Fundamentals - Ch. 9 Patient Teaching and Health Promotion
Terms in this set (40)
mode of learning where individuals learn visually, through what they see
mode of learning where individuals learn aurally, through what they hear
mode of learning where individuals learn by actually performing the task or handling items
the material is presented in a way that appeals to the learners beliefs, feelings, and values
the learner takes in and processes information by listening to or reading the material
the learner processes the information by performing an action or carrying out a task
represent the desire changes or additions to current behaviors and attitudes; they state what you are trying to teach the patient to do.
a review or patient demonstration of what has previously been learned or demonstrated (ex. Nurse taught patient how to draw up insulin on pg 120)
return of information and how it was interpreted
What is the ultimate goal of patient teaching?
the prevention of illness, promotion of wellness, and restoration of health
Nurses teach their patients about their:
disease or disorder
surgery / treatment
occurs when the patient is at an optimal level of readiness to learn and apply a particular piece of information
What does preoperative care cover?
the various phases of the surgery, what will be experienced, what can be expected, and the exercises to be done afterward
What must a patient be taught before being discharged?
proper home care
Patient teaching contributes to achievement of the goals of
Healthy People 2020, a program of the U.S. Department of Health and Human Services, and the Health Goals for Canada.
An objective of Healthy People 2020 is to
"attain high quality, longer lives free of preventable disease, disability, injury, and premature death."
requires looking ahead to meet the patient's ongoing needs at home; this process begins at time of admission
The planning of a patient discharge includes:
assessing for special needs, learning to identify for appropriate teaching moments, and providing learning opportunities that are brief and focused on preparing the patient for self-care
In order to prepare a teaching plan, what do you need to know prior?
what the patient's learning needs are: what does the patient need to know about the disease or condition, diet (if related to disease or condition), activity regimen or limitations, medications (prescription and OTC), wound care, treatments, or self-care at home?
*Prioritize learning needs so you can concentrate on teaching essential knowledge first
Focused assessment for teaching and learning
any barriers to learning
ability to learn
cultural factors to be considered
language level and literacy; need for interpreter
patient's health benefits
emotional and physical readiness to learn
patient's learning goals
patient's best learning style
family support and availability
concerns about learning skills
concerns about care after discharge
materials available for teaching
location for teaching with appropriate environment
times when teaching could take place
Factors affecting learning:
poor vision or hearing, impaired motor function, illiteracy, and impaired cognition; age may also interfere with the strength or dexterity for performing certain tasks.
pain, nausea, fatigue, a sense of being overwhelmed by all that is happening, and multiple interruptions
Cultural values and expectations affecting learning:
Need to work within patient's values and cultural system.
Values and expectations can interfere with patient's ability to cooperate and learn needed skills for self-care.
Confidence and ability
Often patients express a lack of self-confidence, saying, "I'll never be able to do that." You have to explore these feelings carefully, enhancing their self-esteem rather than harming. Praise and encouragement go much further than admonishment in promoting needing learning. The teaching may be needed be broken down into small steps.
Special considerations for teaching the elderly
Provide written material
Provide good lighting
Provide good teaching material in large print
Encourage patient to wear glasses if needed
Encourage patient to wear and adjust hearing aids
Use short sentences and pause frequently
Keep medical terms to a minimum
Ask questions at frequent intervals
State the most important points first, and repeat them at the end of the session
Some patients who speak English as a second language may not be able to read English, even if they are fully literate in their own language. What should the nurse do?
Offer printed & audiovisual materials in their native language, if available. If English is limited, use an interpreter for teaching sessions. When printed materials are used, go over them with the patient & ask questions to determine whether they understood the information. Be aware of patient's education level so you can tailor your vocabulary and teaching material, but avoid talking down to people.
Why should you assess what patients already know about the skills they need to learn?
so that you can build on their current knowledge base
Should you assume the patient is literate?
Never. Many adults have gotten through school without learning to read adequately and they may have spent a lifetime hiding this fact from everyone. A teaching plan that incorporates visual and kinesthetic techniques will often be the most effective for these individuals.
Readiness to learn
Assess the patient's readiness to learn.
Motivation plays a large role in effective learning.
The desire to return to independence or the comfort of home is often the motivating factor.
Work with patients to show them the advantage of learning what they need to know.
When will teaching sessions be more successful?
When the patient is comfortable, well rested and there are a minimum of interruptions. Always begin by establishing rapport and developing trust, and maintain a warm, sincere attitude.
Preparing a teaching plan includes:
Analyzing assessment data
Establishment behavioral objectives or goals
Creating a plan to assist patient in reaching the goals in a timely and effective manner
Who is allowed to have input in the development of the teaching plan?
It is essential that it is developed collaboratively, with input from all of the disciplines involved in the patient's care.
"Patient will change the wound dressing using aseptic technique" is a ____________________ objective.
behavioral; behavioral objectives should be stated in terms that make their achievement easy to evaluate. You would evaluate that objective by watching the patient change the wound dressing and determining whether correct aseptic technique was used.
The teaching plan is part of the
care plan. Some agencies use a separate form for the teaching plan so that there is plenty of room to note the specifics. Specialty areas may have a standardized teaching plan.
Resources for teaching
books, audiovisual materials, pamphlets, and hands-on equipment
local government agencies often provide printed and online listings of community public service programs
hospital social workers and representatives are also good sources of information
Some instructional materials are designed to assist the medical professional, and others are directed to the patient.
She internet has a wide variety of resources available for patient teaching.
NIH - National Institutes of Health
CDC - Centers for Disease Control and Prevention
NIMH - National Institute for Mental Health
Implementing the Plan
Begin by establishing a time with the with the patient to begin the teaching
Teaching done when visitors, physician rounds, and treatments will not cause interruptions
One-on-one or in a group setting
Patient should be comfortable
Keep teaching session short
Involve patient in the process
You may need to incorporate teaching into daily care
Involves obtaining feedback from the patient regarding what was taught; Uses the feedback to determine whether effective learning has in fact taken place.
(Evaluating the effectiveness of teaching is critical to the success of the process)
Every staff nurse is legally responsible for providing patient education; documentation is essential.
Patient education flow sheet may be used
Nurse's note should include:
-Specific content taught
-Method of teaching used
-Evidence of evaluation with specific results
Coordination with Discharge Planning
Patients may be discharged home before necessary learning is complete. Specific learning needs should be discussed with all involved parties, including the patient, and the plan for teaching shared with PCP, home health services, family or significant others. Printed plan must be sent home with the patient.
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