Evidence Based Patient Teaching By: Amelia O’Bryan, Nicole Bohall and Jimmy Spinelli

Goal for Patient Teaching “Our goal for patient education is to optimize the quality, cost and outcomes of healthcare by providing patients and their families with the information they need to actively participate in their care, make informed choices about their health behaviors, and engage in self-care with confidence and competence.”

What EBP Says EBP shows that patient education provided by nurses positively influences patient outcomes and reduces hospitalizations. Individualized patient education helps patients better manage their illnesses, which improves their function and quality of life.

5 Basic Principles of Education -Realistic learning objectives are prioritized and outset. -Learner(s) is engaged in interaction and feedback -Method, Pace and sequence are based on pts needs, preferences and skills. -Teaching and learning are facilitated through variety of means. -Teaching focuses on helping the pt acquire relevant skills and behaviors to promote health.

Teaching Process ● Assess ● Diagnosis ● Planning ● Implementation ● Evaluate

Barriers to the Teaching-Learning Process ●Cultural beliefs ●Powerlessness / frustration ●Lack of family/social support ●Low intellect / Cognitive function ●Visual and/or Hearing impairment ●Pain ●Anxiety/Depression ●Noise/Distractions ●Age ●Medications ●Fatigue ●Financial

Literacy Rate in the United States Statistic Verification Source: U.S. Department of Education, National Institute of Literacy Research Date: U.S. Illiteracy StatisticsData Percent of U.S. adults who can’t read14 % Number of U.S. adults who can’t read32 Million Percent of U.S. adults who read below a 5th grade level 21 % Percent of prison inmates who can’t read63 % Percent of high school graduates who can’t read19 % Global Illiteracy Number of people worldwide who can’t read774 Million Percent of the worlds illiterate who are female 66 % -Wide range achievement test (WRAT 3) evaluates reading spelling and arithmetic skills for patients from Rapid estimate of adult literacy in medicine, is a test to determine approximate reading level by evaluating pronunciation of health care terms -Simple tests such as “can you read this medicine label to me?” - Give them a paper to read and have them explain it in their own words after reading.

Other Teaching Tools ● Pictures ● Videos ● Audiotapes ● Models ● Online resources ● Pamphlets

Teaching Strategies Affective -Role playing -Group discussions -One-on-one discussion Psychomotor -Demonstration (by nurse) -Practice -Return demonstration Cognitive -Discussions (one-on one or group) -Lecture -Question-and Answer session -Role play -Independent project

Teach Back ●Teach back is a proven method to confirm when the HCP has explained the necessary information in a manner patients can understand. ●It is an EBP approach we can use that asks patients to repeat in their own words what they need to know or do using a non-shaming approach ●This approach forces the pt to participate. Active participation keeps the pt involved and is proven to lead to better outcomes. I.e. “I want to be sure I explained everything clearly. Please tell me in your own words what I said.”

Evaluating Pt Teaching -Have the pt “teach” you (teach back) -Have the pt demonstrate a skill -Be effective in Role play “real life situation” -Pt can answer questions the nurse asks

Evaluating effectiveness of OUR teaching 1.List 3 barriers to Patients learning 2.Identify 3 tools that can be used to teach a Pt. 3.What is the % of americans that read below a 5th grade level? Why is this important? 1.What are the most important aspects to promote effective learning? (select all that apply) a.Literacy level b.Active participation c.Multiple approaches d.Evaluation of teaching

How Learners Learn: Tell me and I will forget Show me and I will remember Involve me and I will understand ~Confucius

References Donaldson, N., Rutledge, D., & Pravikoff, D. (1999). Principles of effective adult-focused patient education in nursing. Online Journal Of Clinical Innovations, 2(2), Friedman, A., Cosby, R., Boyko, S., Hatton-Bauer, J., & Turnbull, G. (2011). Effective Teaching Strategies And Methods Of Delivery For Patient Education: A Systematic Review And Practice Guideline Recommendations. Journal of Cancer Education, Illiteracy Statistics. (2013, April 28). Retrieved March 30, 2015, from adults-who-cant-read Lewis, S. (2011). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, Missouri: Elsevier/Mosby. Potter, P., & Perry, A. (2013). Fundamentals of nursing (8th ed.). St. Louis, Missouri: Mosby Elsevier. Tamura-Lis, W. (2013). Teach-Back for Quality Education And Patient Safety. Urologic Nursing, 33(6), doi: / X