Patient Education.pptx

PATIENT EDUCATION
BY
MRS.HEPZIBAH ARULMANI.P
TUTOR
SRMTCON

INTRODUCTION
Nurses’ patient education is important for building
patients’ knowledge, understanding and preparedness for
self-management. The ultimate goal of patient
educational program is to achieve long-lasting changes
in behavior by providing patients with the knowledge to
allow them to make autonomous decisions to take
ownership of their care as much as possible and improve
their own outcomes.

CONCEPT OF PATIENT EDUCATION
• Education on health issues is necessary for a patient’s
physical and mental health.
• Everybody finds themselves in situations where they
require special knowledge and skills in order to meet
their basic needs and sustain their lives.
• All patients have the right to be educated on
maintaining their health, disease prevention, and health
promotion.

Cont;
• Health promotion is the process of advancing knowledge,
influencing attitudes, and determining relevant solutions so
that people can make informed choices, change their
behavior and subsequently attain a desirable level of physical
and mental health improve their social and physical
environment.
• Effective patient education starts from the time patients are
admitted to the hospital and continuous until they are
discharged.

Cont;
• Nurses should take advantage of any appropriate
opportunity throughout a patient’s stay to teach the
patient about self-care.
• The self- care instruction may include teaching
patients how to inject insulin, bathe an infant or
change a colostomy pouching system.

DEFINITION
Patient education is the process by which health
professionals and others impart information to patients
and their caregivers that will alter their health behaviors
or improve their health.

MEANING OF PATIENT EDUCATION
• The Latin origin of the word doctor “decree” means “to
teach" and the education of patients and their families, as
well as communities, is the responsibility of all
physicians.
• Family physicians are uniquely suited to take a leadership
role in patient education.
• Family physicians build long- term, trusting relationships
with patients, providing opportunities to encourage and
reinforce changes in health behavior.

FAMILY PHYSICIANS ROLE
• Patient education is,therefore,an essential component of
residency training for family physicians.
• Patient education is critically important because it is
clear that the leading cause of death are closely
associated with unhealthy lifestyles.
• There is also strong evidence to suggest that counselling
and patient education provides substantial benefits.
- Cont;

• Providing patients with complete and current
information helps create an atmosphere of trust,
enhances the doctor-patient relationship and empowers
patients to participate in their own health care.
• Effective PE also ensures that patients have sufficient
information and understanding to make informed
decisions regarding their care.
• To provide effective patient education ,variety of
practical skills must be mastered.

PURPOSES OF PATIENT TEACHING
The three main purposes of patient education are
• To maintain and promote health
• Prevent illness, restore the patient’s health,
• Teach the patient how to cope with their condition.

RESIDENT ATTITUDE
The resident should develop attitudes that:
• Recognize PE as essential to the discipline of family
medicine and as an integral part of each patient
encounter.
• Recognize that educational interventions are essential in
the treatment of disease and in the maintenance of health.
• Recognize the responsibility of the physician to educate
the patient and the family.

• Emphasize the necessity of educating the patient and /or
responsible parties in issues involving informed consent.
• Appreciate the importance of assessing a patient’s
educational needs, readiness to learn and comprehension
of information.
• Value the opportunity to utilize “teachable moments "in
a patient-physician encounter.
• Understand the need to empower the patient in the
decision - making process. - Cont;

• Value the power of a trusting, long - term doctor -patient
relationship in effecting behavior change.
• Promote the physician’s role in influencing the health
status of the community through involvement in
community education projects.
• Recognize the responsibility to model healthy lifestyle
practices.
• Recognize that cultural differences affect health beliefs
and that PE must take these differences into account.

KNOWLEDGE
PRINCIPLES OF PATIENT EDUCATION:
• Adapt teaching to the patient’s level of readiness, past
experience, culture and understanding.
• Create an environment conducive to learning with trust,
respect and acceptance.
• Involve patients throughout the learning process by
encouraging them to establish their own goals and
evaluate their own progress.

Cont;
• Provide motivation by presenting material relevant to
the patient’s needs.
• Provide opportunities for patients to demonstrate their
understanding of information and to practice skills.

SKILLS
Basic Skills:
• Identify patient’s educational needs.
• Gather information about patient’s daily activities,
knowledge, health beliefs and level of understanding.
• Inform patient of findings clearly and concisely.
• Discuss treatment plans in terms of specific behaviors.
• Encourage questions and provide appropriate answers.

Short - term plans for acute illness:
• Prepare patient for symptoms and effects of condition,
examination or treatment.
• Assess patient’s ability to carry out treatment plan;
identify barriers and individualize treatment plan
accordingly.
• Assess patient’s understanding by having him or her
restate the treatment plan.
• Document educational efforts in specific terms in the
record.

Long – term strategies for chronic disease:
• Involve patient in setting treatment goals and plan.
• Present manageable amounts of information to
patient.
• Provide opportunities for patient to discuss feelings.
• Provide patient with adequate feedback on progress
toward goals.
• Document educational efforts in specific terms in the
record.

Health promotion:
• Determine patient’s health – risk behaviors through
interview and health –risk appraisals.
• Introduce health – promotion topics during “teachable
moments”
• Assess patient’s priorities and readiness to change health –
related behaviors.
• Employ educational messages appropriate for various
stages of behavior change.Incorporate use of appropriate
community resources.

Incorporation of patient education in practice:
• Develop patient education handouts and protocols.
• Select instructional materials appropriate for patient’s
readiness to learn and level of understanding.
• Develop systems to facilitate use of patient education
materials in office practice.
• Develop systems to involve office staff in assisting with
patient education.
• Utilize family conferences when appropriate.
• Be aware of emerging technologies.

PREREQUISITES(PRELIMINARYASSESSMENT)
OF PATIENT EDUCATION
• Before even starting to educate the patient, the nurse
must always assess the patient to see what type of
environment will be most beneficial for them and
factors that may interfere.
• Another component to consider about the environment
is appropriate lighting, temperature.
• Along with comfort, it is important to always asses the
patient for any pain before proceeding.

Cont;
 Pain would interfere with patient’s necessary level of
strength in order to perform learned skills and distract
them from the learning material.
 Also she should be well-rested in order to stay alert
and fully engaged in discussions for maximum
learning.
 The patient should always be assessed for coordination
and sensory acuity as well in order for them to perform
certain motor skills and receive and respond to
messages being taught. Lastly, the nurse must take into
consideration their condition and how it may interfere
with the learning process.

BARRIERS TO PATIENT EDUCATION
• Physical condition
• Financial considerations
• Lack of support system
• Misconceptions about disease and treatment
• Low literacy /comprehension skills
• Cultural /ethnic background /language barriers
• Lack of motivation
• Environment
• Negative past experience
• Denial of personal responsibility

NEED & IMPORTANCE OF PATIENT
TEACHING
• Patient education enables patients to assume better
responsibility for their own health care, improving
patients’ ability to manage acute and chronic disorders.
• Patient education provides opportunities to choose
healthier lifestyles and practice preventive medicine.
• Patient education attracts patients to the provider and
increases patients’ satisfaction with their care, while at
the same time decreasing the provider’s risk of liability.

Cont;
• Patient education promotes patient-centered care and
as a result, patients’ active involvement in their plan
of care.
• Patient education increases adherence to medication
and treatment regimens, leading to a more efficient
and cost- effective health care delivery system.

Cont;
• Patient education ensures continuity of care and
reduces the complications related to illness and
incidence of disorder/disease.
• Patient education maximizes the individual’s
independence with home exercise programs and
activities that promote independence in activities of
daily living as well as continuity of care.

PROCESS OF PATIENT EDUCATION
The process of patient teaching refers to the steps
follow to provide teaching and to measure learning.
The steps involved in the teaching-learning process are:
 Assessing learning needs
 Developing learning objectives
 Planning and implementing patient teaching
 Evaluating patient learning
 Documenting patient teaching and learning

Assessing the Learning needs:
Learning needs vary according to the patients health
status every time during his stay in the hospital and even
after the follow up visits.
e.g.: i)On admission the patient teaching would include the
????? ii)Before starting of the treatment patient would
want to know???
iii)Before the surgery or during any special treatment or
investigation patient must understand it…….

Developing learning objectives:
• What you want to achieve at the end of the teaching should
reflect in the learning objectives of the patient.
• Objectives should be achievable and assessable.
• Mention clearly what is expected form the patient in
relation to his attitude, lifestyle, understanding etc.
Planning and implementing patient teaching
• Always be ready for patient teaching.
• P.T can be more fruitful if it is well planned and organized.

Cont;
• Planning is done according to the need of the patient.
• Environment, Time of the P.T., patients health status has
be taken into consideration.
• Good to take an appointment with the patient and fix the
time of the P.T. and also tell the approximate time you
are going to require.
• Use of charts, flash cards, posters can be useful.
• Introduce the topic and also don’t forget to tell the
patient and the family that they may stop you anytime
during the patient teaching to clear their doubt.
• Before ending the P.T. confirm that client understood the
topic and also whether the objectives of the P.T. are
achieved.

Evaluating the patient teaching:
• Check out the P.T. objectives.
• Evaluate the P.T. according to the objectives
met/unmet/needs more time to change the attitude of
the patient.
• Take feed back from the patient, family members, and
other patients if at all they were attending the P.T.

Documenting the P.T.:
• Document the Patient Teaching, along with the Topic,
Time, patients response and number of participants who
attended the P.T. to avoid the repetition of the information
for the patient and prevent health care professional from
repeated works.
• It is safe for the nurse because client may admit some
time that he was unaware about the facts that created
harmful situation for him or others(Oxygenation –safety
precautions)

THERAPEUTIC PATIENT EDUCATION
DEFINITION:
Therapeutic patient education is pedagogical
accompaniment that aims to help patients acquire skills
they need to best manage their addictive behaviors and
regain control of their health.

CONCEPT OF THERAPEUTIC PATIENT
EDUCATION
• TPE is designed therefore to train patients in the skills
of self-managing or adapting treatment to their
particular chronic disease, and in coping processes and
skills.
• It should also contribute to reducing the cost of long –
term care to patients and to society.

Cont;
• It is essential to the efficient self - management and to
the quality of care of all long - term diseases or
conditions, though acutely ill - patients should not be
excluded from its benefits.
• TPE is education managed by healthcare providers
trained in the education of patients, and designed to
enable a patient, to manage the treatment of their
condition and prevent avoidable complication while
maintaining or improving quality of life.

CHARACTERISTICS
• It is focused on the patient.
• It is offered by trained professionals.
• It is multidisciplinary.
• It must be structured. Organization is fundamental since it is
a long –term operation.
• It is a continuous process.
• It is an intrinsic part of health assistance.
• It is a process of systematic learning
• It includes an assessment.

COMPETENCIES EXPECTED OF
HEALTHCARE PROVIDERS IN TPE
Healthcare providers should be able individually and in
teams to:
• Adapt their professional behavior to patients and their
diseases(acute/chronic).
• Adapt their professional behavior to patients, individually,
and in their families and groups.
• Recognize the needs of patients.
• Help patients to learn. - Cont;

• Adapt constantly their roles and actions to those of the
health care and the education teams with whom they
cooperate.
• Communicate empathetically with patients.
• Take account of the patient’s emotional state, their
experience and their representations of the disease and its
treatment.
• Educate patients in managing their treatment and in using
the available health, social and economic resources.

Cont;
• Educate and advice patients on the management of
crises and of factors that interfere with the normal
management of their condition.
• Use and integrate these tools in the care of patients
and in the patients learning process.
• Take account in therapeutic patient education of the
educational, psychological and social dimensions of
long – term care.

Cont;
• Help patients to manage their way of life.
• Select patient - education tools.
• Evaluate PE for its therapeutic effects and make the
indicated adjustments.
• Periodically evaluate & improve the educational
performance of healthcare providers.

PATIENT PREPARATION
Therapeutic education is an integral part of the assumption
of responsibility and healthcare treatment, and there are many
different skills that the patient must be guided to learn. For this
reason patients need to learn these skills gradually. These skills
include:
 Learning to understand oneself
 Self – monitoring
 Self – care capabilities
 Understanding the disease and how it is treated
 Ability to adapt therapy to one’s own lifestyle.

Cont;
• All this is completed bearing in mind the objectives
of their process:
• Improving the patient’s quality of life.
• Increasing control of clinical conditions.
• Improving adherence to therapy.
• Improving the quality of services offered.
• Optimizing care management times.

Cont;
• Promoting the more rational use of services.
• Reducing the consumption of drugs and related costs.
• Enhancing the role of the patient
• Reducing the number of hospitalizations.
• Optimizing care management times.

ROLE OF NURSE IN TPE
• When focusing on patients learning needs, before
begin the teaching process, must ask a number of
questions and perform specific assessments.
• This is important to determine her readiness and ability
to learn.
• The very first thing that must ask is if patient is willing
or able to accept the reality of her illness. - Cont;

Cont;
• So the next step need to do is introduce a teaching plan.
• In order to provide an effective teaching plan you must
consider the developmental and physical factors of
patient.
• For patient, nurse assessed her to make sure she was
able to read and write.
• This will make the learning process much easier,
allowing her to understand and apply the things she is
learning.

Cont;
• Another consideration need to take is patient’s age.
• Since patient is an elder, the best teaching approach
would be in short sessions and making sure she is
involved in discussions.
• According to LeCroy (2009), “To decrease frustration
in the learning process, information should be given in
an easy-to- understand format since the learner’s
attention can wane after only 10 minutes”.

Cont;
• Next you have to consider their physical capability.(So
in order for her to learn, I think it would be more
beneficial to use a cognitive or visual method rather
than a psychomotor method.)
• Finally after all these components are evaluated and
you have taught your patient the material needed, you
must evaluate what they have learned.

Cont;
• As stated by Hohler (2004), “To assess what your
patient has learned and determine whether he needs
more teaching, ask open-ended questions or have him
explain what he’s learned”.
• Then you can evaluate what the patient absorbed and
what needs more work.

VALUE OF PATIENT EDUCATION
• Education may be provided by any healthcare
professional who has undertaken appropriate training
education, and education is usually included in the
healthcare professional’s training.
• Health education is also a tool used by managed care
plans, and may include both general preventive
education or health promotion and disease or condition
specific education.
• It can also help the patients by a better lifestyle, it
give them the ability to learn new information.

Cont;
• The value of patient education can be summarized as
follows:
• Improved understanding of medical condition, diagnosis,
disease or disability.
• Improved understanding of methods and means to
manage multiple aspects of medical condition.
• Improved self –advocacy in deciding to act both
independently from medical providers and in
interdependence with them.

LEARNING DOMAINS
COGNITIVE AFFECTIVE PSYCHOMOTOR
The client will give
5 examples of side
effects of Lasix.
The client will
share his / her
feelings related to
taking Lasix for
hypertension.
The client will
practice new health
– related behaviors
regarding using of
Lasix for example:
Checking blood
pressure& heart
rate regularly.

OBJECTIVES OF PATIENT EDUCATION
Patient education is aimed at people with various
health conditions to help improve their understanding of
their health status through interactive communication
between patient and healthcare provider enabling
knowledge and self – care skills to be provided.
Healthcare providers trained in those educational skills
may contribute to:

Cont;
• Improved quality of life, as well as longer life, of
their long – term care patients.
• Improved quality of care in general (as acutely ill –
patients should also benefit from those educational
skills).
• Lower medical, personal and social costs, and
ultimately lower global costs.

IMPORTANCE OF PATIENT EDUCATION
Five key reasons why patient education should be a
strategic priority:
• Hospital reimbursements
• Chronic illness prevention
• Healthcare cost reduction
• Clinician time savings
• Patient experience improvements

Cont;
Hospital reimbursements:
Healthcare organizations to rely heavily upon value –
based care reimbursements, accelerating the shift
toward patient – centered care.
Now, providers are increasing patient education
efforts to ensure they continue to meet the standards of
value based care.

Cont;
Chronic illness prevention:
One of the most successful ways to combat chronic
illnesses is through self – management supported by patient
education.
Healthcare cost reduction:
• PE can help providers inform and remind patients of the
proper ways to self – manage care and avoid
nonessential readmissions.

Cont;
• Better education can also help patients understand the
care setting most appropriate for their condition and
avoid unnecessary trips to the hospital.
Clinician time savings:
This means patient visits must be short, which can be
problematic for several reasons. To start, shorter
consultation times have been linked to poorer health for
patients and increased burnout for doctors.

Cont;
• Short appointments make it difficult for patients to
communicate with their doctors and for doctors to ensure
patients fully understand the next steps they should be
taking in their care plan.
Patient experience improvements:
Ongoing patient education improves self – efficacy and
delivers better patient results by helping them adhere to
medication and treatment regimens, identify abnormal
symptoms, and decide what steps to take when issues arise.

BENEFITS OF PATIENT EDUCATION
• Patient education is the act of sharing medical
information with patients and /or their caregivers.
• It is also a tool used by managed care plans and may
include both general preventative education or as a
method to improve a patient’s health status for a
specific condition, disease or disability.
• Each member of the patient’s care team needs to be
involved. - Cont;

• Improved health outcomes
• Improved understanding of condition
• Increased use of cognitive coping strategies
• Increased motivation
• Improved quality of life
• Improved long –term outcomes
• Improved feelings of well – being
• Satisfaction - Cont;

• Empowers patients to take an active role
• Less time off work
• Greater independence
• Increased self - efficacy
• Increased self - management
• Increased life – expectancy
• Reduces complication
• Overall better healthcare experience

Cont;
Benefits of providing patient education:
• Healthcare professional satisfaction
• Effective use of resources
• Reduced burden on tax payers
• Fewer appointments required
• Fewer hospital admissions
• Shorter stays in hospital
• Fewer out - patient visits

PRINCIPLES OF PATIENT EDUCATION
• Patient - centered care is the practice of caring for
patients ( and their families) in ways that are
meaningful and valuable to the individual patients.
• It includes listening to informing and involving
patients in their care.
Picker’s Eight Principles Of Patient – Centered
Care:

Cont;
• Respect for patient’s preferences
• Coordination and integration of care
• Information and education
• Physical comfort
• Emotional support
• Involvement of family and friends
• Continuity and transition
• Access to care

Respect for patient’s preferences:
Involve patients in decision – making, recognizing they
are individuals with their own unique values and
preferences. Treat patients with dignity, respect and
sensitivity to his / her cultural values and autonomy.
Coordination and integration of care:
During focus groups, patients expressed feeling
vulnerable and powerless in the face of illness. Proper
coordination of care can alleviate those feelings. - Cont;

Patients identified three areas in which care coordination can
reduce feelings of vulnerability:
 Coordination of clinical care
 Coordination of ancillary and support services
 Coordination of frontline patient care
Information and education:
In interviews, patients expressed their worries that they
were not being completely informed about their condition or
prognosis. - Cont;

To counter this fear, hospitals can focus on three kinds of
communication.
 Information on clinical status, progress and prognosis
 Information on processes of care
 Information to facilitate autonomy, self – care and health
promotion.
Physical comfort:
Three areas were reported as particularly important to
patients: - Cont;

 Pain management
 Assistance with activities and daily living needs
 Hospital surroundings and environment
Emotional support & alleviation of fear and anxiety:
Caregivers should pay particular attention to:
 Anxiety over physical status, treatment and prognosis
 Anxiety over the impact of the illness on themselves and
family
 Anxiety over the financial impact of illness - Cont;

Involvement of family and friends:
Family dimensions of patient – care were identified as
follows:
 Providing accommodations for family and friends
 Involving family and close friends in decision making
 Supporting family members as caregivers
 Recognizing the needs of family and friends

Continuity and transition:
Patients expressed concern about their ability to care for
themselves after discharge.
Access to care:
Patients need to know they can access care when it is
needed. Focusing mainly on ambulatory care, the following
areas were of importance to the patient:
 Access to the location of hospitals, clinics and physician
offices
 Availability of transportation.
 Availability of appointments when needed.

ELEMENTS OF AN EDUCATIONAL,
PROGRAM
• Establish ,with learners, guidelines for organizing their
own learning.
• Guide learners in the selection of relevant health or
service problems and objectives.
• Assign to each problem adequate learning time.
• Contract with learners the criteria of certifying
evaluation.

Cont;
• Provide learners with valid self – evaluation.
• Instruments select relevant learning sites.
• Provide learning resources.
• Adjust the program on the basis of continuous
assessment.
• Ensure a system of program accreditation.

EFFECTIVE PATIENT TEACHING
STRATEGIES
Start right away:
Teaching should really begin at the time of admission.
During assessment, planning and diagnosing, nurses should
identify the needs and problems of the patient and his or her
family, as well as their education level.
Document the teaching process:
Good documentation can help maintain care continuity when
the patient’s care is transitioned from one nurse to the next.

Cont;
Set goals together:
From the beginning, the nurse and patient should decide
together on goals and objectives, ensuring that each person
understands the goals and why achieving the goals is important.
Emphasize necessary strategies:
In the inpatient setting, many patients fear losing their
independence. Patients will be motivated to learn what is
necessary for them to care for themselves. Nurses should
therefore emphasize these strategies.

Timing is everything:
Choose a mutually agreed upon time to teach. Look for a
time that is good for both you and the patient. For example,
patients that have just heard their diagnosis may need time to
process that information before they are open to learning.
Know what they already know:
Nurses do not want to spend time going over something that
the patient already knows. That time is better spent educating
or coaching the patient in other ways.

Consider education level and literacy:
Not all patients can understand complex medical terms and
some may not be able to read. Other patients may be very well -
educated and be familiar with terminology. Tailor your teaching
to each patient’s level of understanding to be the most effective.
Seeing and hearing is believing:
Customize your teaching to the patient’s physical abilities. If a
patient can’t hear well’ they may not digest verbal instructions.
Those that are vision – impaired won’t be able to read patient
handouts.

Cont;
Break it up:
Look for those ideal teaching moments where you
can impart small bits of education and engage the
patient by evaluating his or her understanding. Doing
this in small increments helps you and the patient.
Consider costs and income :
Keep your recommendations practical, especially for
patients on a fixed income.

PROVIDING EDUCATION TO PATIENTS OF
DIFFERENT AGES
Educating children, adolescent and young adult patients:
When providing pediatric patients and their families
with education, it is important to recognize that a
different approach is needed. The ability of children to
understand a diagnosis of cancer and its treatment can
be dependent on their developmental level.
- Cont;

Infancy:
During infancy education is directly solely towards the
parent or caregiver.
Toddlerhood:
During this stage of development education is also solely
directed towards the parent or caregiver however, as the
child gains autonomy and independence, it is important
the toddler is included in aspects of care as they are
capable of some degree of understanding, especially with
regards to procedures. - Cont;

Education should be provided using age appropriate
teaching strategies. Although children of this age are able
to comprehend more words, they may taken things literally
therefore caution is needed.
Early childhood:
During this stage of development, education should
include both the parents and child with the aim of
facilitating communication between the parent and child
about all aspects of their treatment and ongoing care.

Cont;
Middle and late childhood:
both the parents and child however; health
professionals are able to establish a one - on - one
relationship and can provide education directly to the
child, without the parent present if requested.

Cont;
Adolescence:
include both the parents and adolescent however, if
requested, can be delivered separately. Health
professionals are able to establish a one - on - one
relationship and it is important to understand the
characteristic of the developmental stage in order for
education to be effective.

Cont;
Patient – centered care:
Patient centered care can be defined as providing care
that is respectful of and responsive to individual
preferences, cultural traditions, family situations, social
circumstances and lifestyle, to support active involvement
of both the patient and their family in all healthcare
decisions.

Cont;
Family – centered care:
The family is the basic unit of society and when a
child becomes ill, the entire family can be affected.
Family – centered care recognizes that each family is
unique, the family is the constant in the child’s life and
they are experts on the child’s abilities and needs.

PATIENT EDUCATION METHODS
It is important to choose the correct method to educate
the patients. First and foremost interaction will be on a one
– to – one basis followed with printed literature to enhance
memory and act as a reminder.
Computer – aided teaching:
Computer or other output devices allow patients to view
and to hear patient education materials in the hospital&
some of these materials can be reviewed at home.

Cont;
Video education:
It is very similar to computer – based training. But
,it is more difficult to evaluate learning. A written post
test could be used after the video is reviewed. But ,it is
important with both of these media to consider the
patient’s educational level, language and hearing/seeing
abilities.

Cont;
Demonstration:
It is another effective patient – teaching technique.
Patients can be showed how to complete a task or how a
process works in a one – on – one setting, and then they
can do the task more effectively at home. However, in
an acute care setting this might be more difficult to do.

Cont;
Written material:
It seems so easy and routine. But, it can be effective.
For instance, material with pictures can offer
instructions or explanations. Written material related to
prescribe medicines is also a necessity. And ,it can offer
instructions in a step by step fashion. once, it is
important to evaluate the patient’s literacy level,
language ,and sight before handing out routine teaching
materials.

Cont;
Discharge instructions:
At the time of discharge, patients can be equipped
with a set of instructions with follow – up appointments,
medication teaching, and phone numbers. Many
discharge instructions can easily be printed using
personal health record (PHR) and electronic medical
record (EMR) software systems. These instructions
usually give phone numbers & follow – up appointment
instructions.

Cont;
Discharge prescriptions:
Prescriptions for discharge medications are usually
included in these instructions.it is important to verify
that the patient knows the names ,the purpose, and the
dosage instructions for these medications.
Countless methods of educational materials including:

Health education is carried out at 3 main levels;
Individual Health Education:
Doctors and nurses, who are in direct contact with
patients and their relatives, have opportunities for much
individual health education. The biggest advantage of
individual health teaching is that we can discuss, argue
and persuade the individual to change his behavior. The
disadvantage is that the numbers we reach are small.

Group Health Education:
The groups are many – mothers, school children,
patients, industrial workers – to whom we can direct
health teaching. The choice of subject in group health
teaching is very important; it must relate directly to the
interest of the group. For instance, mothers may be taught
about baby care; school children about oral hygiene; a
group of TB patients about tuberculosis, and industrial
workers about accidents.

Education of the general public(Mass Approach)
For the education of the general public, we employ
“mass media of communication’ – Posters, health
magazines, films, radio, television, health exhibitions and
health museums. Mass media are generally less effective in
changing human behavior than individual or group
methods. But however, they are very useful in reaching
large numbers of people with whom otherwise there could
be no contact. For effective health education mass media
should be used in combination with other methods.

Methods of Group Teaching:
These have been classified as below:
One – way or didactic methods:
• Lecture
• Films
• Charts
• Flannel graph
• Exhibits
• Flashcards

Lectures:
Lectures are the most popular method of health teaching. In
this, communication is mostly one-way, i.e., the people are only
passive listeners; there is no active participation on their part in
learning.
Films:
These are mass media of communication. They can be of value
in educating small groups.
Puppets:
Puppets are dolls made by hand and a story can be narrated
using them it is a popular teaching aid to health teaching.

Flannel graph:
A flannel graph consists of a wooden board over which is
pasted or fixed a piece of rough flannel cloth or khadi. It
provides an excellent background for displaying cut out
pictures and other illustrations. These illustrations and cut out
pictures are provided with a rough surface at the back by
pasting pieces of sand-paper, felt or rough cloth, and they
adhere at once, put on the flannel. Flannel graph is a very chief
medium, easy to transport and promotes thought and criticism.
The pictures must be arranged in proper sequence based on the
talk to be given.

Exhibits:
These consist of objects, models, specimens, etc. They
convey a specific message to the observer. They are essentially
mass media of communication.
Flash Cards:
They consist of a series of cards, approximately 10 x 12
inches – each with an illustration pertaining to a story or talk to
be given. Each card is “flashed” or displayed before a group as
the talk is in progress. The message on the cards must be brief
and to the point.

Two-way or Socratic Methods:
• Group discussion
• Panel Discussion
• Symposium
• Workshop
• Role playing
• Demonstration

Group Discussion:
• Group discussion is considered a very effective method
of health teaching. It is a tow-way teaching method.
People learn by exchanging their views and experiences.
• To be effective, the group should comprise not less than
6, and not more than 12 people.
• There should be a group leader who initiates the subject,
helps the discussion in the proper manner, prevents side-
conversations, encourages everyone to participate and
sums up the discussion in the end.

Cont;
• The proceedings of the group discussion are recorded by
a “recorder”, who prepares a report on the subject and
agreements reached.
Panel Discussion:
• Panel discussion is a novel method of health education.
The success of the panel depends upon the Chairman.
• The Panel consists of a Chairman or Moderator, and 4 to
8 speakers.

Cont;
• The Panel sits and discusses a given problem in front of a
group or audience.
• The Chairman opens the meeting, welcomes the group and
introduces the panel speakers who are experts on the subject.
• He introduces the topic briefly and invites the panel speakers
to present their points of view. There are no set speeches, but
only informal discussion among the panel speakers.
• It is said that the discussion should be spontaneous and
natural.

Symposium:
A Symposium is a series of speeches on the selected
subject by experts. There is no discussion on the subject by
the experts. In the end, the audience may raise questions
and contribute to the Symposium.
Workshop:
The Workshop consists of a series of meetings. The
total workshop is divided into small groups, and each
group will choose a Chairman and a recorder. Each group
solves a part of the problem with the help of consultants
and resource personnel. Learning takes place in a friendly,
happy and democratic atmosphere under expert guidance.

Role Play:
Role Play or socio-drama is a particularly useful
device for putting up problems of human relationship.
The group members enact the roles as they have
observed or experienced them, e.g. the expectant mother
in an antenatal clinic, the public health nurse on a home
visit, etc. The size of the group should not be more than
25. Role play is followed by a discussion of the
problem.

BARRIERS IN PATIENT EDUCATION
Psychological barriers:
• Emotional disturbance
• Fear level of intelligent
• Ego
Environmental barriers:
• Lack of ventilation
• Lack of privacy
• Over crowding

Cont;
Cultural barriers:
• Level of knowledge and understanding
• Customs
• Belief
• Religion
• Language
Internal barriers:
• Fear
• Anger
• Anxiety
• Depression

TIPS TO IMPROVE PATIENT EDUCATION
Preventing re-hospitalization is a huge responsibility,
especially in consideration of costly penalties that are
levied for early readmissions. To accomplish this,
nurses need to constantly improve patient teaching and
education prior to discharge. Some of the things nurses
can do to advance patient education include:
- Cont;

• Delegate more responsibilities to support staff and be
more focused on patient education.
• Begin educating patients with every encounter from
admission.
• Find out what the patient already knows. Correct any
misinformation.
• Feed patients information in layman’s terms. Utilize visual
aids as often as possible.
• Question their understanding of the care, and plan for the
next lesson. - Cont;

• Use return demonstration when administering care. Involve
the patient from the very first treatment.
• Ask the patient to tell you how they would explain (step-by-
step) their disease or treatment to their loved one.
• Make sure the patient understands the medications as you
administer them. Make sure they understand how and when
to refill medications.
• Provide patients with information about signs and
symptoms of their condition that will require immediate
attention

ROLE OF NURSE IN PATIENT EDUCATION
• Prevention of medical conditions such as obesity,
diabetes or heart disease.
• Patients who are informed about what to expect during
a procedure and throughout the recovery process.
• Decreasing the responsibility of complications by
teaching patient about medications, lifestyle
modifications and self monitoring devices like a
glucose meter or blood pressure monitor.
• Reduction in the number of patients readmitted to the
hospital.
• Retaining independence by learning self – sufficiency.

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