ATI Nurse s Touch Professional Communication Client Education

ATI Nurse's Touch: Professional Communication - Module 1 - Client Education Welcome to the module on client education. In this module you learn about client education and why it's such an important part of being a professional nurse. 1. Introduction. (2:12) You'll discover your role in providing: - Client Education: including... 1. Identifying client’s needs 2. Best environment, materials 3. Teaching clients of different age groups 4. As well as teaching the motivation for different types of learning 5. You’ll also discover which approaches are more appropriate for teaching a child vs. teaching an older adult. - In addition to age differences you’ll look at: 1. Different teaching approaches 2. Best way to learn 3. Observe, hands-on - You’ll also look at the different domains of learning: Cognitive, Affective, Psychomotor - And how the different domains of learning affect your clients’ comprehension of info. - Individual client teaching vs. Group teaching 2. Role of a Nurse. a. Client Educator (1:14) i. Assessment of the Client (1:00): 1. Where to begin: a. Assessment or data collection b. Determine individual needs prior to ever providing for a patient ii. Client’s Learning Needs (1:11): When determining your patient’s educational needs, the most basic question you need to ask is “What does my client need to Learn?” The Healthcare Education Association defines “learning needs” as gaps in knowledge that exists between the desired level of performance and the actual performance. To identify your client’s learning needs, you need to: 1. Influencing Factors: concerns, experience, support, motivations 2. Assessment Methods: a. Conversation or observation b. Interviews, questionnaires, or records 3. Personalized Plan: promotes most favorable outcome iii. Assessing Clients’ Learning Needs (1:13): Mrs. Lawson nervous in L&D 3. Learning Environment. a. Best Learning Environment (1:00): What is the best environment? Depends on individual needs vs. group needs as well as content needs. You might need a different setting for teaching a client about the purpose of a medication (e.g. insulin administration). 2 important things to keep in mind when choosing the environment are privacy and confidentiality. i. Promote a Positive Learning Environment Part 1 (1:08): When teaching a client you want to choose a space that is: 1. Conducive To Learning: a. Space Requirements: Have enough chairs? Need a table? b. Noise May Disrupt: Construction noise, for example, can hinder c. Limit Interruptions: It’s distracting to have interruptions! ii. Promote a Positive Learning Environment Part 2 (0:57): Creating a learning environment also requires consideration of 2 more elements: 1. Light: appropriate for content 2. Temperature: focus on client comfort b. Culture Slide 1 (1:08): Culture can also affect learning. To understand this you must 1st identify what culture really is. Culture is the knowledge, beliefs, morals, customs, traditions, and habits characteristic of a population of people that guide their thinking and decision-making. It’s a given that you’ll work with clients whose cultures are different from your own. Prepare to: i. Encounter Differences: especially differences that are hard for you to understand because they’re so different from your own. Nevertheless, provide these clients with the same level of care and understanding that you give to all your clients. ii. Avoid Ethnocentrism: this is the pitfall of thinking that your cultural ways are better than others. In other words, when you think you’re right & they’re wrong. iii. Accept, respect other cultures: recognize a client’s cultural needs to you can identify culturally appropriate interventions to incorporate into your client’s teaching plan. c. Cultural Variables That Affect Learning (1:27): i. Six Specific Variables That Affect A Client’s Learning: 1. Communication: when you’re working with a client who speaks a different language. You must also consider nonverbal communication. 2. Personal Space: many consider personal space about an arm’s length. 3. Social Organizations: family structure & religious involvement may impact learning. Does the client’s learning require the patriarch of the family to be present for teaching? Will religious beliefs affect compliance? 4. Time: Every culture has a specific view and concept of time. You may find this challenging when establishing short & long-term goals. 5. Environmental Control: culture affects the use of the health system. Some pts may not use healthcare resources d/t cultural beliefs or practices. 6. Biological Variations: specific biological and genetic differences not only affect a person’s physical appearance but also the risk of certain medical conditions. d. Reading Level for Written Material (1:07): i. Printed Education Materials (PEMs): these don’t mean clients understand 1. Ensure learning, comprehension 2. Assess client reading level 3. Recommended PEM reading level: 5th grade level, lay terms: a. ***General Rule of Thumb: clients usually read 2-4 grade levels below their highest level of education.*** 4. Teaching Clients of Different Ages. (0:47) a. Teaching Clients of Different Ages: imagine that you need to provide teaching for three clients: a child and adult and an older adult. Each has a new diagnosis of diabetes mellitus. Is your teaching going to be the same for each of these clients? Obviously no! The Joint Commission requires that teaching plans address: i. Stage-specific competencies of each client ii. Developmental stage: 1. Physical, cognitive, and psychosocial maturation. iii. Developmental trends: 1. Based on client’s age. iv. Click ahead to take a look at the differences between teaching children, adults, and older adults. b. Pedagogy (0:46): this is the art and science of helping children learn. It sounds simple enough, right? Not exactly. Pediatric clients can range from infants to adolescents and they have very different developmental stages and developmental needs i. Helping Children Learn: ii. 4 Stages of Childhood: each stage is very different & has different educational needs. You will need to incorporate strategies specific to that age! 1. Infant and Toddler (Birth to 3 y/o) (1:10): a. Sensorimotor cognitive stage: learn through senses b. Psychosocial stage: i. Trust vs. Mistrust ii. Autonomy vs. shame, doubt iii. Naturally curious, but dependent c. Focus teaching toward caregiver: i. Include child when possible 1. Play with equipment d. Strategies: repetition, sensory stimulation, allow play 2. Preschooler (3 to 6 y/o) (1:11): a. Preoperational cognitive stage: i. magical thinking; limited sense of time. b. Psychosocial stage: i. Initiative vs. guilt ii. May view illness as punishment iii. Short attention spans iv. Concrete thinkers c. Build trust, teaching in bursts d. Strategies: drawing, stories, play; positive reinforcement 3. School-Age (6-12 y/o) (1:07): a. Concrete operations cognitive stage i. Draw conclusions ii. Increased conversational skills b. Psychosocial stage: i. Inferiority vs. industry ii. See selves as individuals iii. More realistic, understand cause & effect c. Promote sense of independence d. Strategies: i. Step-by-step instructions, structured teaching, use past experiences. e. Using Developmentally Appropriate Language (1:00): James w/ SOB being taught how to use an inhaler. 4. Adolescent (12-18 y/o) (1:09): a. Formal operations cognitive stage i. Think outside the box ii. Understand complex info b. Psychosocial stage: ` i. Identity vs. role confusion ii. Abstract thinking, logical reasoning c. Strategies: i. Treat as adults ii. Respect privacy, individuality iii. Interact with client alone iv. Audiovisuals, computer resources c. Andragogy (0:45): i. Teaching adults 1. Independent 2. Resistant to change ii. Responsibilities: 1. Relevance of info 2. Solving current problems iii. Strategies: 1. Drawing on past experiences 2. Encouraging self-directed learning 3. Focusing on immediate problem d. Geragogy (0:50): i. Teaching older adults ii. Physical challenges: 1. Diminished eyesight, hearing, mobility 2. Identify challenges, tailor teaching plan iii. Cognitive challenges: 1. Slower processing time, decreased memory, altered time perception iv. Strategies: 1. Reminiscence involvement, repetition of info 2. Material appropriate for specific challenges 5. Learning Styles. a. Learning Styles (1:02): learning styles are: i. How individuals process info: Visual, auditory, tactile. ii. Identify learning styles through: observation, interviews, administer tools b. Visual (0:47): i. Visual preference: reading content; observing demonstration ii. Strategies: handouts to read, videos to watch, demonstration technique c. Auditory (0:44): i. Auditory preference: verbalize info; make sure client restates info. ii. Specific strategies: talk about info, encourage group discussion, use audiotapes d. Tactile (0:39): i. Tactile preference: highlight info; taking notes ii. Specific strategies: keep client’s hands busy, handling equipment, taking notes e. Kinesthetic (0:44): i. Kinesthetic preference: talking, doing; working hands on ii. Specific strategies: return demonstration, simulation, role-playing f. Using a Variety of Instructional Strategies (0:51): Mrs. Lawson breastfeeding in L&D 6. Learning Domains. a. Learning Domains (0:41): 3 domains are cognitive, affective, psychomotor. Use methods that appeal to each of these domains for the best outcomes. b. Cognitive Domain (1:03): the thinking domain (intellectual abilities & thinking skills): i. 6 Levels of Cognitive Behavior: knowledge, comprehension, application, analysis, synthesis, evaluation. ii. Specific Methods For Teaching: written materials, 1-on-1 discussion, audiovisuals. c. Affective Domain (0:55): the feeling domain (feelings, values, & emotions) i. 5 Levels of Affective Behavior: receiving, responding, valuing, organization, & characterization. ii. Specific Methods For Teaching: role playing; group discussion iii. Appealing To The Affective Domain (1:11): Mrs. Lawson difficulty with breastfeeding. d. Psychomotor Domain (1:22): the skills domain (physical skills, abilities) i. 7 Levels of Psychomotor Behavior (using breastfeeding as an example): 1. Perception: she demonstrates awareness of breastfeeding techniques 2. Set: shows readiness to try techniques 3. Guided Response: attempts to perform techniques with your guidance 4. Mechanism: develops confidence in performing techniques 5. Complex Overt Response: performs breastfeeding techniques with independence and skill 6. Adaptation: able to adapt techniques to specific situations 7. Origination: able to create a new technique that fits her needs & needs of her infant. 7. Teaching Individuals and Groups. a. Individual and Group Education (1:06): i. Individual client education: 1. Individual learning needs 2. Personalized learning plan ii. Group education: 1. Advantages: interactions, sharing 2. Disadvantages: time, effort b. One-on-One Teaching (1:02): i. Allows focus on domains: allows you to focus on client & specific needs ii. Assessment of the learner iii. Main advantage = personalization iv. Encourage involvement, discussion v. Interaction vi. Disadvantages: too much info; puts client on the spot, isolated c. Demonstration (0:50): i. Providing A Step-by-Step Demonstration Video (0:42): Mr. Watts prescribed Enoxaparin for blood clots. Nurse demonstrates how to inject it. d. Gaming (1:02): i. Client participates in activity w/ preset rules/is competitive: increases retention ii. Individuals or groups iii. Identify objectives and rules prior to game starting iv. Provide praise or a reward when client or team successfully completes game e. Lecture (0:49): i. Teaching a group: prepare material fit for all members ii. Advantage: deliver large amount of info iii. Drawbacks: limited interaction; difficult to address affective, psychomotor Domains. iv. Effective Lecture Delivery: introduction, main content, summary v. Engaging Your Audience: humor, audiovisuals vi. Setting: good lighting, focus on lecturer f. Group Discussion (0:52): i. Encourage sharing of info, thoughts, and feelings of a specific topic: 1. Allows teaching in cognitive, affective, & psychomotor domains ii. Group size: keep small; 6-8 members iii. Beginning the discussion: overview of objectives iv. Role of facilitator: flexible flow of discussion; discussion stays on topic; give each member equal chance to contribute. g. Simulation (1:08): i. Fictional experience reflecting real-life situation: promotes retention ii. Allows teaching in cognitive, affective, & psychomotor domains iii. Follow with debriefing iv. Disadvantages: development takes time, planning; never same as real life