Textbook of Medical-Surgical Nursing 3e

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Chapter 2   Thoughtful practice

PATIENT EDUCATION A guide to patient education

CHART 2-9

between physical fitness and health? Develop a plan to assist the man to maintain muscle tone and promote well-being.  ONLINE RESOURCES  A wide range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at http://thepoint.lww.com, including videos, animations, journal articles, review questions, quizzes and the e-book. Subscribers may also access Lippincott’s extensive online point-of-care procedure guide LNPS, which provides a wealth of evidence-based, reliable information. REFERENCES AND SELECTED READINGS Books Alfaro-LeFevre, R. (2011). Critical thinking, clinical reasoning and clinical judgment: A practical approach (5th ed.). Philadelphia: W.B. Saunders. Andrews, M. M. & Boyle, J. S. (2011). Transcultural concepts in nursing care (6th ed.). Philadelphia: Lippincott Williams & Wilkins. Bastable, S. B. (Ed.). (2008). Nurse as educator: Principles of teaching and learning for nursing practice (3rd ed.). Boston: Jones & Bartlett Learning Carpenito, L. J. (2012). Nursing diagnosis: Application to clinical practice (14th ed.). Philadelphia: Lippincott Williams & Wilkins. 3. Include the person, family or significant others, nursing team members and other healthcare team members in the evaluation. 4. Identify alterations that need to be made in the teaching plan. 5. Make referrals to appropriate sources or agencies for ­reinforcement of learning after discharge. 6. Continue all steps of the teaching process: assessment, diagnosis, planning, implementation and evaluation. d. Select appropriate teaching aids. e. Keep the plan current and flexible to meet the person’s changing learning needs. 6. Involve the learner, family or significant others, nursing team members and other healthcare team members in all aspects of planning. Implementation 1. Put the teaching plan into action. 2. Use language the person can understand. 3. Use appropriate teaching aids and provide Internet resources if appropriate. 4. Use the same equipment that the person will use after discharge. 5. Encourage the person to participate actively in learning. 6. Record the learner’s responses to the teaching actions. 7. Provide feedback. Evaluation 1. Collect objective data. a. Observe the person. b. Ask questions to determine whether the person ­understands. c. Use rating scales, checklists, anecdotal notes and ­written tests when appropriate. 2. Compare the person’s behavioural responses with the ­expected outcomes. Determine the extent to which the goals were achieved.

CLINICAL REASONING EXERCISES 1  A female university student with a 2-year history of irritable bowel syndrome makes an appointment to speak with the nurse practitioner at the university health centre to discuss her increased use of antidiarrhoeal medication. The student states, ‘I’ve been very busy with my studies and several activities this semester, and I haven’t been eating right.’ What health promotion components guide the nurse in assessing the student’s situation? What is the evidence base for offering information and health programs to help this young adult make appropriate health decisions and establish positive health behaviours? Identify the criteria used to eval- uate the strength of the evidence for this practice. 2  After falling from a piece of machinery at a construc- tion site, a 40-year-old man is recuperating at home after being in the hospital. A community nurse visits three times a week to perform abdominal wound care. During a visit, the man complains that he misses his daily exercise routine and asks when he will be able to resume exercising. Determine the factors that influence his ability to engage in exercise. What factors support the overall relationship g. What are the person’s expectations? h. What does the person want to learn? 2. Organise, analyse, synthesise, and summarise the collected data. Nursing diagnosis 1. Formulate the nursing diagnoses that relate to the person’s learning needs. 2. Identify the learning needs, their characteristics and their aetiology. 3. State nursing diagnoses concisely and precisely. Planning and goals 1. Assign priority to the nursing diagnoses that relate to the individual’s learning needs. 2. Specify the immediate, intermediate and long-term learning goals established by teacher and learner together. 3. Identify teaching strategies appropriate for goal attainment. 4. Establish expected outcomes. 5. Develop the written teaching plan. a. Include diagnoses, goals, teaching strategies and expected outcomes. b. Put the information to be taught in logical sequence. c. Write down the key points. Assessment 1. Assess the person’s readiness for health education. a. What are the person’s health beliefs and behaviours? b. What physical and psychosocial adaptations does the person need to make? c. Is the person ready to learn? d. Is the person able to learn these behaviours? e. What additional information about the person is needed? f. Are there any variables (e.g., hearing or visual impairment, cognitive issues, literacy issues) that will affect the choice of teaching strategy or approach?