Chapter 5 Patient Education to Promote Health PDF

Chapter 5 Patient Education to Promote Health Clayton’s Basic Pharmacology for Nurses, 19th edition Michelle Willihnganz, MS, RN, CNE 1  Lesson 5.1 Patient Education to Promote Health...

Chapter 5 Patient Education to Promote Health Clayton’s Basic Pharmacology for Nurses, 19th edition Michelle Willihnganz, MS, RN, CNE 1  Lesson 5.1 Patient Education to Promote Health (1 of 2) 1. Differentiate among the cognitive, affective, and psychomotor learning domains. 2. Identify the main principles of learning that are applied when teaching a patient, family, or group. 3. Describe the essential elements of patient education in relation to prescribed medications. 2  Lesson 5.1 Patient Education to Promote Health (2 of 2) 4. Describe the nurse’s role in fostering patient responsibility for maintaining well-being and for adhering to the therapeutic regimen. 5. Identify the types of information that should be discussed with the patient or significant others. 3  Three Domains of Learning  Cognitive domain: Involves learning and storing knowledge  Affective domain: Involves feelings, needs, values, and opinion  Psychomotor domain: Involves learning new skills 4  Audience Response Question 1  The nurse is preparing to teach a postsurgical patient who has a new colostomy about proper colostomy care. The patient says, “Just show me how to do it; let me try, and I’ll learn what to do.” Which domain of learning is indicated by this statement? a) Cognitive b) Affective c) Psychomotor d) Determined 5  Principles of Teaching and Learning (1 of 2)  Focus the learning  Consider learning styles  Organizing teaching sessions and materials  Motivate the patient to learn  Determine the patient’s readiness to learn  Space the content  Use repetition to enhance learning  Consider the patient’s education level 6  Principles of Teaching and Learning (2 of 2)  Incorporate cultural and ethnic diversity  Teach appropriate use of the Internet  Encourage adherence  Use relevant content  Communicate goals and expectations 7  Learning Focus and Learning Styles  Focus the learning  Repeat information to help master concepts  Environment should be quiet and well lit  Provide essential equipment  Encourage active participation  Consider learning styles  Fit teaching techniques to learner’s style  Provide a variety of media for learning such as pamphlets, videos, models, slides, photographs, charts, and computer instruction 8  Materials and Motivation  Organization of teaching sessions and materials  Use objectives and an outline for teaching  Allow time to practice and ask questions  Review what has been taught  Motivation  Provide positive feedback when teaching  Determine through patient outcomes when more teaching is needed 9  Learning, Content, Repetition, and Education Level  Readiness to learn  Ensure patient’s basic needs are met first  Depends on what patient already knows and motivation to learn  Make the content relevant  Spacing the content: Stagger the material presented in one session  Use repetition to enhance learning  Consider education level 10 Principles of Learning: Adult Education  Adults need to first understand why they must learn something  Assess what the adult already knows and what information is desired  Make the content relevant to that individual 11  Principles of Learning: Older Adults  Assess vision, hearing, short- and long-term memory, and fine and gross motor skills  Assess concerns regarding cost  Older adults may consider the balance between proposed treatment and quality of life  Slow pace of the presentation, allow time to process new information 12 Principles of Learning: Fear and Anxiety  Provide information in small increments: Ability to focus on details is reduced  Anticipate inopportune times to initiate teaching  Allow time for practice and review  Praise efforts and positive aspects 13  Cultural and Ethnic Diversity  Incorporate cultural and ethnic diversity  Communication is vitally important within any cultural group  Members of healthcare team should always try to ascertain the patient’s beliefs about illness  Adapt educational materials to meet a variety of cultural considerations 14  Use of the Internet  Common for consumers to access the Internet for healthcare inquiries  Quality of information on Internet varies  Essential for nurse to maintain an educational partnership with patient and his or her caregivers 15  Adherence (1 of 2)  Patients have right to make their own life choices  Positive reinforcement helps patients succeed  Response and compliance depend on numerous variables  Beliefs and perceptions  Effects on lifestyle  Acceptance/denial of illness  Stress 16  Adherence (2 of 2)  Response and compliance depend on numerous variables  Comprehension and understanding  Multiple physicians  Costs of treatment  Family support  Control over disease  Side effects  Expectations and fears  Physical limitations 17  Strategies to Increase Adherence  Challenges to nursing: Poor adherence increases costs unnecessarily  Case Management Adherence Guidelines, version 2: Tool used to help identify those at risk for nonadherence  Ethnography: Used to observe how patients follow healthcare regimen at home 18  Relevant Content  For learning to take place, the patient must perceive the information as being relevant  Start with simple and attainable goals to build the patient’s confidence 19  Goals and Expectations of Therapy (1 of 2)  Goal is to assist patients with achieving greatest degree of control possible  Offer support and encouragement  Assist patient with exploring options rather than giving up  Needs and expectations are constantly changing 20  Goals and Expectations of Therapy (Slide 2 of 2)  Shared input into goals and outcomes  Keep records of the essential data that are needed to evaluate prescribed therapy  Write out information in a manner the patient can read and understand  Contact healthcare provider for advice  Summary statement of patient’s unmet needs should be written and placed in chart 21  Audience Response Question 2  The nurse is supposed to perform postoperative teaching for a patient who is scheduled to be discharged the next day. The patient appears fatigued, in pain, and irritable. The nurse knows that there will be little time for teaching on the day of discharge. What is the nurse’s best course of action? a) Deliver the teaching now because there won’t be enough time tomorrow. b) Allow the patient to nap, and return to perform the teaching in 1 hour. c) Teach the family member who is present, so he or she can share the information with the patient after discharge. d) Determine the patient’s need for analgesia and rest, and return to perform the teaching after the patient feels better. 22  Audience Response Question 3  An older adult patient is being prepared for discharge after experiencing a stroke with some residual damage. The patient and family are scheduled to receive a large amount of information from the nurse regarding proper care and safety at home. What is the nurse’s best course of action? a) Present the patient and family with all of the information a few days before discharge. b) Present the patient and family with all of the information the day before discharge. c) Break the teaching content down into manageable sections and present them individually in the days before discharge. d) Have a home health nurse teach the patient and family at home a week after discharge. 23  Audience Response Question 4  The nurse is preparing a patient for discharge after a surgical procedure. Which method is best for teaching the patient about his or her prescribed drugs? a) Prescription blank handwritten by the physician b) Magazine ads featuring the prescribed medications c) Verbal explanations along with drug summary sheets d) Unit-dose packages from this morning’s medications 24  Audience Response Question 5  The nurse who is new to a large urban hospital has found that many of the hospitalized patients are of different cultural groups in the area. Which approach is best for the nurse to take in caring for these patients? a) Care for all patients the same way because it is more efficient. b) Ask not to be assigned to these patients due to the nurse’s lack of experience. c) Develop a plan of care that is individualized to each patient’s needs. d) Follow a more experienced nurse around for several months to gain more experience. 25 Questions? 26