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Reiki Program in the GWU Hospital Cardiac Catheterization
Lab Phase One ~ Six Week Report ~ December 8, 2003 ~ January 16, 2004 by Luann Jacobs |
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The Basic Program of Phase One: The Reiki Master practitioners in the Cardiac Catheterization Relaxation Program (CCRP) at George Washington University Hospital (GWUH) have completed the first six weeks of a 24 week pilot program. We started the program with an informational kick-off for nursing staff on September 10, 2003. We followed up with a full day Level One Reiki training class on November 8, 2003 to increase staff understanding of the nature of relaxation through the use of Reiki touch for both our program with the cardiac catheterization patients and for staff use as a self relaxation tool. Twelve nurses and one project coordinator from the Cardiac Catheterization Lab and the Cardiovascular Unit attended and received their Level One Reiki certification. Participants completed an attitude questionnaire about knowledge of Reiki and other CAM modalities and their impressions of its ability to effect their own health and job satisfaction. In the second part of Phase One we will be resampling staff attitudes on the frequency and effectiveness of self Reiki on their health and job satisfaction. The Relaxation Program with Cardiac Catheterization patients began on December 8, 2003. Two Reiki Master practitioners are available five hours per day during Phase One (12 weeks). Patients are offered the Reiki relaxation prior to their procedure at no charge to them. At the completion of six weeks, we have seen over eighty cardiac cath patients for Reiki relaxation prior to their procedure. This six week period contained the two holiday weeks of Christmas and New Years and several days of severe weather which have contributed to reduced days of practitioner participation and some reduction in numbers of patients scheduled for cardiac catheterization. Individual CD players contribution to privacy and peacefulness: To extend the effects of the Reiki touch relaxation, individual music CD players have been provided to help maintain the relaxed state prior to the patient’s procedure. In a few patients with extreme anxiety, the practitioner was able to accompany the patient into the cardiac cath lab and maintain the hands on relaxation while the patient was prepared for the beginning of the procedure and the IV sedation was begun. Since the hands on Reiki touch relaxation is optional, not all patients elect to try it. However, those patients are also offered music CD players, or audio relaxation tapes to help reduce anxiety, or boredom while awaiting the procedure. The plan to include a visual and auditory relaxation TV channel (called the Care Channel) hospital wide will help many patients self regulate their anxiety or boredom. These individual CD players also help with maintaining patient confidentiality. The holding area for cardiac catheterization contains space for four stretchers, and a nurses’ desk in very close proximity with no sound barriers. The ability to unintentionally hear the confidential patient information through a cloth curtain barrier presents an issue for HIPAA regulations. High levels of noise is another factor contributing to patient anxiety. The cardiac catheterization holding area is a hallway for transport of trash bearing wheeled barrows, foot traffic from one department to another, and patients coming out of their procedures and going to the PACU, and patients going to ICU-2. Swinging double doors are at one end of the holding area. Patients can be seen and felt to jump from the startling noise level. The constant traffic and people talking contributes to reducing patients’ calm. The closed cloth curtains combined with individual CD players helps to make a noisy and visually distracting area less intrusive, more relaxing, and more private. Evaluating the effects of the Reiki Relaxation Program in Cardiac Catheterization: In order to evaluate the impact of the CCRP we devised four questionnaires to be used with patients, staff, and cardiologists. Pre-Cath Questionnaire: Three statements ask patients to rate their confidence level, state of anxiety and satisfaction with their experience so far today at the hospital through a visual analog scale. Post-catheterization: Three statements post catheterization ask patients to remember their feelings of anxiety or tension while waiting the procedure, confidence during the procedure, and feelings of being cared for during their time here through a visual analog scale. Nursing Questionnaire: Three statements ask one nurse staff member in the cardiac catheterization procedure to rate the patient’s relaxation level, smoothness of the procedure, and overall positive impact of the relaxation program through a visual analog scale. Cardiologist Questionnaire: Three statements ask the cardiologist to rate the patient on his relaxation appearance, smoothness of the procedure, and overall positive impact of the relaxation program through a visual analog scale. Results of the Pre-Cath Questionnaire: The Reiki practitioners have implemented the pre-cath questionnaire successfully. These results indicate that patients are confident in the cardiologist and the hospital but have some degree of apprehension (tension) about undergoing the cardiac catheterization procedure, even when they have had the procedure before. The novice has anxiety based on apprehension of the unknown, the previously-experienced has anxiety based on anticipatory waiting. When asked about satisfaction with their experience so far, the criticisms are centered around two issues: waiting; and being needle stuck for blood draws, then again for IV insertion (meaning couldn’t these procedures be combined therefore saving the patients one unnecessary needle stick.) Waiting for the procedure produces signs of irritation, increased anxiety, and head or stomach complaints as the time since their last meal increases. The relaxation techniques do diminish these effects. Results of the Post-Cath Questionnaire: The intention was for the Reiki practitioners to deliver the post-cath questionnaire to patients in the PACU recovery area after the cardiac catheterization procedure. This has not been consistently practical due to the time of practitioners’ availability, the variable patient waiting time going into the procedure, and the variable procedure time. Having the PACU staff ask patients the post-cath questionnaire would solve this problem. Results of the Nursing Staff Questionnaire and the Cardiologist Questionnaire: The intention was to put these questionnaires in the patients’ cardiac cath chart for one nursing staff member and the cardiologist to complete after the cardiac cath procedure, then placed in a bin for collection by the CCRP program manager. To date we have not found a way to implement these questionnaires in a satisfactory way with regard to chart issues. Comments about the effectiveness of the Cardiac Cath Reiki Program: Patients who receive the Reiki relaxation program offer these comments. “My back pain is gone.” “My headache is gone.” “My IV pain is gone. How did you do that? You weren’t even touching it.” “I didn’t even know I was tense till I started to relax with your touch.” “I feel so much calmer. I am deeply calm within. Thank you so much.” “I am scheduled for surgery. Could you do this again with me before surgery?” “My procedure went smoothly. I know your helping me calm down before I went in was key.” “The music was wonderful, and my doctor continued it during the procedure. It really helped.” Staff comments about patients and Reiki relaxation program: “Thank you, it really helped this patient.” “This patient really benefited from the music; I passed it (CD player) along to another patient while he is waiting.” “When are you teaching another class? I want to learn this for myself.” Extending our influence, or where do we go from here? The CCRP program has two phases. Phase One is 12 weeks, half of which is now completed, with the next six weeks continuing with Reiki practitioner/patient contact of five hours a day, five days a week. Phase Two sees a diminution of the practitioner contact hours to two hours per day, five days a week. What is yet to be accomplished in phase one and proposed for phase two? Reexamining nursing staff use of Reiki for self help. A three month post training questionnaire will help assess the staff’s ability to integrate Reiki into a self care program, and how it has impacted their job satisfaction. Educating cardiologists and patients: One way to extend the influence of this program is to provide cardiologists and their patients with the appropriate materials (pamphlets, relaxation tapes, music suggestions) to improve patient readiness to relax. It has been demonstrated that practicing relaxation through the use of guided imagery tapes outside of the stressful situation (pre-procedure) helps patients to continue their successful use of stress reduction at the time of the procedure. Feelings of being more in control help reduce stress. Letter to the Cardiologist: A letter to each cardiologist about each patient who has been seen for Reiki relaxation has been approved and will be implemented in the second six weeks of Phase One (see appendix, Letter to Cardiologist.) This letter identifies each patient by name, the treating Reiki Master practitioner, and the patient’s response to the Reiki relaxation. Also included, if appropriate, will be suggestions for lifestyle education or programs for lifestyle change that might be of benefit to the patient to improve overall health, and thereby cardiac health. Nursing Education and Training: A three month post course follow up attitude survey will be used to assess the effectiveness of the Reiki Level One Training for Nurses. Attitudes regarding the use of Reiki for self health, nursing care, and job satisfaction will be sampled. A second training class for nurses to learn Reiki Level One will be offered. There are seven allotted places to be filled. Nurses in the PACU, in Cardiac cath and the third floor CVC have been requesting information on the next Reiki class. Phyllis Ahern, Director of CVC, will work with the CCRP program manager to develop the dates for training and select the participants. This education and training extends the knowledge of what we are doing with patients, allows the staff a tool for self care, and gives the staff a way of helping each other through stressful work days. Collecting Patient, Nursing Staff and Cardiologist Questionnaire Data: Implementing the questionnaires is essential to providing data on attitudes about the CCRP relaxation effects and the program’s value. The CCRP needs help from the PACU in administering the Post-Cath Patient Questionnaire, and requires permission to place the forms for the Nurse and the Cardiologist in the patients record until after the procedure, where it can then be removed and collected for analysis. Phase Two-Volunteers to extend the CCRP influence (week 13 through 24): As the hours of daily participation by the relaxation practitioners diminish from five hours to two (ten hours per week) the implementation of the Reiki Volunteers is essential to extend the relaxation program started by the CCRP program manager. The Foggy Bottom community has a unique group of Reiki practitioners who have been practicing Reiki as ReikiPartners.org for over five years. These practitioners are from all walks of life and are willing to become bonafide volunteers within the Hospital to do Reiki relaxation with patients and families of patients who are in need of relaxation. The CCRP program manager, and founder of ReikiPartners.org has met with the Director of Volunteer Services, Archie Davenport, to outline the credentialing process for bonafide volunteers. It is our recommendation that this Reiki Volunteer Program be unique from the Volunteer Services, as the intention and tasks may be different, but that we will work jointly to coordinate our programs. In addition, the Reiki Partners Meeting Group has shifted their meeting place from the Center for Integrative Medicine to the Third Floor South Conference Room and is meeting weekly on Thursday evening from 7 to 9 PM. This group is organized by Luann Jacobs, CCRP program manager, and founder of ReikiPartners.org. Family members under stress, or staff in need of relaxing touch may drop by the group for a session at no charge. There will be a further description of the Reiki Volunteer Program at the end of the next six weeks, outlining credentialing, safety of touch issues, responsibilities, hours, supervision, and the referral process from staff to the volunteer. This program will be implemented in Phase Two. CCRP Forms Used
Nurses ~ Pre-Training Attitude Sample
Prior to receiving your cardiac catheterization procedure you may
elect to receive hands-on relaxation sessions
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© 2004, ReikiPartners |
