Chapter 1 Health ASSESSMENT bachelor of.

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1. Chapter 1 Overview of Education in Health Care

2. Historical Foundations for Patient Education in Health Care Patient education has long been a common intervention used in health care. Three phases in the development of organized health care

3. Historical Foundations (cont’d) First phase Mid-1800s to the turn of the 20th century Emergence of nursing and other health professions Technological developments Spread of communicable diseases Growing interest in the welfare of mothers and children Florence Nightingale ’ s Health Teaching in Towns and Villages

4. Historical Foundations (cont’d) Second phase First four decades of the 20th century Division of Child Hygiene established Diagnostic tools, scientific discoveries, new vaccines and antibiotic medications, and effective surgery and treatment practices National League of Nursing Education (NLNE) recognized that public health nurses were essential.

5. Historical Foundations (cont’d) Third phase Began after World War II Significant scientific accomplishments Profound changes in health care delivery Mid-1960s, health care became a right and not a privilege for all Americans Titles XVIII and XIX of the Social Security Act and the creation of Medicare and Medicaid

6. Historical Foundations (cont’d) Third phase ( cont ’ d) American Public Health Association formed the Committee on Educational Tasks in Chronic Illness in 1968. Developed a model that defined the educational processes necessary for patient and family education President Nixon and the concept of patient education U.S. Department of Health, Education, and Welfare

7. Historical Foundations (cont’d) Third phase ( cont ’ d) American Hospital Association ’ s Statement on a Patient ’ s Bill of Rights Outlines patients ’ rights to receive current information about their diagnosis, treatment, and prognosis Guarantees a patient ’ s right to respectful and considerate care The Joint Commission ’ s Accreditation Manual for Hospitals Broadened the scope of patient education and specified that criteria for patient education be established

8. Historical Foundations (cont’d) Third phase (cont ’ d) Healthy People 2000 , Healthy People 2010 , and Health People 2020 established educational and community-based programs. Pew Health Professions Commission Published a broad set of competencies for the 21st century Many competencies focus on the teaching role of health professionals.

9. Historical Foundations (cont’d) Role of the nurse as educator has evolved from a disease-oriented approach to a more prevention-oriented approach. Emphasis now on empowering patients to use their potentials, abilities, and resources to the fullest

10. The Evolution of the Teaching Role of Nurses In nursing, patient education has long been a major component. Florence Nightingale, the ultimate educator National League of Nursing Education (NLNE), now the National League for Nursing (NLN) Observed in 1918 that health teaching is an important function within the scope of nursing practice

11. Evolution of Teaching Role (cont ’ d) American Nurses Association (ANA) Responsible for establishing standards and qualifications for practice, including patient teaching International Council of Nurses (ICN) Endorses health education as an essential component of nursing care delivery

12. Evolution of Teaching Role (cont’d) State Nurse Practice Acts Universally include teaching within the scope of nursing practice Nursing career ladders often incorporate teaching effectiveness as a measure of excellence in practice. Professional nurses are responsible for: Educating colleagues Serving as a clinical instructor for students in the practice setting

13. Social, Economic, and Political Trends Affecting Health Care Significant forces influencing nursing practice: Federal government and Healthy People 2020 Recommendations from the Institute of Medicine The Affordable Care Act (ACA) Growth of managed care Emphasis on public education for disease prevention and health promotion

14. Trends (cont’d) Significant forces influencing nursing practice ( cont ’ d): Importance of health education to reduce the high costs of health services Concern for continuing education as vehicle to prevent malpractice and incompetence Expanding scope and depth of nurses’ practice responsibilities Consumers demanding more knowledge and skills for self-care

15. Trends (cont’d) Significant forces influencing nursing practice ( cont ’ d): Increasing number of self-help groups Demographic trends influencing type and amount of health care needed Incidents of medical harm Increased prevalence of chronic conditions Impacts of advanced technology

16. Trends (cont’d) Significant forces influencing nursing practice ( cont ’ d): Health literacy increasingly required Research findings that client education improves compliance Advocacy for self-help groups Increased use of online technologies Screenings occasioned by advances in genetics and genomics

17. Purpose, Goals, and Benefits of Client and Staff Education Purpose: to increase the competence and confidence of clients for self-management Primary goal: to increase the responsibility and independence of clients for self-care Benefits of education to clients: Increases consumer satisfaction Improves quality of life Ensures continuity of care

18. Purpose, Goals, and Benefits ( cont ’ d) Benefits of education to clients (cont’d): Decreases client anxiety Reduces complications of illness and incidences of disease Promotes adherence to treatment plans Maximizes independence Empowers consumers to become involved in planning their own care

19. Purpose, Goals, and Benefits ( cont ’ d) Benefits of education to staff: Enhances job satisfaction Improves therapeutic relationships Enhances patient-nurse autonomy Increases accountability in practice Provides opportunity to create change that matters

20. The Education Process Defined Education Process : a systematic, sequential, planned course of action on the part of both the teacher and learner to achieve the outcomes of teaching and learning Teaching/Instruction : a deliberate intervention that involves sharing information and experiences to meet the intended learner outcomes

21. The Education Process (cont’d) Learning : a change in behavior (knowledge, attitudes, and/or skills) that can be observed or measured, and that can occur at any time or in any place as a result of exposure to environmental stimuli

22. The Education Process (cont’d) Patient Education : the process of helping clients learn health-related behaviors to achieve the goal of optimal health and independence in self-care Staff Education : the process of helping nurses acquire knowledge, attitudes, and skills to improve the delivery of quality care to the consumer

23. ASSURE Model A useful paradigm to assist nurses to organize and carry out the education process A nalyze the learner S tate the objectives S elect instructional methods and materials U se instructional methods and materials R equire learner performance E valuate/revise the teaching plan

24. The Contemporary Role of the Nurse as Educator Nurses act in the role of educator for a diverse audience of learners—patients and their family members, nursing students, nursing staff, and other agency personnel. Despite the varied levels of basic nursing school preparation, legal and accreditation mandates have made the educator role integral to all nurses.

25. Role of Nurse as Educator ( cont ’ d) The new educational paradigm focuses on the learner learning. Instead of the teacher teaching The nurse becomes the “guide on the side.”

26. Role of Nurse as Educator ( cont ’ d) Nursing education transformation Gap between nursing education and practice Patient engagement Nursing Alliance for Quality Care (NAQC) goals: Consumer-centered health care, performance measurement and public reporting, advocacy, and leadership

27. Role of Nurse as Educator ( cont ’ d) Quality and safety education in nursing Robert Wood Johnson Foundation (RWJF) Quality and Safety Education in Nursing (QSEN) competencies: Patient-centered care Teamwork and collaboration Evidence-based practice

28. Role of Nurse as Educator ( cont ’ d) Quality and safety education in nursing RWJF Quality and Safety Education in Nursing competencies (cont’d): Quality improvement Informatics Safety

29. Role of Nurse as Educator (cont ’ d) Institute of Medicine report: The future of nursing Written in response to the Affordable Care Act Describes the role of nursing in a transformed healthcare system

30. Role of Nurse as Educator (cont ’ d) Institute of Medicine (cont’d) The Future of Nursing recommendations: Remove scope of practice barriers. Expand opportunities for nurses to lead in collaborative efforts. Implement nurse residency programs.

31. Role of Nurse as Educator ( cont ’ d) Institute of Medicine (cont’d) The Future of Nursing recommendations (cont’d): Increase proportion of nurses with baccalaureate degrees to 80% by 2020. Double number of nurses with a doctorate by 2020.

32. Role of Nurse as Educator ( cont ’ d) Institute of Medicine (cont’d) The Future of Nursing recommendations (cont’d): Ensure that nurses engage in lifelong learning. Prepare and enable nurses to lead change to advance health. Build infrastructure for the collection and analysis of data.

33. Barriers to Teaching and Obstacles to Learning Barriers to teaching are those factors impeding the nurse’s ability to deliver educational services. Obstacles to learning are those factors that negatively impact the learner’s ability to pay attention and process information.

34. Barriers and Obstacles (cont’d) Factors affecting the ability to teach: Lack of time to teach Inadequate preparation of nurses to assume the role of educator with confidence and competence Personal characteristics Low-priority status given to teaching Environments not conducive to the teaching–learning process

35. Barriers and Obstacles (cont’d) Factors affecting the ability to teach (cont’d): Absence of third-party reimbursement Doubt that patient education effectively changes outcomes Inadequate documentation system to allow for efficiency and ease of recording the quality and quantity of teaching efforts

36. Barriers and Obstacles (cont’d) Factors affecting the ability to learn: Limited time due to rapid discharge from care Stress of acute and chronic illness, anxiety, sensory deficits, and low literacy Low literacy and functional health illiteracy Negative influence of hospital environment Variations in readiness to learn, motivation and compliance, and learning styles

37. Barriers and Obstacles (cont’d) Factors affecting the ability to learn (cont’d): Extent of behavioral changes (in number and complexity) required Lack of support and positive reinforcement from providers and/or significant others Denial of learning needs, resentment of authority, and locus of control issues Inconvenience, complexity, inaccessibility, fragmentation, and dehumanization of the healthcare system

38. ESSAY QUIZ Questions Under which conditions should certain teaching methods and tools be used? What are the common mistakes made in the teaching of others? How can teaching and learning best be evaluated?