Background/Purpose:

The education of patients is a central part of the nursing role in the UK. Nowhere is it more important than in relation to drugs such as methotrexate, where the effect is delayed and side effects are anticipated. Nurses had expressed variable confidence in  educating patients starting Methotrexate and training for this varied from none, some training and observing other nurses to being observed. We were interested to explore this with a survey of nurses who educate patients starting Methotrexate. These are the results from the respondents.

Methods: A survey was designed using an online survey tool around questions about their role; training; confidence and we used multiple choice questions on clinical situations testing knowledge. A web link to the survey was sent to possible participants with encouragement to spread the link to colleagues.

Results:

44 nurses completed the online questionnaire. 70% were nurse specialists and 30% monitoring nurses. 62% had been counselling for more than 5 years.

Training: 17% had no training prior to starting this role. 66% described it as some training and 17% as a lot. For those who had training, 55% described it as very helpful and 45% as less than helpful. 61% expressed that they would have liked more training. Ranking training requirements, respondents rated knowledge highest followed by communication then consultation skills and finally experience.

Confidence: 60% of respondents described themselves as very confident in this role, with 23% confident and 15% somewhat confident. One person was not confident at all. 43% reported that their education of patients had changed a lot and 50% reported that this had changed somewhat while they had been performing the role. The time it took to become confident in the role was variable with 10% confident in 1-2months, 53% in 3-6 months and a further 20% by a year.

Competence: This was tested with MCQs on clinical situations. There was 90-100% accurate response to questions about vaccinations, antibiotics and liver function. Questions on pregnancy and alcohol, however, scored approximately 50% for complete accuracy. A question on Shingles was not well understood. A variety of written information was used in the education processs, this information was often used together. The Arthritis Research UK information sheet was used by 80% and judged to be very helpful.

Conclusion: The nurses included in this survey show a great variation in the training they had prior to starting this role with  those nurses performing the role for the longest period of time having had the least training. The majority would like more training. Most respondents took 3-12 months to feel confident in this role. A training package aimed at satisfying these aspirations could shorten this period and result in better and more consistent education for patients. This should result in improved concordance and safety of treatment.

---

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/nurse-training-confidence-and-competence-for-educating-patients-commencing-methotrexate-therapy/