Client Education

Principles of adult learning theory

1. Are internally motivated and self-directed 2. Bring life experiences and knowledge to learning experiences, relate to what is already known 3. Are goal oriented 4. Are relevancy oriented, applied immediately 5. Are practical 6. Able to learn in groups

Education Process

1. Assessment/Diagnosis a) Learning Needs (what) b) Readiness to Learn (when) c) Learning Styles (how) 2. Planning a) Develop Teaching Plan and b) Behavioral Outcomes (Objectives) 3. Implementation a)Perform act of Teaching b) Specific Instructional Methods & Tools c) might be relayed to a different health professional 4. Evaluation a) Determine Behavioral Change (outcome) b) asking patient if they understand

Research shows that informed patients...

1.More likely to comply with medical treatment plans 2. Find innovative ways to cope with illness a) Patients more likely to do their own research if they understand the illness 3. Manage symptoms of illness more effective 4. Less likely to experience complications 5. More satisfied with care- this is what is measured in acute care facilities, reimbursement for care provided is linked to this

Planning

1.What will be taught (order of priority) Distinguish "need to know" from "nice to know". "Need to know", have patient select where to start. 2. When teaching will occur Length of hospital stay / # of home health visits Patient input - time of day, length of sessions Grab precious "teachable moments" 3. Where teaching will occur Consider comfort and privacy Limit distractions and interruptions 4. Who will teach Nurse, other health care providers, other patients? 5. Who will learn Patient, family, another caregiver, friend or neighbor?

Evaluation- Behavioral outcome

Asking if patient has questions is not enough Do you understand? Do you have any questions? Are you ready to go home?

Possible indicator of low literacy

Incomplete registration forms Frequently missed appointments Skipped tests & referrals Medication non-adherence Excuses Unable to name meds or explain purpose or timing of administration Difficulty explaining medical concerns No questions

Learning Needs Assessment: culture/beliefs/language

Language, talking on their level of knowledge, make sure to suggest methods that do not interfere with culture, keep in mind who your teaching to (who is more influential)

Implementation: teaching methods

One-on-one sessions Small group discussions and support groups Demonstration and return demonstration Role-playing Games Programmed instruction- youtube

Implementation: teaching materials

Pamphlets and brochures Posters and flip charts Videos and closed circuit television Computer - assisted instruction - Internet, CDs Models

Age-specific learning characteristics: preschooler (3-6)

build trust, simply drawings, play therapy

Age-specific learning characteristics: older adults (65+)

concrete examples, build on past experience, brief explanations, short sessions, integrate new behaviors with established ones

Age-specific learning characteristics: school age (7-11)

encourage independence, play therapy, drawings, models, dolls, short movies

Age-specific learning characteristics: middles aged (40-65)

maintain independence, re establish normal life patters

Age-specific learning characteristics: young adults (18-40)

problem-focused, immediate application, active participation, self-direted

Readiness to learn

1. Motivation 2. Barriers-language, not feeling good, past stigmas about health professionals 3. Aspects to think about a) Comfort/energy level b) Age-different approaches c) Emotional state-not a good time to teach if they are in a bad mood d) Cognitive ability-bring it down to the basics, don't assume e) Sensory ability f) Literacy-don't talk over their head Personal Health literacy

Learning needs Assessment: Readiness

1. Motivation- can be long term or different 2. Adherence (compliance)- ask patient if they take any med and how they take it, ask what patient's definition of health, ask if they see a provider on a regular basis, be open and not judgmental 3. Sensory and physical state-if they don't feel good they are more likely not adhere to listening to a health professional, make sure they are able to hear and see you in order to understand 4. Literacy level-how long they have been in school, ask if they can read

Care Planning: NANDA, NOC, NIC

1. NANDA Knowledge Deficit Ineffective Therapeutic Regime Management Ineffective Health Maintenance Health-Seeking Behaviors Knowledge, Readiness for Enhanced 2. NOC Knowledge: ______ (A to Z) 3. NIC Teaching: ______ Parent Education: _____ Anticipatory Guidance - foreseeing- telling the patient what will be happening in the future within a process or test Learning Facilitation Learning Readiness Enhancement- how can you get the patient to the point where they are ready to learn

Did you know

1. Patients are best able to understand written materials prepared at grade level five. 2. Emergency department instructional materials average 10th grade readability - out of the range for most patients. 3. American Cancer Society patient education materials commonly used to deliver messages about cancer detection methods, lifestyle risks, and treatment modalities, more than half are written at 12th grade level or higher. 4. Low health literacy costs the health system between $50 and $73 billion a year

Develop Learning Objectives

1. WHO DOES WHAT HOW WHEN Patient will demonstrate dressing change without cueing before discharge 2. Use action words: list, state, explain, demonstrate Avoid terms that cannot be measured or observed easily understand, appreciate

Domains of Learning

1.Cognitive a) Using brain to problem solve, make decisions, use critical thinking skills b) For kids, moving from a simple idea to a more complex one 2. Affective a) Linked to emotion, feelings b) Difficult to measure compared to cognitive c) Make a patient care about what you are teaching and trust in you d) More of a connection with the patient 4. Psychomotor a) More how to teach patients how to do an injection, change dressings, how to take BP

Learning Needs Assessment: patient priorities

May have different priority of what is important to them regarding what they want to learn about

Education evaluation

Return demonstrations - psychomotor skills Restate instructions in own words Ask questions - areas of instruction that need reinforcing? Simple written tests or questionnaires - cognitive learning Talk with the patient's family, other health care team members Assess physiological measurements - adherence to plan Review the patient's record of self-monitoring Ask patient to problem solve a hypothetical situation

Documentation

The patient's learning needs The patient's preferred learning style and readiness to learn The patient's current knowledge about his or her condition and health care management Learning objectives and goals Information and skills you have taught Teaching methods you used Evaluation of what the patient has learned and how learning was observed to occur

Learning Needs Assessment: baseline knowledge

Through Google or explanations of other professionals

Principles for print materials

Use plain language (reading level - 5th/6th) No medical jargon Simple words (1-2 syllables) Short sentences (4-6 words) Short paragraphs (2-3 sentences) Avoid needless words Headings and bullets Lots of white space Easy to read font Font size - 14 Contrast - dark print/light background

Age-specific learning characteristics: adolescence (12-18)

develop trust, use peers for support, address fears

Age-specific learning characteristics: birth-3 years

orient to caregiver allow to play with objects