Patient Education

1. Patient Education
Binal Joshi
Assistant professor
Child health Nursing
MTIN,CHARUSAT

2. CONTENT
Patient education
• Patient Teaching
• Importance,
• Purposes,
• Process
Integrating nursing process in patient teaching

3. OBJECTIVE
Identify the appropriate topics that address a patient’s health education
needs.
Describe the similarities and differences between teaching and learning.
Identify the role of the nurse in patient education.
Identify the purposes of patient education.
Identify basic learning principles

4. Use communication principles when providing patient education.
Describe the domains of learning.
Discuss how to integrate education into patient-centered care.
Differentiate factors that determine readiness to learn from those
that determine ability to learn.
OBJECTIVE

5. Compare and contrast the nursing and teaching processes.
Write learning objectives for a teaching plan.
Establish an environment that promotes learning.
Include patient teaching while performing routine nursing care.
Use appropriate methods to evaluate learning.
OBJECTIVE

6. • Patient education is one of the most important roles for a nurse in any
health care setting.
• Shorter hospital stays, increased demands on nurses’ time, an increase in
the number of chronically ill patients, and the need to give acutely ill
patients meaningful information quickly emphasize the importance of
quality patient education.
• As nurses try to find the best way to educate patients, the general public
has become more assertive in seeking knowledge, understanding health,
and finding resources available within the health care system.
INTRODUCTION

7. • Nurses provide patients with information needed for self-care to
ensure continuity of care from the hospital to the home (Falvo, 2010).
• Patients have the right to know and be informed about their
diagnoses, prognoses, and available treatments to help them make
intelligent, informed decisions about their health and lifestyle.
• Part of patient-centered care is to integrate educational approaches
that acknowledge patients’ expertise with their own health
INTRODUCTION

8. • Creating a well-designed, comprehensive teaching plan that fits a
patient’s unique learning needs reduces health care costs,
improves the quality of care, and ultimately changes behaviors to
improve patient outcomes.
• Ultimately this helps patients make informed decisions about their
care and become healthier and more independent
(Edelman and Mandle, 2010; Villablanca et al., 2010).
INTRODUCTION

9. Maintenance and
Promotion of
Health and Illness
Prevention
Restoration of
Health
Coping with
Impaired
Functions
PURPOSES OF PATIENT EDUCATION

10. • Patient education has long been a standard for professional
nursing practice.
• All state Nurse Practice Acts recognize that patient teaching
falls within the scope of nursing practice (Bastable, 2006).
• In addition, various accrediting agencies set guidelines for
providing patient education in health care institutions.
STANDARDS FOR PATIENT EDUCATION

11. • These standards require nurses and the health care team to assess
patients’ learning needs and provide education about many topics,
including medications, nutrition, the use of medical equipment,
pain, and the patient’s plan of care.
• Successful accomplishment of the standards requires collaboration
among health care professionals and enhances patient safety.
STANDARDS FOR PATIENT EDUCATION

12. • Educational efforts should be patient-centered by taking into
consideration patients’ own education and experience, their
desire to actively participate in the educational process, and
their psychosocial, spiritual, and cultural values.
• It is important to document evidence of successful patient
education in patients’ medical records. Standards such as
these help to direct your patient education
STANDARDS FOR PATIENT EDUCATION

13. • Nurses have an ethical responsibility to teach their patients (Heiskell, 2010).
• TJC’s Speak Up Initiatives helps patients understand their rights when receiving
medical care. The program offers the following Speak Up tips to help patients become
more involved in their treatment:
Speak up if you have questions or concerns. If you still do not understand, ask again. It is
your body, and you have a right to know.
Pay attention to the care you get. Always make sure that you are getting the right
treatments and medicines by the right health care professionals. Do not assume
anything.
Educate yourself about your illness. Learn about the medical tests that are prescribed
and your treatment plan.
Role of the Nurse in Teaching and
Learning

14. Ask a trusted family member or friend to be your advocate
(advisor or supporter).
Know which medicines you take and why you take them.
Medication errors are the most common health care
mistakes.
Use a hospital, clinic, surgery center, or other type of health
care organization that has been carefully evaluated.
Participate in all decisions about your treatment. You are
the center of the health care team.

15. In addition, patients are advised that they have a right to be informed about the care
they will receive, obtain information about care in their preferred language, know the
names of their caregivers, receive treatment for pain, receive an up-to-date list of
current medications, and expect that they will be heard and treated with respect.
Teach information that patients and their families need.
To be an effective educator, the nurse has to do more than just pass on facts. Carefully
determine what patients need to know and find the time when they are ready to learn.
When nurses value and provide education, patients are better prepared to assume
health care responsibilities

16. Teaching is an interactive process that promotes
learning. It consists of a conscious, deliberate set of
actions that help individuals gain new knowledge,
change attitudes, adopt new behaviors, or perform
new skills (Billings and Halstead, 2009).
Learning is the purposeful acquisition of new
knowledge, attitudes, behaviors, and skills (Bastable,
2008). Complex patterns are required if the patient is
to learn new skills, change existing attitudes, transfer
learning to new situations, or solve problems
(Redman, 2007).
TEACHING AND LEARNING

17. Teaching as Communication

19. Cognitive domain

20. Affective domain

21. Psychomotor Domain

25. APPROPRIATE TEACHING METHODS BASED
ON DOMAINS OF LEARNING

26. Discussion
• Involves nurse and one patient or a nurse with several patients
• Promotes active participation and focuses on topics of interest to patient
• Allows peer support
• Enhances application and analysis of new information

27. Lecture
Is more formal
method of
instruction
because it is
teacher controlled
Helps learner
acquire new
knowledge and
gain
comprehension
Question-and-
answer session
Addresses
patient’s specific
concerns
Assists patient in
applying
knowledge
Role play,
discovery
Allows patient to
actively apply
knowledge in
controlled
situation •
Promotes
synthesis of
information and
problem solving
Independent
project
(computer-
assisted
instruction),
field
experience
Cognitive Domain

28. Affective
• Role play
• Discussion
Psychomotor
• Demonstration
• Practice
• Return
Demonstration
• Independent
projects,
• Games

29. Motivation to Learn
• Attentional Set
• Motivation
• Use of Theory to Enhance Motivation and
Learning
• Psychosocial Adaptation to Illness
• Active Participation
BASIC LEARNING PRINCIPLES

30. Ability
to
Learn
Developmental
Capability
Learning in Children
Adult Learning
Physical Capability

31. Infant
• Keep routines (e.g., feeding, bathing) consistent.
• Hold infant firmly while smiling and speaking softly to convey
sense of trust.
• Have infant touch different textures (e.g., soft fabric, hard plastic)

32. Toddler
Use play to teach procedure or activity
(e.g., handling examination equipment,
applying bandage to doll).
Offer picture books that describe story
of children in hospital or clinic.
Use simple words such as cut instead
of laceration to promote
understanding.

33. Preschooler Use role play, imitation, and play to make learning fun.
Encourage questions and offer explanations. Use simple
explanations and demonstrations.
Encourage children to learn together through pictures
and short stories about how to perform hygiene.
School-Age
Child
Teach psychomotor skills needed to maintain health.
(Complicated skills such as learning to use a syringe
take considerable practice.)
Offer opportunities to discuss health problems and
answer questions.

34. Adolescent
• Help adolescent learn about feelings and need for
self-expression. • Use teaching as collaborative
activity.
• Allow adolescents to make decisions about health
and health promotion (safety, sex education,
substance abuse).
• Use problem solving to help adolescents make
choices.

35. Young or Middle Adult
• Encourage participation in teaching plan by setting mutual goals. •
Encourage independent learning.
• Offer information so adult understands effects of health problem.
Older Adult • Teach when patient is alert and rested.
• Involve adult in discussion or activity.
• Focus on wellness and person’s strength.
• Use approaches that enhance sensorial impaired patient’s
reception of stimuli
• Keep teaching sessions short.

36. Learning
Environment

91. NURSING
PROCESS
Assessment
Diagnosis
Planning
Intervention
Evaluation

93. NURSING ASSESSMENT QUESTIONS
Previous Learning and Identification of Learning Needs and Preferences
• What do you want to know about ______________?
• What do you know about your illness and your treatment plan?
• Which experiences have you had in the past that are similar to those you are experiencing
now?
• Together we can choose the best way for you to learn about your disease. How can I best help
you?
• When you learn new information, do you prefer to have it given to you in pictures or written
down in words?
• When you give someone directions to your house, do you tell the person how to get there,
write out the instructions, or draw a map?

94. Self-Management
• How does (or will) your illness affect your current lifestyle?
• Which barriers currently exist that prevent you from managing your
illness the way you would like to manage it?
• What role do you believe your health care providers should take in
helping you manage your illness or maintain health?
• How involved do you want a family member to be in the management
of your illness? Who is that family member?
Culture and Spiritual Influences
• Which cultural or spiritual beliefs do you have regarding your illness
and the prescribed treatment?

95. For Family Caregivers
• When are you available to help, and how do you plan to help
your loved one?
• Your spouse needs some help. How do you feel about
learning how to assist him or her?
• Tell me how you feel about performing the care activities
that your family member requires.

96. Assess
Learning needs
Motivation to learn
Ability to learn
Teaching environment
Resources for Learning
Health Literacy and Learning Disabilities

97. Sample Nursing Diagnosis
Deficient knowledge (affective, cognitive, psychomotor)
Ineffective health maintenance
Impaired home maintenance
Ineffective family therapeutic regimen management
Ineffective self-health management
Noncompliance (with medications)

98. Goals and Outcomes
PLANNING
• Setting Priorities
• Timing
• Preparation and selection of teaching material

99. IMPLEMENTATION
Maintaining Learning Attention and
Participation
Building on Existing Knowledge
Teaching Approaches
Incorporating Teaching with Nursing Care
Instructional Methods
Illiteracy and Other Disabilities
Cultural Diversity
Using Teaching Tools
Special Needs of Children and Older Adults

100. Teaching Approaches
Telling
Participating
Entrusting
Reinforcing

101. Instructional
Methods
One-on-One Discussion.
Group Instruction
Preparatory Instruction
Demonstrations.
Analogies.
Role play
Simulations

102. Providing Patient Education
• You facilitate learning by using the following
interventions when providing patient education to older
adults:
• Begin and end each teaching session with the most
important information.
• Present information slowly.

103. • Speak in a low tone of voice (lower tones are easier to hear
than higher tones).
• Allow enough time for understanding the material.
• Emphasize concrete material that applies to current
situations.
• Present only crucial information to avoid overwhelming the
learner.
• Provide specific information in frequent, small amounts.
• Repeat important information.
• Relate new material to previous life experiences.

104. • Build on existing knowledge.
• Allow patients to progress at their own pace (older adults
are more cautious; thus it may take longer to adopt a
behavior change).
• Use group experiences if appropriate to enhance problem
solving.
• If using written material, assess patient’s ability to read and
use information that is printed in large type and in a color
that contrasts highly with the background (e.g., black 14-
point print on buff-colored paper).
• Avoid blues and greens because they are more difficult to
see

105. EVALUATION
• Were the patient’s goals or outcomes realistic and observable?
• Did the patient value the information provided?
• Was the patient willing to change an existing or adopt a new behavior?
• What barriers prevented learning or change in behaviors?
• Is the patient able to perform the behavior or skill in the natural setting (e.g., home)?
• How well is the patient able to answer questions about the topic?
• If the patient is completing a log, how well does the log match what was taught?
• Does the patient continue to have problems understanding the information or
performing a skill? If so, how can the nurse change the interventions to enhance
knowledge or skill performance?

106. A patient needs to learn to use a
walker. Which domain is required
for learning this skill?
The nurse is planning to teach a
patient about the importance of
exercise. When is the best time for
teaching to occur? (Select all that
apply.)
1. Affective domain
2. Cognitive domain
3. Attentional domain
4. Psychomotor domain
1. When there are visitors in the
room
2. When the patient’s pain
medications are working
3. Just before lunch, when the
patient is most awake and alert
4. When the patient is talking about
current stressors in his or her life

108. A patient newly diagnosed with cervical
cancer is going home. The patient is
avoiding discussion of her illness and
postoperative orders. What is the nurse’s
best plan in teaching this patient?
The school nurse is about to teach a
freshman-level high school health class
about nutrition. What is the best
instructional approach to ensure that the
students meet the learning outcomes?
1. Teach the patient’s spouse
2. Focus on knowledge the patient will need
in a few weeks
3. Provide only the information that the
patient needs to go home
4. Convince the patient that learning about
her health is necessary
1. Provide information using a lecture 2. Use
simple words to promote understanding 3.
Develop topics for discussion that require
problem solving 4. Complete an extensive
literature search focusing on eating
disorders

109. 1.A nurse is going to teach a patient how to perform
breast self-examination. Which behavioral objective
does the nurse set to best measure the patient’s ability
to perform the examination?
2.A patient with chest pain is
having an emergency cardiac
catheterization. Which
teaching approach does the
nurse use in this situation?
1. The patient will verbalize the steps involved in breast
selfexamination within 1 week.
2. The nurse will explain the importance of performing
breast self-examination once a month.
3. The patient will perform breast self-examination
correctly on herself before the end of the teaching
session.
4. The nurse will demonstrate breast self-examination on a
breast model provided by the American Cancer Society
1. Telling approach
2. Selling approach
3. Entrusting approach
4. Participating approach

110. . The nurse is teaching a parenting class to a group of
pregnant adolescents. The nurse pretends to be the
baby’s father, and the adolescent mother is asked to show
how she would respond to the father if he gave her a can
of beer. Which teaching approach did the nurse use?
1. Role play
2. Discovery
3. An analogy
4. A demonstration

111. An older adult is being started on a
new antihypertensive medication.
In teaching the patient about the
medication, the nurse:
A patient needs to learn how to
administer a subcutaneous
injection. Which of the following
reflects that the patient is ready to
learn?
Speaks loudly.
Presents the information once.
Expects the patient to understand the
information quickly.
Allows the patient time to express
himself or herself and ask questions
1. Describing difficulties a family
member has had in taking insulin
2. Expressing the importance of
learning the skill correctly
3. Being able to see and understand
the markings on the syringe
4. Having the dexterity needed to
prepare and inject the medication

112. A patient who is hospitalized has
just been diagnosed with diabetes.
He is going to need to learn how to
give himself injections. Which
teaching method does the nurse
use?
When a nurse is teaching a patient
about how to administer an
epinephrine injection in case of a
severe allergic reaction, he or she
tells the patient to hold the
injection like a dart. Which of the
following instructional methods
did the nurse use?
1. Simulation
2. Demonstration
3. Group instruction
4. One-on-one discussion
1. Telling
2. Analogy
3. Demonstration
4. Simulation

113. When a nurse is teaching a patient about how to
administer an epinephrine injection in case of a severe
allergic reaction, he or she tells the patient to hold the
injection like a dart. Which of the following
instructional methods did the nurse use?
• Telling
• Analogy
• Demonstration
• Simulation

114. A nurse is teaching a group of
young college-age women the
importance of using
sunscreen when going out in
the sun. What type of content
is the nurse providing?
A nurse is planning a
teaching session about
healthy nutrition with a
group of children who are in
first grade. The nurse
determines that after the
teaching session the children
will be able to name three
examples of foods that are
fruits. This is an example of:
A nurse is teaching a 27-year-
old gentleman how to adjust
his insulin dosages based on
his blood sugar results. What
type of learning is this?
1. Simulation 2. Restoring
health 3. Coping with impaired
function 4. Health promotion
and illness prevention
1. A teaching plan. 2. A learning
objective. 3. Reinforcement of
content. 4. Enhancing the
children’s self-efficacy.
1. Cognitive
2. Affective
3. Adaptation
4. Psychomotor

115. ANSWERS
1-4
2-2
3-3
4-3
5-3
6-1
7-1
8-4
9-2
10-2
11-2
12-1
13-4
14-2
15-1

116. Thank you….