Data presented in 2011 identified a lack of steroid management knowledge in both patients and hospital staff. Numerous strategies have now been put in place to address this. These strategies have not only focused on patient education, but also on raising steroid awareness across the Trust.
The first 48 respondents of a pre steroid education nurse survey, concerning steroid awareness, showed that, 48% did not know what an adrenal crisis is, but that 65% knew that stopping steroids could lead to a deterioration in the patients health. Regular nurse training sessions have been set up to teach nurses how to correctly manage steroid dependant Inpatients and how to deal with an addisonion crisis. Each nurse is issued with a plastic endocrine prompt card which identifies keys steps and pertinent questions to help general nurses care for endocrine patients. To alert staff to steroid dependence, steroid warning labels and stamps have been produced for case notes and a steroid management protocol has been written. The steroid pack, previously produced, has been made into a QR code for downloading to smart phones, addressing the on the go requirement without being internet reliant or platform specific. To support patients in administering the emergency hydrocortisone injection, a step by step patient video accessible from the trust web site has also been produced.
An audit of 120 patients educated through the steroid pack showed that 87% of patients now know how to titrate their steroids in given scenarios and for those with Internet access, 86% found the patient video useful.
Steroid education and management for patients and staff alike must involve tools of reference accessible whenever required, so to help deal with the life threatening situation of cortisol insufficiency both within the hospital setting and outside.