patient education goes hand

7/31/2019 Patient Education Goes Hand

1/5

Patient education goes hand-in-hand with improved patient outcomes and quality of life.Educating the patient is an integral part of the nurse's role in patient care. In order toensure the success of the patient teaching plan, the processes involved in developing anursing patient teaching plan should be centered around the patient and inclusive of thefamily.

Difficulty: Moderately Challenging

InstructionsPatient AssessmentThe first step in care planning is accurate and comprehensive assessment. In the acutecare setting, a thorough admission nursing assessment should be followed by regular

reassessments as often as the patient's status demands. In the long- term care setting,the MDS (Minimum Data Set) is the starting point for assessment. Home health utilizes

the OASIS assessment. Other settings will have established protocols for initialassessments and ongoing reevaluation.

1. Step 1

This step requires the analysis and organization of information about the patient.Determine the patient's level of understanding about her disease, injury or condition.

2. Step 2

Use the information gathered about the patient to judge how well she will be able tounderstand and apply what is taught to her.

3. Step 3

Be sure to factor in cultural considerations that are specific to that patient such asethnicity and religion. It will be necessary to factor in any information you haveabout the patient's level of development as well. It may be necessary for the nurseto motivate the patient in order for her to learn. Ability to learn is affected if thepatient is too tired, in pain, upset or distracted.

PlanningOnce the initial assessment is completed, a problem list should be generated. This maybe as simple as a list of medical diagnoses, or may involve working through the RAP(Resident Assessment Protocol) process associated with the MDS. The "problem" list

may actually include patient/resident strengths as well as family/relationship problems,which are affecting the person's overall well-being.

4. Step 1

Once the problem list is complete, look at each problem and ask the question, "Will thisproblem get better?" (Or, "Can we make this problem better?") If the answer is yes,

then your goal will be for the problem to resolve or show signs of improvement withinthe review period. In the acute setting, the review period may be as short as next shift,

next day or next week. In the long-term or home health setting, the review period will


2/5

likely be longer. In any case, the goal should be specific, measurable and attainable. Do

not write a goal that a stage 4 pressure ulcer "will be improved by next week." This is

not specific or measurable, and most likely not attainable. A better goal statementwould be for "stage 4 pressure ulcer to improve to less than full thickness andlength/width to __X__cm in the next 90 days." The approaches (or interventions)

should also be measurable and realistic, and should be documented elsewhere in the

record when performed. An example of a problem that will improve would be self-caredeficit related to hip fracture. With rehab, this problem is likely to resolve.

If the problem is not likely to improve or resolve, then ask the question, "Can we keepthis from getting any worse, or developing complications?" Examples of this type of

problem would be diabetes or congestive heart failure. These problems are not going to

get better, but we can generally intervene and prevent or minimize complications ordecline. Your goal statements should again be specific and measurable. "Will maintain

blood sugar within acceptable range as determined by MD", or "Will maintain SBP >100

and 50 and 60 and


3/5

For all problems, interventions/approaches may be physician ordered, facility protocol

or accepted standard practices. Facility policy will determine how specific the written

approaches will be. Some facilities may require specific medications, doses, and times,etc. to be spelled out in the care plan, while others may endorse the use of approachessuch as: "Administer medications as ordered. See MAR, MD orders for current orders."

7. Step 1

The method of implementation of the nursing patient teaching plan should bespecific to the patient's learning style and desired outcomes that were identified.

8. Step 2

Prepare to document patient responses and level of understanding as the nurseperceives them while the teaching plan is implemented.

9. Step 3

Prepare to document any other relevant information that will assist with theevaluation of learning.

Formulate Evaluation Process

10. Step 1

An evaluation process will need to be formed in order to assess patient outcomes.The following specific elements of patient learning will need to be evaluated: patientknowledge, behavior, attitude, and skills. The evaluation should include a review of

the documentation that details patient responses and level of understanding thatwere recorded during the implementation steps.

11. Step 2

The evaluation plan should include observations of the family's understanding ofwhat will be required of them for the patient to achieve desired outcomes.

12. Step 3

The last key element of the evaluation plan is the nurse's recommendation for

follow-up procedures to be used in the event that the patient's learning was notsufficient to produce desired outcomes.

The care planning process is never truly completed until the patient/resident isdischarged from the current care setting or is deceased. The care plan needs to be fluid

and changeable, as patient/resident status changes. Periodic scheduled reevaluation

must take place, with changes being made as needed. Unscheduled updates should alsobe made as condition warrants. When a problem has resolved, that problem can be

completed. If the person has had a major change in a problem area that results in


4/5

changes in goals and approaches, it may be easiest to resolve the problem and enter an

entirely new problem, goal(s) and approaches, rather than making many changes to the

existing problem.

Remember that the ultimate purpose of the care plan is to guide all who are involved in

the care of this person to provide the appropriate treatment in order to ensure the

optimal outcome during his/her stay in our healthcare setting. A caregiver unfamiliarwith the patient/resident should be able to find all the information needed to care forthis person in the care plan.

Nursing leadership

The aim of leadership development was to place nursing on the health agenda and to ensure

nursescontributions to the achievement of the WHO goalof Health for All (WHO 1998). The

objectives included development of clear goals based on shared and internalized values and

principles; gaining political commitment; and identifying strategies to bring about change and

develop each other. The plan of action for developing nursing leadership was to create a sense of

unity and goal directedness, develop strategies and management capacity of nurses, analyse theenvironment to take advantage of opportunities, and to network and support each other.

Challenges concerning nursing leadership include mentoring of younger nursing leaders,

determination and persistence to reach the identified goals, building partnerships and teams, and

creating a critical mass of nurse leaders knowledgeable of the issues and willing to continue to

lead.


5/5

patient education goes hand

Documents