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Culture Documents
Patient Education Learning Need
Patient Education Learning Need
Patient Education Learning Need
Learning Module
INTRODUCTION
The information given to the patient should be appropriate for the patient's age,
literacy level, education, and language skills. Patient materials should be geared
between sixth- and eight-grade reading levels. Use of medical terminology or
jargon should be avoided. For example, the term's "myocardial infarction" and
"MI" should not be used in place of "heart attack" unless they have already been
defined for the patient.
With shorter lengths of stay and limited time for teaching, print and audiovisual
materials are important adjuncts for any discharge teaching plan. They are,
however, just adjuncts and should not replace individualized instruction. Printed
materials are useful for reinforcing information provided to patients while in the
hospital and also serve as a ready resource. Printed material is an important
reminder of key points after patients return home.
Family members are the vital links in the transition from hospital to home care.
Families must be included in discussions and demonstrations. Family is any person
who plays an important role in the patient's life.
Every effort must be made to ensure that learning takes place in incremental steps
and that patients are not overwhelmed with too much information at one time
"TEAM WORK"
Patient Assessment:
The FIRST STEP in patient education is the review the Admission Assessment for
learning needs.
Then meet with the patient to determine what are specific needs for that patient.
Rehabilitation:
Patient/family may need to know, depending on patient's physical needs:
- Rehabilitation techniques (example: special exercises, speech therapy, etc.)
- Safe and effective use of equipment.
Pain Management:
- Understanding pain and the risk of pain
- How to describe pain
- How pain will be managed
Personal Hygiene:
Instructions for bathing and toileting may be needed.
Psychosocial:
Information about possible emotional reactions, interpersonal functioning or
normal feelings secondary to diagnosis or treatment.
Community Resources:
The patient/family may need helpful local resources:
- Transportation services
- Health clinic(s)
- Home health care agency
- Outpatient Dialysis
- Support Group(s) or Self-Help Group(s)
Patient Rights:
All patients or a family member must be informed of their rights with regard to:
- Informed consent
- Privacy
- Treatment options
- Advanced directives
- Respect
Patient Responsibilities:
Patient/family members must be informed of their responsibility to communicate:
- present complaints
- present illnesses
- prior hospitalizations
- types of medications/alternative treatments that the patient is using or has used
- other health related issues/concerns
- questions about the diagnosis or care plan.
Follow-up Care:
Instructions involved in discharge planning:
- Where to go for follow-up care
- When to get help (for example, side effects to report)
- Where to get medical equipment or medications.
PHYSICAL NEEDS:
- What kind of care does the patient will need at home (i.e., care for themselves, or
if support is needed.
- Can the patient hear clearly or read small printed materials.
AGE:
- Choose language and teaching methods appropriate for the patient's age and
education level.
SUPPORT SYSTEM:
- Assess not only the patient but also anyone involved in the patient's care.
Especially if a family member/significant other is going to be the patient's
caregiver after discharge.
FEELINGS:
- Assess if the patient is having difficulty accepting their condition.
They may feel: overwhelmed, afraid, angry, or depressed.
This may affect the patient's readiness or ability to learn.
OTHER NEEDS:
- Patient's reading level and ability to learn
- Ability to understand English
- Financial and/or insurance coverage for durable medical equipment and supplies
and medications.
Next, you want to set goals and priorities. Then, decide which ones you will
teach to your learner to change his/her behavior.
To Review:
1. Identify your learner's educational needs
2. Assess your patient and/or significant other's learning needs
3. Identify barriers to learning
4. Identify the best teaching plan for your patient
5. Set goals/priorities
Actual Teaching:
At this point you are ready to "fill in the gaps" of your learner's knowledge and
skills. You may need to "correct" wrong ideas about care of self at home.
You teach any time you talk to your patient and/or significant other(s).
Teaching and learning take place until the day your patient leaves the hospital.
All health care providers - physicians, nurses, social worker, dietitian, rehab
therapist, respiratory therapist, and others who provide direct patient care -
supplement teaching.
This is why you want to refer your patient to outside agencies or support groups.
These places can be good sources of education.
REVIEW:
First, you identify who your learner(s) is/are. If you see that your patient is not able
to receive any teaching, you then identify the patient's significant other. This
significant other will be your learner.
Second, you want to know if there are things that make it difficult for your patient
and/or significant other to learn (barriers to learning). You can ask questions like:
- What circumstances make it difficult for the patient and/or significant other to
learn?
- How can I help the patient and/or significant other overcome these difficulties?
Third, you plan your teaching. Ask yourself the following questions to choose the
best teaching plan:
- What does the patient already know about his/her health condition?
- What else does this patient need to know about his/her health condition?
- What does the patient know that needs reinforcement?
Agree on responsibilities.
The patient's responsibilities may include:
- Giving you accurate health information
- Following instructions
- Asking questions when something isn't clear
The health care provider's responsibilities include:
- Explaining the care you provide
- Answering questions
- Treating the patient with respect
Offer feedback.
Inform the patient on how they are progressing. Give praise and encouragement
when patient
shows effort or progress.
Diet/Nutrition
Document the type of diet the patient is on.
Self-Care
Any activity/behavior that needs to be taught to the patient, to be initiated at home
for health
maintenance and self-management.
- S/S which signal a relapse
- S/S to expect during an exacerbation of chronic condition(s)
- How to record duration, location, severity of S/S
- Calling MD immediately when S/S occur
- Use of (name of equipment) at home
- Other: BP check, Limit or quit smoking/drinking, Importance of diet/rest/ or
exercise
Equipment/Rehabilitation
For example:
For Dx of Asthma:
- Nebulizer/Inhaler
- Peak flow meters
- Spacers
For Dx of Diabetes:
- Needles & Syringes
- Alcohol wipes
- Glucometer
- Strips
- Lancets
For Dx of CVA:
- Canes
- Walkers
- Wheelchair
Choose one (1) of the three (3) case scenarios and document patient education on
the
Interdisciplinary Patient Education Record.
The health care provider/educator should review the Admission Assessment for
learning needs.
Readiness assessment
Columns 6 to 8 Indicate your judgement of the patient's/caregiver's readiness to
learn.
If the patient is uncooperative and you do not have another family member to
teach, indicate this
and make another attempt later.
Example of a patient that denies need for learning:
An insulin dependent diabetic patient denies need for learning, ask the patient if
you can return to
observe him giving his next injection and document findings in outcome section.
Focus
Columns 9 to 27 These columns indicate the subject matter being taught.
Some subjects may be taught repeatedly and by different
disciplines.
The subject headings provide a quick glance at the patient's educational activities.
Barriers
Contains the checklist of potential barriers to learning that need to be considered
when providing the education.
Content
Column 28 Leaves enough room to state the teaching content, name of literature,
or video.
Documentation may be continued on the back of the form.
For example: Diabetic patient - content signs/symptoms of hyperglycemia and
hypoglycemia; blood
glucose monitoring; insulin administration; safety and personal hygiene issues -
stressed dental,
foot, and skin care; diet; activity; given BD Home Care Kit/Literature; referral to
local diabetes
support groups, the ADA; etc.
It is not always possible to capture the essence of the teaching in a single entry.
If you have documented your teaching in another location in the chart, use this box
to indicate where
it may be found (e.g. nursing progress note of date of entry). You may also use the
back of the form
to further describe your teaching activities.
Methods
Columns 29-32 Indicate which method was used to communicate the information.
The method selected should be appropriate to the age, culture, and language of
your patient.
Outcome
Column 33 to 35 Indicate the results of your teaching/patient's learning.
If the patient is unable to verbalize or give a return demonstration, the column
"needs review" is
checked. When this column is checked teaching must be repeated and reinforced.
If the patient verbalized understanding and/or gave a return demonstration, check
the
corresponding column, and then move onto another topic/area of instruction.
Initials
Column 36 The health care provide initials in this column each time an entry is
made.
The first time the initials are used on the form, the signature key on the bottom of
the form must be
legibly completed.
Initial, sign your full name and add your title/department.
1. I believe that I am teaching every time I interact with a patient. I can't write
all that down. Where does it all end? Which of the many areas of teaching
should I document?
Some teaching merits special attention and documentation because the patient
and/or caregiver
will be able to influence the outcome of care by applying this knowledge.
Examples of teaching are preparations for tests and procedures, safe and effective
use of
medications, safe and effective use of equipment, understanding potential food and
drug
interactions, signs and symptoms of complications, dietary restrictions, and how to
contact
community services.
Teaching is incorporated into routine care as you explain what you are doing, ask
and answer
questions and demonstrate techniques.
Summarize what you covered during your shift as you complete your shift notes.
If the treatment plan or condition changes, the educational needs of the patient
must be
reassessed.
You need to call the caregiver in or ask the social worker to help to identify the
family
member(s)/caregiver(s).
If the caregiver is going to be another institution (e.g. nursing home), the patient
care needs are
communicated in the transfer form or discharge instructions.
6. What if my patient or the caregiver does not speak English or cannot hear?
Utilize the Volunteer Interpreter List or call one of the telephonic interpreter
services such as Language Line or CyraCom or call Social Work Services to
schedule an interpreter for the hearing impaired and other language interpreters.
If the teaching can be done through demonstration or drawing pictures and the
return demonstration
indicates comprehension and learning, you have completed your task.
7. What if the topic that I just reviewed with the patient was already documented
as being taught by someone else?
The idea of this form is to document the collaboration of the interdisciplinary
health care team.
Many of our teaching materials are reviewed or developed with input from an
interdisciplinary group
so that a single educator can provide all the teaching. However, if you assess a
learning need and
provide instruction, you should document it.