MIDTERMS

• Implementation of Health Education

  Analysis of program implementation consisting of measuring the attainment process, objectives, or determining the achievement of means designed to accomplish program goals
• Implementation of the teaching plan

  • May not go as envisioned
  • The nurse must constantly assess the patient's response during this phase
  • The nurse needs to speak in terms the patient understands
  • The nurse needs to be specific on what is to be covered
  • The nurse needs to keep the message short and concise
• Interpersonal Skills


  • Effective teaching is based on the nurse's ability to establish rapport with the patient
  • The nurse who is empathic to the patient shows sensitivity to the patient's needs and preferences
  • An atmosphere in which the patient feels free to ask questions promotes learning
• Steps in Implementation


  1. Deciding what will be taught (together with the patient)

  2. Determining when teaching will occur (taking into account patient preferences)

  3. Deciding where teaching takes place (considering comfort and privacy)

  4. Identifying who will teach and learn (including the patient and others like spouse, children or caregiver)

  5. Planning how teaching will occur (based on patient's preferred learning style)
• What will be taught

  • Look at the information that the patient "needs to know", and "what is nice to know"
  • Start with the information that the patient needs to know and select where the patient wants to start
• When teaching will occur

  • Plan when you will teach, taking the length of hospital stay
  • Determine what works with patients and offer options that are realistic
  • Assess how quick the patient can learn information
  • Keep teaching session short no more than 30 minutes and shorter than 5 minutes
• Where teaching takes place

  • Plan where you will teach, and include comfort and privacy
  • If patient may ask intimate question, look for an empty room
  • Try to limit distractions and interruption
• Who will teach and learn

  • Patients who had similar experience can be helpful
  • Include teaching people other than the patient such as spouse, children or caregiver
• How teaching will occur

  • Global learners likes to understand big picture first and work down to details
  • Linear learners wants details first and expect a bigger picture to emerge
  • Visual learners need teaching material that involve reading, writing, and watching visual media
  • Auditory learners need to hear information through spoken explanations
  • Tactile learners must touch, manipulate and perform task to learn
  • Teaching methods and materials may be use depending on the patients preferred learning style and which methods and materials are most appropriate for specific situations
• Evaluation


  A systematic process by which the worth or value of something, teaching and learning is judged
• Evaluation


  The process that can justify that what we do as nurses and as nurse educators makes a value-added difference in the care we provide
• Evaluation


  A process within a process, a critical component of the nursing process, the decision-making process, and the education process. It is the final component of each of these processes
• Determining the Focus of Evaluation

  • For which audience is the evaluation being conducted?

  For what purpose is the evaluation being conducted?

  Which questions will be asked in the evaluation?

  What is the scope of the evaluation?

  Which resources are available to conduct the evaluation?
• Assessment


  Gather, summarize, interpret, and use data to determine the extent to which an action was successful
• Evaluation


  Gather, summarize, interpret, and use data to decide a direction for action
• Evaluation Model


  Process (Formative):

  The process or formative evaluation is to make adjustments in an educational activity including personnel, materials, facilities, objectives, or even one's own attitude
• Content Evaluation


  To determine whether learners have acquired the knowledge or skills taught during the learning experience

  To what degree did the learners learn what they were taught?

  To what degree did learners achieve preset behavioral objectives?
• Impact Evaluation


  To determine the relative effects of education on the institution or the community

  To obtain information that will help decide whether continuing an educational activity is worth its cost
• Total Program Evaluation


  Determines the extent to which all activities for an entire department or program over a specified time meet or exceed the goals originally established
• Designing the Evaluation


  • The design of an evaluation is created within the framework, or boundaries, already established by focusing the evaluation

  An important question to be answered in designing an evaluation is "How rigorous should the evaluation be"
• Questions to be asked when designing evaluation tool

  • What types of data will be collected?

  From whom or what will data be collected?

  How, when, and where will data be collected?

  By whom will data be collected?
• Evaluation Instrument


  An evaluation should be conducted with existing instruments, because instrument development requires considerable expertise, time, and expenditure of resources

  The instrument must measure the performance being evaluated exactly as that performance has been operationally defined for the evaluation

  An Appropriate instrument should have documented evidence of its reliability and validity
• Evaluation of Learning


  Evaluation is the last step of the teaching process. It is a continuous and crucial step in the teaching process. Evaluation includes determining if the teaching session was successful and the patient learned the intended information. Evaluation also provides the needed evidence that the patient received the and understood educational material.
• Evaluation of Teaching


  A major purpose of evaluation is to assess the effectiveness of the teaching activities and decide which modifications, if any, are necessary. When learning objectives are not met, reassessment is the basis for planning modification of teaching-learning activities. Several activities can evaluate teaching effectiveness, including the following:

  Feedback from the learner, Feedback from colleagues, Situational feedback, Self-evaluation
• Barrier to Evaluation


  • Lack of clarity

  Lack of ability

  Fear of Punishment or Loss of Self-Esteem
• Patient education is a key component to disease management, convalescence, and overall wellness maintenance
• Documentation of Patient Education

  Documentation of patient education provides a means of monitoring the type of patient education performed, the patient response, and additional educational needs
• Steps in Effective Documentation

  Use a standardized form

  Document formal and informal teaching

  Describe the response of the learners

  When possible, put copies of educational materials in the chart

  Update the teaching plan
• What to Document


  • The patient's learning needs

  The patient's preferred learning style and readiness to learn

  The patient's current knowledge about his or her condition and health care management

  Learning objectives and goals as determined by both you and the patient

  Information and skills you have taught

  Teaching methods you have used, such as demonstration, brochures, and videos

  Objective reports of patient and family responses to teaching

  Evaluation of what the patient has learned and how learning was observed to occur
• Barriers to Documentation of HE

  • The interactions of patient, physician and systemic factors have implications for the implementation of patient education

  The failure of adequate patient education may be attributed to the lack of patient adherence

  The failure of nurses' knowledge and skill level

  Organization of necessary programs in the current health care system

  The lack of educational resources
• Evaluation is a powerful strategy for distinguishing programs and interventions that make a difference. It is a driving force for developing and adapting sound strategies, improving existing programs, and demonstrating the results of teaching in time and other resources
• Patient education is an essential nursing practice standard that meaningfully impacts a patient's health and quality of life. Education is used to empower the patient and is an important aspect of with improved health outcomes
• Evidence-Based Practice


  A problem solving approach that enables clinicians to provide the highest quality of care for patients and families by integrating critical appraisal and critique of the most relevant research, considering the clinician's own expertise, and considering the preferences and values of the patient
• Evidence-Based Practice (EBP)


  The conscientious use of current best practice evidence in making decisions about patient care. It is a lifelong problem solving approach to clinical practice that integrates the most relevant and best research, one's own clinical expertise and patient preferences and values.
• Evidence-based medicine


  Generated from systematic reviews of clinically randomized trials, acknowledged as the strongest evidence upon which practice decisions are made.
• EBP


  The integration of best evidence available, nursing expertise, and the values and preferences of the individuals, families and communities who we serve.
• EBP


  The integration of best research evidence with clinical expertise and patient values to facilitate decision making.
• EBP emphasizes the use of research findings rather than ritual, isolated and unsystematic clinical experiences, ungrounded opinions, and tradition as a basis of practice.
• With the application of EBP

  Better patient outcomes, which can decrease the demand for healthcare resources, allowing healthcare organizations to reduce expenses.
• EBP is an essential component of safe, quality patient care. Nurses must be aware of current practices in order to provide care to patients with complicated and debilitating conditions.