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83 Cards in this Set
- Front
- Back
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How do patients participate in healthcare decisions?
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Primary care providers expect patients to take an active role in making decisions about their health; patients and families need information so that they make informed decisions.
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Hospitals stays are brief, in this aspect how is teaching important?
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Patients are often sent home still needing medications, dressing changes and skilled procedures, such as urinary catheterization.
Nurses have a responsibility to to teach family members how to provide care and teach patients to care for themselves as they are able. |
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Healthcare is Expensive, in this aspect why is teaching important?
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Helping to increase patient compliance with medical and nursing regimens, which can shorten hospital stays and decrease frequency of medical treatments and admissions.
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What is the basic purpose of teaching and learning?
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-Perform self-care
-Make informed decisions about their healthcare options *You can use teaching to promote wellness, prevent or limit illness, restore health, adapt to changes in body function, and facilitate coping with stress, illness, and loss. |
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Who are Learners?
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-Clients, families, and others who care for the resident.
-They are wherever you work; hospitals, an ambulatory setting, home care, or in the community. -Informal one-to-one teaching while performing nursing interventions -Formal teaching to groups of people -Nurses are responsible for teaching healthcare workers whom they supervise, helping new nurses learn how to use equipment, clinical instruction of nursing students, new graduates and other members of the healthcare team. -It may be informal or may be presenting specific topics at unit meetings and conferences |
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The American Nurse Association's (ANA) nursing teaching requirements
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Promoting and protecting health, safety, and rights of patients.
-Provide health teaching that addresses healthy lifestyles, risk-reucing behaviors, developmental needs, activities of daily living, and preventive self-care. -Use health promotion and health teaching methods appropriate to the situation and the patient's values, beliefs, health practices, patient's developmental level, learning needs, readiness and ability to learn, language preference, spirituality, culture, and socioeconomic status. -Seeks opportunities for feedback and evaluation of the effectiveness of the strategies used. |
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The Joint Commission standard requirements of educators
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-Educators in healthcare organizations to consider the literacy, developmental and physical limitations, financial limitations, language barriers, culture, and religious practices of every patient.
-Teaching must also include any person who will be responsible for the patient's care. |
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The AMerican Hospital Association's (AHA) "Patient Bill of Rights"
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-The right of the patient to receive high-quality care
Patient rights include a clean and safe environment; protection of privacy; complete and current information about their diagnosis, treatment, and prognosis; information communicated in way they can understand; and the right to be informed of hospital policies and practices that relate to them. |
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Nurses' teaching role and responsibility is defined in the?
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Nurse Practice Act
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What does the educational process consist of?
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Teaching and Learning
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Teaching
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-An interactive process that involves planning and implementing instructional activities to meet intended learner outcomes or providing activities that allow the learner to learn.
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Effective communication skills for teachers
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-Adequately convey information
-Assess verbal and nonverbal feedback -Accommodate various learning styles |
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What can nurses use to achieve effective client learning?
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Teaching, counseling, and behavioral modification
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Learning
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A change in behavior, knowledge, skills, or attitudes.
-It occurs as a result of planned or spontaneously occurring situations, events, or exposures. |
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Conscious, goal oriented learning
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Is intended and deliberate
-It invokes motivation to learn |
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Five Rights of Teaching
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Right Time
-Is the learner ready? Is there a relationship? Is there time? Right Context -How is the environment? Right Goal -Is the learner actively involved? Are they committed? Are family and friends involved? Are the learning objectives realistic and valued? Right Content -Is it appropriate for the client's needs? Is it new or reenforced information? Is it presented at the learner's level? Is it relevant to the learner? Right Method -Is it the learning style of the learner? Does it fit the client's learning ability? Are the teaching Strategies varied? |
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Cognitive Learning
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Includes storing and recalling information in the brain.
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Cognitive Learning 6 levels of behavior
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Ranging from simple to complex processes, it encompasses six levels of behavior: memorization, recall, comprehension and analysis, synthesis, application, and evaluation of ideas.
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Strategies and tools to support teaching cognitive-type content
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Includes lectures, reading materials, panel discussions, audiovisual materials, programmed instruction, computer-assisted instruction (CAI), and problem-based learning (like care studies and care plans)
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Psychomotor Learning
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Involves learning a skill that requires both mental and physical activity.
-It requires the learner to accept and value the skill (the affective domain) as well as know about the skill (the cognitive domain) |
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Strategies and tools used to teach psychomotor skills
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Includes demonstration and return demonstration, simulation models, audiovisual materials (like DVDs and videos), journaling and self-refection, and printed materials (especially with pictures)
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Affective Learning
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Involves changes in feelings, beliefs, attitudes, and values. It is considered the "feeling domain".
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Strategies and tools for promoting affective learning
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Include role modeling, group work, panel discussion, role playing, mentoring, one-to-one counseling and discussion, audiovisual materials (like DVDs, videos and interactive computer based modules), and printed materials.
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Anderson and Krathwohol adapted Bloom's model describing learning with these domains
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Remember
Understand Apply Analyze Evaluate Create |
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Motivation
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-Desire from within.
-Created by and idea, a physical need, an emotion, or some other kind of force. -It is greatest when clients recognize the need for learning, believe it is possible to improve their health, and are interested in the information they are being given. -Based on physical and social needs, the need for task mastery or success, and health beliefs. |
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Readiness
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Is the demonstration of behaviors that indicate the learner is both motivated and able to learn at a specific time.
-This includes the physical and emotional capacity to take in, process, and recall information --> Physical condition (like pain, strength) and intact cognition contribute to a patient's readiness to learn. -->Emotions can inter free or enhance the ability to learn (stress, emotional pain vs. mild anxiety) |
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Timing
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Related to readiness; You must present information at a time when the learner is open to learning.
-People retain information better when they have an opportunity to use it soon after it is presented. -The learner might need more time to absorb and apply information especially when complex thinking is required . |
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Active involvement
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-Learning is more meaningful when the client is actively engaged in the planning and the learning activities.
-Learners retain 10% of what they read, but they retain 90% of what they speak and do. -Demonstration is particularly effective for kinesthetic learners (which most adults are). |
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Feedback
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Is information about the learner's performance.
-Positive feedback encourages learners and boots morale when it comes to tackling difficult content or devoting the time and effort needed to get the most out of the educational process. -There's times to point out errors but do so in a positive way when possible. - Fear of failure or judgement can be a serious barrier to learning at what could be the patient's most teachable moment. |
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Repetition
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-The client is more likely to retain information and incorporate it into his like if the content is repeated.
-Each time the learner hears the information, the likelihood of retention increases. |
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Learning Environment
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-For most people, an ideal learning environment is private, quiet physically and psychologically comfortable, and free from distractions.
-Provide good lighting, and comfortable seating that is conducive for conversations. -Make the best of what you have. |
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Scheduling the Session
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-Plan for uninterrupted time to allow you to adequately assess and understand the client.
-Doesn't need to be long, but must be uninterrupted. -Based on client condition, shorter teaching sessions may be best for comprehension and retention. -A moment can be a teaching session. |
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Amount and Complicity of Content
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-The more complex or detailed the content, the more difficult it is for most people to learn and retain.
-The greater the change, the greater the challenge for both teacher and client. |
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Communication
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-Is central to the teaching and learning process in which teachers and learners communicate information, perceptions and feelings.
-Barriers include; pain, anxiety, fatigue, illness, hunger, etc. -Pay attention to verbal and nonverbal feedback |
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Special Population
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-For clients who have special needs you must plan carefully to ensure that you use appropriate strategies to maximize learning.
-Include a family member or caregiver in the teaching to reinforce the learning and act as safety net for implementing the information. |
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Stages of Cognitive Development
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-Pre-operational Stage: (2-7yrs old) beginning to acquire language skills and find meaning through use of symbols and pictures.
-Stage of Concrete Operations: (7-11yrs old) The child learns best by manipulating concrete, tangible objects and can classify objects in tow or more ways. Logical thing begins, can understand the relationship between numbers and the idea of reversibility. Also recognize the perspective of others. -Formal Operations Stage: (11+yrs old) Use abstract thinking and deductive reasoning. Relate general concepts to specific situations, consider alternatives, begin to establish values, and try to find meaning in life. (Not everyone reaches this stage including adults) *For clients who have not achieved the stage of formal operations, use examples instead of definitions; use concrete rather than abstract terms. |
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Teaching Older Adults
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-Consider the numerous factors that can adversely affect the teaching.
-Barriers include; vision and hearing impairments, illness pain reduced social interaction, reduced mobility, medication effects, sensory deficit, social cultural factors, and noisy or chaotic environment. -Allow extra time for rest periods |
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Teaching Children
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-Use strategies to gain trust, reduce their anxiety, promote cooperation, and enhance their emotional readiness to learn.
-May need to simplify the content and use pictures and concrete examples -A reward system is often an effective way of improving compliance |
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Cultural Factors
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-Awareness of norms, values communication, social structure, time orientation, and cultural identification are important in planning teaching.
-Cultural sensitivity involves respect for clients' identity and needs no matter what |
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Health Literacy
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The ability to understand basic health information and services needed to make appropriate healthcare decisions
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Health Illiteracy
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Occurs when the language spoken is not the patient's preferred language
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Learning Assessment
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-Will help determine the right setting for the teaching, the necessary content to cover, learning goals, and teaching strategies.
-Includes: Learning Needs, Client's knowledge level, health beliefs and practices, physical readiness, emotional readiness, ability to learn, literacy level, neurosensory factors, and learning styles |
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Analysis/Nursing Diagnosis
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Deficient Knowledge is the most frequently used nursing diagnosis for a teaching plan. It's either a problem or the etiology of a problem.
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Deficient Knowledge as the Primary Problem
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-Use deficient knowledge only if you believe that the lack of knowledge is the primary problem.
-Use it to describe conditions in which the patient needs new, additional, or extensive knowledge. -Identify the specific knowledge deflect as the problem, and follow with the etiology and related signs and symptoms. |
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Deficient Knowledge as the Etiology
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Deficient knowledge is probably most effectively used as the etiology of other nursing diagnoses such as:
-Ineffective health maintenance -Risk for impaired parenting -Ineffective therapeutic regimen management -Risk for imbalance nutrition |
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Wellness Diagnoses
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Teaching is the primary intervention for wellness diagnoses, such as Effective Breastfeeding, Health-Seeking Behaviors, Readiness for Enhanced Communication, etc
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Incorrect Uses of Deficient Knowledge
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Always look beyond the knowledge deficit to see what problematic responses it produces. Beware of routine or premature diagnosing. Do not use Deficient Knowledge for problems involving the client's ability to learn. (including fear, anxiety, delayed cognitive development, and feelings of powerlessness
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Contractual Agreements
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-Are statements of understanding between teacher and learner about how to achieve mutually set goals
-It ascribes the responsibilities of both teacher and learner, time frame for the teaching, content to be included, and expectations of all participants. |
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Teaching Goals
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Are broad in scope and set down what is expected as the final outcome of the teaching and learning process. They should address all domains of learning.
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Learning Objectives
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Single, specific, one-dimensional behaviors that must be completed to accomplish the goal. They are short therm and ideally are accomplished in one or two sessions. Should include action verb, and activity that can be measured, the circumstances of the learner's performance, and how learning will be measured.
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The process of creating a teaching plan differs from that of creating a nursing care plan in what two ways?
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1. In a teaching plan, the interventions are actually teaching strategies.
2. When planning teaching, you will plan content, sequencing, and the types of instructional materials to be used. |
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Teaching strategies
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Are the method used to present content
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What does the content of your teaching include?
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The information your learner must understand to reach the desired goal.
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Instructional Materials
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Tools that are used to introduce information and reinforce learning.
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Scheduling and sequencing
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Refer to how you organize the information, that is, in what order to present the topics.
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Nursing Interventions Classification (NIC) Interventions
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NIC standardized interventions related to patient learning depend on the nursing diagnoses you have identified. The NIC lists 30 patient education interventions from which to choose, depending on the content being taught.
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Lecture
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Traditional method in which one ore more presenters orally share information while learners listen.
Advantages: Cost-effectie, useful for conveying basic concepts and information, use media rich formats, auditory and visual learning styles, and may be recorded. Disadvantages: Does not allow for individualization of teaching, passive learning, may not be geared to the level of the learner, not for psychomotor or affective domains, over-saturation occurs, boredom, doesn't promoting critical thinking, and provides little opportunity for assessment of learner comprehension |
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Group Discussion
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Effective group discussion requires an atmosphere of trust that encourages everyone to participate.
Advantages: Effective for teaching in the affective and cognitive domains, students enjoy a learning environment with opportunities for interaction with peers, social involvement can enhance content. Limitations: Less effective with large groups, teacher must be comfortable with less structure and unpredictable responses, requires good leadership skills of the instructor, not suited for psychomotor domain, "group think" affects the group, students hold back, brainstorming fails when distracted, disruptive or dominating participants can sabots the discussion |
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Demonstration and Return Demonstration
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Advantages: Effective in teaching psychomotor skills, used in small groups, return demonstration can increase self confidence
Disadvantages: Doesn't work well with large groups, not for participants that learn at different rates, time-consuming, labor intensive, preparation time, space. |
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One-to-One Instruction and Mentoring
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Advantages: relationship established, allows reluctant to more readily ask questions, useful for all 3 teaching domains, build skills and problem-solve in situations with expert supervision, guidance, and feedback.
Disadvantages: labor intensive, fewest number of learners, over whelming to learners in short period of time, it tends to isolate the learner from others, personality conflicts may occur. |
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Printed Materials
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Advantages: Standardized information, good way to reinforce material, allows the teacher to cover and highlight the main points, and they are portable.
Limitations: Assumes literacy, motivation to read the content, organization to keep track of materials, and visual acuity to decipher the print, must be wrote at the 5th grade reading level |
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Audiovisual Materials
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Advantages: Engages both sight and hearing, and can accommodate large groups
Disadvantages: Not at efficient as a lecture or reading, expensive, outdated equipment must be replaces |
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Simulation
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Advantages: Portrays realistic patient based situations, it increases learner confidence, allows to evaluate effectiveness, troubleshooting areas of concern, can learn new skills without risk to patients.
Disadvantages: Simulators require special equipment, extensive prep time, specialized training, expensive, technically complex, small number of learners can participate at a time, scheduling and logistical challenges occur, and it is time consuming |
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Role-Playing
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Advantages: Safe method to rehearse real-life situations before being less structured the simulation
Disadvantages: Requires follow-up discussion to allow learners to express feelings, attitudes and observations, must be willing to participate, may feel self-conscious, some may dominate more of the experience |
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Role-Modeling
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Advantages: Allows he learner to identify with the teacher, increases motivation and ability to perform a desire behavior, high learner interest, doesn't require additional preparation
Limitations: Learners need to be aware and receptive to this type of teaching, some role-models can send wrong messages |
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Self-Instruction
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Advantages: Learners can work at their own pace and time schedule, convenience, transportation not required, some expenses can be avoided
Disadvantages: must have literacy skills, motivation, can be isolating, not continuous feedback or support, without access to an instructor, students might not know if they are on track and adequately understanding the material |
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Distance Learning (video/teleconferencing)
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Advantages: link many individuals separated by distance, opportunity for interaction with technology
Disadvantages: Requires good technological skill form the teacher, expensive equipment, and a great deal of preparation and organization |
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Online Sources of Information
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Advantages: Internet makes a vast amount of information available, makes it possible for consumers to participate in self-care and make informed decisions, patients feel empowered, they often cope better and experience less uncertainty when information is available
Limitations: Teacher has little control over the quality of information, Must read recommended sites beforehand |
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Computer-Assisted Instruction (CAI) and Online Coursework
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Advantages: Allows learners to proceed at their own pace, can access programs at a time that is convenient fro them, feedback is provided, interactions with instructors and peers, interactive learning, retention of information
Disadvantages: Learners must have access to a computer, have adequate visual acuity and literacy skills, and have computer skills, must plan to meet in person with teacher. |
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Gaming
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Advantages: Use with individuals or groups and can be fun, active learning, retention of information, can build learners
Disadvantages: Participants may not enjoy the competitive atmosphere or may have physical or social impairments that produce participation, can cause disinterest, rejections when feeling insecure about gaming skills, distraction from eating point if winning is overemphasized |
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Concept Mapping
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Promotes reflection and critical thinking, helps to identify patterns and structure within the content, takes a large amount of information and summarizes the key aspects into concise, visual format, active learning discourages routine memorization
Limitations: Difficult for learners with limited spatial reasoning ability, larders need to be taught how to create a concept map |
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Documentation of Teaching and Learning
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PrProvides legal evidence that teaching was done and communicates the information to there health professionals. May include; objective statements, nursing notes, many agencies provide special documentation
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Evaluation of Learning
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It is essential to improving the quality of instruction, evaluate the entire nursing process.
Method commonly used for outcomes evaluation include; tests and written exercises, oral questions/interviews/questionnaires/checklists, direct observations of client performance, reports and client records |
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Describe various viewpoints an individual may have in regards to health
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-A condition in which all functions of body and mind are normally active. (Health Perceptions)
-The World Health Organization (WHO) defines health as a state of complete physical, mental or social well-being and not merely the absence of disease. |
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Define health education as a part of health promotion
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-Clients/families need information for decision making
-Shorter hospital stays increase need for teaching about home-care needs -Teaching facilitates compliance and shortens hospital stays and medical complications -Teaching empowers clients and families |
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Explain the role of the nurse in health education
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-The ANA standard of practice related to patient teaching states:
-“The registered nurse employs strategies to promote health and a safe environment.” |
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Cognitive learning
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Storing and recalling information in the brain. Ranging from simple to complex processes, it encompasses six levels of behavior: memorization, recall, comprehension and analysis, synthesis, application, and evaluation of ideas.
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Psychomotor learning
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Learning a skill that requires both mental and physical activity. Requires the learner to accept and value the skill (the affective domain) as well as know about the skill (the cognitive domain.)
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Affective learning
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Involves changes in feelings, beliefs, attitudes, and values. It is considered the “feeling domain.”
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Describe the essential pieces of a teaching plan
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Assessment, Analysis/Nursing Diagnosis, Planning Outcomes, Planning Interventions/Implementation, Evaluation of Learning
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Identify data needed to determine the learning needs of a client
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The client’s need for information is based on actual or anticipated healthcare or developmental needs. What is the client’s medical (or other) problem? What behavioral changes are needed? What self-care knowledge and skills doest he client need?
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Discuss evaluation outcomes
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-The patient learning is an outcome that is achieved or not
-Evaluation criteria are identified prior to implementing the plan -It's an On-going process -Revisions are made |
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List documentation points that should be included
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Date and time, What did you teach?, How did you teach?, Who was taught?, How did it go?, What information was left with the client?, Who was there?, Signature
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