Patients of the British Columbia Home Parenteral Nutrition Program require intravenous nutrition due to intestinal failure, the impairment of the bowel’s ability to absorb adequate nutrition and fluid. Patients with intestinal failure are reliant on intravenous, or parenteral, nutrition and infuse their nutrition via an infusion pump into their bloodstream through a central venous catheter. Home parenteral nutrition patients are at risk during a power outage or natural disaster because power is required to keep solutions cold and operate an infusion pump. Patients might be further compromised by a lack of access to clean water and telephone service. Moreover, roads and bridges might be blocked and hospitals as well as emergency rooms might be crowded with injured people.
To address patient concerns about disaster planning, the British Columbia Home Parenteral Nutrition Program developed an emergency preparedness booklet, My Emergency Preparedness Plan: Information For and About Adult Patients of the BC Home Parenteral Nutrition (HPN) Program. The booklet prompts patients to record their emergency contact information, medical history, medical contacts, medications and home parenteral nutrition information. The booklet provides instructions on how patients can remain safe, how they can be prepared for an evacuation and how they can keep themselves nourished and hydrated should they not have access to power. Patients are encouraged to have both a general emergency pack and a home parenteral nutrition emergency pack.
Patient safety was the targeted measurable outcome, as determined by (1) the change in confidence level and (2) the change in being prepared for a disaster both before and after having received the My Emergency Preparedness Plan booklet. Patient safety was measured through a survey instrument. The results of the survey demonstrated that patients’ confidence increased (p<0.001) after receiving the booklet compared with before. Forty-seven percent of the survey respondents were “not confident at all” about emergency preparedness compared with 0% after receiving the booklet; 11% were “confident” or “very confident” before compared with 63% after. There was an increase in the percentage of recommended items patients had in a general emergency pack after receiving the booklet compared with before (p=0.009). Before receiving the booklet, 42% of patients did not have a general emergency pack; this decreased to 26% after receiving the booklet. Likewise, patients had an increase in the percentage of recommended items in a home parenteral nutrition emergency pack after receiving the booklet compared with before (p=0.009). Thirty-two percent of respondents did not have this pack before receiving the booklet compared with 16% after. Overall, 74% of patients found the booklet to be “helpful” or “very helpful.
The British Columbia Home Parenteral Nutrition Program believes that emergency preparedness is a shared responsibility. The My Emergency Preparedness Plan booklet strives to empower patients and families to feel confident and be prepared for an emergency or disaster situation. The booklet provides information on how to be safe; and it is the patient’s responsibility to act on this information. An electronic copy of the booklet is found on the Program’s website at www.bchomenutrition.org/emergency-preparedness.html.