Nursing Assessment of Factors Affecting Patient Teaching

Nursing

1.https://docs.google.com/document/d/1vSwavAxCHRfKlAAcLV9-_Ot93N2dNPQW/edit

 link  one above is the grading Rubric i need you to use when writing the work.

2.https://docs.google.com/document/d/12UKuuk4zRBTEJpXHVZEg3vaQbLD5xUEa/edit#bookmark=id.gjdgxs 

the link two is an example i need you to look  at  follow same format and writing a patient teaching on the topic. "How to use inhalers and it's benefit". i want it done APA format 3 to 4 page with 3 source of intext citation. use this  textbook below as one source and then any other two.

Harding, M. M., (2020). Lewis's medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier. use this link and the table format example in the second link above which is an example of how the work needs to look like.

TABLE 4.6

 

Assessment of Factors Affecting Patient Teaching

Key Factors and Questions

Physical

• What is the patient’s age?

• Is the patient acutely ill?

• Is the patient fatigued or in pain?

• What is the primary diagnosis?

• Are there other medical problems?

• What is the patient’s current mental status?

• What is the patient’s hearing ability? Visual ability? Motor ability?

• What drugs does the patient take that may affect learning?

Psychologic

• Does the patient appear anxious, afraid, depressed, defensive?

• Is the patient in a state of denial?

• What is the patient’s level of motivation? Self-efficacy?

Sociocultural

• What are the patient’s beliefs about their illness or treatment?

• Is the proposed teaching consistent with the patient’s cultural values?

• What is the patient’s educational experience, reading ability, primary language?

• What is the patient’s present or past occupation?

• How does the patient describe their financial status?

• What is the patient’s living arrangement?

• Does the patient have family or close friends?

Learner

• What does the patient already know about the health problem?

• What does the patient think is most important to learn?

• What prior learning experiences could be a frame of reference for current learning needs?

• Is the patient ready to learn? Change behavior?

• How does the patient learn best (e.g., reading, listening, looking at pictures, doing, playing games)?

• In what kind of environment does the patient learn best? Formal classroom? Computer/Web-based setting? Informal setting, such as home? Alone or in a group?

• In what way should the caregiver(s) be involved in patient teaching?

Psychologic Factors

TABLE 4.9

 

Comparison of Teaching Strategies

Description Advantages Limitations

Discussion (“Teach Back”)

• Purpose is to exchange points of view about a topic or to arrive at a decision or conclusion

• Can be done with patient, with patient and caregiver, or with group

• Example: Weight loss

• Allows for an active exchange of information and experiences among participants

• Good when patients have experience with subject and have information to share

• Nonthreatening format

• Can use peers (patients with common problems) to teach

• May need more time depending on topic and number of participants

Lecture-Discussion

• Useful when group of patients and caregivers can benefit from basic information

• Lecture portion is short (i.e., 15–20 min)

• Discussion (“teach back”) follows lecture

• Example: Basic principles of cardiac rehabilitation (e.g., exercise, nutrition)

• Combines short lecture to present basic information with time for discussion

• Provision of printed material related to lecture content is useful and recommended

• Need to limit number of lecture topics to 3–5

• May need more time depending on topic and number of participants

Demonstration/Return Demonstration (“Show Back”)

• Purpose is to teach patient and caregiver to perform a skill

• Return demonstration (“show back”) can show patient’s ability to perform skill (see Fig. 4.5)

• Examples: Dressing change, injection

• Provides for learning and practice of physical skills

• Dividing skill into series of smaller steps helps mastery and provides reinforcement

• May need more time for practice needed to master skill

• Patients with limited manual dexterity may have difficulty

Use of Teaching Resources

• Audiovisual aids to supplement teaching

• Printed materials (e.g., brochures)

• CDs/DVDs

• Hospital-based TV (see Fig. 4.4)

• Digital and communication technologies (e.g., mobile applications, Web-based patient education programs, game-based education, online support groups)

• Telehealth

• Enhances the presentation through visual and/or auditory stimulation

• Best used in combination with other teaching strategies

• Use of digital and communication technologies for health information is the preferred choice for many

• Web access in patient rooms is standard in most health care agencies

• Health information can be given and reinforced to patients remotely

• Review materials for accuracy, reading level, completeness, before using

• Evaluate websites, games, applications, programs, for validity of information

• May not be appropriate for all learners (e.g., lack of interest, decreased mental capacity)

• Finances (e.g., equipment purchase, Internet service) may be a limiting factor to using digital technology

 

TABLE 4.11

 

Evaluating Patient and Caregiver Learning

Technique Strategy and Examples

Observe patient or caregiver directly

• Ask person to show you how to change the dressing

• Return demonstration (“show back”) determines whether:

• Skill has been mastered

• Further instruction is needed

• Patient and caregiver are ready for new or more content

Observe verbal and nonverbal cues

• Teaching may have to be delayed, more teaching needed, or different strategy used if patient or caregiver:

• Asks you to repeat instructions

• Loses eye contact

• Begins to doze in chair or bed

• Becomes restless or fidgety

• Does not speak English

Ask open-ended questions (“teach back”)

• Open-ended questions provide more information about understanding than closed-ended questions, which need only a “yes” or “no”

• Ask questions such as:

• “How often do you need to change the dressing?”

• “What will you do if you develop chest pain at home?”

Talk with caregiver (“teach back”)

• Involve caregiver in the evaluation process

• Ask questions such as:

• “What medications is she taking?”

• “When does he use his oxygen?”

Seek the patient’s self-evaluation of progress

• Ask patient’s opinion about their progress

• Assess what evidence the patient has that the goals are being met

• Assess if the patient is ready to learn new material