Importance of Quality Patient Education due to: 1. Shorter hospital stays
2. increase # of ill patients
3. increase demand on nurses’ time
4. need to give acute pts meaningful informationWell-designed, comprehensive teaching plans fit pt’s unique learning needs to: 1. reduce health care costs
2. improve quality of care
3. change behaviors to improve pt outcomes ONCH. 25 TEACHING AND LEARNING SPECIFICALLY FOR YOUFOR ONLY$13. 90/PAGEOrder NowPurpose of Patient Education1. Maintainence & Promotion of Health and Illness Program
2. Restoration of Health (get back to baseline)
3. Coping with Impaired FunctionsMaintenance & Promotions of Health & Illness1. Nurses resources in school, clinic, workplace who provide info that enable pts to assume healthier behaviors.
2. When pts become more halth conscious they seek early diagnoses of health problems. Restoration of Health1. Ill pt need inormation & skills to help them regain their levels of health.
2. Nurse learn to identify pt’s willigness & motivation to learn.
3. Include famlily but don’t expect the to do it. Coping wih impaired Functions1. Many learn to cope with permanent health alterations.
2. New knowlede & skills taught for ADLs
3. Comparing desired with actual state enables you to plan effective teaching programs. Teachingis an interactive process that promotes learning. Learningpurposeful acquisition of new knowledge, attitudes, behaviors and skills. Role of Nursing in Teaching & LearningNurses have an ethical responsibility to teach their patients. Teach information that pts and family need. Teaching As Communication ProcessNeed effective interpersonal communication. Teacher & learner become involved and increase learner’s knowledge & skills. Steps of Teaching Process1. identify a need – use pt request or perceive need based on diagnosis
2. identify specific learning objective – what pt will ne able to do after instruction
3. nurse sender who conveys the message
4. pt is the receiver/learner
5. feedback & evaluation – mechansim to eval success, with positive reinforcementDomains of Learning1. Cognitive
2. Affective Learning
Utilize 1 or all 3Cognitive Learningincludes all intellectual behaviors, requires thinking:
*synthesis – break down create something new
*evaluation – (hardest)Affective Learninghardest of all 3. Deals with expression of feelings and acceptance of attitutudes, opinions, or values:
*characterizing (most complex)Psychomotor Learninginvolves acquiring skills that require integration of mental and muscular activity:
*origination (most complex)How People Learn:*motivation – influences your teaching approach
*motivation influenced by previous knowledge, experience, attitudes & sociocultural factors
*physical and cognitive attributes
*intellectual thought process
*learning style affets preferences for learningMotivation to Learn Based On:*Attention Set
*Use of Theoy to Enhance Motivation & Learning
*Self efficacyAttention Set*Physical discomfort, anxiety & environmental distractions influence the ability to attend.
*Mild level of anxiety motivates learning
*High level prevents learning
*Manage pt’s anxiety before educating to improve comprehensionMotivationforce that acts within person to cause the person to behave in a particular way:
1. social motive – need to connect, approval or self-esteem
2. task mastery motive – based on achievement and competence
3. physical motive – return to level of normalcy
*none have an effect unless the person believes health is importantSelf-Efficacyconcept included in social learning theory which refers to person’s ability to sucessfully complete a task. Social Learning Theorystates people continuosuly attempt to control events that affect their livesUse of Theory to Enhance Motivationuse various interventions based on theory when developing pt education plans, attitudes and vales not easy to change by simply teaching factsPsychosocial Adaptation to IllnessPt needs to grieve. Readiness to learn related to stage of grieving. When pt enters stage of acceptance, stage compatible with learning introduce teaching plan. Emotional response to Illness1. Denial – pt avoids discussion, provide support & careful explanations of all procedures
2. Anger – pt blames & complains, dont argue, listen, teach in present tense
5. Acceptance – pt recognizes reality of condition, activly persues info, focus teaching on future skills & knowledgeActive Participationlearning occurs when pt is actively involved in educational sessions. For example after parking lot demo, pt able to determine which type of car seat fits their car and easist to use. Ability to Learn1. Development Capability – know pt’s level of knowledge and intellectual skills before beginning teaching plan.
2. Learning in Children – be creative, use aids that are developmentally appropiate
3. Adult Learning – responsible for changing their own behavior. Assess what pt knows & teach what pt wants to know, set mutual goals.
4. Physical Capability – do not overestimate pt’s development or status. Learning EnvironmentRoom well lit, good ventilation, appropiate furniture, and comfortable temperature, quiet setting with infrequent interruptions.
Group teaching – room small enough so everyone can see each other’s verbal and nonverbal responses. Assessment Teaching Processgather data abt pt’s learning needs, motivation, ability to learn, teaching resources frm pt & fam, learning environment, medical record, nursing history and literature. Diagnosis Teaching Processid pt’s learning needs on basis of 3 domains of learningPlanning Teaching Processestablish learning objectives stated in behavioral terms. Id priorities re: learning needs. Collaborate w/pt. id teaching method to use. Implementation Teaching Processinvolve pt in learning activities, include family caregiverEvaluation Teaching Processdetermine outcomes of teaching-learning process. Measure pt’s acheivement. reinforce info as neededHealth Literacycognitive and social skill that determine motivation & ability to use information to promote good health. Includes pt’s reading, math, comprehension, ability to make health-related decisions & consumer of healthRisk for Low Health Literacyelderly
chronic mental/physical health conditionsFunctional Illiteracyinability to read above 5th grade levelRaces for Low Health LiteracyHispanic – lowest
African/Native American/Alaska Native
White and Asian Pacific Islander – highestLower Health Literacy Scoresolder adults
no English before entering school
below poverty level
no h. s. educationA patient needs to learn to use a walker. Which domain is required for learning this skill?
A) Affective domain
B) Cognitive domain
C) Attentional domain
D) Psychomotor domainPsychomotor domainThe nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.)
A) When there are visitors in the room
B) When the patient’s pain medications are working
C) Just before lunch, when the patient is most awake and alert
D) When the patient is talking about current stressors in his or her lifeWhen the patient’s pain medications are working
Just before lunch, when the patient is most awake and alertA patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse’s best plan in teaching this patient?
A) Teach the patient’s spouse
B) Focus on knowledge the patient will need in a few weeks
C) Provide only the information that the patient needs to go home
D) Convince the patient that learning about her health is necessaryProvide only the information that the patient needs to go homeThe school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes?
A) Provide information using a lecture
B) Use simple words to promote understanding
C) Develop topics for discussion that require problem solving
D) Complete an extensive literature search focusing on eating disordersDevelop topics for discussion that require problem solvingA nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient’s ability to perform the examination?
A) The patient will verbalize the steps involved in breast self-examination within 1 week.
B) The nurse will explain the importance of performing breast self-examination once a month.
C) The patient will perform breast self-examination correctly on herself before the end of the teaching session.
D) The nurse will demonstrate breast self-examination on a breast model provided by the American Cancer Society. The patient will perform breast self-examination correctly on herself before the end of the teaching session. A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation?
A) Telling approach
B) Selling approach
C) Entrusting approach
D) Participating approachTelling approachThe nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby’s father, and the adolescent mother is asked to show how she would respond to the father if he gave her a can of beer. Which teaching approach did the nurse use?
A) Role play
C) An analogy
D) A demonstrationRole playAn older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse:
A) Speaks loudly.
B) Presents the information once.
C) Expects the patient to understand the information quickly.
D) Allows the patient time to express himself or herself and ask questions. Allows the patient time to express himself or herself and ask questions. A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn?
A) Describing difficulties a family member has had in taking insulin
B) Expressing the importance of learning the skill correctly
C) Being able to see and understand the markings on the syringe
D) Having the dexterity needed to prepare and inject the medicationExpressing the importance of learning the skill correctlyA patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use?
C) Group instruction
D) One-on-one discussionDemonstrationWhen a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use?
D) SimulationAnalogyA nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first?
A) How to use an inhaler during an asthma attack
B) The need to avoid people who smoke to prevent asthma attacks
C) Where to purchase a medical alert bracelet that says she has asthma
D) The importance of maintaining a healthy diet and exercising regularlyHow to use an inhaler during an asthma attackA nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing?
B) Restoring health
C) Coping with impaired function
D) Health promotion and illness preventionHealth promotion and illness preventionA nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of:
A) A teaching plan.
B) A learning objective.
C) Reinforcement of content.
D) Enhancing the children’s self-efficacy. A learning objective. A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this?
D) PsychomotorCognitivePatient Education (Potter Perry/PPT)… Patient Education
(reduces ___)Promotes optimal levels of health
Preventative education helps reduce health care costs and hardships3 Types of Patient EducationMaintenance and Promotion of Health and Illness Prevention
Restoration of Health
Coping with Impaired FunctionsNurse must establish ___ before teachingReport with patient/learner3 Types of Learning *Domains*Cognitive
PsychomotorCognitive (1/3 Domains of Leaning)
(type of learning)Intellectual *understanding* of knowledgeAffective (2/3 Domains of Leaning)
(type of learning)Expression of *attitudes* and acceptance of attitudes, opinions, or values
(ex. value clarification)Psychomotor (3/3 Domains of Leaning)
(to ensure effective learning..)Focuses on acquiring *skills* that require integration of mental and muscular activity (ex. using a fork)
Request *return demonstration* to validate effective learning3 Types of Basic Learning *Principles*Motivation to Learn
Ability to learn
Learning EnvironmentMotivation to Learn (1/3 of Basic Learning Principles)
(requires these three things..)Patient’s desire or willingness to learn
1. Attentional Set
3. *Self-Efficacy*Attentional Set (1/3 of Motivation to Learn)
(attentional set refers to..)
(___, ___, and ___ can limit attention set)Mental state of *paying attention*
Discomfort, *anxiety* (can motivate learning in small doses), environmental distractionsMotivation (2/3 of Motivation to Learn)
(3 types of motivaiton and examples)The force that acts on or within a person
1. Social (seek approval from role models)
2. Task-Mastery (senior learns diabetes testing to gain independence)
3. Physical (patient with leg amputation wants to learn how to walk again)Self-Efficacy (3/3 of Motivation to Learn)
(4 sources and examples of self-efficacy are..)Believe in yourself
1. Enactive *Mastery Experiences* (pt completes skill)
2. Vicarious *(Demonstrative) Experiences* (demonstration)
3. *Verbal Persuasion* (express belief in pt’s ability)
4. *Physiological State* (positive effects from skill promote repeated use)Ability to Learn (2/3 of Basic Learning Principles)
(some conditions may ___)Some conditions may fatigue a patient and require the teaching to be postponedFactors that affect Ability to Learn include..
(6 types [1 big one])1. Physical Strength
2. Sensory Deficit
3. Reading Level
4. Developmental Level
5. Cognitive Function
6. Pain, Fatigue, *Anxiety*Learning Environment (3/3 of Basic Learning Principles)
(when using groups…)Allows a person to focus on the learning task
*Lighting, Ventilation, Furniture, Temperature, Noise, Privacy*
Position groups so everyone is facing each otherNursing Process and Teaching Process
(relation)Nursing Process and Teaching Process are *NOT* the sameNursing Process focuses on.. Focuses on the patient’s total health care needsTeaching Process focuses on.. Focuses on the patient’s learning needs and ability to learnNursing Process: Assessment
(example)Ask questions to *identify motivation to learn* (mobilization aid is motivating to move and regain a sense of freedom)Assess *Health Literacy*
(high-risk demographic)X5Cognitive and social skills that determine motivation and ability of individuals to access, understand, and use information
Identify and accommodate to patient’s learning style
Elderly, minorities, immigrants, low-income, and people with chronic mental and/or physical health conditionsAppropriate Time to Implement Teaching is when.. During a similar activity (ex. teach proper skin care techniques when performing skin care)The Ideal Teaching Duration is.. 10-15 minutesReinforcement can be…
(3 types and examples of reinforcement..)*Positive* or Negative
1. Social (ex. smiles, compliments, words of encouragement)
2. Material: works well with children (ex. food, toys, music)
3. Activity (ex. acquiring more *freedom*)In order for therapy to have an effect the patient must..
(example)No therapy has an effect unless a person believes that health is important (ex. patient with lung disease who continues to smoke)
Importance of Quality Patient Education due to: 1. Shorter hospital stays