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Fundamentals ch 25 study guide
Health Assessment I (NR-302)
Chamberlain University
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Chapter 25
Patient Education
The Joint Commission sets standards for patient and family education.
Purposes of Patient Education
- Maintenance and Promotion of Health and Illness Prevention:
- Restoration of Health: injured or ill patients need information and skills to help them regain or maintain their levels of health. a. The family is a vital part of the patients return. b. Family should be involved in the teaching process if the patient-family relationship has been assessed and is wanted/needed.
- coping with impaired functions: family members need to help if possible
Teaching and Learning
Role of the Nurse in Teaching and Learning In the Patient Care Partnership , the American Hospital Association indicates that patients have the right to make informed decisions about their care. The information required to make informed decisions must be accurate, complete and relevant to patient’s needs.
TJC’s Speak Up Initiatives helps patients understand their rights when receiving medical care. The program offers the following SPEAK UP tips: s peak up if you have questions of concerns p ay attention to the care you get Educate yourself about you illness Ask a trusted family member of friend to be your advocate Know which medicines you take and why you take them Use a hospital, clinic, surgery center, or other type of health care organization that has been carefully evaluated Participate in all decisions about your treatment
Teaching as Communication: the teacher and learner become involved together in a teaching process that increases the learner’s knowledge and skills.
Learning objectives: what the learner will be able to do after successful instruction
Domains of Learning
Three domains:
- cognitive (understanding) a. patients need to learn how diabetes affects the body and how to control blood glucose levels for healthier lifestyles b. knowledge, comprehension, application, analysis i. discussion (one on one or group) ii. lecture iii. question and answer session iv. role play, discovery v. independent project (Computer assisted instruction), field experience
- affective (attitudes) a. patients begin to accept the chronic nature of diabetes by learning positive coping mechanisms b. patients being able to just look at a wound and not be affected by it c. receiving, responding, valuing, organizing,characterizing i. role play ii. discussion (group) iii. discussion (one on one)
- psychomotor (motor skills) a. requires learning how to use a glucose levels at home b. perception, set, guided response, mechanism, complex overt response, adaption, origination i. demonstration ii. practice iii. return demonstration iv. independent projects, games
Basic Learning Principles
Motivation to learn Attentional Set: the mental state that allows the learner to focus on and comprehend a learning activity. Physical Discomfort, anxiety and environmental distractions influence the ability to attend. Determine the patients comfort level before beginning a teaching plan. o A mild level of anxiety motivates learning o A high level of anxiety prevents learning Motivation: a forces that acts on or within a person (idea, emotion or a physical need) to cause the person to behave in a particular way. Use of theory to Enhance Motivation and Learning: o Social learning theory: provides one of the most useful approaches to patient education because it explains the characteristics of the learner and guides the educator in developing effective teaching interventions that result in enhances learning and improved motivation. o Self efficacy: concept included in social learning theory, refers to a person’s perceived ability to successfully complete a task. When people believe that they are able to execute a particular behavior, they are more likely to perform the behavior consistently and correctly. Come from 4 sources: Enactive mastery experiences: once the demonstration is complete, the child uses the enhaler Vicarious experiences: the nurse demonstrates how to use the inhaler Verbal persuasion: nurse who is wishing to teach a child recently diagnosed with asthma how to correctly use an inhaler
Physiological and affective states: as the child’s wheezing and anxiety decrease after the correct use of the inhaler, he or she experiences positive feedback, further enhancing his or her confidence to use it o When nurses implement interventions that include self efficacy, their patients frequently experience positive outcomes. Psychosocial adaption to illness: readiness to learn is related to the stage of grieving. o Denial or disbelief o Anger o Bargaining o Resolution o Acceptance Active Participation:
Ability to Learn Developmental Capability: Learning in children: o Infant: touch texture o Toddler: applying bandage to a doll, picture books, learn together though interacting o Preschooler: role play encourage questions and offer explanations, learn through pictures and short stories o School aged: teach psychomotor skills, offer opportunites to discuss health problems and answer questions o Adolescent: self expression, make decisions, use problem solving o Young or middle adult: encourage participation in teaching plan, independent learning, offer information o Older adult: teach when patient is alert and ready, involve in discussion, focus on wellness, keep teaching sessions short Adult learning: Physical capability: o Size o Strength o Coordination o Sensory acuity
Learning Environment
Nursing Process
Teaching environment: ventilation, lighting, furniture, temperature, size
Assessment : learning needs, motivation to learn, ability to learn, teaching environment, resources for learning, health literacy and learning disabilities
Diagnosis : when the nursing diagnosis is deficient knowledge, the diagnostic statement describes the specific type of learning need and its cause Deficient knowledge regarding psychomotor learning related to inexperience with medication self administration o Nursing diagnoses that indicates a need for education include the following: o Deficient knowledge (affective, cognitive, psychomotor) o Ineffective health maintenance o Ineffective family therapeutic regimen management o Ineffective self-health management o Noncompliance (with medications) o When you can manage or eliminate health care problems through education, the related factor of a diagnostic statement is deficient knowledge o an older adult is having difficulty managing a medication regimen that involves a number of newly prescribed medications she has to take at different times of the day. The nursing diagnosis is ineffective self health management related to deficient knowledge. o When identifying conditions that cause barriers to effective learning such as acute pain or activity intolerance, teaching is inappropriate. Delay teaching until the nursing diagnosis is resolved or the health problem controlled.
Planning: develop a teaching plan, determine goals and expected outcomes, involve the patient in selecting learning experiences. ALWAYS USES WILL o Will administer or will empty colostomy bag o A patient has deficient knowledge related to an illness. The patient benefits most by first learning about the correct way to take the medicines and how long to wait before calling for help when chest pain occurs. After you meet basic survival needs, you can then talk about other topics like exercise and nutritional status. o Timing: although long sessions cause concentration and attentiveness to decrease, make sure that teaching sessions are not too brief. The patient needs to comprehend the information and give feedback. It is easier to tolerate and retain interest in the material during frequent sessions lasting 10-15 minutes. o Shorter hospital stays and lack of insurance reimbursement for outpatient education sessions often necessitate longer teaching sessions. o Make sure times between teaching sessions are not too long o Organizing: simple to complex ideas because a person must learn the simple facts and concepts before learning how to make associations or complex interpretations of ideas. o Start and end with essential concepts
Implementation: critically analyze assessment data when identifying learning needs and developing the teaching plan. o Do not start with something that the patient already knows. Build on previous knowledge and experience. o Telling: use the telling approach when teaching limited information Preparing a patient for an emergent disgnostic procedure) If a patient is highly anxious but it is vital for information to be given, telling is effective. The nurse outlines the task the patient will perform and gives explicit instructions. No opportunity for feedback with this method. o Participating: the nurse and the patient set objectives and become involved in the learning process together. There IS opportunity to for discussion, feedback, mutual goal setting, and revision of the teaching plan. Collaborating on developing an appropriate teaching plan. Review the objectives together, determine if they were met, and plan what will be covered in the next session. o Entrusting: provides the patient the opportunity to manage self care. The nurse observes the patients progress and remains available to assist without introducing more new information.
Fundamentals ch 25 study guide
Course: Health Assessment I (NR-302)
University: Chamberlain University
