CHAPTER 1

HEALTH EDUCATION
▪ Creation of Medicare and Medicaid
▪ Creation of Committee on
Introduction Educational Tasks in Chronic Illness
▪Role of education in health care ▪ Developed a model that defined the
▪Patient intervention educational processes necessary for
▪Education of nursing staff and students patient and family education
▪Role of nurse as educator
Historical Foundations for Patient
Historical Foundations for Patient Education in Health Care: Phase 3 (2
Education in Health Care: Phase 1 of 4)
▪ Formative period of organized health ▪ 1970s
care ▪ Publication of The Need for Patient
▪ Emergence of nursing and other health Education
professions ▪ Focus on health education in U.S.
▪ Technological developments Department of Health, Education, and
▪ Emphasis on patient–caregiver Welfare
relationship ▪ American Hospital Association's
▪ Spread of communicable diseases ▪ Statement on a Patient’s Bill of Rights
Growing interest in the welfare of ▪ Right to receive current
mothers and children information about one’s diagnosis,
▪ Emergence of Florence Nightingale as treatment, and prognosis
an advocate ▪ Right to respectful and considerate
care
Historical Foundations for Patient
Education in Health Care: Phase 2 Historical Foundations for Patient
▪ Establishment of Division of Child Education in Health Care: Phase 3 (3
Hygiene of 4)
▪ Factors leading to education ▪ 1970s (cont.)
programs: ▪ The Joint Commission’s
▪ Diagnostic tools Accreditation Manual for Hospitals
▪ Scientific discoveries ▪Broadened the scope of patient
▪ New vaccines and antibiotic education and specified that criteria for
medications patient education be established
▪ Effective surgery and treatment
practices Historical Foundations for Patient
▪ Recognition by National League of Education in Health Care: Phase 3 (4
Nursing Education (NLNE) that public of 4)
health nurses were essential ▪ 1980s and 1990s
▪ Healthy People initiatives
Historical Foundations for Patient ▪ Pew Health Professions Commission
Education in Health Care: Phase 3 (1 ▪ Published a broad set of
of 4) competencies for the 21st century
▪ Began after World War II ▪ Many competencies focus on the
▪Period of significant scientific teaching role of health professionals
accomplishments
▪1960s ▪ 21st century
▪ Health care viewed as a right, not a ▪ 5 Million Lives campaign
privilege ▪ Sullivan Alliance
▪ Passing of Titles XVIII and XIX of
the Social Security Act
Shift in the Role of the Nurse as ▪ Publication of Healthy People 2030
Educator ▪ Recommendations from the Institute of
▪ Evolved from a disease-oriented Medicine
approach to a more prevention-oriented ▪ Passage of the Affordable Care Act
approach (ACA)
▪ Expansion of Medicaid
▪ Emphasizes empowering patients to ▪ Growth of managed care
use their potentials, abilities, and ▪ Emphasis on public education for
resources to the fullest disease prevention and health promotion
▪ Consideration of social determinants of
The Evolution of the Teaching Role of health
Nurses (1 of 3)
▪ Flornce Nightingale Social, Economic, and Political
▪ Developed first school of nursing Trends Affecting Health Care (2 of 4)
▪ Stressed importance of environment ▪ Reduction of healthcare costs through
and other factors health education
▪ National League of Nursing Education ▪ Continuing education as vehicle to
(NLNE) prevent malpractice and incompetence
▪ Now the National League for ▪ Expansion of scope of nurses’ practice
Nursing (NLN) responsibilities
▪ Stressed importance of health ▪ Consumer demand for more
teaching knowledge and skills for self-care
▪ Increasing number of self-help groups
▪ American Nurses Association (ANA)
▪ Establishes standards for practice, Social, Economic, and Political
including patient teaching Trends Affecting Health Care (3 of 4)
▪ Changing demographics
The Evolution of the Teaching Role of ▪ Focus on preventing medical harm
Nurses (2 of 3) ▪ Increased prevalence of chronic
▪ International Council of Nurses (ICN) conditions
▪ Endorses health education as an ▪ New technology
essential component of nursing care ▪ Increasing need for health literacy
delivery
Social, Economic, and Political
▪ State Nurse Practice Acts Trends Affecting Health Care (4 of 4)
▪ Universally include teaching within ▪ Desire to improve compliance through
the scope of practice patient education
▪ Nursing career ladders often ▪ Increased use of online technologies
incorporate teaching effectiveness as a ▪ Screenings occasioned by advances in
measure of excellence in practice genetics and genomics

The Evolution of the Teaching Role of Purpose, Goals, and Benefits of

Nurses (3 of 3) Patient and Nursing Staff/Student
▪ Professional nurses are responsible for: Education (1 of 3) ▪Purpose
▪ Educating colleagues ▪Increase the competence and
▪ Serving as a clinical instructor for confidence of clients for self-
students in the practice setting management

Social, Economic, and Political ▪Primary goal

Trends Affecting Health Care (1 of 4)
 ▪Increase the responsibility and ▪ Helping nurses improve the delivery
independence of clients for self-care of quality care

Purpose, Goals, and Benefits of ASSURE Model

Patient and Nursing ▪ Analyze the learner.
Staff/Student Education (2 of 3) ▪ ▪ State the objectives.
Benefits of education to patients ▪ Select instructional methods and
▪ Increases consumer satisfaction materials.
▪ Improves quality of life ▪ Use the instructional methods and
▪ Ensures continuity of care materials.
▪ Effectively reduces complications of ▪ Require learner performance.
disease ▪ Evaluate the teaching plan and revise
▪ Empowers consumers as needed.

Purpose, Goals, and Benefits of The Contemporary Role of the Nurse

Patient and Nursing Staff/Student as Educator
Education (3 of 3) ▪ Benefits of ▪ Importance of solid foundation in the
education to staff ▪ Enhances job principles of teaching and learning
satisfaction
▪ Improves therapeutic relationships ▪ Alignment with legal and accreditation
▪ Enhances patient–nurse autonomy mandates
▪ Increases accountability in practice ▪ Challenge of preparing nurses
▪ Provides opportunity to create change
that matters ▪ Shifting role of educator
▪ Guide on the side
The Education Process Defined (1 of
2) Interprofessional Education and
▪ Education process Practice
▪ Systematic, sequential, science-based ▪ Barriers
▪ Consists of teaching and learning ▪ Time constraints
▪ Rigid curriculum structures
▪ Teaching/instruction ▪ Desire to maintain professional
▪ Deliberate interventions identity
▪ Sharing information and experiences ▪ Limited faculty support
to meet the intended learner outcomes
▪ Interprofessional practice
▪ Learning ▪ Competencies and evaluation
▪ Change in behavior that can be
observed or measured Patient-Centered Care
▪ Focused on reaching shared
The Education Process Defined (2 of understanding with patients
2)
▪ Patient education ▪ Associated with better health outcomes
▪ Helping people learn health-related
behaviors ▪ Supported by a number of agencies:
▪ Goal: Optimal health and ▪ IOM Crossing the Quality Chasm: A
independence in self-care New Health System for the 21st Century
▪ Nursing Alliance for Quality Care
▪ Staff education (NAQC)
 ▪ AACN new Essentials of ▪ Factors that negatively impact the
Baccalaureate Education learner’s ability to pay attention and
▪ Centers for Medicare and Medicaid process information
Services (CMS) national surveys
Factors Affecting the Ability to Teach
Quality and Safety Education in (1 of 2)
Nursing ▪ Lack of time to teach
▪ Robert Wood Johnson Foundation ▪ Lack of confidence and competence
(RWJF) Quality and Safety Education in ▪ Personal characteristics
Nursing (QSEN) competencies: ▪ Low-priority status given to patient
▪ Patient-centered care and staff education
▪ Teamwork and collaboration ▪ ▪ Environments not conducive to the
Evidence-based practice teaching–learning process
▪ Quality improvement
▪ Informatics Factors Affecting the Ability to Teach
▪ Safety (2 of 2)
▪ Absence of third-party reimbursement
The Institute of Medicine Report: The
Future of Nursing (1 of 2) ▪ Doubt that patient education
▪ Written in response to the Affordable effectively changes outcomes
Care Act
▪ Inadequate documentation system
▪ Recommendations: ▪ Difficult to record the quality and
▪ Remove scope of practice barriers. quantity of teaching efforts
▪ Expand opportunities for nurses to
lead in collaborative efforts. Factors Affecting the Ability to Learn
▪ Implement nurse residency (1 of 2)
programs. ▪ Limited time due to rapid discharge
▪ Increase proportion of nurses with from care
baccalaureate degrees to 80% by 2020. ▪ Stress of illness
▪ Double number of nurses with a ▪ Low literacy and functional health
doctorate by 2020. illiteracy
▪ Negative influence of hospital
The Institute of Medicine Report: The environment
Future of Nursing (2 of 2) ▪ ▪ Variations in readiness to learn,
Recommendations (cont.): motivation and compliance, and learning
▪ Ensure that nurses engage in lifelong styles
learning.
▪ Prepare and enable nurses to lead Factors Affecting the Ability to Learn
change to advance health. (2 of 2)
▪ Build infrastructure for the collection ▪ Extent of behavioral changes needed
and analysis of data. ▪ Lack of support and ongoing positive
reinforcement
Barriers to Teaching and Obstacles to ▪ Denial of learning needs, resentment of
Learning authority, and locus of control issues
▪ Barriers ▪ Inconvenience, complexity,
▪ Factors impeding one’s ability to inaccessibility, fragmentation, and
deliver educational services dehumanization of the healthcare system

▪ Obstacles
 ▪ Cost-effectiveness of educational
efforts

Questions to Be Asked About

Teaching and Learning (1 of 3)
▪ How can the healthcare team work
together more effectively to coordinate
educational efforts?
▪ What are the ethical, legal, and
economic issues involved?
▪ Which theories and principles support
learning?
▪ What assessment methods and tools
can be used?
▪ Which learner attributes influence
education efforts?

Questions to Be Asked About

Teaching and Learning (2 of 3)
▪ What can be done about the inequities
in the delivery of education services?
▪ How can teaching be tailored to a
specific population?
▪ To what extent does teaching improve
health status and reduce costs of health
care?
▪ Which instructional methods and
materials are available?

Questions to Be Asked About

Teaching and Learning (3 of 3)
▪ Which elements need to be taken into
account when developing and
implementing teaching plans?
▪ When should certain teaching methods
and tools be used?
▪ What are the common mistakes made
in the teaching?
▪ How can teaching and learning best be
evaluated?

State of the Evidence

▪ Research- and non-research-based
literature available
▪ Areas needing more research:
▪ Benefits of Information Age
technologies
▪ Effects of biological sex on learning
▪ Socioeconomics of learning
▪ Strategies of teaching diverse groups