strat power point

7/31/2019 Strat Power Point

1/49

Application of Nursing toPatient Teaching


2/49

The Nursing Process in Patient Teaching

The teaching- learning process is an integof the nursing process

With a focus on learning and with regardprinciples variables, techniques and strateteaching and learning, the steps of the nu

process assessing, planning, implementevaluating- are used for the purpose of mthe teaching and learning needs of the paand his family


3/49

Learning needs are defined as gaps in knowledge that existbetween the desired level of performance and the actual leveperformance (Healthcare Education Association, 1985)

Learning needs is a gap between what someone knows and wsomeone needs or wants to know.

Of the three determinants, learning needs must be identifiedso that an instructional plan can be designed to address anydeficit in the cognitive, affective, or psychomotor domains.


4/49

Not every individual perceives a need for education Once this is determined, the information gathered can , in tu

be used to set objective and plan appropriate and effectiveteaching and learning approaches for education to begin at apoint suitable to the learner rather than from an unknown or

inappropriate place In one early study, there was only 20% nurse- patient agreem

score with respect to congruency on needs/ problems identiRoberts,1982)


5/49

Mordiffi, Tan and Wong (2003) cite more recent evidence frotheir research that the preoperative information provided bynurse and doctors was considered insufficient by the majorit(66.7%) of patients who rated knowledge about anesthesia bescheduled surgery to be very or extremely important to them

According to the estimates of many cognitive experts in behaand social sciences (Bloom 1968, Bruner 1966) most learners 95% of them, can master a subject with a high degree of succgiven sufficient time and appropriate support


6/49

It is task to the educator to facilitate the determinaof what exactly needs to be learned and identifyapproaches for presenting information in a way thwill be best understood by the learner


7/49

Assessment of Learning Needs

Assess the patients learning needs and physical, emotional andexperiential readiness for health education

What are his health beliefs and behaviors?

What psychosocial adaptations is he making?

Is he ready to learn?

Is he able to learn these behaviors?

What are his expectations?

What additional information is needed about him?


8/49

Important steps in the assessment of the learnneeds:

Identify the learner Choose the right setting

Collect data about the learner

Collect data from the learner

Involve member of the healthcare team

Prioritize needs

Determine availability of educational

Assess demands of the organization

Take time management issues into account


9/49

Important point with respect to time managemissues:

Although close observation and active listening take time, it much more efficient and effective to do a good initial assessmthan to waste time going back to discover the obstacles tolearning that prevented progress in the first place

Learners must be given time to offer their own perceptions o

their learning needs if the educator expert them to charge anbecome actively involved in the learning process


10/49

Assessment can be made anytime and anywhere the educatoformal or informal contact with learners.

Informing someone ahead of time that the educator wishes tspend time discussing problems or needs gives the personadvanced notice to sort out his or her thoughts and feelings

Minimizing interruptions and distractions during plannedassessment interviews maximizes productivity such that theeducator might accomplish in 15 minutes what otherwise mihave taken an hour in less directed more frequently andinterrupted circumstances


11/49

Methods to Assess Learning Needs

The nurse in the role of educator must obtain objective data athe learner as well as subjective data from the learner. Thefollowing are the various methods that can be used in conjunwith one another to yield the most reliable information (Hag1989)

Informal Conversations Structured Interviews

Focus Groups

Self administered Questionnaires


12/49

TestsObservations

Observing health behaviors in several different time periodshelp to determine conclusions about established patterns ofbehavior that cannot and should not drawn from a single

observationPatients Charts

Physicians progress notes, nursing care plans, nurses notesdischarge planning form can provide information on the learneeds of the client


13/49

Assessing Learning Needs of Nursing Sta

Williams (1998) specifically addressed the importance oidentifying the learning needs of staff nurses using thfollowing methods:

Written job description

Formal and Informal Requests

Quality Assurance Reports Chart Audits

Rules and Regulation


14/49

Formulation of Teaching Plan

A teaching plan is a blueprint for action to achieve the goal athe objectives that have been agreed upon by the educator anlearner

After mutually agreed upon goals and objectives have beenwritten, it should be clear what the learner is to learn and wh

the teacher is to teach A predetermined goal and related objectives serve as basis f

developing a teaching plan

Organizing and presenting information in the format of aninternally consistent teaching plan require skill by the nurse

educator


15/49

Teaching an informal group like a mothers class or a formalorganized activity involving students or professionals like aseminar or symposium entails preparation and planning

This ensures that the topic , chairman, speakers, logistics, phset up and most especially the participants are all well organ

and informed Health education plan may emphasizes a phase of the behav

change process that is related to the clients health needs/problem

The plan may also follow the sequence of that process from

training to the continued performance of a behavior that helpresolve health need/ problem


16/49

Process of generating a teaching plan helps tHealth Educator

Recognize and use methods of learning that invthe client as an active participants

Include a list of specific actions or abilities thatclient may perform at intervals during the edu

interventions and at the end


17/49

Three major reasons for constructing teachinplans are

To force the teacher to examine the relationshipthe steps of the teaching process to ensure the lapproach to teaching, which can serve as a maporganizing and keeping instruction on target

To communicate in writing and in an outline fo

exactly what is being taught, how it is being tauand evaluated and the time allotted foraccomplishment of the behavioral objectives

To legally document that an individual plan forlearner is in place and is being properly implem


18/49

A teaching plan should consist of the followineight basics elements (Ryan and Marinelli, 19

The purpose A statement of overall goal

A list of objectives ( a sub objectives if nec

An outline of related content

The instructional methods used for teachirelated content

The time allotted for the teaching of eachobjectives

The instructional resources( materials/to

equipment) needed The methods used to evaluate learning


19/49

Planning

An ongoing phase of the teaching process, involvconsideration of the ff.:

Why Teach?

What should be taught?

How should Teaching be done?

Who should teach and who should be taught?

When Should Teaching Occur?

Where should teaching occur?


20/49

Implementation of Teaching Education

Put the teaching plan into action Knows the materials to be presented

Provide the atmosphere conducive to lear

Use language the patient can understand

Use appropriate teaching techniques andmethods

Use some equipments that the patient wilafter discharge


21/49

Encourage the patient and his family to participatactively in learning

Coordinate the activities of the patient his familysignificant others and other health team members

Emphasize the importance of learning to the care

after discharge Records the patients responses to the teaching ac


22/49

Kotz (1997) suggest several strategies to achieclients lead as outlined following sections:

Get and Keep the Clients Attention Stick to the Basic

Use time wisely

Reinforce Information


23/49

Learning Throughout the Life Cycle

One basic assumption underlies teachingeffectiveness, all people are capable of learninhowever the ability to learn does vary from pperson and from situation to situation.

Further, learning needs and learning abilities

throughout life and the clients chronological developmental stage greatly influence the abilearn

Teaching approaches must be modified accorclients developmental stage and level of

understanding


24/49

Examples of patient education program specifeach developmental stage:

Patient Education for Children Readiness for learning (evidence of willingnelearn) varies during childhood depending onmaturation level

Responding to knowledge deficits of young ch

requires that the nurse work closely with chilcaretaker. Including the family on significant in teaching is especially important when carinyoung children

Young children learn primarily through play,

including play into teaching activities for chiltherefore enhance learning.


25/49

Tips in Teaching Children

Ensure that the client is comfortable Encourage caregiver participation

Asses the childs learning readiness, motiva

developmental level. Do not equate age withdevelopmental level

Assess the childs psychological status

Determine self care abilities of child and car

Use play, imitation and role play to make leafun and meaningful


26/49

Use different visual stimuli, such as boochalkboards and videos to convey inforand arises understanding

Use terms that are easily understood by

client and the caregiver

Provide frequent repetition and reinforce


27/49

Develop realistic goals that are consistedevelopmental abilities

In planning teaching approaches , remethat the goal of educating children are tpresent excessive anxiety improve coop

and fasten the recovery process (Biddin1993)


28/49

Patient Education for FamiliesAdolescents

As individual approach adolescent, theybetter able to conceptualize relationshipbetween things

Usually reading and comprehension abhave advanced and adolescents can

understand more complex information Because one of the strongest influences

adolescents is peer support , group meeare often useful in teaching

The nurse can often be a powerful teacacting as a role model

The accom an in dis la rovides u


29/49

Tips in Teaching Adolescents

Show respect for adolescents by recogntheir struggles to gain knowledge andexperience of adulthood while breakingfrom the grasp of childhood

Boost adolescents confidence by asking

input and opinions on health care matte Encourage adolescents to explore their

feelings above self- concepts and indepe

Be sensitive to the peer pressure mayadolescents face


30/49

Help adolescents identify and build thepositive qualities

Gear teaching to the adolescentsdevelopmental level and use language tclear yet appropriate to the health care s

To encourage and informed decision mengage adolescents in problem solvingactivities


31/49

Patient Education for Women

Consider patient education on: Pregnancy

Childbirth

Postpartum Behavior

Physical changes during and after preg Child rearing

Family Planning


32/49

Patient Education for Older Adults/Senior Cit

Aging is accompanied by many physiolchanges. As a result of these changes, solder adult experience perceptual impa

The nurse must thus assess for perceptuchanges and adjust teaching material

accordingly eg, providing large print wmaterial and verifying that the client heinstructions as directions are strategies in teaching older adults


33/49

Tips in Teaching Older Adults

Ensure that the clients is comfortable, pfatigue, a full bladder or hunger can implearning

Assess the clients learning readiness,

motivation and developmental level. Do

equate age with developmental level Assess the clients psychological status

Depression, severe anxiety, denial caninterfere with learning

Ascertain the time of a day when the clibest able


34/49

Use terms that are easily understood by the Avoid talking down to the client; a condescepaternalistic manner impede learning

Present materials slowly and use examples

Encourage client involvement and participa

Ask for feedbacks and employ active listeni

Provide frequent feedback

Assess for perceptual impairment andindividualize teaching strategies accordingl


35/49

For Memory Impaired Clients Use repetition

Use a variety of cues ( spoken words, wmaterials pictures and symbols)

For Visually Impaired Clients

Provide large prints materials

Provide magnifying glasses

Be sure client is wearing prescriptioneyeglasses

Provide adequate lightning and reduce


36/49

For bearing- impaired Clients Face the client directly when speaking

Use short sentences and words that are easunderstood

Use signal to reinforce verbal life

Eliminate distractions (noises) as much as


37/49

Evaluation

Collect objective data

Observe the patient

Ask questions to determine if the patientunderstands

Use rating scales, checklists, anecdotal no

written tests when appropriate Compare the patients behavioral outcom

the outcome criteria, determined extends which the goals were achieved

Include the patient, his family and or signothers, nursing team member and other hteam member in the evaluation


38/49

Identify attractions that need to be made teaching plan

Male referrals to appropriate resource peragencies for reinforcement of leaving aftedischarge

Continue all steps of teaching and learninprocess: assessing, planning, implementinevaluating


39/49

The following strategies can be used to evalclient learning:

Oral Questioning

Observation

Return Demonstration


40/49

Evaluation is facilitated by the use of the goal thmeasurable and specific several activities can in evaluating teaching effectiveness:

Feedback from the learner

Feedback from the colleague

Situational feedback Self -evaluation


41/49

Teaching Demonstration

Unlike lecture, which essentially is tellinstudents which the teacher wishes themlearn, a demonstration primarily involveshowing

Have the advantage of enabling studen

observe the demonstration engaged in learning task rather than simply talking

A good demonstration can be like a pictworth a thousand words


42/49

In a demonstration, students are afford theopportunity of looking at something instead oftalking or hearing about it

Demonstration is done by the teacher to showlearner how to perform a particular skill

Return Demonstration is carried out by the lean attempt to perform a task with cues from thteacher as needed


43/49

Demonstration

Prior to giving demonstration, the teachshould inform learners of the purpose oprocedure , the sequential steps involveequipment needed and the actions expethem

Equipment should be tested before useensure that it is complete and in working

For the demonstration method to be emeffectively, the learners must be able tosee and hear the step of being taught.


44/49

Therefore, the demonstration method is best suteaching individuals or small groups

The demonstration can be enhanced if the teachslows down the pace of performing the demonstexaggerates some of the steps( de Tornyay and

Thompson) or breaks lengthy procedures into aof shorter steps


45/49

In the process of demonstratinskill to either nurses or patien

is important to explain why e

step needs to be carried out i

certain manner

Demonstration allows for men

rehearsal of procedure (Hagg

1989).


46/49

Return Demonstration

Should be planned to occur as closepossible to when the demonstration given

Learners may need reassurance to retheir anxiety prior to beginning of the

performance because the opportunitreturn demonstration may be viewedthem as a test


47/49

This may lead them to believe theexpected to carry out the expectaof perfect performance the very ftime around

Allowing the learner to manipulatequipment before being expecteduse it may help to reduce anxiety

levels


48/49

Advantages of Demonstration

and Return Demonstration Especially effective for

learning in thepsychomotor domain

Actively engages thelearner throughstimulation of visual,auditory and tactile

senses

Limitations ofDemonstration and Retu

Demonstration: Requires plenty of t

to be set aside forteaching as well as

learning Size of audience mu

be kept small to ens

opportunity for pract

and close supervisio


49/49

Repetition of movement andconstant reinforcementincreases confidence,competence and skill

retention Provides opportunity for

over learning to achieve thegoal

Requires plenty of timebe set aside for teachinwell as learning

Size of audience must b

kept small to ensureopportunity for practice close supervision

strat power point

Documents