reach patients directly, particularly if your hospital system has the infrastructure to get information out. It's imperative for us to accept opportunities such as blog posts, podcasts, and interviews when we can and within our comfort level to get appropriate information directly to the patients.

We participate currently in outpatient outreach programs for our rural areas, attending health fairs, performing skin exams, educating on how to protect themselves from the sun, and answering general questions these families and patients may have.

What innovative approaches or technologies can be adopted to address specific dermatologic needs, such as chronic skin conditions or skin cancer screenings?

Leveraging telehealth can allow us to have a greater reach particularly in areas that have limited access. Strategies such as our mobile mobile care unit, [electronic] consult and visits allow us to reach the patients that have limited access to dermatologic services. Webinars have also helped us get a face-to-face with those that we typically would not be able to. For example, one of our physicians recently did a lunch and learn virtually, with some pediatricians in West Virginia, where they had very little access for dermatologic care.

What strategies can health care providers employ to ensure that the consensus-derived best practices for EB management are accessible and feasible for hospitals with varying resources and capacities?

Groups such as our EB Clinical Research Consortium, can help develop consensus-based guidelines. In systems such as ours at CCHMC, we're leveraging our experts in various disciplines that care for our EB patients to help us design organ system specific guidelines that we eventually would like to publish and make available more broadly.

Additionally, we are in the midst of an intensive website redesign right now to add resources for both patients and families with EB and the providers that care for these patients. Having a comprehensive and frequently updated single source of information will make it possible for people to find what they need more quickly and efficiently and leave fewer care gaps.

The ultimate goal is to partner with our patients' PCPs [primary care physicians] and neonatologists to make sure that they have the resources and education needed to provide care for their EB patients. We also need to partner with the families to educate them on what resources are available.

What role do family members and caregivers play in the management of patients with EB in the hospital, and how can their input contribute to developing effective care strategies?

Parents and caregivers have to advocate for their children particularly when their children are in a hospital that's unfamiliar with EB. Resources such as hospital wallet cards, that one of my colleagues is currently working on Beth Moeves [APRN-CN, advanced practice registered nurse in the CCHMC Epidermolysis Bullosa Center] is going to provide sources of information that's well organized, concise, and relevant to the hospitalized patient. The card discusses the how-tos for providing safe care for EB patients.

We also spend a good deal of time educating our families on what they need to request when they're admitted. They get really hot and sometimes, with their skin being so fragile, they need just extra cushioning on the bed so we have them request a fan or a requested egg crate mattress to put on top of the bed. Our team is in frequent contact with the admitting team to provide guidance and assistance. Our team is working to develop an emergency care package that contains the needed supplies for emergency care if they're in a hospital that does not carry the typical supplies that would be needed for say like an [intravenous] securement dressing.