Exam 8 Client Education Flashcards
The basic purpose of teaching and counseling is to
Help patients and families develop the self-care abilities (knowledge, attitude, skills) they need to maximize their functioning and quality of life (or have a dignified death.)
Patient education
The process of influencing the patient’s behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health.
Teach provides
The knowledge patients need to make an informed healthcare decision and to implement a plan of care.
Counseling provides the
Resources and support patients need to participate actively in self care and to facilitate their coping with what cannot be changed.
Why do we educate?
- Maintain and promote health
- Prevent illness
- Restore health
- Facilitate coping
- Improve quality of care
- Reduction in health care cost
Maintains and promoting health
Nurses help patients to value health and develop specific health practices that promote wellness.
Restoring health
All patient teaching and counseling focus on developing self care practices that promote recovery.
Facilitating coping
Work not only with the patient, but also with the families and friends to help them to come to terms with patients illness and whatever lifestyle changes are needed.
Learning
The process by which a person acquires or increases knowledge or changes behavior in a measurable way as a result of the experience.
Much patient education focuses on three critical areas:
Preparation for receiving care
Preparation before discharge from a healthcare facility documentation of patient education activity
TEACH
T-tune into the patient E-edit patient information A-act on every teaching moment C-clarify often H-honor the patient as a partner in the education process
Three critical developmental areas to consider when developing a teaching plan
1 patients physical maturation and abilities
2 psychosocial development,
3 cognitive capacity
Other teaching learning process
Patients emotional maturity and moral and spiritual development.
Pedagogy
Teaching of children and adolescents.
Andragogy
The study of teaching adults
Teaching adult learners must believe
They need to learn before they are willing to learn.
May need to be shown the importance of learning new information, health practices, or skills.
Developing a teaching plan for older adults
Identify any learning barriers such as sensory loss, limited physical mobility, or inability to comply.
Successful teaching plans for older adults
Extra time Short teaching sessions Accommodations for sensory deficits Reduction of environmental distractions Instructions that relates new information to familiar activities or information.
The Cope Model
C:creativity
Help the family to overcome obstacles to carrying out healthcare management and learning how to generate alternatives.
O:optimism
Help the family caregivers learn how to view the caregiving situation with confidence.
P:planing
Help the family learn how to plan for future problems and to develop contingency plans that reduce uncertainty
E:expert information
Help the family learn how to obtain expert information from healthcare providers about what to do in specific situations. This information empowers caregivers by encouraging them to develop plans for solving caregiving problems.
Culturally competent patient teaching
Develop an understanding of the patients culture.
Work with a multicultural team in developing educational programs.
Be aware of personal Assumptions, biases, and prejudices.
Understand the cultural values of the patient or group.
Develop written materials in the patients native language.
Use testimonials of persons with the same cultural background as the patient.
Literacy
The ability to read and write needed to function successfully in our society.
Health literacy
The ability to read, understand, and act on health information.
The Ask me 3
What is my main problem
What do I need to do
Why is it important for me to do this
( the three questions patients should ask. If not then we should answer them in our teaching in plain language that they can understand.)
Patients learn in three domains
Cognitive
Psychomotor
Affective
Cognitive learning
The storing and recalling of new knowledge in the brain.
Learning includes intellectual behaviors such as: acquisition of knowledge, comprehension, application, analysis, synthesis, and evaluation.
Psychomotor learning
a physical skill involving the integration of mental and muscular activity .
Affective learning
Changes in attitudes, values, and feeling
Effective communication techniques
Be sincere and honest, show genuine interest
Avoid giving too much detail, stick to the basics.
Ask if the patient has any questions
Be a cheerleader for the patient. Avoid lecturing
Use simple words.
Vary your tone of voice
Keep the content clear
Listen and do not interrupt when the patient speaks.
Assessment parameters: factors that affect learning
- Knowledge, attitudes, and skills needed for the patient and family to manage healthcare independently.
- Readiness to lean
- Ability to learn
- Learning strengths
Promoting patient family compliance
Be certain that healthcare instructions are understandable and designed to support patient goals.
Include the patient and family as partners in teaching learning process.
Use interactive teaching strategies
Remember that teaching and learning are process that rely on strong interpersonal relationship with patients and their families.
Suggested teaching strategies for the three learning domains
Cognitive domain - lecture or discussion, panel discussion, discovery, audiovisual materials, printed materials, programmed instruction, computer-assisted instruction programs.
Affective domain - role modeling, discussion, panel discussion, audiovisual materials, role playing, printed materials.
Psychomotor domain - demonstration, discovery, audiovisual materials, printed materials.
Descriptions of common teaching strategies
Role modeling - “Actions speak louder than word”. Patients watch their nurses closely.
Lecture - presentation of information to patient, allow time for questions and answers.
Discussion - two-way exchange of information, ideas, and feeling.
Panel discussion - presentation of information by two or more people.
Demonstration - techniques, procedures, exercise, and the use of special equipment, combine with a lecture and discussion, is an effective strategy. Patients learning can be evaluated by return demonstration.
Discovery - a problem or situation is presented to the patient or group of patients, who are then guided to discover the solution or approach. Good method for teaching problem-solving techniques and independent thinking.
Role playing-gives the learner a chance to experience, relive, or anticipate an event.
More teaching aids
Audiovisual materials-such as computer programs, online courses, PowerPoint presentations, film, television programs, video-tapes, overhead transparencies, flip charts, posters, and diagrams are popular and effective teaching strategies.
Printed materials.
Programmed instruction-patients can use them independently.
Web-based instruction-web sites appropriate to the patients disease process.
Contractual agreements
A pact between two people setting out mutually agreed on goals. Contracts between nurses and patients are usually informal and not legally binding.
Informal teaching
Unplanned teaching sessions that deals with the patients immediate needs and concerns.
Formal teaching
Planned teaching done to fulfill learner outcomes.
Evaluating learning outcome
Some type of proof or feedback that the patient has learned what you taught.
Methods of evaluation
Cognitive domain - oral questioning the patient. Level of Knowledge of subject
Affective domain - patients response to direct questions.
Reintroduce the topic at a later time to see if patient still understand without discussing topic first.
Observational skills.
Positive reinforcement
To affirm the efforts of patients who have mastered new skills, knowledge or attitudes.
Negative reinforcement
Is usually ignored and is generally ineffective.
Common teaching mistakes
Ignoring the restrictions of the patients environment.
Failing to accept that patients have the right to change their mind.
Using medical jargon
Failing to negotiate goals
Duplicating teaching that other team member have done.
Overloading the patient with information
Choosing the wrong time for teaching
Not evaluating what the patient has learned.
Not reviewing educational media, or relying exclusively on media
Failing to document patient teaching and plan for follow-up or teaching reinforcement.
Documenting
The nurse is legally responsible for documenting teaching in the patients record.
Documentation of the teaching learning process includes:
Summary of the learning need
The plan
The implementation of the plan
The evaluation results.
The evaluation statement is crucial
And must show concrete evidence that demonstrates that learning has occurred.
If desired learning has not occurred your notes should indicate how the problem was resolved.
Counseling
The interpersonal process of helping patients to make decisions that promote their overall well-being.
Short term counseling
Focuses on the immediate problem or concern of the patient or family.
Situational crisis
When a patient faces an event or situation that causes a disruption in life.
Long term counseling
Extends over a prolonged period.
Developmental crisis
When a person is going through a developmental stage or passage. Such as women going through menopause.
Four skills effective in motivational interviewing
Reflective listening - restate the patients response back to him or her.
Asking open questions - encourages discussion of the reason for making desired changes.
Affirming - supports the patient’s efforts and encourages further exploration
Summarizing - links and reinforces material that has been discussed
Noncompliance with a therapeutic regimen can be a significant problem for elderly people. Which of the following is one of the common reasons for noncompliance in the elderly? A. Lack of time B. religious practice. C. Childlike behavior D. Inadequate financial resources.
D. Noncompliance is often associated with inadequate finances, along with factors such as patient confusion, disappointment, misunderstanding,or fear.
A nurse is preparing to teach a 45-year old patient with asthma how to use his inhaler. One of the best methods to teach the patient this skill is by: A. Demonstration B. lecture C. Discussion D. Panel session
A. Demonstration of techniques, procedures, exercises, and the use of special equipment is an effective patient teaching strategy.
A nurse has taught a diabetic patient how to administer his daily insulin. The nurse should evaluate the teaching-learning process by:
A. Determine the patients motivation to learn
B. deciding if the learning outcomes have been achieved
C. Allowing the patient to practice the skill he has just learned
D. Documenting the teaching session in the patients medical record.
B. the nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning. The key to evaluation is meeting the learned outcomes stated in the teaching plan.
A nurse is using the health belief model to assess a patient. Using this model, what should the nurse begin to understand?
A. Which clinical and financial resources the patient requires to improve his lifestyle
B. what motivates the patient to learn new behaviors
C. The effect the health delivery system has on the patients health problem.
D. Whether the patient is willing to take actions to support health.
D. The health belief model is designed to explain why persons are willing to take action to support their health.
Nurses play a vital role in patient teaching because of their: A. Need for self-actualization B. expertise in healthcare C. Desire to help others D. Ability to provide illness care
B. nurses who are skilled educators can improve patients health and well being. It’s is a function of their education and experience and their use of cognitive, technical, interpersonal, and ethical/legal skills.
One of the best ways to affirm the efforts of patients who master new knowledge, attitudes, or skills is through:
A. Dialog and discussion
B. a grading scale
C. Positive reinforcement
D. Encouraging the family to learn with the patient.
C. People feel encouraged and supportive when their efforts are acknowledge by another person, especially when they trust and value that other person.
The primary purpose of a contractual agreement between nurse and patients when beginning a teaching plan is to:
A. Create a formal and legal bond between the nurse and patient
B. motivate both the patient and nurse to do what is necessary to meet the patients learning outcomes.
C. Outline the patients learning outcomes.
D. Limit the scope of the teaching session.
B. a contractual agreement is a pact between two people make, setting out mutually agreed on goals
When using facts from the patients medical record as part of the necessary information to assess learning needs, the nurse is using which type of data source? A. Primary B. historic C. Secondary D. Hospital-owned.
C. Past and current patient medical records are considered secondary of informational and can provide a history of medical problems as well as documentation of nursing, diagnoses, and interventions
When preparing a health promotion program for patients in an adult daycare center, what is the first step the nurse must take?
A. Develop learning outcomes
B. develop a teachings plan
C. Assess the patients learning needs and learning readiness
D. Diagnosis the patients learning needs
C. The first step of the teaching-learning process is to assess the patients learning need and learning readiness
A nurse instructs a group of parents about how to make their home safe for their toddlers. This is an example of teaching aimed toward which of the following? A. Restoring health B. facilitating coping C. Preventing illness D. Promoting health
C. Through assessment of the patients learning needs may revel the need for vehicular safety, home safety, domestic violence recognition, recreation safety, and occupational safety, and health education. This type of patient education is aimed at enhancing health protecting behaviors.
8 ways to waste time teaching
- Assumption
- Teach before you know who you are teaching
- Talk talk talk
- Lecture
- Don’t let learner interrupt you
- Listen in a hurry
- Ignore or make light of learners concerns
- Teach when the problem is not a lack of information.
No Time To Teach by Fran London MS, RN
Tell me…….. I’ll forget
Show me……. I’ll remember
Involve me…….I’ll understand
Teaching plan communicates the following information to all members of the nursing team
The nursing diagnoses that specifically relate to the patients learning needs and the priorities of these diagnoses.
The goals of the teaching strategies.
The teaching strategies that are appropriate for goal attainment.
The expected outcomes, which identify the desired behavioral responses of the learner.
The critical time period within which each outcome is expected to be met.
The patients behavioral responses ( which are documented on the teaching plan).
