NUR 101: Health Education and Patient Care

Overview of Education in Health Care

• Health education is a significant aspect of nursing practice, and nurses play a crucial role in teaching patients, families, and nursing staff/students.
• The chapter aims to shed light on the historical evolution of patient education in health care and the nurse's role as a teacher.

Historical Foundations for Patient Education in Health Care

• Patient education has been a part of health care since the first healer gave advice to patients (May, 1999).
• Early healers, such as physicians, herbalists, midwives, and shamans, educated patients on hygienic and therapeutic measures (Bartlett, 1986).
• The National League of Nursing Education (NLNE) recognized the importance of health teaching as a function within the scope of nursing practice (1918).
• Organizations such as the American Nurses Association (ANA), International Council of Nurses (ICN), State Nurse Practice Acts, Joint Commission (JCAHO), and American Hospital Association (AHA) have promoted health education as an essential component of nursing care delivery.

Historical Development in Health Education

• Mid-1800s: Nursing was acknowledged as a unique discipline, and teaching became an important role of nurses as caregivers (promoting health of the well public).
• Early 1900s: Public health nurses in the US understood the significance of the nurse's role as a teacher in preventing disease and maintaining health.
• Florence Nightingale, considered the ultimate educator, emphasized the importance of teaching patients and healthcare professionals about proper conditions in hospitals and homes to improve health.
• 1918: The National League of Nursing Education (NLNE) identified course content for nursing school curricula to prepare nurses to assume the role of teachers.
• 1950s: The first references to patient education appeared in the literature, and patient education began to be seen as a specific task (Falvo, 2004).
• 1960s and 1970s: Patient education focused on educating individual patients, and hospitals became involved in various education programs and projects.
• 1980s and 1990s: National health education programs focused on disease prevention and health promotion.

The Evolution of the Teaching Role of Nurses

• Nursing was first acknowledged as a unique discipline in the mid-1800s, and the responsibility for teaching was recognized as an important role of nurses as caregivers.
• By the early 1900s, public health nurses in the US understood the significance of the nurse's role as a teacher in preventing disease and maintaining health.
• The National League of Nursing Education (NLNE) observed the importance of health teaching as a function within the scope of nursing practice (1918).
• Today, the Certified Nurse Educator (CNE) exam has been developed to raise the visibility and status of the academic nurse educator role (NLN, 2006).

Social, Economic, and Political Trends Affecting Health Care

• Achieving national priorities in health care, such as reducing the costs of health care, preventing disease, and promoting health, requires a focus on patient and family education.
• Universal accessibility to health care, greater emphasis on outcome measures, and recognition of the economic and social values of health education are significant trends influencing health care practice.
• Consumers are demanding increased knowledge and skills about how to care for themselves and prevent disease, and self-help groups are becoming more prevalent.
• Demographic trends, such as the aging of the population, require nurses to emphasize self-reliance and maintenance of a healthy status over an extended life span.

Purposes, Goals, and Benefits of Patient and Nursing Staff/Student Education

• The purpose of patient education is to increase the competence and confidence of patients to manage their own self-care, and of staff and students to deliver high-quality care.
• Benefits of patient education include increased consumer satisfaction, improved quality of life, ensured continuity of care, reduced incidence of illness complications, increased compliance with treatment, decreased anxiety, and maximized independence.
• Benefits of education to staff include enhanced job satisfaction, improved therapeutic relationships, increased autonomy in practice, and improved knowledge and skills.
• Benefits of preceptor education for nursing students include prepared clinical preceptors, continuity of teaching/learning from classroom curriculum, and evaluation and improvement of student clinical skills.

The Education Process Defined

• The education process is a systematic, sequential, planned course of action on the part of both the teacher and learner to achieve the outcomes of teaching and learning.
• The education process focuses on the planning and implementation of teaching based on an assessment and prioritization of the client's learning needs, readiness to learn, and learning styles.### Teaching/Instruction
• Deliberate intervention involving sharing information and experiences to meet intended learner outcomes

Learning

• Change in behavior (knowledge, skills, and attitudes) that can be observed and measured, occurring at any time or place due to environmental stimuli

Patient Education

• Process of helping clients learn health-related behaviors to achieve optimal health and independence in self-care

Staff Education

• Process of helping nurses acquire knowledge, attitudes, and skills to improve delivery of quality care to consumers

ASSURE Model

• A useful paradigm to assist nurses in organizing and carrying out the education process
  • Analyze the learner
  • State objectives
  • Select instructional methods and materials
  • Use teaching materials
  • Require learner performance
  • Evaluate/revise the teaching/learning process

The Contemporary Role of the Nurse as Educator

• Must have a solid foundation in principles of teaching and learning
• Recognize theories in nursing and educational psychology that provide frameworks
• Examples of theories: Dorothy Orem's Self-Care Theory, Betty Neuman's Systems Model Theory, Watson's Theory of Human Caring, Patricia Benner's Novice to Expert Theory
• Role of educator is not primarily to teach but to promote learning and provide an environment conducive to learning
• Legal and accreditation mandates, as well as professional nursing standards of practice, have made the educator role of the nurse an integral part of high-quality care
• Nurses will need to learn basic principles of teaching and how to apply them

Nursing Education Transformation

• Six key areas:
  • Entrance into nursing education
  • Pathways for nursing education
  • Student population characteristics
  • Student experiences
  • Teaching in nursing and transition into practice
  • Professional oversight of nursing education and practice

Patient Engagement

• Guide patient-provider relationships for the improvement of quality and safety in care delivery
• Six dimensions of quality outlined in the Crossing the Quality Chasm report that need improvement:
  • Safety
  • Effectiveness
  • Patient-centeredness
  • Timeliness
  • Efficiency
  • Equity

Quality and Safety Education in Nursing (QSEN)

• Project to educate nursing students on patient safety and healthcare quality
• Key areas:
  • Patient-centered care
  • Teamwork and collaboration
  • Evidence-based practice
  • Informatics
  • Safety

Barriers to Teaching and Obstacles to Learning

• Factors that impede the nurse's ability to deliver educational services or negatively affect the learner's ability to pay attention and process information
• Examples: environment, organization's culture, level of cooperation between disciplines, beliefs and knowledge of team members, types of patient education activities, and patient population