BNUR1900 F24 Client Education PDF

BNUR1900 Nursing Fundamentals Module 6: Client Education Presented by Peter Kennedy RN, BScN, MBA October 31, 2024  During this module, students will: ✓Develop an understanding of the role of education in...

BNUR1900 Nursing Fundamentals Module 6: Client Education Presented by Peter Kennedy RN, BScN, MBA October 31, 2024  During this module, students will: ✓Develop an understanding of the role of education in nursing care ✓Identify and apply the domains of Learning learning to nursing care ✓Identify how to assess a client’s basic Objectives learning needs ✓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 1.22 Incorporates knowledge from nursing science, social sciences, humanities, and health-related research into plans of care. 1.26 Adapts practice in response to the spiritual beliefs and cultural practices of clients. 5.6 Supports clients to navigate the health care systems and other service sectors to optimize health and well-being. 8.5 Assists clients to access, review, and evaluate information they retrieve using information and communication technologies (ICTs). Plan  Patient education occurs every shift you work It may be subtle, or it can be planned and formal Nurses must bring together their theoretical Overview of knowledge, communication skills, and their knowledge of teaching and learning, in order Patient/Client to provide competent and comprehensive care to their patients Education “As health care professionals, it is our responsibility to facilitate client centered learning in a way that clients can understand and that respects their perspective, needs, and values.” (RNAO, 2012, p. 7) Knowing Your Own Learning Style You were required to complete a self assessment to determine your own learning style What was the result? Do you agree? Do you perceive that you have a different learning style?  It is important that we understand Knowing the different ways that people learn the You may not conduct an Learning assessment with each individual, but as you get to know a Style of patient/client, you may develop an Others understanding of their learning style Understanding Context Nurses must understand the concept of context when providing education Goal of Patient Education To assist individuals, families, or communities in achieving optimal health Overall goals: Maintaining and promoting health and preventing illness Restoring health Optimizing quality of life with impaired functioning  Nurses provide people with information and Maintaining skills that people need to maintain, manage, and improve their health across health care and settings When patients become more health Promoting conscious, they are more likely to effectively manage their health and to seek early Health and diagnosis of health problems The internet has enabled easy access to to Preventing endless health information and resources This may present challenges Illness (misinformation) and benefits (apps to support self-management) Restoring Health Many people will seek information and skills that will help them to manage, regain, or maintain their health Some people will find it challenging to adapt to an illness or diagnosis and may not be as active in their approach Family often plays a key role in supporting a person’s health journey, and may need as much information as the person does For example, if one of the goals is to regain independence, it is important that the family understands this so they can foster and support independence, not dependence  Important to identify the patient’s needs Optimizing Quality of Determine the family’s Life with willingness to help Impaired Function Provide education to the family to support the patient in health care management  Teaching An interactive process that promotes learning Most effective when it addresses the learner’s needs, learning style, and capacity Teaching Learning The purposeful acquisition of knowledge, skills, and behaviours and attitudes With successful teaching, learners can acquire new skills or change existing attitudes Learning Teaching and learning typically begin after a person identifies a need to know or acquire more knowledge about something Effective teaching depends on effective communication – listening and speaking  To assist families, individuals, or communities in achieving optimal health Helps develop knowledge and skills Patient/Client that can lead to better lifestyle Education choices and/or health outcomes Improved health outcomes directly impact the overall health care system  Creating or adapting the environment to facilitate learning Nursing Using a patient-centered approach in Role in assessing the learning needs of the patient Teaching Using the most appropriate educational and strategy Learning We have an ethical responsibility to teach patients and empower them to manage their own health  Patients have the right to make informed decisions about their health and health care The information they receive must be accurate, complete, and relevant to their needs Informed Decision- Some people will request health information. For others, you will need to observe and assess patients to Making determine their learning needs Far beyond just sharing facts – we need to determine individual learning needs, find an appropriate time and place for teaching, determine the readiness for learning, and evaluate the impact of education on outcomes  The Canadian Nurses Association (2017) Code of How Does Ethics states that patients have the right to informed decision- Teaching Fit in making With In order for patients to make Professional informed choices, they need to be Responsibilities? provided information at a level, and in a manner, which is appropriate for them How Does Teaching Fit in With Professional Responsibilities? A teaching plan that is comprehensive and well designed to meet the learner’s needs can: Improve quality of care Help individuals reach optimal wellness Increase independence/quality of life Reduce health care costs  As nurses, we must utilize all of our skills to determine the learning needs of an individual How Does Verbal/communication Teaching Fit in Observation With Professional Awareness of cultural, social, Responsibilities? familial influences on the person’s emotions, attitudes, and health behaviours Teaching as Communication Teaching closely parallels the communication process Teaching depends in part on effective interpersonal communication Case Study In preparation for a trip to Vietnam and Cambodia, Mr. and Mrs. Bennet visited a travel clinic, which recommended that they update their immunizations (diptheria-pertussis-tetanus, Hep A, typhoid) and take anti-malarial drugs for the Cambodia portion of the trip (one pill daily starting one day before stay, continuing during stay, and one week after). When they came in for their immunizations, they expressed some concerns about taking the antimalarial drugs. They had been talking to friends who told them these drugs had severe adverse effects and caused hallucinations. They had investigated several internet sites that their friends recommended: these sites indicated that antimalarial drugs were not required for where they were going. Mrs. Bennet emailed the Cambodian Consulate in Canada and was told that malaria was not a concern where they are going. Domains of Learning Cognitive Learning Affective Learning Psychomotor Learning  Cognitive Discussion (one-on-one or group) Storytelling Teaching Lecture Question-and-answer session Role play and discovery Methods Independent projects and field experience Based on Affective Role play Domains Discussion (one-on-one or group) Psychomotor of Learning Demonstration Practice Return demonstrations Independent projects and games  Nurses must understand HOW Basic people learn Learning Principles What does learning depend on?  Learning Environment Ideal learning environment is a well-lit, well-ventilated room with appropriate furniture and a comfortable temperature A quiet space with few distractions and interruptions, and privacy Can occur in hospital rooms, classrooms, community centers, a patient’s home  Emotional capacity Emotions can help or hinder learning and focus Be aware of a patient’s level of anxiety Intellectual capability Assess patient’s knowledge and intellectual level before beginning a teaching plan (consider math, reading, comprehension skills) Ability to Physical capability Learn Psychomotor skills require strength, coordination, sensory acuity Consider impacts of pain, fatigue, hunger, energy on learning Developmental stage Learning in children (understandable information, realistic expected outcomes) Adult learning (collaborate with them to determine needs and goals) Learning Style and Preference Everyone processes information differently by seeing and hearing, reflecting and acting, reasoning logically and intuitively, and analyzing and visualizing Visual learners learning best by watching Kinesthetic learners learn best when they can manipulate tools and find out how they work Environmental, social, emotional, psychological, and physical stimuli affect people differently  Motivation is the desire or willingness to learn – it influences a person’s behaviour Learning is unlikely to occur when a Motivation person is not ready or does not want to Learn to learn Social motives Task mastery motives Physical motives  Social learning theory helps educators understand learners and develop interventions that enhance motivation and learning Motivation When people believe that they can and Social execute a particular behaviour, they are more likely to perform the behaviour Learning consistently and correctly Theory Self-efficacy: a person’s perceived ability to successfully complete a task Motivation and Transtheoretical Model of Change Health education often involves changes in behaviour – and change is hard!  Current focus in health care on client RNAO centered care, which acknowledges the person as a partner in care BPG Facilitating Patients have much more information available to them than ever before (e.g., Client thanks to the internet) Centered RNAO provides guidelines for client Learning centered learning to ensure we are meeting the needs of the person, not just simply (CLL) meeting what we (as HCPs) think they need A Patient-Centered Approach to Patient Education Patient-centered care that positions the patient as the focus of care delivery and as a partner in the delivery of care The LEARNS model discussed above provides a nursing process framework incorporating social learning theory that facilitates a patient-centered approach LEARNS Model Nursing and Teaching Process Assessment Analysis (Diagnosis) Planning Implementation Evaluation Learning Objectives  Telling Selling Teaching Participating Approaches Entrusting Reinforcing  In small groups, review the following article: https://journals.lww.com/nursing Learning /fulltext/2013/10000/patient_edu cation_tips_for_new_nurses.24. Activity aspx Discuss the article and, as a group, reach a consensus on the key message(s) from the article  What is Teach Back? A way to ensure that you explained information clearly – not a test of the patient/family Asking a patient/family to explain in their own words what they need to do Teach A way to check for understanding (determine if there needs to be further teaching or Back reiteration) A research-based health literacy intervention that improves patient-provider communication and patient health outcomes https://www.ihi.org/education/IHIOpenSchool/re sources/Pages/AudioandVideo/ConnieDavis- WhatIsTeachBack.aspx Health Literacy “The ability of an individual of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way that is appropriate to the individual and system contexts.” (Liu et al., 2020, p. 1) Personal health literacy: the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others Organizational health literacy: the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others  Simplifying communication with and confirming comprehension for all patients, so that the risk of miscommunication is minimized Health Making the office environment and the health care system easier to navigate Literacy ‘Universal Supporting patients’ efforts to improve their health Precautions’ (AHRQ, 2015)  Geragogy is the application of principles of adult learning theory to teaching for older persons Teaching should be relevant, related to what is already known, and should emphasize Learning in concrete and practical information Consider the increased social and medical Later Life complexity of many older persons Pace assessment and teaching according to an individual’s stamina Data can be collected by self-report, report by proxy, and/or observation Learning in Later Life Older persons are still capable of learning and their brains may actually allow them to make more neural connections Encourage older persons to participate in new learning Assess for health literacy Literacy Highest level of education Consider how you communicate when providing teaching Begin and end with the most important information The Teach Back Method may be a helpful tool to use when providing client education Application to the Older Person Health assessment Health history Physical assessment Functional assessment (ADLs, IADLs) Mental status assessment (MMSE) Mood measures (Depression) Assessment of social supports (Caregiver burden) Environmental/safety assessment In some instances, using an integrated assessment be a more effective method Older American’s Resources and Service (OARS) – considers social resources, economic resources, mental health, physical health, ADLs Fulmer SPICES (sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, and skin breakdown)  Jay, Jenny’s brother, has not been feeling well lately. He went to see his doctor who ordered some bloodwork. Jay has been diagnosed with diabetes and has been sent to the diabetic clinic for guidance on how to manage his new diagnosis. Jay brings his partner, Mark, with him so he can understand diabetes better. Jenny is frustrated with Jay as she thinks he doesn’t take good care of his health; she is angry with him for ‘getting diabetes’. Jenny’s husband, Robert, is Indigenous and he says he knows a Perpetual lot of people who have diabetes. He discusses the medicine wheel used in his Indigenous traditions to help Case Study Jay understand the journey of life and offer ways to help Jay adjust to his new diagnosis. Mark tells Jay that he will only listen to advice based on ‘western medicine’. David continues with his hearing concerns, but John, his RN, has indicated some concerns about his cognitive function also, based on his mini-cognitive assessment. He has sent David to a gerontological specialist for further investigations.  Answer the following questions based on the information you have about the family, and your knowledge from todays and previous classes: 1) What is the teaching priority for Jay? Would the teaching priority for Mark be the same as for Jay? 2) Provide an example of each of the domains of learning which will need to be addressed to support Jay in his Perpetual 3) self-care and management of diabetes. Use your information from the communication class to Case Study develop a response to Mark’s reference to ‘western medicine’. 4) What domain of learning would you consider to be the priority for David? Take into account his concerns identified in last week’s case study. 5) Provide two techniques which you might utilize to address this identified domain of learning for David. Questions