TEACHING/LEARNING CHARISSE REED, MSN, RN

What is Learning? Acquisition of knowledge or skill by practice, study, or instruction.

Domains of Learning Cognitive- the thinking part- making decisions, problem solving, etc. Affective- the feeling part- changes one’s beliefs, attitudes, or values. Psychomotor- the doing part- the physical demonstration of what is learned.

Qualitites of a Teaching/Learning Relationship Pt & Nurse are equal participants Rapport is developed Pt. demonstrates readiness to learn

Purposes of Patient Education Promote Health & Wellness (1o Prevention) Prevent or Dx illness early (2o Prevention) Restore Optimal Health & Wellness after illness has been diagnosed (3o Prevention) Promotion of Coping

Examples: Primary Prevention- vaccinations, Fluoride in water, child restraints in cars Secondary Prevention – Physical Assessments, vision screening, self breast exams Tertiary Prevention – Rehab after a hip replacement, drug rehab, education for newly diagnosed diabetic.

Promotion of Coping Education can help the patient deal with: Chronic Illness or Disability New or frightening procedure Adapting to new devices Adjusting to new dietary restrictions Grief, loss, eventual death

Step 1: Assessment What does patient Need to Know? What does he/she already know? What is the priority? Are there any barriers to learning? Language? Cultural? Religious? Is the patient Ready to Learn? What motivates him/her? What de-motivates him/her? “Compliance” vs. “Adherence”

Assessing Readiness to Learn, continued What is the patient’s physical/sensory state? Poor vision? Pain? Poor fine-motor skills? What is the patient’s literacy level? Can he/she read? Write? Understand?

Step 2: Nursing Diagnosis The first part of the nursing diagnosis might be: Deficient Knowledge Ineffective Health Maintenance Ineffective Therapeutic Regime Management Health Seeking Behaviors (see table on pg 143 for possible “Related to”s)

Step 3: Setting Goals (Outcomes) Patient centered Patient involved Be brief and be realistic. Who + Does + What + How + When = Goal Example: Pt. will demonstrate dressing change using sterile technique before discharge.

Step 4: Implementing Teaching Lecture Demonstration Role Play (or dolls) Pamphlets Videos Internet Equipment & Models (Use whatever is available, and whatever works)

Tips for Effective Teaching Use an interpreter if necessary Patient should be well rested Patient should be comfortable, pain free Teaching session should be brief– about 10 minutes at a time Observe for “teachable moments” Include family/friends if they are interested. Provide positive feedback or praise.

Step 5: Evaluation Measureable goals are the key to easy evaluation! Teach-back: have patient tell you what you have told them. Return Demonstration: have patient perform a skill.

Step 6: Documentation Communicates the plan and the progress to other members of the health care team Fulfills the requirements of the job description as put forth by local, state, and national licensing agencies. It provides a legal record of what was taught.

Lifespan Considerations Infants- Teach the parents Toddlers/Preschoolers- Let them handle equipment. Be honest about painful procedures. School age- Show how they contribute to their own health Adolescents – include them in the planning. Show alternatives and the consequences Elderly- motivated by things that improve their self esteem & independence.

Final Considerations Nurse can influence the patient, but cannot control him or her Teaching plan must be individualized for each patient, taking into account age, literacy, and what the patient needs to learn.

Questions?????