health ed - chapter 1

8/2/2019 Health Ed - Chapter 1

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Chapter 1

Overview of Education inHealth Care


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Historical Foundations of theNurse Educator Role

Health education has long beenconsidered a standard care-giving role

of the nurse. Patient teaching is recognized as an

independent nursing function.

Nursing practice has expanded toinclude education in the broad conceptsof health and illness.


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Historical Foundations (contd)

Organizations and Agencies Promulgating

Standards and Mandates:

1. NLNE (NLN) first observed health teaching as animportant function within the scope ofnursing practice

responsible for identifying course contentfor curriculum on principles of teaching andlearning


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2. ANA

- responsible for establishing standards andqualifications for practice, including patientteaching

3. ICN

- endorses health education as an essential

component of nursing care delivery


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4. State Nurse Practice Acts

- universally includes teaching within the scopeof nursing practice

5. JCAHO

- accreditation mandates require evidence ofpatient education to improve outcomes

6. AHA

- Patients Bill of Rights ensures that clientsreceive complete and current information


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7. Pew Health Professions Commission

- puts forth a set of health profession

competencies for the 21st century- over one-half of recommendations pertain toimportance of patient and staff education


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Trends Affecting Health Care

Social, economic, and political forces thataffect a nurses role in teaching:

federal initiatives outlined in Healthy People2010

growth of managed care

increased attention to health and well-being ofeveryone in society

cost containment measures to controlhealthcare expenses

concern for continuing education as vehicle toprevent malpractice and incompetence


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Trends (contd)

expanding scope and depth of nursespractice responsibilities

consumers demanding more knowledge andskills for self-care

demographic trends influencing type andamount of health care needed

recognition of lifestyle related diseases which

are largely preventable health literacy increasingly required

advocacy for self-help groups


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Purpose, Benefits, and Goals ofPatient, Staff and Student Education

Purpose: to increase the competence andconfidence of patients to manage their

own self-care and of staff and studentsto deliver high-quality care

Benefits of education to patients:

- increases consumer satisfaction- improves quality of life- ensures continuity of care


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Purpose, Benefits and Goals (contd)

- reduces incidence of illness complications- increases compliance with treatment

- decreases anxiety

- maximizes independence

Benefits of education to staff:

- enhances job satisfaction

- improves therapeutic relationships

- increases autonomy in practice

- improves knowledge and skills


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Purpose, Benefits and Goals (contd)

Benefits of preceptor education fornursing students

prepared clinical preceptors

continuity of teaching/learning fromclassroom curriculum

evaluation and improvement of studentclinical skills


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Purpose, Benefits, and Goals (contd)

Goal: to increase self-care responsibilityof clients and to improve the quality of

care delivered by nurses


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The Education Process

Definition of TermsEducation Process: a systematic, sequential,

planned course of action on the part of both

the teacher and learner to achieve theoutcomes of teaching and learning

Teaching/Instruction: a deliberate intervention

that involves sharing information andexperiences to meet the intended learneroutcomes


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The Education Process (contd)

Learning: a change in behavior(knowledge, skills, and attitudes) that can

be observed and measured, and canoccur at any time or in any place as aresult of exposure to environmentalstimuli


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The Education Process (contd)

Patient Education: the process of helpingclients learn health-related behaviors toachieve the goal of optimal health and

independence in self-careStaff Education: the process of helping

nurses acquire knowledge, attitudes,

and skills to improve the delivery ofquality care to the consumer


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ASSURE Model

A useful paradigm to assist nurses to organizeand carry out the education process.

Analyze the learner

State objectives

Select instructional methods and materials

Use teaching materials

Require learner performance

Evaluate/revise the teaching/learning process


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Role of the Nurse As Educator

Nurses act in the role of educator for adiverse audience of learnerspatientsand their family members, nursingstudents, nursing staff, and otheragency personnel.

Despite the varied levels of basicnursing school preparation, legal and

accreditation mandates have made theeducator role integral to all nurses.


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Role of Nurse As Educator (contd)

Nurses function in the role of educator as:- the giver of information

- the assessor of needs

- the evaluator of learning

- the reviser of appropriate methodology

The partnership philosophy stresses the

participatory nature of the teaching andlearning process.


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Barriers to Teaching

Barriersto teaching are those factorsimpeding the nurses ability to optimally

deliver educational services.

Major barriers include: lack of time to teach

inadequate preparation of nurses to assume the

role of educator with confidence and competence personal characteristics

low-priority status given to teaching


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Barriers to Education (contd)

environments not conducive to the reaching-learning process

absence of 3rd party reimbursement

doubt that patient education effectivelychanges outcomes

inadequate documentation system to allow

for efficiency and ease of recording thequality and quantity of teaching efforts


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Obstacles to Learning

Obstaclesto learning are those factors thatnegatively impact on the learners ability

to attend to and process information.

Major obstacles include: limited time due to rapid discharge from care

stress of acute and chronic illness, anxiety,

sensory deficits, and low literacy functional health illiteracy


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Obstacles (contd)

lack of privacy or social isolation of health-careenvironment

situational and personal variations in readiness

to learn, motivation and compliance, andlearning styles

extent of behavioral changes (in number and

complexity) required


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Obstacles (contd)

lack of support and positive reinforcement fromproviders and/or significant others

denial of learning needs, resentment ofauthority and locus of control issues

complexity, inaccessibility, and fragmentation,of the healthcare system


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Questions To Be Asked

The following questions can be posed about theelements of the education process, the role ofthe nurse as educator, and the principles ofteaching and learning:

How can the healthcare teams work togethermore effectively to coordinate educationalefforts?

What are the ethical, legal, and economicissues involved?


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Questions (contd)

Which theories and principles support theeducation process?

What assessment methods and tools can beused to determine learning needs, readiness

and styles? Which learner attributes positively and

negatively influence education efforts?

What can be done about the inequities in thedelivery of education services ?


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Questions (contd)

Which elements need to be taken into accountwhen developing and implementing teachingplans?

Which instructional methods and materials areavailable to support teaching efforts?

Under which conditions should certainteaching methods and tools be used?

How can teaching be tailored to meet theneeds of specific clientele?


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Questions (contd)

What are the common mistakes made in theteaching of others?

How can teaching and learning best be

evaluated?

What other questions might you ask?


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Perspectives on Research in Patientand Staff Education

most nonresearch-based literature focuses onhow to do patient teaching

more attention is given to the needs of learnerswho have acute, short-term problems than tothose who have chronic, long-term conditions

more research is needed on new teaching

technologies, especially computer-assistedmodalities, distance education, and Internet-based health information sites


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Perspectives on Research (contd)

further investigation is needed on the cost-effectiveness of education efforts

future research must address:

gender issues measurement of behavioral outcomes

effects of educational interventions

theoretical basis for education in practice cost-effectiveness of educational efforts

health ed - chapter 1

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