Educating Patients Understanding Barriers,Learning Styles, .docx

Educating Patients: Understanding Barriers,
Learning Styles, and Teaching Techniques
Linda Beagley, MS, BSN, RN, CPAN
Health care delivery and education has become a challenge for
providers.
Linda Beagley, M
cator, Swedish Cov
Conflict of intere
Address corresp
nant Hospital, 51
e-mail address: lbe
� 2011 by Ame
1089-9472/$36.
doi:10.1016/j.jo
Journal of PeriAnesth
Nurses and other professionals are challenged daily to assure
that the
patient has the necessary information to make informed
decisions.
Patients and their families are given a multitude of information

about
their health and commonly must make important decisions from
these
facts. Obstacles that prevent easy delivery of health care
information
include literacy, culture, language, and physiological barriers. It
is up
to the nurse to assess and evaluate the patient’s learning needs
and read-
iness to learn because everyone learns differently. This article
will
examine how each of these barriers impact care delivery along
with
teaching and learning strategies will be examined.
Keywords: patient education, barriers, culture, literacy,
perianesthesia
nursing.
� 2011 by American Society of PeriAnesthesia Nurses
EDUCATING PATIENTS HAS become a challenge
for health care providers because the patient
length of stay has decreased and the need to deliver
complex information has increased. A new version
of the melting pot society requires special efforts

by health care professionals to ensure that the pa-
tient understands the information given to him or
her. Barriers that inhibit patient education are liter-
acy, language, culture, and physiological obstacles.
Assessing and evaluating the learning needs of
the patient are essential before planning and im-
plementation of an educational plan. Presenting
a well-formulated plan will increase the likelihood
of a successful recovery for the patient. In this
article, barriers will be dissected and strategies
examined to determine what will best suit the edu-
cational needs of the patient.
S, BSN, RN, CPAN, is a PACU Clinical Edu-
enant Hospital, Chicago, IL.
st: None to report.
ondence to Linda Beagley, Swedish Cove-
40 N. California Ave, Chicago, IL 60625;
[email protected]
rican Society of PeriAnesthesia Nurses
00

pan.2011.06.002
esia Nursing, Vol 26, No 5 (October), 2011: pp 331-337
Adult Learning
To effectively educate patients, health care pro-
viders must have an understanding of the princi-
ples of adult learning. Malcolm Knowles, who
began to study adult learners in the 1960s, is
known as the father of adult learning principles be-
cause of his extensive writing on adult education.
The term andragogy, the art and science of teach-
ing adults, is synonymous with that of Knowles.
He deduced that adults learn differently than chil-
dren. His studies determined five assumptions on
learning: self-concept, experience, readiness to
learn, orientation to learning, and motivation to
learn.
1
According to Knowles, as a person ma-
tures, his self-concept moves from one of being
a dependent personality towards one of being
a self-directed human being. Humans accumulate

a growing reservoir of knowledge, followed by
a readiness to learn, which increasingly is oriented
towards developmental tasks related to social roles
with immediate application of their new knowl-
edge. Knowles’ final assumption reflects the moti-
vation of learning as moving from external to
internal.
1,2
Table 1 compares and summarizes
Knowles’ assumption regarding the adult (andra-
gogy) and the child (pedagogy) learner.
331
mailto:[email protected]
http://dx.doi.org/10.1016/j.jopan.2011.06.002
Table 1. Assumptions Differences of Pedagogy and
Andragogy1,2
Assumptions Pedagogy Andragogy
Self-concept Dependency Self-directed
Experience Happens to learner Rich resource
Readiness Biologic and academic development Evolving social

and life roles
Orientation to learning Logical; directed by teacher Life
centered; task/problem centered
Motivation External approval of teacher Internal drive; life
goals
332 LINDA BEAGLEY
Literacy Barrier
Literacy is defined as ‘‘an individual’s ability to
read, write and speak in English and compute
and solve problems at levels of proficiency neces-
sary to function on the job and in society, to
achieve one’s goals, and to develop one’s knowl-
edge and potential.’’
3
Illiteracy does not discrimi-
nate; it can be found in all populations, and
a person’s grade level is not an accurate gauge
for reading ability.
4
Having any level of illiteracy
can cause a number of problems with activities
of daily living, such as analyzing a transportation

schedule, following directions, understanding rec-
ipes, and completing job applications. Low liter-
acy is described as those people who have the
ability to read, write, and understand information
only at the seventh grade reading level. According
to the US Department of Health and Human Ser-
vices (DHHS),
3
demographics does play a role in
literacy; certain groups demographically have
a higher prevalence of low literacy. Table 2 out-
lines this population.
Low literacy and low health literacy are related but
not interchangeable. Health literacy is defined in
Healthy People 2010 as ‘‘the degree to which indi-
viduals have the capacity to obtain, process, and
understand basic health information and services
needed to make appropriate health decisions.’’
5
Low health literacy is content specific. An individ-

Table 2. Demographics of Low Literacy3
Fewer years of education
Lower cognitive ability
Elderly
Some racial or ethnic groups from the South or
Northeast
Female
Incarceration
Low income status
ual may be able to read and write in certain con-
texts but struggle to comprehend the unfamiliar
vocabulary and concepts found in health-related
materials or instructions.
5
According to the US
Department of Education, which conducts a na-
tionwide survey of adult Americans to evaluate lit-
eracy skills,
5
an estimated nearly one half of

Americans (90 million) have difficulty understand-
ing and acting on health information. These stud-
ies have linked low health literacy with delayed
diagnosis, poor disease management skills, and
higher health care costs. These same individuals
demonstrate a limited understanding of their dis-
ease processes resulting in worse health care out-
comes.
6
Unnecessary health care costs ranging
from $106 to $238 billion are attributed to limited
health literacy.
7
Factors associated with health literacy are depen-
dent on the skills, preferences, and expectations
of health information providers. At times, health
care professionals may be oblivious to the effect
of limited health literacy on patients and the health
care system. In one study
7
of 240 health care pro-
viders and students, researchers found fewer than

12% of participants were aware of their degree of
limited health literacy. Twenty-five percent were
found to have a common misconception that
health literacy could be determined by race, eth-
nicity, culture, age, or socioeconomic status.
7
To
heighten matters, responders inaccurately be-
lieved that patients with a higher level of education
were not at risk for having limited health literacy
(7.4%). In health care, nurses comprise the largest
group of providers and are responsible for ensur-
ing patient education. The researchers recom-
mend health literacy education for nurses during
the education process.
Cutilli
8
completed a systematic review of the liter-
ature for the purpose of analyzing and evaluating
the research on health literacy and the elderly.

EDUCATING PATIENTS 333
Age becomes an important demographic marker
with an inverse relationship to health literacy.
Cutilli found that as the patient’s age increases,
the health literacy level decreases. This is an
important element because of the aging popula-
tion in the United States and the projected trend
of aging. By 2030, it is estimated that 20% of the
population will be 65 years and older.
9
The
Federal Interagency Forum on Aging
9
reports older
Americans are proportionately more likely to have
below basic health literacy than other age groups.
Thirty-nine percent of people aged 75 years or
older have below average health literacy skills
compared to 23% of people aged 65 to 74 years
and 13% of people aged 50 to 64 years.
Language and Culture Barrier

The United States has been known as a melting pot
of diversity over the last 100 plus years. Some
changes, however, have occurred from those early
years. Ethnicities are found in large urban neigh-
borhoods, as well as the suburbs and rural areas
of the country. The diversity now existing across
the country has presented many challenges for
health care providers. In 2001, DHHS published
national standards on culturally and linguistically
appropriate services. These DHHS standards
10
re-
quired health care institutions to demonstrate cul-
tural competency while caring for patients in
a manner responsive to their beliefs, interpersonal
styles, attitudes, language, and behaviors of the in-
dividual and required that care be provided in
a manner that demonstrates respect for individual
dignity, personal preference, and cultural differ-
ences.

Health care providers must be knowledgeable of
cultural competencies. Nurses should have aware-
ness of biases and prejudices by examining gener-
alizations they might use routinely about cultures
other than their own. Any biases must be con-
fronted. A commitment to learn more about the
cultures that have been generalized in the past
must be made.
11
Second, core cultural values
need to be examined and understood about the
varying populations that frequent the institution.
Cultures have several core values on which all
other values are based.
12
This foundation is a start-
ing point for health care providers in understand-
ing different cultures.
A challenging aspect is the ability to communicate
effectively to the patient whose native language is

not English. Thoroughly assessing the patient’s
comprehension and the need for a translator is vi-
tal. Every attempt must be made to provide a qual-
ified translator whether the translator is physically
present or available via a telephone translation
line. Family members as translators may not be
able to translate important terms needed in obtain-
ing informed consent or education. Furthermore,
caregivers must provide written education mate-
rials for the patient to take home. Many concepts
are not easily translated, and it is imperative to
have a fluent translator translate the written
word into the targeted language.
11
An estimated 40 different languages are spoken by
the patients who use the services at one Midwest
community hospital. Managing multiple languages
and cultures has proven to be a challenge. The hos-
pital intranet offers resources for many of the cul-
tures including common practices, values, and

beliefs. Another unique attribute for this hospital
is the diverse nursing population. In the surgical
arena, every effort is made to pair similar culture/
language of the patient to the health care provider.
This luxury of a diverse nursing population is not
common for many facilities, creating a need to
rely on telephone language lines or hospital-
employed interpreters.
Madeleine Leininger’s theory of cultural care diver-
sity and universality defines culture as a guide
whereby the individual’s thinking, as well as his de-
cisions and actions, is patterned and usually passed
on from one generation to another.
12
A person
uses culture as a framework in viewing the world,
including health and the need for health care. Be-
cause patients can feel a sense of losing control,
they have a tendency to hold onto family beliefs

when they become ill. Successful teaching plans
are congruent with patient and family values.
4
Nursing care that incorporates cultural values
and practices can be positively related to patient
satisfaction, and patient compliance to treatment
will be greater. Conflict will result if nursing care
is in discord with the patient’s belief systems.
Knowing one’s patient is important for delivery of
care. A recent Swahili refugee was admitted to
have a cholecystectomy. She had been treated
with tribal medicine, which resulted in several
334 LINDA BEAGLEY
healed burn scars on her abdomen. Arousing from
anesthesia, the patient relayed through her inter-
preter that she wanted to see what was removed
during surgery. The nurse tried to explain that
the patient’s gallbladder had been removed and
sent to pathology. The patient continued to insist

that she needed to see the gallbladder. For this pa-
tient, it was imperative to visualize the gallbladder
to confirm that she was healed from her illness.
The nurse recognized the needs of the patient,
contacted the surgeon, and between the two of
them, they were able to have the patient see her
gallbladder through pictures taken during surgery.
Another example of the importance of cultural
awareness is demonstrated in the story below.
The diabetic educator consults with patients
who have gestational diabetes frequently in the
clinic. A Muslim patient and her husband were
scheduled for education. In this patient’s culture,
the educator was not permitted to address the
patient directly and was to speak only to the
husband. To acknowledge the patient’s cultural
beliefs, the educator instructed the husband,
who then instructed the patient in her presence.
The educator used several different teaching tech-

niques to quantify that the patient could safely ad-
minister insulin to herself.
In the American culture, the patient is the key deci-
sion maker in health care.
13
The patient may consult
with other family members, but ultimately, the pa-
tient makes the final decision.
14
Traditionally, Amer-
ican families have been defined as having a mother,
father, and child/children. Familial hierarchy can be
different for some cultures. How is the ‘‘family’’ de-
fined for this patient? Is it the immediate nuclear
family or the family that may include extended fam-
ily members,closefriends,or neighbors?Identifying
who isthe healthcare decision makerfor the patient
is important.
4,13
For some cultures, the decision
maker is the head of the household or the entire

extended family. All key players must be involved
in any decisions because they will either reinforce
or block health care behaviors.
The nurse must be aware of both verbal and non-
verbal communication behaviors. There are vast
differences in culturally defined communication
behaviors. Before discussion of personal informa-
tion, it is important to understand cultural prac-
tices related to nonverbal communication during
conversation, communication practices related to
the opposite gender, and cultural practices of so-
cial conversation.
4
Gender-specific topics could
be taboo for some cultures. For some, direct eye
contact is a sign of disrespect. Be aware of cultures
in which disagreement is perceived as impolite-
ness. The patient may be agreeing with what the
health provider is saying purely out of civility
rather than out of agreement.

13,15
Physical and Environmental Barriers
Physiological factors play a role in how the patient is
ableto process health information. As a person ages,
visual clarity and auditory acuity will decrease, mak-
ing it difficult for the person to receive information.
Many times, a patient may refuse to wear corrective
devices. Altered mental capacity because of patho-
logic disease processes, such as Alzheimer disease,
or pharmacologic interventions, such as medica-
tions, can create a barrier for effective teaching.
Increasedagingmay causedeclineincognitive capa-
bilities in processing information, memory, and
comprehending abstractions.
16
As the adult ages,
the ability to reason and process information occurs
at a slower rate and reaction or response time in-
creases significantly after the age 65. Managing
multiple messages simultaneously is harder to do.

Short-term memory loss and the quantity of new
information may limit the length of the teaching
session and amount of information given. The
capacity to draw conclusions from inference
decreases in the older adult. Vague terms of
‘‘adequate,’’ ‘‘several times a day,’’ and ‘‘often’’ can
have multiple meanings. Directions should be spe-
cific to time and order with quantities defined.
Physical conditions can limit mobility and the pa-
tient’s ability to sit and be receptive to learning.
Many times, patients seek out health care be-
cause of pain or not feeling well. Uncontrolled
pain will block the patient’s ability to receive in-
formation. Anticipation, anxiety, and fear are all
contributing factors in diminishing reception of
knowledge. In the perianesthesia area, pain and
anxiety are obstacles that must be identified
and controlled for the patient to comprehend
information.

Because of busy schedules, environmental barriers
are challenging at times. Poor lighting, noise levels,
and room temperatures can inhibit the learning
Table 3. Learning Styles With Teaching
Strategies
Learn Styles Teaching Strategies
Visual Visual material
Handouts—easy to read
Variety of technology—computers,
overhead, video, TV, Internet
Auditory Rephrase key points
Vary speed, volume, and pitch
Write down key points
Positioned to hear the message clearly
Use multimedia—tapes, music
Kinesthetic Frequent breaks to move around
Learner writes own notes
Provide tactile activities

Product samples
process. These barriers are difficult to control be-
cause of capped thermostats and controlled light-
ing. Noise levels are under careful consideration
because of the complaints of patients who have
not been able to rest because of noise while hospi-
talized. Hospitals have responded by instituting
quiet times during the day. Physical space for the
health care professional to share information
with the patient that is private, quiet, and with
minimal distractions can be at a premium,
although necessary for effective learning. Lastly,
time to devote to adequate teaching is a large bar-
rier in today’s health care environment. Profes-
sionals are asked to do more with less, including
time. Patients’ length of stay has shortened be-
cause of many factors, giving the nurse less time
with the patient to accomplish important teaching

elements.
Learning Styles
Besides understanding barriers that impact the re-
ception of education, the nurse must be aware of
how an individual learns. Learning patterns are de-
veloped as a child and the ‘‘learner’’discovers what
works best for his or her individual learning style.
Assessment of the patient is essential for effective
teaching, which may require more than one learn-
ing style for comprehension. Learning patterns in-
clude visual, auditory, and kinesthetic.
17
A visual
learner prefers to see what he or she is learning.
Pictures and images help the learner understand
ideas and information better than an explanation.
The auditory learner needs to hear the message
or instructions being given. This type of learner
wants to be talked through a process rather than
reading about it first. The kinesthetic learner

does not like lecture or discussion, preferring the
movement of the skill or task. Demonstration
and return demonstration works best with kines-
thetic learners.
17,18
Once the learning style is established, the nurse
adapts the teaching materials to the preferred
style. For the visual learner, the nurse will have ma-
terials for the patient to read or watch. The infor-
mation should be well organized, interesting,
appealing, and easy to read. With today’s advance-
ment of technology, there are many choices to of-
fer the visual learner, including computers, live
video feeds, close circuit television, photography,
and the Internet.
For the auditory learner, the nurse should rephrase
important points and questions in several different
ways to communicate the intended message. Vary-
ing the speed, volume, and pitch helps create an

interesting aural texture. An environment where
the patient and family can hear the message is im-
portant while encouraging the patient to write key
elements. A quiet space, preferably with the ability
to close the door along with minimal distractions,
assists the teacher to maximum the learning for an
auditory learner. To assist the auditory learner, in-
corporate multimedia of sounds, music, or speech.
Kinesthetic learners prefer frequent breaks so that
they can move around. The nurse should encour-
age the patient to take notes while providing tacti-
cal and hands-on activities. Providing samples
will allow the kinesthetic learner to practice
what he or she is learning, verifying comprehen-
sion through return demonstration. Table 3 sum-
maries learning styles with teaching strategies.
In the perianesthesia arena, more than one type of
teaching strategy may be necessary to successfully
deliver the message and establish comprehension.

For example, the follow-up telephone call was indi-
cating negative outcomes for several patients who
were to remove their urinary catheter at home. The
patient teaching before going home for this patient
population had become labor intensive, yet urinary
catheters were still being removed without deflat-
ing the catheter balloon, causing harm to the
patient and unhappy surgeons. Brainstorming,
336 LINDA BEAGLEY
a group of nurses looked to see how those in the
unit could improve the education process and out-
comes. The result was to continue to demonstrate
to the patient and significant other how to deflate
the balloon and remove the catheter. A return dem-
onstration was verified by both the patient and the
family member, each practicing using the syringe
and inserting it into the catheter port (without re-
moving the catheter). The department also devel-

oped a step-by-step handout with pictures for the
patient to take home. All three learning styles
were instituted to ensure a positive change of no
longer having patients remove the urinary device
with the balloon intact.
Teaching Methodologies
Teaching methodologies are multiple, and not all
will work in the perianesthesia setting. The most
common method is lecture, in which the presenter
gives information to the learner and learning is pas-
sive. Discussion allows for participation and for
the ability of the learner to ask and answer ques-
tions and share feelings. Demonstration is a useful
technique using both psychomotor and social
skills of the learner. In health care, demonstration
with return demonstration is commonly used
when a new technique or skill is to be learned by
the patient. An example of demonstration was the
urinary catheter instructions and patient demon-
stration previously mentioned.

Another common method of teaching is the use of
printed instructions. Printed health care informa-
tion should avoid technical language: use short
simple sentences and write at a level that most pa-
tients will understand.
4
The recommendation for
written instructions is that they be at the fifth
grade level. Avoidance of glossy paper and small
fonts also assists the learner.
The Internet can be a friend or foe when obtaining
health care information. Hospitals are setting up
Web sites for patients to obtain information. In
one pre-surgical testing department, the nurse
gives the scheduled surgical patient a Web site
where he or she can learn more about anesthesia
before coming to the hospital. Health care profes-
sionals also need to establish that the patient is ob-
taining reliable information on the Internet and
steer the patient to government and academic sites
that are proven to be more trustworthy.

19
Inpa-
tients can watch health-related stations on their
televisions.
11
On the obstetric unit, patients can
access the television to learn about a variety of is-
sues related to the mother and care of the new
baby. The disadvantage of watching a television
station or already-taped segment is the inability
to ask and have questions answered immediately.
The nurse must be diligent in following up with
the patient to answer questions and reinforce the
teachings from the video.
Conclusion
For effective delivery of health information and ed-
ucation, the nurse must be aware of the barriers
that can impede the patient’s ability and readiness
to learn. Awareness of the potential barriers of lit-
eracy, culture, language, and physiological factors
will help the nurse determine what tools he or

she may need to assist in the delivery of informa-
tion. Awareness of one’s biases and prejudices
and overcoming them will assist in the education
process. The nurse assesses the patient’s under-
standing by looking at both verbal and nonverbal
cues that the patient is displaying. Using more
than one way of delivering the message will pro-
mote the patient’s learning. A family member pres-
ent during key moments will assist and help the
patient to remember the information. The astute
nurse will be more successful in overcoming bar-
riers if she or he is aware of patient’s needs and
areas where additional assistance is needed.
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http://nwlink.com/%7Edonclark/hrd/styles/vakt.html Educating
Patients: Understanding Barriers, Learning Styles, and Teaching
Techniques Adult Learning Literacy Barrier Language and
Culture Barrier Physical and Environmental Barriers Learning
Styles Teaching Methodologies Conclusion References
NURSING
PRACTICE &
SKILL
Author
Zeena Engelke, RN, MS
Cinahl Information Systems, Glendale, CA
Reviewers
Alysia Gilreath-Osoff, RN, BSN, CEN,
SANE
Sara Richards, MSN, RN
Nursing Practice Council
Glendale Adventist Medical Center,
Glendale, CA
Editor

Diane Pravikoff, RN, PhD, FAAN
April 13, 2018
Published by Cinahl Information Systems, a division of EBSCO
Information Services. Copyright©2018, Cinahl Information
Systems. All rights
reserved. No part of this may be reproduced or utilized in any
form or by any means, electronic or mechanical, including
photocopying, recording, or by
any information storage and retrieval system, without
permission in writing from the publisher. Cinahl Information
Systems accepts no liability for advice
or information given herein or errors/omissions in the text. It is
merely intended as a general informational overview of the
subject for the healthcare
professional. Cinahl Information Systems, 1509 Wilson Terrace,
Glendale, CA 91206
Patient Education: Home Care – Teaching Medication
Self-Administration
What Is Teaching Medication Self-Administration in Home
Care?
› Teaching medication self-administration in home care is the
process of teaching patients
to safely and independently take their prescribed medications in
the home environment.
Medication self-administration involves having the patient
follow the five “rights” of
medication administration: right patient (i.e., self), right
medication, right dose, right time,
and right route

• What: Teaching medication self-administration in home care
typically involves
educating and verifying that the patient understands
–the name of the medication, its mechanism of action, and what
it is used for
–correct dose
–correct timing of administration
–correct route of administration (e.g., oral or via subcutaneous
injection) and the proper
technique for self-administering the drug
–potential adverse effects and potential interactions with other
medication, food, and
supplements
–appropriate storage
–the importance of communicating information about
medication that is currently being
taken to healthcare clinicians, including both prescription and
over-the-counter (OTC)
medications
• How: A variety of teaching/learning and motivational
activities (e.g., face-to-face
instruction, telephone communication, written materials,
computer-mediated programs)
can be utilized to support patients and family members in
learning about medication
self-administration
–Combined strategies (e.g., face-to-face communication and
providing a written
pamphlet) have been shown to be more beneficial than verbal
instruction only

–For patients with a complex medication regimen, offering
information in more than one
session allows the patient to process smaller amounts of
information and avoid feeling
overloaded with information
• Where: Teaching about medication self-administration in
home care occurs in the home
environment. In some cases, teaching might begin in an
ambulatory care setting (e.g.,
the treating clinician’s office) or prior to discharge from the
hospital or a long-term care
facility
–Patients should receive consistent educational information in
all healthcare settings and
in the home throughout the course of patient care
• Who: Patient teaching about medication self-administration in
home care is provided by
healthcare professionals (e.g., registered nurses, pharmacists,
physicians) and should not
be delegated to assistive staff members
What Is the Desired Outcome of Teaching Medication Self-
Administration in the Home?
› Education about medication self-administration can empower
patients and allow them to
• understand the name, dose, route, timing, and purpose of each
prescribed medicine
• build confidence and skills necessary for successful

medication self-administration (e.g., filling pill organizers,
drawing up
insulin, using safe injection techniques, properly disposing of
syringes, using aerosol delivery systems correctly, using cues
to promote proper timing of medications, properly storing
medication)
• observe for adverse effects of medication when taken with
specific other medications, foods, or supplements and seek
medical assistance as needed
• engage in lifestyle changes to decrease risk for complications
(e.g., maintaining a consistent intake of vitamin K when
taking warfarin, regularly checking EPINEPHrine expiration
dates, wearing a medical alert bracelet when taking high-risk
medications)
• recognize the importance of communicating information about
medications that are currently being taken, including
prescription and OTC medications, to healthcare professionals
and participate in shared decision making about medication
self-administration
• cope with the psychosocial and emotional aspects of having an
illness that requires medication and adhering to a prescribed
medication regimen
Why Is Teaching Medication Self-Administration Important in
Home Care?
› Teaching home care patients how to correctly take their own
medications helps to promote safe, cost-effective delivery of
medications; self-administrationof medications is an important
component of self-care
› Errors in medication self-administration can lead to decreased
symptom control, increased risk for severe health issues, and a

greater number of emergency department visits,
hospitalizations, and nursing home placement, and can
significantly increase
healthcare costs for preventable complications
› Patient education is required by The Joint Commission (TJC),
and medication safety is an integral part of TJC Home
Care National Patient Safety Goals. The home care nurse is
required to provide patients with written information on
medications that are being taken in the home care setting and to
educate about their role in providing information about
the medications they are taking (e.g., giving a list of current
medications to the treating clinician, serially updating the list,
carrying medication information in the event of an emergency)
(TJC, 2018)
Facts and Figures
› Children are at increased risk for having problems with
managing medication. In a study of children receiving
medications
for asthma,the following were the most common areas of risk
(Wilson et al., 2015):
• Responsibility in medication administration (i.e., the degree to
which the patient takes his/her medication); researchers
reported that about 39% of children take their medication “all of
the time,” 7% take their medication “quite a bit of the
time,” and 46% are at high risk for not taking responsibility for
taking their medication
• Wellbeing of the child’s caregiver, particularly related to
coping and stress management
• The child’s well-being, including his/her behaviors and
emotions

• Medication adherence
› A multidisciplinary work group at Johns Hopkins Health
System developed and implemented a post discharge home-
based,
pharmacist-provided medication management service. This
service not only enhanced continuity from hospital to home, it
ensured that pharmacists identified and resolved medication
discrepancies, educated patients about their medications, and
provided primary clinicians and community pharmacists with a
complete and reconciled medication list. While prevention of
readmissions was not a targeted outcome of the project, only 8%
of patients who received the service were readmitted within
30 days. On average, the readmission rate for similar patients in
the same hospital was 16–17% (Pherson et al., 2014)
› Improper use of dry powder inhalers can result in an
insufficient amount of the drug being deposited in the lungs. In
a study
of patients with chronic obstructive pulmonary disease,
educational handouts were given to help patients who were
already
using inhalers. Researchers found that the handouts alone were
effective in improving inhaler technique; vision and health
literacy did not impact on the patients’ inabilities to learn
proper technique (Alsomali et al., 2017)
› Prescription opioid abuse is epidemic. Opioid diversion to
family members and friends is a major source of abused
prescription opioids. Nurses play a key role in reversing this
opioid abuse by providing essential anticipatory guidance each
time a patient receives a medication prescription (Manworren et
al., 2015)
› In Spain, researchers studied 45 patients with infective
endocarditis (IE) who self-administered parenteral antibiotics in

a
“hospital-in-home” (HIH) environment. During each self-
administration session, a nurse or treating clinician briefly
visited
the patient. The rate of inpatient readmission was 12.5% and no
patients died while in the HIH program (Pajarón et al., 2015)
› In a study of 23,614 patient records, researchers concluded
that when patients with a high risk for adverse reactions and
a slow immunotherapy buildup phase were excluded, systemic
reaction (SR) rates during home immunotherapy were
significantly lower than SR rates during office-
basedimmunotherapy (Schaffer et al., 2015)
› When prescribing oral cancer agents, clinicians must be aware
of factors that affect adherence; these include side effects,
forgetfulness, beliefs about medication necessity, established
routines for medication self-administration, social support,
ability to fit medications in lifestyle, cost, and medication
knowledge. Depression and negative expectations can also
negatively influence adherence (Irwin et al., 2015)
› In a qualitative study of mental healthcare professionals,
researchers found that although health professionals recognize
that
treatment adherence is a major issue, they frequently do not use
evidence-based interventions to address the problem. The
researchers concluded that it is necessary for clinicians to
challenge their own pre-existing beliefs about treatment
adherence
to more effectively help patients manage medications (Brown et
al., 2015)
What You Need to Know Before Teaching a Patient about

Medication Self-
Administration in the Home Care Setting
› Prior to initiating medication self-administration, the nurse
must carefully assess the patient’s ability to safely self-
administer
medication. This is often determined using subjective judgment,
including subjectively judging the patient’s knowledge
of each medication, cognitive ability to follow instructions,
ability to read medication labels and package inserts, manual
dexterity needed to administer the prescribed medications,
ability to administer each medication, and ability to recognize
adverse effects and report them to the treating clinician
• The Self-Administration of Medication (SAM) tool used to
assess a patient’s ability to self-administer medications offers
consistency in evaluation, can be completed in a short time, and
is more objective than the perceptions of healthcare
clinicians. Other similar tools are available
• Assessing medication self-administration abilities in stroke
patients is particularly important. Stroke patients might not be
aware of their cognitive deficits and can overestimate their
competence related to medication self-administration
› TJC’s focus on medication safety requires that home care
nurses accurately and completely reconcile medications in
the home environment. This process includes comparing current
and newly ordered medicines, communicating about
medications with the next clinician who will provide patient
care, giving a written list of the patient’s medicines to the
patient and family,and educating the patient and family about
the list (TJC, 2018). To improve medication safety, TJC
suggests that patients should adopt the following:
• Properly discarding old or outdated medications (for
information about safe disposal of medicines, refer to the

U.S. Food and Drug Administration (FDA) Web site at
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/
BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeD
isposalofMedicines/default.htm)
• Bringing all prescription and OTC medicines and supplements
to physician office visits or to a local pharmacy for review
• Carrying a list of the names and numbers of healthcare
providers and pharmacies used
• Carrying a list of all prescription medications and OTC
medications and supplements that are currently being taken with
dosages, special instructions, and known allergies
› Patients should be taught basic information about drug safety
in the home such as the importance of
• keeping drugs in their original, labeled containers
• finishing a prescribed medication (e.g., an antibiotic) unless
instructed otherwise
• not saving drugs for future use and not giving them to another
person
• keeping drugs out of reach of children
• storing medicines at proper temperatures (e.g., refrigerate as
needed, store in a clean and dry area, keep away from extreme
temperatures)
• reading medication labels carefully and following all
instructions
• being aware of look-alike, sound-alike drugs
› Home care patients with a complex medication regimen should
be taught strategies for organizing their medications
and establishing a system of cues for taking them at specific
times (e.g., posting a schedule on the refrigerator; creating
a medication calendar with pictures of the pills; having someone

send text reminders to take medicines; using a
self-administration medication documentation sheet to keep
track of administration; using pill boxes, egg cartons, or
cupcake
tins to organize medications; using color-coded sections to
designate specific days and times)
› Common concerns about oral medication self-administration
include adhering to the routine of taking multiple pills several
times a day, coping with having severe or constant adverse
effects, and coping with medication-relatedfinancial difficulty
› Older adults often self-administer medications despite being at
increased risk for having problems managing their
medication. A common mistake is often omission of a
prescribed medication
› Medication administration routes that are used in the
outpatient setting or in the home care setting each have their
own risks
and benefits; for example:
• Outpatient parenteral antibiotic therapy (OPAT)was
introduced in the U.S. in the 1970s. OPAT is currently practiced
worldwide and is a safe and effective option for carefully
selected patients
• Home self-administered allergen immunotherapy, which was
previously considered controversial, is now thought to be a
safe option for carefully preselected patients
› Although oral medication administration is the easiest, most
common method, it is contraindicated in patients who have
gastrointestinal (GI) abnormalities, including patients with a

nasogastric tube (NGT), gastrostomy tube, or poor gag reflux
and patients who are unable to swallow or are unresponsive
• Home care patients taking oral medicines need to be cautioned
about drugs that cause gastrointestinal distress
• Patients taking sublingual medicines should be reminded not
to swallow them, and patients taking buccal medications
should be taught to allow the medicine to dissolve against the
mucous membrane of the cheek and then swallow the saliva
› It is common for patients with asthma to use up to three
metered-doseinhalers (MDIs) daily, and each meter requires
performing multiple steps for safe and accurate use. Most
patients do not use their MDIs correctly and many healthcare
professionals lack knowledge about proper technique. Spacer
devices can be used with certain MDIs to improve technique
and allow the patient to inhale for a longer period. Dry-powder
inhalers are recommended as an effective alternative.
Although variations exist among types of MDIs, patients should
be educated to generally perform the following steps:
• Remove the cap and hold inhaler upright
• Shake the inhaler
• Breathe out slowly and completely
• Place the inhaler 1–2 inches away from the mouth or in the
mouth
• Start to breathe in slowly and press the lever as indicated on
the inhaler
• Inhale slowly over a period of 3–5 seconds
• Hold breath at full inhalation for 10 seconds
• Exhale
• Repeat if indicated after 1 minute
• Rinse mouth with water if using an inhaled steroid
› During the past decade, self-administration and safe handling
and disposal of oral chemotherapy agents by patients with
cancer have been areas of concern, yet not all clinics, hospitals,

and healthcare agencies have implemented standard
protocols for teaching patients and family members about these
medications
• To help patients more effectively manage self-administration
of prescribed oral chemotherapy agents, refer to the Oncology
Nursing Society oral adherence toolkit at
https://www.ons.org/practice-resources/toolkits/oral-adherence
• Education alone is not enough to promote adherence to oral
medication regimens for cancer. Adherence tools, technologies,
and reminder aids can be used to assist patients in adhering to
an oral regimen
› According to the American Association of Poison Control
Centers (www.aapcc.org),the most common poisons are found
in medications (e.g., pain medicine, including OTC agents,
prescribed pain relievers, and illicit drugs; sedatives, hypnotics,
and antipsychotics; antidepressants; and cardiovascular drugs).
Recent online alerts caution readers to beware of potentially
dangerous health effects after using synthetic marijuana and
liquid nicotine. Lack of patient concern about the appropriate
use of medication (e.g., saving medication for future personal
use to avoid having to see a healthcare clinician,giving
prescribed medication to others, and taking more medication
than prescribed in the hope that it will be curative) can result in
adverse reactions, organ failure, and death
› Although certain educational interventions (e.g., providing
reading materials, engaging the patient in self-care training)
are used most commonly in clinical practice to teach patients
about medications and self-administration, counseling and
behavioral interventions have been found to be more effective
in enhancing medication adherence
› Evidence of the effectiveness of specific medication

adherence-enhancinginterventions is limited. Researchers warn
that
findings should be interpreted with caution
• The strongest evidence-based support for improving
medication adherence involves policy-level interventions that
promote
reduced out-of-pocket expenses, case management, and
educational interventions
• Among patients with different clinical conditions, medication
adherence is highly variable. In a comparative study of the
effectiveness of interventions, the greatest opportunities for
medication adherence improvement were seen in patients with
asthma, depression, or hypertension
› The most successful strategies for teaching patients about
medication self-administration are individualized educational
interventions
• Patient education and teaching tools (e.g., handouts, books,
videos) should be tailored to the patient’s specific needs and
priorities
• Visually oriented informational handouts (i.e., those with
diagrams and limited wording) should be patient-friendly and
easy to read
• All teaching should be patient-centered and evidence-based
–Home care patients should be given detailed and accurate
medication information; they should be instructed to avoid the
use of advertised medications and products unless they have
been reviewed by healthcare professionals

• Educational information should be delivered in a culturally
sensitive manner and in a language and at a level that is easily
understood by the patient and family
• Professional certified medical interpreters, either in person or
via phone, should be used when there are language barriers
• Simple, nonmedical language should be used for all patients
and families, but especially when low literacy levels are
assessed
› Preliminary steps that should be performed prior to teaching a
patient about medication self-administration in the home care
setting include the following:
• Become knowledgeable about the requirements of TJC related
to patient education
• Review facility/agency protocols specific to patient education,
particularly about medication self-administration practices
in the home care setting
• Become familiar with facility/agency practices for teaching a
patient about medication self-administration
• Identify acceptable patient teaching resources that are
available onsite and via the Internet
› Verify availability of supplies prior to initiating the
educational session (noting that supplies will vary based on
patient
assessment, below). Supplies can include
• a teaching guideline or documentation form outlining key
content areas
• printed and audiovisual materials about medication self-
administration procedures
• medication administration equipment (e.g., medications in
their original containers, a pill organizer, syringes, alcohol

wipes, MDIs)
• information about Internet and community resources that are
available to assist patients with self-administration of
medication and with proper storage and disposal of medications
• information on how to contact members of the healthcare team
with questions or concerns
How to Teach a Patient about Medication Self-Administration in
the Home Care
Setting
› Perform hand hygiene
› Don personal protective equipment (PPE), if indicated
› Identify the patient per facility protocol
› Establish privacy
› Introduce self and explain planned education
› Assess the patient for
• readiness to learn
–Patients can be at different stages of readiness; it is important
to individualize your approach based on each individual
learner’s readiness
• preferred learning style
–Individuals are auditory, visual, or tactile learners, and learn
by hearing (e.g., listening to other patients talk about the
challenges of managing the side effects of medications), by
seeing (e.g., observing the home care nurse draw up insulin),
and by doing (e.g., filling a pill organizer)
–To quickly identify one’s preferred learning style, have the
learner think back to the last time he or she learned something,
and ask, “How did you go about it?”
• patient-identified learning priorities

–When there is incongruence between the patient’s priorities
and the healthcare provider’s goals, all will need to explore
why the incongruence exists (e.g., when the patient being
treated with an antibiotic decides not to continue to take it
because he/she is feeling much better)
• learning barriers
–Barriers can include impaired memory or cognitive
difficulties; learning disabilities; physical limitations; language;
low
literacy; impaired hearing, sight, and/or speech; financial
issues; and cultural, psychosocial, and/or emotional concerns
- Patients with a low literacy level can have difficulty
calculating dosages and measuring liquids. In the home care
setting, the nurse has an ideal opportunity to observe what a
patient uses to measure a medication dose and how he/she
determines how much to take
- Cultural beliefs and practices should be carefully examined
because they can influence ideas about medication use
• learning needs and desires
–Many home care patients are preoccupied with the complexity
of their care and might need to be encouraged to learn
more about medication self-administration
› Plan for timely delivery of relevant information
• The plan for medication instruction should be comprehensive,
but tailored to meet the patient’s specific learning needs; it
should be divided into information segments that are scheduled

at intervals to avoid overwhelming the patient
–There should be clear delineation in the healthcare team of
who provides what information and at what time throughout
the course of patient care; for example,
- an acute care nurse provides the hospitalized patient with
written information about drugs, discusses the risks and
benefits of taking the drugs, helps him or her learn how to self-
administer the drugs, and emphasizes the importance of
timely and consistent use of the drugs
- at discharge to home, a pharmacist who fills prescriptions in
the community reinforces the medication instructions,
emphasizing the medication name, purpose, dose, route,
frequency, and potential adverse effects
- during a follow-up appointment, the home health nurse
reconciles the patient’s medications, assesses the patient’s use
of
the medications, listens to the patient’s concerns about the
drugs, and educates about the need to alter patient behavior
(e.g., eliminate alcohol consumption to avoid liver damage) and
change habits of self-administration as appropriate
• High-quality teaching tools (e.g., clear, concise drug
information sheet written at a 5th grade reading level; a DVD
about
the safe use of digoxin; a Website about the national Drug
Take-Back program for safe medication disposal) should be
identified in advance to support teaching and learning
–The assessment of the patient’s learning characteristics, along
with his/her clinical needs, should guide the selection of
appropriate teaching tools
• When appropriate, patient education should be scheduled when

family members or caregivers are available to support the
patient in learning
› Implement the patient education plan
• Discuss and set mutually achievable goals for learning about
medication self-administration with the patient
–Anticipate a planned approach to teaching and learning, but be
prepared to be flexible and individualize information based
on the patient’s changing needs and desires
• Emphasize the name, dose, route, timing, purpose, and adverse
effects of each medication, and educate about safety
concerns related to medication self-administration
–Make the education situation as realistic as possible; if
feasible, schedule home visits to coincide with the patient’s
medication self-administration times
–Allow sufficient time for the patient to practice skills and talk
about any concerns
–If the patient is not able to safely administer his/her
medication regimen, arrange for family members or other
caregivers
to support the patient as needed
• Promote collaborative partnerships between the patient and
members of the healthcare team to achieve the highest levels of
medication adherence
–Use open-ended requests that allow the patient to explain or
demonstrate and that enable the healthcare provider to verify
the patient’s understanding (e.g., “Tell me [or show me] how
you take your medication”)
–Ask specific questions about the patient’s medication regimen

(e.g., “What time do you take the medicine?”, “How many
pills do you take?”, “What is the name of this green pill?”)
–Observe facial expressions and other cues that indicate that the
patient does not understand the prescribed medication
regimen
• Use a variety of teaching and learning strategies for best
results
–Direct communications (e.g., face-to-face conversation,
telephone calls) are fundamental in helping patients learn about
medication self-administration
–Written materials (e.g., a booklet, fact sheets) have received
mixed reviews
- The effectiveness of print materials varies based on
comprehensibility, visual appeal, legibility, text style, size, and
layout
–Some computer-mediated medication programs have been
customized for older adults (e.g., with enlarged text size,
high color contrast between the text and the background, slower
animations to allow for processing information, extra
wide scroll bars). These programs allow the nurse to enter
patient-specific information (e.g., medication regimen, blood
pressure readings) so that the information can be tailored to
meet the patient’s specific learning needs; such programs can
be effective in reducing medication errors and increasing
adherence in older adults
–Internet resources are readily available to most patients,

although healthcare professionals disagree as to the value of
Internet information
- One strategy to enhance Internet use by patients is to provide
a list of relevant Websites that are thought to be accurate,
current, and understandable
› Evaluate the patient’s response to education
• Continually assess learning throughout the continuum of care
• Use a teach-back method to evaluate learner understanding
–Have the patient repeat medication information and/or
demonstrate medication self-administration while allowing the
educator to listen, observe, and clarify the information or skill
demonstration, as needed
–Remember that specific information is better recalled than
general information
• Use a self-efficacy (i.e., the extent to which a person …
NR305 Week 4 Patient Teaching Plan Grading Rubric
Criteria Ratings Pts
This
criterion is
linked to a
Learning
Outcome
Health
Topic (20
points)

Describe
in detail
why this is
an
important
topic for
patient
education.
Use
evidence
from the
textbook,
lesson or
an outside
scholarly
source to
support
your
rationale.
20.0 pts
Excellent
rationale for
the
importance
of the topic
and clearly
supported
by related
evidence
from text,
lesson or
outside
scholarly

source
18.0 pts
Good
rationale for
the need for
the
importance
of the topic
and
supported
by related
evidence
from text,
lesson, or
outside
scholarly
source
16.0 pts
Minimal
rational
e for
patient
educati
on on
the
topic
and
support
ed by
related
evidenc
e

8.0
pts
Topic
identi
fied
but
no
ration
ale
provi
ded
0.0
pts
This
sect
ion
is
blan
k
20.0
pts
This
criterion is
linked to a
Learning

Outcome
Patient
Population
(15 points)
Describe,
in detail,
the
characteri
stics of the
population
you are
planning
to teach
with the
Visual
Teaching
Tool.
(This may
include
age,
gender,
health
status,
similarities
among
individuals
, or any
other
important
15.0 pts

Excelle
nt
descript
ion of
patient
populati
on
includin
g
several
charact
eristics
listed in
detail
13.0 pts
Good
descript
ion of
patient
populati
on with
several
charact
eristics
listed
12.0 pts
Minimal
descript
ion of
patient
populati
on, 1-2

charact
eristics
listed
briefly
6.0 pts
Populat
ion is
poorly
describ
ed, with
no
addition
al
charact
eristics
listed
0.0
pts
Thi
s
se
cti
on
is
bla
nk
15.0
pts

characteri
stics.)
This
criterion is
linked to a
Learning
Outcome
Learning
Barriers
(20 points)
What are
some
potential
learning
barriers
for this
population
of
learners?
How can
you
address
these
learning
barriers in
your
Visual
Teaching
Tool
design?

(Barriers
might be
cultural,
physical,
20.0
pts
Excell
ent
descri
ption
of
potent
ial
learni
ng
barrie
rs;
thoro
ugh
plan
for
addre
ssing
barrie
rs
18.0
pts
Good
descri
ption

of
potent
ial
learni
ng
barrie
rs;
appro
priate
plan
for
addre
ssing
barrie
rs
16.0
pts
Brief
descri
ption
of
potent
ial
barrier
s and
plan
for
addres
sing
them
is
presen
t but
lacks

detail
8.0
pts
Mini
mal
descr
iptio
n of
pote
ntial
barri
ers;
plan
for
addr
essin
g
barri
ers
lacki
ng
0.
0
pt
s
T
hi
s
se
cti
o
n

is
bl
an
k
20.0
pts
education
al, or
environme
ntal. Refer
to the
assigned
article in
the project
guidelines
for more
informatio
n.)
This
criterion is
linked to a
Learning
Outcome
Setting
(20 points)
Describe,

in detail,
the setting
where you
will utilize
your
Visual
Teaching
Tool.
Include
details as
appropriat
e, such as
room or
table set
up,
20.0
pts
Exce
llent
desc
riptio
n of
setti
ng;
inclu
des
thor
ough
cons
idera
tion
of
how

the
teac
hing
will
take
plac
e
18.0
pts
Goo
d
des
cript
ion
of
setti
ng;
incl
ude
s
con
side
ratio
n of
how
the
teac
hing
will
take
plac
e
16.0

pts
Brief
desc
ripti
on of
setti
ng
with
little
to no
disc
ussi
on of
detai
ls
relat
ed to
how
the
teac
hing
will
take
plac
e
8.0
pts
Mini
mal
desc
ripti
on
of

setti
ng
with
no
addi
tion
al
deta
ils in
rega
rds
to
how
the
teac
hing
will
take
0
.
0
p
t
s
T
h
i
s
s
e
c
ti
o
n

i
s
b
l
a
n
k
20.0
pts
technical
equipment
needed,
whether
teaching
will take
place in a
group or
one-on-on
e.
(Examples
: primary
care clinic,
health fair,
school,
home)
plac
e

This
criterion is
linked to a
Learning
Outcome
Learning
Objectives
(20 points)
Write
three
specific
learning
objectives
your visual
teaching
tool will
address.
20.0
pts
Lear
ning
obje
ctive
s
are
clea
r,
very
well-
writt

en;
writt
en
per
assi
gnm
ent
guid
eline
18.
0
pts
Lea
rni
ng
obj
ecti
ves
are
writ
ten
per
the
ass
ign
me
nt
gui
deli
nes
and
16.0
pts

Lea
rnin
g
obje
ctiv
es
are
pre
sent
and
mak
e
sen
se
of
the
topi
c;
but
are
8.
0
p
ts
L
e
a
r
ni
n
g
o
bj

e
ct
iv
e
s
a
r
e
p
0
.
0
p
t
s
T
h
i
s
s
e
c
t
i
o
n
i
s
b
l
a
20.0
pts

(Refer to
examples
in the
assignme
nt
guidelines
to
complete
this
section.)
s;
and
mak
e
sens
e for
the
sele
cted
topi
c
ma
ke
sen
se
for
the
sel
ect

ed
topi
c
not
writ
ten
per
the
assi
gn
men
t
gui
deli
nes
r
e
s
e
n
t,
b
u
t
a
r
e
o
ff
-t
o
pi
c
o

r
u
n
cl
e
a
r
n
k
This
criterion is
linked to a
Learning
Outcome
Evaluation
Plan (15
points)
Write a
paragraph
describing
how you
could
evaluate
whether
your visual
teaching
tool was
successful

and met
the
learning
objectives.
Consider
the
population
’s abilities
and the
setting.
15
.0
pt
s
Ex
ce
lle
nt
ev
al
ua
tio
n
pl
an
;
ve
ry
de
tai
le
d,
re

ali
sti
c
fo
r
th
e
po
pu
lat
io
n’
s
ab
ilit
ie
s
an
d
se
13
.0
pt
s
G
oo
d
ev
al
ua
tio
n
pl
an

;
ad
eq
ua
te
de
tai
l;
re
ali
sti
c
fo
r
th
e
po
pu
lat
io
n’
s
ab
ilit
ie
s
an
d
se
12.
0
pt
s
Fa

ir
ev
al
ua
tio
n
pl
an
;
lac
ks
de
tai
l,
m
ay
no
t
be
re
ali
sti
c
for
th
e
po
pu
lat
io
n’
s
ab
ilit
ies
an

d
se
6.
0
pt
s
E
va
lu
ati
o
n
pl
an
is
p
o
or
ly
wr
itt
en
,
an
d/
or
is
n
ot
re
ali
sti
c
fo

r
th
e
p
o
p
ul
ati
o
n
an
d
0
.
0
p
t
s
T
h
i
s
s
e
c
t
i
o
n
i
s
b
l
a

n
k
15.0
pts
tti
ng
tti
ng
tti
ng
se
tti
n
g
This
criterion is
linked to a
Learning
Outcome
Clarity of
Writing
Criteria
(15 points)

In-text
citations in
APA
format
(author,
year).
Full
sentences
with good
flow.
Free from
spelling
errors.
Excellent
grammar.
1
5
.
0
p
t
s
E
x
c
e
ll
e
n
t

w
ri
ti
n
g
o
v
e
r
a
ll
,
a
ll
c
ri
t
e
ri
a
m
1
3
.
0
p
t
s
G
o
o
d
w
ri

ti
n
g
o
v
e
r
a
ll
,
1
c
ri
t
e
ri
o
n
n
o
t
m
1
2
.
0
p
t
s
F
a
i
r
w

r
i
t
i
n
g
o
v
e
r
a
l
l
,
2
c
r
i
t
e
r
i
a
n
o
6
.
0
p
t
s
P
o
o

r
c
l
a
ri
t
y
o
f
w
ri
ti
n
g
,
3
c
ri
t
e
ri
a
n
o
t
m
0
.
0
p
t
s
V
e

r
y
p
o
o
r
c
l
a
ri
t
y
o
f
w
ri
ti
n
g
,
m
u
lt
i
p
l
e
e
rr
15.0
pts

e
t
e
t
t
m
e
t
e
t
o
r
s
This
criterion is
linked to a
Learning
Outcome
Use of
Template
0.0
pts
Corre
ct
templ

ate,
no
points
deduc
ted.
0.0 pts
Templ
ate not
used =
-12.5
points
(10%)
0.0
pts
This
criterion is
linked to a
Learning
Outcome
Late
Deduction
0
.
0
p
t
s

0
p
o
i
n
t
s
d
e
d
u
c
t
e
d
0.0 pts
Not
Submitted
on Time -
Points
deducted
1 day late =
6.25
deduction;
2 days late
= 12.5
deduction;
3 days late
= 18.75
deduction;
4 days late
= 25

deduction;
5 days late
= 31.25
0.0
pts
S
u
b
m
i
t
t
e
d
o
n
t
i
m
e
deduction;
6 days late
= 37.5
deduction;
7 days late
= 43.75
deduction;
Score of 0
if more than

7 days late
Total Points: 125.0
PreviousNext
https://chamberlain.instructure.com/courses/63392/modules/ite
ms/8217886
https://chamberlain.instructure.com/courses/63392/modules/ite
ms/8217905
Chamberlain College of Nursing NR305 Health Assessment
Patient Teaching Plan
NOTE: Please do NOT remove any of the text on this form. Do
NOT use any other form but this one. Fill it in and submit in its
entirety to aid in its grading.
Your Name: Date:
Purpose: The purpose of this Patient Teaching Project is to
develop a patient teaching plan and create a visual teaching tool
aimed at promoting health and preventing disease for a
specified patient population.
Directions:
· This Teaching Plan is Part 1 of the Patient Teaching Project.
You will use this Patient Teaching Plan to create a Visual
Teaching Tool in Part 2 of this project.
HEALTH TOPIC
ANSWER
State the topic you have selected for your Teaching Project.
(Please select from the list provided in the Teaching Project

guidelines located in Module 4.)
Describe in detail why this is an important topic for patient
education. Use evidence from the textbook, lesson or an outside
scholarly source to support your rationale.
POPULATION
ANSWER
Describe, in detail, the characteristics of the population you are
planning to teach with the Visual Teaching Tool.
BARRIERS
ANSWER
What are some potential learning barriers for this population of
learners?
(Barriers might be cultural, physical, educational, or
environmental. Refer to the assigned article in the project
guidelines for more information.)
Describe how you could develop your Visual Teaching Tool in a

way that will address these potential barriers.
SETTING
ANSWER
Where do you plan to utilize your Visual Teaching Tool?
(Examples: primary care clinic, health fair, school, etc…)
Will you be teaching one-on-one, in small groups, or to a large
crowd?
LEARNING OBJECTIVES
ANSWER
Write three specific learning objectives your visual teaching
tool will address.
Example:At the end of this education, the learner will be able to
list 3 benefits of regular physical activity.
1.
2.
3.
EVALUATION
ANSWER
Write a paragraph describing how you could evaluate whether
your visual teaching tool was successful and met the learning
objectives. Consider the population’s abilities and the setting.
REFERENCES
ANSWER

List any references used to create this Teaching Plan in APA
format.
(Hanging indent not required.)
Remember to also use in-text citations within this document,
when appropriate (Author, year).
NR305_W4_Patient Teaching Plan Form Rev. 8/2018
KC 1
Chamberlain College of Nursing
NR
305
Health Assessment
NR305_
W4_Patient Teaching Plan Form
Rev. 8/2018
KC
1

NOTE: Please do NOT remove any of the text on this form.
Do NOT use any other form but this one.
Fill it
in and submit in its entirety to aid in its grading.
Your
Name:
Date:
Purpose:
The purpose of this Patient Teaching Project is to
develop a patient teaching plan and
create
a
visual teaching tool
aimed at promoting
health and preventing disease
for a specified patient
population.
Directions
:
·
This Teaching Pl
an is Part 1 of the Patient Teaching Project.
You will use this Patient Teaching
Plan to create a Visual Teaching Tool in Part 2 of this project.

HEALTH TOPIC
ANSWER
State the topic you have selected
for your Teaching Project.
(Please select from the list
provided
in the Teaching Project guidelines
located
in Module 4.)
Describe in detail why this is an
important topic for patient
education. Use evidence from the
textbook, lesson or an outside
scholarly source to support your
rationale.

Chamberlain College of Nursing NR305 Health Assessment
NR305_W4_Patient Teaching Plan Form Rev. 8/2018
KC 1
NOTE: Please do NOT remove any of the text on this form. Do
NOT use any other form but this one. Fill it
in and submit in its entirety to aid in its grading.
Your Name: Date:
Purpose: The purpose of this Patient Teaching Project is to
develop a patient teaching plan and create a
visual teaching tool aimed at promoting health and preventing
disease for a specified patient
population.
Directions:
You will use this Patient Teaching
Plan to create a Visual Teaching Tool in Part 2 of this project.
HEALTH TOPIC ANSWER
State the topic you have selected
for your Teaching Project.
(Please select from the list provided
in the Teaching Project guidelines
located in Module 4.)
Describe in detail why this is an

important topic for patient
education. Use evidence from the
textbook, lesson or an outside
scholarly source to support your
rationale.
Week 3 Discussion: Failure of Democracy and
the Rise of Totalitarianism
1
1 unread reply.
1
1 reply.
Required Resources
Read/review the following resources for this activity:
● Textbook: Chapter 4, 5
● Lesson
● Minimum of 1 scholarly source (in addition to the textbook)

Initial Post Instructions
During the 1930s, much of the world seemed to give up on their
hope for a democratic
solution to their problems and instead turned to totalitarianism,
both in Europe and in
Asia.
For the initial post, select and address one of the following:
● Germany/Hitler
● USSR/Stalin
● Japan/Tojo
Address the following questions for your selection:
● What effects did the history, politics, and economies of those
areas play in their
decisions to turn to totalitarianism?
● What role did the Great Depression in the United States play
in their plight?
Follow-Up Post Instructions
Respond to at least two peers or one peer and the instructor. At
least one of your
responses should be to a peer who chose an option different
from yours. Further the
dialogue by providing more information and clarification.
Writing Requirements
● Minimum of 3 posts (1 initial & 2 follow-up)

● Minimum of 2 sources cited (assigned readings/online lessons
and an outside
source)
● APA format for in-text citations and list of references

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