Nursing Fundamentals: Client Education

Course Information

• Course name: Nursing Fundamentals
• Module: Client Education
• Module presenter: Peter Kennedy RN, BScN, MBA
• Date presented: October 31, 2024
• Course code: BNUR1900

Learning Objectives

• Students will develop an understanding of the role of education in nursing care.
• Students will identify and apply the domains of learning to nursing care
• Students will identify how to assess a client's basic learning needs
• Students will identify strategies to utilize for effective teaching within the context of the older adult (with consideration of cognitive, neurological, and sensory deficits).

Entry to Practice Competencies

• Incorporate knowledge from nursing science, social sciences, humanities, and health-related research into plans of care
• Adapt practice in response to spiritual beliefs and cultural practices of clients
• Support clients in navigating healthcare systems to optimize health and well-being
• Assist clients in accessing, reviewing, and evaluating information using ICTs

Overview of Patient/Client Education

• Patient education may be subtle or formal, occurring across every shift
• Nurses must combine theoretical knowledge, communication skills, and knowledge of teaching/learning to deliver complete care
• Nurses have a shared responsibility to facilitate client-centered learning respectful of individual needs and perspectives

Knowing Your Own Learning Style

• Students were required to complete a self-assessment to identify their personal learning style
• Students should reflect individually on their results and determine if they align with their self-perception
• Students should individually consider if they identify with a different learning style

Knowing the Learning Style of Others

• It is important to understand different learning styles
• Assessing individual learning styles may not be possible, but nurses should develop understanding through interactions with patients

Understanding Context

• Nurses must consider context when educating patients

Goal of Patient Education

• Assist individuals, families, or communities in achieving optimal health
• Maintain and promote health, preventing illness
• Restore health
• Optimize quality of life with impaired functioning

Maintaining and Promoting Health and Preventing Illness

• Nurses provide information and skills for maintaining, managing, and improving health across healthcare settings
• Increased health awareness leads to managing health proactively and seeking early diagnosis

Restoring Health

• Many seek information and skills to manage, regain, or maintain health
• Adapting to illness or diagnosis can be challenging
• Family often plays a significant role in the health journey and requires support

Optimizing Quality of Life with Impaired Function

• Identifying patient needs is essential
• Determining the family's willingness to help patients is crucial
• Educating families to support patients in health care management is important

Teaching and Learning

• Teaching is an interactive process that promotes learning, most effective when it aligns with learner needs, style, and capacity
• Learning involves the purposeful acquisition of knowledge, skills, behaviors, and attitudes
• Teaching commonly occurs when a learner identifies a need to know or acquire more knowledge about a topic
• Effective teaching critically depends on effective communication (listening and speaking)

Patient/Client Education

• Aims to help individuals, families, or communities achieve optimal health
• Develops knowledge and skills to improve lifestyle choices and health outcomes, positively affecting healthcare systems

Nursing Role in Teaching and Learning

• Creating an environment conducive to learning is vital
• Utilizing a patient-centred approach for assessing learning needs is important
• Employing the most suitable teaching strategy is crucial
• Nurses are ethically responsible for teaching patients and empowering them to manage their health

Informed Decision-Making

• Patients have the right to make informed decisions about their health
• Information provided must be accurate, complete, and relevant to the patient's needs
• Nurses must determine learning needs of patients
• Nurses need to determine appropriate time and place, evaluate learning readiness, and assess the impact of education on outcomes

How Teaching Fits in With Professional Responsibilities

• A teaching plan must consider learners' diverse needs comprehensively
• A sound teaching plan can improve the quality of care, optimize wellness, increase independence, and lower healthcare costs

How Does Teaching Fit in With Professional Responsibilities?

• Utilize all nursing skills to assess individual learning needs
• Verbal/communication, observation, and understanding cultural, social, and familial influences on emotions, attitudes, behaviors play critical roles
• Nurses must focus on learner's needs.

Teaching as Communication

• Teaching mirrors the principles of effective communication.
• Effective interpersonal communication is essential for effective teaching

Case Study (Mr. and Mrs. Bennet)

• Anti-malarial drug use concerns and miscommunication about side effects and necessity
• Importance of accurately addressing patient/family concerns related to health decisions

Domains of Learning

• Cognitive learning involves recalling, understanding, applying, analyzing, evaluating, creating

Cognitive Learning

• Understand Bloom's Taxonomy.

Affective Learning

• Internalizing Values
• Organizing values
• Valuing
• Responding
• Receiving

Psychomotor Learning

• Divided into subcategories based on actions, from perceptual to complex

Teaching Methods Based on Domains of Learning

• Understand cognitive (Discussion, Storytelling, Lecutre etc), affective(Role play, Discussion) and psychomotor(Demonstration, practice) learning domains learning.

Basic Learning Principles

• Nurses must understand how people learn

Learning Environment

• An ideal learning environment is well-lit, well-ventilated, comfortable, quiet, and private, with appropriate furniture.
• Learning can occur in various settings: hospital rooms, classrooms, community centers, or homes

Ability to Learn

• Emotional, intellectual, and physical capabilities affect learning
• Individual developmental stages influence learning
• Consider learners' emotional state or anxiety level
• Assess cognitive ability
• Understand patient's physical capabilities

Learning Style and Preference

• Everyone learns in different ways (Visual, kinesthetic etc.)
• Factors such as environmental, social, emotional, and physical stimuli contribute to learning styles
• Consider and adapt to diverse learning styles

Motivation to Learn

• Motivation is a key factor for successful learning
• Social motives and task mastery are involved in learning motivation
• Physical motives play a role in learning motivation

Motivation and Social Learning Theory

• Social Learning theory can help educators understand learners and provide interventions to improve motivation and learning
• Believing they can effectively execute a behavior increases a person's likelihood of performing it consistently.
• Self-efficacy refers to a person's confidence in their ability to perform a task effectively

Motivation and Transtheoretical Model of Change

• Understand the stages of change and how nurses can support patients throughout the process of change.
• Provide positive reinforcement and encouragement to patients at each stage of change.

RNAO BPG Facilitating Client-Centered Learning (CLL)

• Client-centred care prioritizes the patient as a partner in their own care
• Patients have access to more health information than ever before
• RNAO provides guidelines for client-centred learning to meet patients' needs rather than assuming needs

A Patient-Centered Approach to Patient Education

• Patient-centered care focuses on the patient as a partner in care delivery.
• The LEARNS model uses social learning theory to support a patient-centered approach to learning

LEARNS Model

• This is a model to help nurses develop client centered learning plans
• A safe, shame-, and blame-free environment supports learning
• This model focuses on listening to the patient for needs, establishing therapeutic relationships, and adapting the learning encounter to suit patients.

Nursing and Teaching Process

• Assessment
• Analysis
• Planning
• Implementation
• Evaluation

Learning Objectives

• Specific, Measurable, Attainable, Relevant, Time-bound goals (SMART goals)

Teaching Approaches

• Telling, Selling, Participating, Entrusting, Reinforcing

Learning Activity

• Review an assigned article and reach consensus on key message (s).

Teach Back

• Teach Back is a method for ensuring clear information transmission and learner comprehension, not a test of the learner.
• Asking patients to reiterate in their words what they've learned assesses their comprehension.
• Further teaching might be necessary for improved comprehension.

Health Literacy

• Personal health literacy and organizational health literacy are important concepts to understand how individuals and organizations support heath literacy.
• Understand principles of effective health literacy
• Communicate effectively and appropriately to all patients

Health Literacy Universal Precautions

• Simplifies communication, minimizes miscommunication
• Creates accessible healthcare environments, supporting patient efforts for health improvement

Learning in Later Life

• Geragogy applies principles of adult learning theory to teaching older people.
• Teaching should relate to existing knowledge and focus on concrete, practical information, accounting for potential social and medical complexities.
• Pace teaching according to individual stamina.
• Consider different data collection methods (self-report, proxy, observation)

Learning in Later Life

• Older adults are still capable of acquiring knowledge and building connections
• Encourage active participation in new learning and assess for health literacy
• Consider their highest level of education and provide information accordingly, starting with the most important information.
• The Teach Back method might help to confirm learner comprehension.

Application to the Older Person

• Assessment of health history, physical and functional capabilities, mental status, and social support is critical.
• Consider utilizing integrated assessment tools to account for social and economic resources.
• Be mindful of any significant issues (e.g., SPICES) impacting learning.

Perpetual Case Study

• Scenario involving a patient and family needing education on new diabetes.
• Identifying teaching priorities for various individuals.
• Practical application of learning domains and communication strategies to complex situations.

Questions

• Various questions regarding teaching priorities, domains, client communication, and identified learning domains to consider and address.