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Writing patient education into job descriptions and making it part of annual job evaluations may help to make it part of patient care and not something separate that is completed when time allows, but it does not ensure the education will be effective.
"The basic premise is that teaching and learning are not equivalent, and just because we do a wonderful job setting up education and teaching our patients and families doesn't mean they are learning," says Kathy Ordelt, RN-CPN, CRRN, patient and family coordinator at Children's Healthcare of Atlanta.
In schools of preparation, students frequently learn what to teach about a disease, such as pneumonia, but not how to effectively deliver the lesson. It is important to provide opportunities for health care professionals to become skilled educators by offering a variety of classes and other resources.
"If we don't offer them the skills, they will keep teaching the way they have learned, either through a co-worker, a boss, or on the fly, and that may or may not be the best way to offer the information and to interact with that patient and family so that learning is actually occurring," explains Ordelt.
A good starting place for staff education on teaching skills is during orientation of new employees. "It sets the stage that patient education is part of patient care and cannot be separated from it," she says.
When included in orientation, it shows people that patient education is important enough to be included in the initial information such as the use of pumps and monitors. Within a 45-minute time slot Ordelt offers basic information on individualizing education, the use of available resources, and evaluating learning. The information is included in the orientation notebook all employees receive.
In addition, once employees arrive on their unit or department, they are given an individual in-service on things specific to their workplace, and patient education has been woven into this training as well. Part of the orientation checklist includes the location of teaching sheets, booklets, and manuals as well as how to access the computerized resources and operate the video-on-demand system. The documentation of patient education is also reviewed.
Helping staff develop their teaching skills is not limited to orientation. Opportunities for continuing education are available.
Six times a year Ordelt produces a one-page flyer titled "Take Five for Patient and Family Education."
"It is our quick in-service flyer that is supposed to take no more than five minutes to read through and gain little pearls about patient education," explains Ordelt.
For the past two years the patient education department has been writing about patient education related to various cultures such as Russian, Chinese, and Arab. Other topics have included conducting a learning needs assessment, tips on teaching children vs. adults, and documentation pointers.
A column also includes information on new patient education resources, such as a booklet, or newsworthy events such as a health education expo.
The flyer is loaded on the staff Intranet and also e-mailed to all educators and members of the family-centered care council so it can be posted on units.
Workshops improve skills
More in-depth learning opportunities are available through a corporate staff educational system. There is a database on the Intranet where employees can sign up for classes. Currently, there are three classes offered by the patient education department that are run several times a year.
Two, four-hour interactive classes are available. One covers writing for patients and families and the other using the computer for health care information, which includes the Intranet and also good web sites on the Internet. A shorter class covers the issue of health literacy. The interactive classes have a size limit but the literacy presentation can be held in an auditorium so more can participate.
Ordelt says while the classes are not always full, there is a good showing.
A new offering to be launched in the coming year is an interactive workshop on patient education skills covering such things as assessing for learning needs, clear teaching, and evaluating learning.
Ordelt participates in other system-wide programs as well. Graduates entering the nurse residence program at Children's Healthcare of Atlanta undergo an in-depth orientation and she provides an hour-long session on teaching techniques as well as information on health literacy.
At this time the nurses are introduced to the "Ask Me 3" campaign (AskMe3.org) used at the health care facility as well. This campaign encourages patients to ask three questions: What is my main problem? What do I need to do? Why is it important for me to do this?
During an annual nursing conference, Ordelt also offers a workshop on patient education and either teaches it herself or finds an outside speaker.
Ordelt says she has not formally measured the results of the classes she offers to determine if they produce better educators. She does know there is a big difference in the skill level of people who take the writing workshop before drafting a teaching sheet or booklet and those who have been through the class. The material is much cleaner and the reading level is more appropriate, she says.