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• A process aimed at encouraging people to want to be healthy, to know how to stay healthy, and to do what they can individually and collectively to maintain health and seek help when needed. "(Alma-Ata declaration, 1978)

Historical Foundations for Healthcare Education

• The start of nursing and other health professions, tech advances, focusing on the patient-caregiver relationship, the increase of tuberculosis and other communicable diseases, and the growing interest in the welfare of mothers and children all impacted patient education.
• Florence Nightingale advocated for the educational responsibilities of district public health nurses in nursing. She wrote "Health Teaching in Towns and Villages advocating for teaching health rules in schools and homes.
• Dreeben (2010) describes the first four decades of the 20th century as the second phase of the development of organized healthcare.
• The Division of Child Hygiene was established in NYC in 1908 where public health nurses taught new mothers how to care for their infants.
• The National League of Nursing Education (NLNE) recognized that public health nurses were essential to community well-being, considering their teaching a precursor to modern patient and health education.
• The third phase of organized healthcare development began after World War II, marked by scientific achievements and changes in healthcare delivery.
• Patient education continued as part of clinical encounters from the late 1940s through the 1950s, overshadowed by the technological focus of healthcare.
• The early 1950s saw the first references to patient education in literature.
• In 1953, Veterans Administration hospitals issued Patient Education and the Hospital Program, a technical bulletin.
• Patient education was seen as a specific task in the 1960s and 1970s, focusing on individual patient education rather than general public health education.
• Two significant events happened in 1971: the U.S. Department of Health, Education, and Welfare published "The Need for Patient Education" and President Richard Nixon sent a message to Congress using the term health education.
• Nixon appointed the President's Committee on Health Education recommending hospitals offer health education to patients' families.
• The American Hospital Association appointed a special committee on health education suggesting educational programs for patients were the responsibility of hospitals and healthcare institutions.
• Patient education was a key part of AHA's Statement on a Patient's Bill of Rights, which outlines a patient right to current healthcare information, in the early 1970s.
• "Patient right", the Bill of Rights reinforced the concept of patient education, making it an obligation and legal responsibility of health professionals,
• Patient education was also recognized as a factor that could affect the efficiency of the healthcare system and a condition of high-quality care.
• National health education programs gained popularity in the 1980s and 1990s as healthcare focused on disease prevention and health promotion.
• The Joint Commission (TJC) established nursing standards for patient education in recognition of its importance by nurses as early as 1993.
• These standards, known as mandates, specify the type, level of care, and services agencies must provide for accreditation.
• Required accreditation encouraged nursing service managers to emphasize unit-based clinical staff education for improved nursing care and client outcomes.
• The Pew Health Professions Commission (1995) published a set of competencies it believed would mark success for health professions in the 21st century influenced by healthcare changes, in the mid-1990s.
• The commission released a fourth report as a follow-up on health professional practice in the new millennium.
• The report offered recommendations pertinent to professional training as well as a new list of competencies for the 21st century.
• Many competencies deal with health professionals' teaching part, including nurses, which entail embracing social responsibility, providing competent care, incorporating determinants of health, practice preventative healthcare, improve healthcare access for those in need, practicing relationship-centered care, providing culturally sensitive are, using communication and tech effectively and helping others learn.

Evolution of the Teaching Role of Nurses

• Nursing is unique because patient education has long been considered a major component of standard care.
• Since the mid-1800s, when nursing was acknowledged as a unique discipline, the responsibility for teaching has been recognized as an important role of nurses as caregivers
• The goal of nurses' teaching is to care for the sick and promote health to the public.
• Florence Nightingale, the ultimate educator and founder of modern nursing, established the first school of nursing
• She devoted much of her career to teaching nurses, physicians, and health officials about the importance of proper conditions in hospitals and homes to improve health and stressed proper nutrition, fresh air, exercise, and hygiene to patients to Improve well-being.
• Public health nurses in the U.S. understood the nurse's role in preventing disease and maintaining health in society by the early 1900s.
• The National League for Nursing (NLN) recognized health teaching within nursing practice by 1918 and recognized nurses' role in promoting health and preventing illness in all settings two decadeds laters.
• The NLN had identified nursing school curricula course content to prepare nurses by 1950.
• For years, the American Nurses Association (ANA, 2015) has issued statements on nursing practice functions, standards, and qualifications, calling patient teaching a key element.
• The International Council of Nurses (ICN) has endorsed the nurse's role as an essential patient educator
• All state NURSE PRACTICE ACTS (NPAs) include teaching within the scope of nursing practice responsibilities.
• Teaching effectiveness is often incorporated into nursing career ladders as a measure of excellence allowing them to achieve the goal by teaching patients, families, and staff.
• Nurses have to provide cost-effective, safe, and high-quality care, as well as providing patient educations and educating their colleagues
• Another role of today's nurse educator is one of training the trainer so they are capable through continuing programs.
• There is a high demand for educators of nursing students and also the role of a clinical instructor
• Staff nurses function as clinical preceptors and mentors to ensure nurses in clinical and academic settings are prepared appropriately for learning
• Possessing knowledge and skills related to teaching & relating that theory is a challenge.
• Clinical educators require a dynamic role that prepares them to teach, engage, and be competent.

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

• Patient education aims to increase competence and confidence for self-management
• The primary goal is to increase the responsibility and independence of clients for self-care
• The single most important action of nurses is to prepare patients for self-care
• Client Education increases consumer satisfacion, improve quality of life, ensures continuity of care, decreases patient anxiety, reduces complications of illness, promotes adherence to treatment plans, maximizes independence and empowers consumers to be involved in care.
• Staff and Student education increases competence and confidence to function independently and interprofessionally allowing for a collaborative team approach
• Improving the quality of nursing care and improve our nation's health are parts of improving health, promoting gender equality, and supporting economics.
• Improves job satisfaction, patient-nurse autonomy, increase accountability in practice.
• Primary aims of nurse educators should be to nourish clients, mentors staff, and serve as instructors
• Nurse's must make educating others a priority for their patients, colleagues, and future members of the profession
• Teaching empowers others so there is no higher calling than to be an educator

The Education Process Defined

• The education process consists of teaching and learning and is logical and planned
• Appraise physical and psychosocial needs and learning styles
• Develop care plan based on mutual goal setting and teaching plan to meet individual needs
• Implement care interventions and standards
• Determine psychosocial outcomes in knowledge

Terms

• Teaching and Learning: interventions that meet intended learner outcomes
• Learning: a change due to stimuli
• Patient education: a process of helping people adopt self-care and health habits
• Staff education: changing behaviors to deliver good care

The ASSURE Model & The Contemporary Role of the Nurse

• The Asure Model (analyzing, stating objectives, select, use, require, evaluate) helps nurses organize the education process
• A nurse helps carry out the role of educator with efficiency and must assume the role of facilitating that environment to create it
• The "teacher/instructor" isn't the main focus but the learner is
• The Wood Johnson Foundation (RWJF) found people should educate student/ patients with the right skills to help improve the delivery with 6 parts: patient centeredness, collaboration, EBP, quality improvement, informatics and safety

Barrier and Obstacles

• Barriers impede nurses to give great education and obstacles affect the patients education such as not having space/ privacy
• Nurses may feel that they do not do enough

Ethical, Legal, and Economic Foundation of the Educational Process

• To give education on the right foundation
• To give responsibilities to a right provider
• Ethics is the behavior and ETHICAL is accepted in society
• Nurses distinguish duties of rights.
• Moral values go through you
• Ethical dilemmas put people in conflict
• Must agree with values, right to self termination
• Must inform one of the laws made
• Facilities getting paid by the money of Medicare/ medicade MUST

Application of autonomy

• A major framework
• A word "Law" is used
• Federal laws are enacted
• Nurses must ensure to make informed decisions include signing information in the chart
• An autonomy is the decision made with others helping the patient in a video format

Veracity

• Truth telling/ consent

1. What choices they'd like to make
2. Disclosure treatment
3. Understand information
4. Not make someone do something

• Patients may refuse treatments
• Truth-telling means role of nurse
• The landmark decision by Benjamin Cardozo of 1914 gave citizens the right to make decisions about their health
• Cisor & Bell gave info on the four parts to patient education and it helps the patient

Confidentially

• Personal information is protected via healthcare, standard or code, legal
• Professional capacity
• Trust issues come when you do not have safety
• Confidential is protected
• Ethically, it may be broken if someone is hurt

NONMALEFICNECE

• Do not Harm...must avoid negligence
• Protect patients + nurses
• What the common problems + solutions are
• The following causes happen specifically against Nurse: Failure to follow standard, no documentation, no monitoring, no advocating, not making patient safe
• Jobs are out lined

Financial Terminology

• To each according to the ability of pay/ Merit
• Nurses + patients are together

Finance:

1. Direct cost: Tangible costs
2. Indirect cost costs you dont see
3. Lost savings can reduce the expense for the services you do

• Good service equals getting more results and happy faces
• Service is cheap to generate