[CHAPTER 1: OVERVIEW OF EDUCATION IN HEALTH CARE]

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Introduction

Teaching is a major aspect of nursing professional role FOCUS outcomes demonstrate extend w/c pts. & significant other learned essential knowledge & skills independent care OR staff RN / nsg. students acquire up-to-date knowledge & skills needed competently & confidently render care consumer variety settings.

Historical Foundations for the Teaching Role of Nurses

TEACHING recognized independent nsg. fxn. Since RN educate others this expanded include concepts health & illness 1918 National League for Nursing (NLN), then National League of Nursing Education (NLNE), observed importance health teaching fxn. within scope nsg. practice

1937 NLN recognized RN agents promotion health & prevention illness all settings w/c practice

1950 NLN id. course content nsg. school curricula prepare RN assume role teachers others Recently NLN dev. 1st certified nurse educator (CNE) exam American Nurses Association (ANA) put forth statements fxn., standards, & qualifications nsg. practice International Council of Nurses (ICN) endorsed RNs role educator essential compontent nsg. care delivery

Today all state nurse practice acts (NPAs) include teaching within scope nsg. practice responsibilities.

Joint Commission (JC), then Joint Commission on Accreditation of Healthcare Organizations (JCHAO), est. nsg. standards for pt. edu. o Standards known as mandates, described type & level of care, treatment, services must be provided agency / organizations receive accrediation

Providers must consider literacy level, edu. background, language skills, & culture every ct. 1970s American Hospital Association 1st dev. Pt.s Bill of Right o Est. guidelines ensure pt. receive complete & current info. concerning diagnosis, treatment, & prognosis terms reasonable expected understand

1995 Pew Health Professions Commission pub. board set competencies believed would mark success health professions 21st century. & role RN educator Provide clinically competent & coordinated care to the public Involve pt. & their families decision-making process regarding health interventions Provide ct. with effective care Ensure cost-effective & appropriate care for the consumer Provide for prevention of illness & promotion of healthy lifestyles for all Americans

2006 Institution for Healthcare Improvement announced 5 Million Lives campaign to reduce 15 million incidents medical harm U.S. hospitals q year.

Sullivan Alliance aimed recruit & educate staff deliver culturally competent care public & increase racial & cultural mix nsg. faculty, students, & staff, who sensitive needs ct.

Once a diseased-orriented approach NOW prevention-oriented approach FOCUS teaching promotion & maintenance of health

[CHAPTER 1: OVERVIEW OF EDUCATION IN HEALTH CARE]

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Disease-oriented pt. edu. (DOPE) to prevention-oriented pt. edu. (POPE) to ultimately become health-oriented pt. edu. (HOPE)

Training the trainer CI should be up to date with clinical skills & innovations practice & possess knowledge & skills principles teaching & learning to link theory learned class to practice envir.

Social,
Healthy People 2010: Understanding and Improving Health o o Federal govt. document puts forth national health goals & objectives future Dev. effective health edu. programs to assist individuals recognize & change risk behaviors, adopt/maintain healthy practices, & make appropriate use

Economic, and Political Trends Affecting Health Care

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available services for health care. Growth of managed care o Shifts reimbursement for healthcare services

Economic & social values of reaching out to communities, schools, & workplaces Importance of health edu. to accomplish economic goal of the high costs of health services o Political emphasis productivity, competitiveness in marketplace, & costcontainment measures restrain health series expenses

Concerned about malpractice claims & disciplinary actions for incompetence. o Continuing edu. has become forefront response to challenge of ensuring competency practitioners

RN continue define professional role, body of knowledge, scope of practice & expertise knowledge & skills about how to care for selves & how to prevent disease Demographic tends o Aging population, require emphasis on self-reliance & maintenance of health status over an extended lifespan

Major causes morbidity & mortality o Lifestyle related & preventable through edu. intervention chronic & incurable conditions o Require individuals & families become informed participants to manage their own illnesses

Advanced tech. complexity care & treatment in home & community-based settings o More rapid hospital D/C & more procedures done outpt. Basis are forcing pt. to be more self-reliant

Ct. health literacy essential skill for health outcomes to worldwide Ct. edu. improves compliance, and health & well-being o Better understanding of recommended treatment plans lead cooperation, decision making, satisfaction, & independence regimens

# of self-help group support ct. meeting physical & psychosocial needs

Purpose, Goals, & Benefits of Ct. & Staff Edu.

Purpose pt. edu. competence & confidence of ct. for self-management responsibility & independence of ct. for self-care Single most important action of RN is to prepare ct. self-care o o consumer satisfaction quality of life

[CHAPTER 1: OVERVIEW OF EDUCATION IN HEALTH CARE]

o o o o o o Ensure continuity of care ct. anxiety

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Effectively complications illness & incidence disease Promote adherence treatment plans Max. independence performance activities daily living Energize & empower consumers become actively involved planning of their care

Staff & student edu. competence & confidence RN fxn. independently in providing care consumer goal of quality of care delivered Benefits to RN: o o o o 1st aims o o o Nourish ct. Mentor staff Serve as teachers & clinical preceptors nsg. students job satisfaction Enhanced pt.-RN autonomy accountability in practice Opportunity create change affect lives of others

The Education Process Defined

Edu. process o Systematic, sequential, logical, scientifically bases, planned course of action consisting 2 major interdependent operations, teachings, & learning

The process involves 2 interdependent players o o Teacher Learner

The nsg. process focuses planning & implementing care based assessment & giagnosis of physical & psychosocial needs o Outcome happens when physical & psychosocial needs ct. are met

The edu. process focuses planning & implementing teaching based assessment & prioritization ct.s learning needs, readiness, & learning styles o Outcome happens when changes knowledge, attitudes & skills occur

Teaching (Instruction) o Deliberate interventions involve sharing info. & experience meet intended learner outcomes in cognitive, affective, & psychomotor domains according edu. plan

Teaching highly versatile strategy that applied preventing, promoting, maintaining, / modifying variety behaviors in learner receptive, motivated, & adequately informed

Learning o A Change in behavior that observed/measured & occur @ any time / in any place as result exposure envir. stimuli

Pat. Edu. o Process assisting people learn health-related behaviors incorporated into everyday life with goal optimal health & independence in self-care

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Staff Edu. o

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Process influencing behavior RN producing changes knowledge, attitudes. & skills to help RN maintain & improve competencies delivery quality care

ASSURE o o o o o o o Useful paradigm assist RN organize & carry out edu. process A - nalyze the learner S - tate the objectives S - elect the instructional methods & materials U - se the instructional methods & materials R - equire learner performance E - valuate the teaching plan & revise as necessary

RN must have solid foundation in the principles of teaching & learning Legal & accreditation members, professional nsg. standards of practice made educator role RN integral part high-quality care to be delivered by all RN

Role of the RN as Educator

RN are: o o o o Giver of info. Assessor of needs Evaluator of learning Reviser of appropriate methodology

Barriers to Teaching & Obstacles to Learning

Barriers to teaching o Factors that impede RNs ability deliver edu. services

Obstacles to teaching o Factors negatively affect ability learner pay attention to & process information

Factors Impacting the Ability to Teacher 1. Lack of time to teach 2. 3. Early D/C Schedule & responsibilites

Feeling of incompetence / lack of confidence teaching skills Personal characteristics Motivation to teach & skill in teaching

4. 5. 6.

Low priority Environment Absence of 3rd party reimbursment Help pt. edu. Relegate teaching & learning

7. 8. o o o o o o o

Questioning whether pt. edu. effective to improve health outcomes Type of documentation system

Factors Impacting the Ability to Learn Lack of time to learn Stress of acute & chronic illness, anxiety, & sensory deficits Low literacy & functional health illiteracy influence of hospital envir. Personal characteristics Extent of behavioral changes needed Lack of support & lack of ongoing + reinforcemet

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Denial of learning needs, resentment of authority, & lack of willingness to take responsibility Inconvenience, complexity, inaccessibility, fragmentation, & dehumanization of HC system

State of the Evidence

Nonresearch literature on pt. edu. prescriptive nature & tends give anecdotal tips on how to take individualized approaches to teaching & learning o Computer literature reveals literally thousands of nsg. & allied health articles & books on teaching & learning that are available from the general to specific

Research-based studies teach specific population groups about variety of topics Using new tech. of computer-assisted instruction, online & other distance learning modalities, cable television, & internet access health info. for both pt. & staff edu.

Role change of educator from teacher to resource facilitator as well as a shift from learner from being passive to active

Gender issue, influence of socioeconomics on learning, & strategies of teaching cultural groups, & special populations need further exploration Est. a stronger theoretical basis for intervening ct. Emphasis on research in nsg. edu. Further investigation undertaken document cost effectiveness edu. effort in hospital stays, readmissions, personal quality of life, & minimizing complications of illness & therapies o Envir. stimuli, factors readiness to learn, & influences learning styles learner motivation, compliance, comprehension, & ability apply knowledge & skills once acquired