Transcript Document

‫اللهم انی اعوذبک من علم الینفع‬
‫پروردگارا به تو پناه می برم از علمی‬
‫که سود نبخشد‪.‬‬
Managerial challenges
in patient Education
Fatemeh Heshmati Nabavi
Assistant Professor in Nursing management.
Mashhad University of Medical Sciences
2014
Patient Misunderstandings Are
Common…
• Among Patients Discharged from the Hospital…
• 41% able to state discharge diagnosis(es)
• 37% able to recount the purpose of all medications
• 28% able to list all their medications
• 14% able to state common side effects of meds
Makaryus AN.Mayo Clin Proc.2005.
Managerial challenges
 Time consuming and complex nature of teaching and learning
process
 Organizational culture
 Interdisciplinary nature
 Culture of clients and their family
Time consuming and complex nature of
teaching and learning process
Malcolm S. Knowles. 1913-1997.
Time consuming and complex nature of
teaching and learning process
Learning Objectives
Skills
Knowledge
Attitude
Step 5:
Evaluate
Learning
Process
Time consuming and complex nature of
Steplearning
1: Assess
teaching and
process
patient knowledge,
learning styles, and
motivation
Step 4: Go teach
the patient.
Step 2: Assess
barriers to learning
Step 3: Set
educational goals
with patient
Stromberg A. Eur. J. Heart Failure. 2005.
Additional Barriers to Learning…
• Functional
• Visual Impairment
• Hearing Impairment
• Decreased mobility
• Illness-Related
• Pain
• Fatigue
• Cognitive Impairment
•
Dementia
•
Delirium
• Depression
Stromberg.EurJCard.2005.
What is the
solution?
Setting Realistic Goals
What is organizational culture and how
can it affect the quality of PE
programmes?
What is Organizational culture
 Is the behavior of humans who are part of an
organization and the meanings that the people attach
to their actions.
organizat
ion
values
Beliefs'
visions
Culture
habits
norms
working
language
• It is also the pattern of such collective behaviors and
assumptions that are taught to new organizational
members as a way of perceiving, and even thinking
and feeling.
What is the Solution?
Making information giving and patient
involvement in decision making an integral part
of the care delivery process.
Interdisciplinary nature of PE Program
Shared decision making is the key
 Patient education developed from the health care professional
deciding what the patient needed to know to a shared decision
making design where physician and patient are equally influential
on the decision making process. The development of patient
education is described for primary and secondary health care, as
well as the impact of biomedical advances, an ageing population
and cultural diversity on patient education. Some of the challenges
for future patient education are identified: training health
professionals as well as patients, involvement of the patient's social
environment and application of e-Health techniques to patient
education.
 A history of patient education by health professionals in Europe and North
America: From authority to shared decision making education
Ciska Hovinga, dPatient Education and Counseling Volume 78, Issue 3, March 2010, Pages 275–
281
In a review of palliative care teams four of the five
randomized trials found that the co-coordinated specialist
approach resulted in similar or improved outcomes in
terms of patient and family satisfaction, anxiety, pain and
symptom control. Those studies that examined costs
showed a tendency to reduce hospital days and equal or
lower costs.
46 A. Deccache, K. van Ballekom / Patient Education and Counseling 44
(2001) 43–48
Fig. 1. Factors facilitating the development of patient education (% answers).
Patient and family culture
Preoperative patient education for openheart patients: A source of anxiety?
patient education should not be initiated before
assessing the patient's cultural and social background
References
•
Makaryus AN, Friedman EA. Patients' understanding of their treatment plans and diagnosis at discharge. Mayo Clin
Proc. Aug 2005;80(8):991-994.
•
Knowles MS, Holton EF, Swanson RA. The Adult Learner. 5th ed. Woburn, MA: Butterworth-Heinemann; 1998.
•
Wehby D, Brenner PS. Perceived learning needs of patients with heart failure. Heart Lung. Jan-Feb 1999;28(1):31-40.
•
Eshleman KY. Adapting teaching styles to accommodate learning preferences for effective hospital development.
Prog Transplant. Dec 2008;18(4):297-300.
•
Paradis V, Cossette S, Frasure-Smith N, Heppell S, Guertin MC. The efficacy of a motivational nursing intervention
based on the stages of change on self-care in heart failure patients. J Cardiovasc Nurs. Mar-Apr 2010;25(2):130-141.
•
Jeppesen KM, Coyle JD, Miser WF. Screening questions to predict limited health literacy: a cross-sectional study of
patients with diabetes mellitus. Ann Fam Med. Jan-Feb 2009;7(1):24-31.
•
Stromberg A. The crucial role of patient education in heart failure. Eur J Heart Fail. Mar 16 2005;7(3):363-369.
•
Schillinger D, Piette J, Grumbach K, et al. Closing the loop: physician communication with diabetic patients who
have low health literacy. Arch Intern Med. Jan 13 2003;163(1):83-90.
Dr. Fatemeh Heshmati Nabavi