FUNDA

• LOW Fowler's - 15-30 degrees

  Semi Fowler's - 30-45 degrees

  Standard Fowler's - 45-60 degrees

  High Fowler's 80-90 degrees
• The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.
• This is all the nurse can do until trust is established; facing the client to attend will disrupt the group.
• As a nurse, you are a visible, competent resource for patients who want to improve their physical and psychological well-being. In the school, home, clinic, or workplace, you promote health and prevent illness by providing information and skills that enable patients to assume healthier behaviors.
• Not all patients fully recover from illness or injury. Many have to learn to cope with permanent health alterations. New knowledge and skills are often necessary for patients and/or family members to continue activities of daily living. Teaching family members to help the patient with health care management (e.g., giving medications through gastric tubes, doing passive range-of-motion exercises) is an example of coping with long-term impaired functions.
• Teaching is most effective when it responds to the learner's needs. It is impossible to separate teaching from learning. Teaching is an interactive process that promotes learning. Teaching consists of a conscious, deliberate set of actions that help individuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills.
• Standards for Patient Education

  • All state Nurse Practice Acts recognises that patient teaching falls within the scope of nursing practice
  • The Joint Commission sets standards for patient and family education
  • Successful accomplishment of standards requires collaboration among health care professionals
• Purposes of Patient Education

  • To help individuals, families, or communities achieve optimal levels of health
  • Maintenance and promotion of health and illness prevention
  • Restoration of health
  • Coping with impaired functioning
• Teaching


  The concept of imparting knowledge through a series of directed activities
• Learning


  Purposeful acquisition of new knowledge, attitudes, behaviors, & skills through experience or external stimulus
• Role of the Nurse in Teaching and Learning

  • Teach information that patients and families need to make informed decisions regarding their care
  • Determine what patients need to know
  • Identify when patients are ready to learn
• Nurses have an ethical responsibility to teach patients.
• The Patient Care Partnership of the American Hospital Association indicates that patients have the right to make informed decisions regarding their care.
• The information required to make informed decisions must be accurate, complete, and relevant to patients' needs, language, and literacy.
• SPEAK UP Initiatives


  • Speak up if you have questions or concerns
  • Pay attention to the care you get
  • Educate yourself about your illness
  • Ask a trusted family member or friend to be your advocate
  • Know which medicines you take and why
  • Use a healthcare organization that has been carefully evaluated
  • Participate in all decisions about your treatment
• Teaching as Communication


  Closely parallels the communication process
• Effective communication involves feedback
• Steps of the teaching process

  • The nurse is the sender who conveys the message to the patient; the receiver in the teaching-learning process is the learner
  • Attitudes, values, emotions, cultural perspective, and knowledge influence the way information is delivered
  • The receiver in the teaching-learning process is the learner. The ability to learn depends on factors such as emotional and physical health, education, stage of development, and previous knowledge
  • Effective teachers can evaluate the success of the teaching plan and provide positive reinforcement
  • Feedback you receive from the learner is equally important because it indicates the effectiveness of instruction and whether or not you need to modify your approach
• Domains of Learning


  • Cognitive - requires thinking and encompasses the acquisition of knowledge and intellectual skills
  • Affective - deals with expression of feelings and development of attitudes, opinions, or values
  • Psychomotor - involves acquiring skills that require coordination & integration of mental & physical movements
• Cognitive Learning


  • Remembering: Learning new facts or information and being able to recall them
  • Understanding: Ability to understand the meaning of learned material
  • Applying: Using abstract, newly learned ideas in an actual situation
  • Analyzing: Breaking down information into organized parts
  • Evaluating: Ability to judge the value of something for a given purpose
  • Creating: Ability to apply knowledge and skills to create something new
• Affective Learning


  • Receiving: Learner is passive and needs only to pay attention and receive information
  • Responding: Requires active participation through listening and reacting verbally and nonverbally
  • Valuing: Attaching worth and value to the acquired knowledge as demonstrated by the learner's behavior
  • Characterizing: Acting and responding with a consistent value system; requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience
• Psychomotor Learning


  • Perception: Being aware of objects or qualities through the use of sensory stimulation
  • Set: Readiness to take a particular action; there are three sets: mental, physical, and emotional
  • Guided response: Early stages of learning a particular skill under the guidance of an instructor that involves imitation and practice of a demonstrated act
  • Complex overt response: Smoothly and accurately performing a motor skill that requires complex movement patterns
  • Adaptation: Motor skills are well developed and movements can be modified when unexpected problems occur
  • Origination: Using existing psychomotor skills to create new movement patterns and perform them as needed in response to a particular situation or problem
  • Mechanism: Higher level of behavior in which a person gains confidence and proficiency in performing a skill that s more complex or involves several more steps than a guided response
• Appropriate Teaching Methods Based on Domains of Learning: Cognitive

  • Discussion (one-on-one or group)
  • Lecture
  • Question-and-answer session
  • Role play, discovery
  • Independent project (computer-assisted instruction), field experience
• Appropriate Teaching Methods Based on Domains of Learning: Affective

  • Role play
  • Discussion (group)
  • Discussion (one-on-one)
• Appropriate Teaching Methods Based on Domains of Learning: Psychomotor


  • Demonstration
  • Practice
  • Return demonstration
  • Independent projects, games
• Basic Learning Principles


  • Motivation to learn - addresses the patient's desire or willingness to learn
  • Ability to learn - depends on physical and cognitive abilities, developmental level, physical wellness, thought processes
  • Learning environment - allows a person to attend to instruction
• Motivation is the force that acts on or within a person to cause the person to behave in a particular way.
• Attentional set is the mental state that allows the learner to focus on and comprehend a learning activity.
• Use of theory to enhance motivation and learning

  • Theories focus on how individuals learn
  • Help guide instructional strategies
• Ability to Learn


  • Developmental capability - Cognitive development, Prior knowledge, Learning in children, Developmental stage, Adult learning
  • Physical capability - Level of personal development, Physical health, Energy
• Teaching Methods Based on Patient's Developmental Capacity: Infant

  • Keep routines (e.g., feeding, bathing) consistent
  • Hold the infant firmly while smiling and speaking softly to convey a sense of trust
  • Have infants touch different textures (e.g., soft fabric, hard plastic)
• Teaching Methods Based on Patient's Developmental Capacity: Toddler


  • Use play to teach procedure or activity (e.g., handling examination equipment, applying bandage to doll)
  • Offer picture books that describe the story of children in hospital or clinic
  • Use simple words such as cut instead of laceration to promote understanding
• Teaching Methods Based on Patient's Developmental Capacity: Pre-school


  • Use role play, imitation, and play to make learning fun
  • Encourage questions and offer explanations. Use simple explanations and demonstrations
  • Encourage children to learn together through pictures and short stories about how to perform hygiene
• Teaching Methods Based on Patient's Developmental Capacity: School-Age Child


  • Teach psychomotor skills needed to maintain health. (Complicated skills such as learning to use a syringe take considerable practice)
  • Offer opportunities to discuss health problems and answer questions
• Teaching Methods Based on Patient's Developmental Capacity: Adolescent

  • Help adolescents learn about feelings and need for self-expression
  • Use teaching as a collaborative activity
  • Allow adolescents to make decisions about health & health promotion (safety, sex education, substance abuse)
  • Use problem solving to help adolescents make choices
• Teaching Methods Based on Patient's Developmental Capacity: Young or Middle Adult


  • Encourage participation in teaching plans by setting mutual goals
  • Encourage independent learning
  • Offer information so the adult understands the effects of health problems
• Teaching Methods Based on Patient's Developmental Capacity: Older Adult

  • Teach when the patient is alert and rested
  • Involve adults in discussion or activity
  • Focus on wellness and a person's strength
  • Use approaches that enhance a patient's reception of stimuli when they have a sensory impairment
  • Keep teaching sessions short
• The ideal setting helps the patient focus on the learning task.
• Teaching a group of patients requires a room that allows everyone to be seated comfortably and participate.
• School-Age Child


  • Encourage children to learn together through pictures and short stories about how to perform hygiene
  • Teach psychomotor skills needed to maintain health. (Complicated skills such as learning to use a syringe take considerable practice.)
  • Offer opportunities to discuss health problems and answer questions