Nurse as Teacher

Question 1

Patient Bill of Rights

Answer 1

• right to be informed

- right to participate in decisions regarding health

Question 2

ANA

Answer 2

identifies client teaching as an independent nursing function

Question 3

JC

Answer 3

sets guidelines and standards for client education

Question 4

NPA

Answer 4

teaching a legal & professional responsiblity

Question 5

True teaching is….

Answer 5

NOT talking AT someone

Can be compared to the nursing process

• Assess, collect information, analyze client’s learning ability, readiness
• Identify knowledge deficits
• Set realistic goals
• Prepare a teaching plan
• Implement teaching plan
• Evaluate client learning

Question 6

Empowerment

Answer 6

• encourages independence/autonomy
• allows for informed choices
• improves quality of life
• decreases hospital admissions

Question 7

Specific strategies are developed to enhance person’s learning

Answer 7

• verbal
• nonverbal
• active listening
• organize information in a logical sequence
• simple complex
• check for feedback from the patient frquently

Question 8

Meet the patient…

Answer 8

• where he or she is

- what do they already know

Question 9

Assessment basics when client teaching

Answer 9

Gather relevant information:

• nursing hx
• physical exam
• readiness/motivation to learn
• reading level
• language barriers
• anxiety level
• nursing dx

Question 10

Implementation basics when client teaching

Answer 10

use teaching plan and verbal/nonverbal communication skills to present the material

Question 11

Evaluating basics when client teaching

Answer 11

• final step in the learning process

- “teach back method”

Question 12

Planning basics when client teaching

Answer 12

• set goals, determine objectives, plan the learning experience
• learner should participate in making the plan and setting priorities
• written specific learning objectives
• selecting teaching strategies
• date and time
• method

Question 13

Examples of written learning objectives..

Answer 13

subject: “The client will…”

actual behavior: “self administer an insulin injection…”

conditions: “under which behavior is to occur” or “in front of the RN”

specific criteria: “using correct technique…”

date/time: to be accomplished

Question 14

Required “tools” a nurse needs as a teacher

Answer 14

1. Knowledge of subject
2. communication skills: clear, simple language
3. empathy/relationship building: stepping into the shoes of the other person

Question 15

3 Domains of learning

Answer 15

1. Cognitive
2. Affective
3. Psychomotor

• learning may involve one or all of these domains
• characteristics of learning in each domain affects the teaching approach

Question 16

Cognitive Learning Domain

Answer 16

• intellectual behaviors
• involves 6 intellectual skills:
• knowledge
• comprehension
• application
• analysis
• synthesis
• evaluation

Question 17

Example of using all 3 domains in teaching with a colostomy

Answer 17

1. teaching how much fluid to use when irrigating a colostomy (cognitive)
2. teaching when to irrigate a colostomy (cognitive)
3. client how to irrigate colostomy (psychomotor)
4. helping the client accept the colostomy (affective)
5. helping the client maintain self-esteem (affective)

Question 18

Affective learning domain

Answer 18

includes feelings, emotions, interests, attitudes, and appreciations

Question 19

Psychomotor learning domain

Answer 19

skills include mental and muscular activity

• ranges from:
• using senses to obtain cues to guide motor activity
• creating new movement patterns to suit a particular problem

Question 20

Factors facilitating learning

Answer 20

1. Motivation
2. Readiness
3. Active Involvement
4. Feedback
5. Simple to complex
6. Repetition
7. Timing
8. Environment
9. Methods
10. Organization
11. Maintaining Client’s Attention
12. Build on client’s existing knowledge
13. teaching aids

Question 21

Motivation

Answer 21

• desire to learn
• greatly influences how quickly and how much a person learns
• motivation is greatest when a person recognizes a need and believes that need will be met through learning…
• client says “I need this”
• learning is more effective when it is in response to a felt need of learner/family
• adults learn what they feel they have a need to know
• adults learn based on life experiences (builds on past knowledge/experiences)

Question 22

Nurses can increase cleint’s motivation in several ways..

Answer 22

• relating the learning to something the client values and helping the client see the relevance of learning to achieving that goal
• make the learning situation pleasant and non-threatening (threatening=barrier)
• encouraging self-direction and independence
• demonstrating a postive attitude about client’s ability to learn
• offering continuing support and encouragement
• creating a learning situation where the client is likely to succeed (reinforce what they already know and add new information in small amounts and reinforce)

Question 23

Readiness

Answer 23

another factor that facilitates learning

• in order for your client to be able to focus on what is to be learned, you must:
  1. have met basic survival needs
  2. have met basic comfort needs

Question 24

Assessing readiness to learn

Answer 24

• ability to concentrate
• ability to remember
• freedom from discomfort
• motivation
• valuing health care (belief that learning improves health)

Question 25

Assessing ability to learn

Answer 25

- comparing what the client can do with what you want them to master - deciding if the client possesses adequate physical strength, size, coordination to perform the taks - senses intact? - can the client read? They may not always tell you/admit they can't - What is their developmental level - socioeconomic status supplies a clue to health beliefs, past experiences, and ability to buy required items - what is composition of client's family, expected roles, support etc.

Question 26

Factors that inhibit learning

Answer 26

1. emotions 2. physiological events 3. cultural barriers

Question 27

Goals

Answer 27

- clearly written - must be measurable/observable - must be realistic - must be written in client language: "Client will be able to correctly self-administer accurate dosage of insulin by 5/30/06"

Question 28

Physiological factor affecting learning

Answer 28

-physical needs must be met before learning can occur (food, water, pain relief)

Question 29

Psychological

Answer 29

- moderate anxiety enhances learning - severe anxiety or lack of anxiety inhibits learning - health beliefs of the client are important for them to take health action - intelligence is the cognitive ability to learn (will affect rate, quantity, and complexity of learning

Question 30

Sociocultural/spiritual factors affecting learning

Answer 30

- these factors influence the client's health beliefs and attitudes because culture determines our experiences, education, health practices, and lifestyle - many cultural groups have their own beliefs and practices related to diet, health, illness, and life style - nurse should not assume that because a client belongs to a certain cultural group, that they have those beliefs - ask questions relating to cultural factors and beliefs - economic factors may also affect client's learning (cannot afford materials needed to learn, suggest foods)

Question 31

Teaching plan basics

Answer 31

- when developing a teaching plan, need to involve the patient - promotes the formation of a more meaningful plan - stimulates the client's motivation - determine teaching priorities: rank learning needs according to priorities - client's principles must be considered