Patient Education: A Proactive Element Of Healthcare Practice

Patient education or client health education can be described as a learning relationship entered into by the nurse and client. The content and learning activities are directed toward providing knowledge or skills needed to meet specific health care needs. Patient education is an important function and responsibility for nurses at all levels of care. Nurses spend an enormous time caring for patients but in many instances minimal time in helping patients understand the causes of their health problem, measures to prevent complications from diseases and ways to maintain optimal health. Should nurses therefore become more proactive in the delivery of patient education? Patient education can be defined as any communication between patient and health-care provider that intentionally addresses a learning need. The nursing process provides a method for individualizing patient care and education for each patient and event by collecting data to identify the needs and problems of an individual patient and family. Patient education is expected to allow the patients to have a better comprehension of an aspect or certain aspects of their health condition, health needs and care. These educational encounters take place in traditional health organizations such as hospitals, community diagnostic centers, and non-health care settings and as such they can be formal. Patient education is therefore essential to guarantee that the patient is informed and knowledgeable about his or her condition, which will facilitate improved health. 

 Advocating For More Patient Education

There is a high need for developing a more structured aspect of patient education, for patient care. Patients who have a strong understanding of their disease or illness are much more likely to recover fully and do not have repeated relapses but benefits with the result of better health and an improved understanding of how they need to live to continue to have optimal health. However, the medical staff, health care facilities and insurance companies also benefit by having a reduced number of unnecessary hospitalizations and ER visits and ultimately impacts and benefits all taxpayers (state and federal) (Jernigan, 2009).  Identifying those most interested in developing skills in patient teaching, providing resources, time, expert input and developing an expectation among the general public for better education and information regarding health and well-being are essential elements to providing and maintaining optimal health. This will also improve quality health care delivery, practice and health care systems. Assuming more responsibility for patient education in the ambulatory setting keeps patients healthier and keeps medical conditions from worsening (Anwar, 1996). It can reduce the need for hospitalization and patients can be taught the importance of prevention, early treatment and overall health maintenance (Anwar, 1996). Patient education is therefore extremely critical to ensuring patient adherence to prescribed regimens for both chronic and non-chronic conditions. It is even more critical because it helps prevent complications, promote self-care and independence, and reduce readmissions. Patient education as an important aspect of treating the patient  provides patients with instruction about their care and provides direction for preventing complications.These complications can cause unnecessary admissions to the hospital, an increase in medication costs and financial burden to the patient, family and insurance company thus educating the patient is a simple and effective way to prevent these complications and also thwart any new diseases from occurring (Jernigan, 2009).

Patient education in any health-care setting is significantly more challenging than in regular educational systems, as patients’ needs and ability to assimilate information will be overshadowed by their health-care deficits. However providing information about patient’s condition and care has proven very beneficial for many patients. One such research study showed that patients who had been subjected to planned teaching in preparation for their treatment experienced less anxiety, increased belief in their control over recovery and higher incidence of health maintenance. Falvo (1994) concluded that the quantity of health care information and patients’ access to it have grown dramatically in the last several years. Although patients may be anxious to be informed and play a more active role in their own care, they aren’t always sophisticated enough to be able to judge which are the more credible sources, so there’s potential for them to be misinformed (Falvo,1994).  

Patient education increases patient compliance, it build trust, reduces anxiety, and minimizes the risk of malpractice lawsuits against  hospital systems and providers. By working to ensure that patients are well-informed, you’ll also be addressing another requirement of the current health care environment – that reduces malpractice risk, and consequently by educating the patient and enabling him or her to make some decisions about treatment options, for example, sharing some of the responsibility, will if something goes wrong, have the patient less likely to blame you for the outcome (Falvo, 1994).At the Saint John’s Health Center, California, patient education is an essential building block in their longstanding mission: to improve the health of the individuals and communities we serve (Saint John’s Health Center, 2008). Not many hospitals even practice and or maintain the consistency of ensuring that the patients are educated. Having a mission in this regard would therefore be futile. A well informed and knowledgeable patient is better able to play a role in helping to improve his or her own care both before entering and after leaving the hospital (Saint John’s Health Center, 2008). It is also a means of empowerment for the patients to take control of their health, thus maintaining optimal health. Certainly, if the patient is content it will be a result of good health and or optimum health being maintained.

Effective Patient Education                    

The individual needs of the patient should be used to set the goals and objectives to guide the learning interventions. When these goals and objectives are stated, the impact of teaching will not be optimized. With ensuring effective patient education the nurse needs to first assess the patient’s ability to learn. The nurse should therefore know what the patient needs to learn and make an assessment as to the need for the health education process with an individual, family or group. For your patient education to be effective, nurses must use methods that ensure that your patients’ comprehension of the material and increase their compliance.  When the educational process is well- designed and clear objectives and goals are stated, successful patient education is achieved. Goals are the desired outcomes of learning, while objectives detail the behaviors that will be performed to achieve the goal (Rankin & Duffy, 1996; Redman, 2004). By applying the following strategies, nurses can improve patient education to achieve a successful outcome: create a positive environment, limit your teaching objectives, divide the information over a period of time, build on previous information discussed from each session, communicate clearly and simply, use multiple teaching methods to convey your message, and ensure comprehension and /or verify understanding and clarify misinterpretations. These same strategies however, can be barriers to patient education. If misused or unused, patient education would have been futile. Patient education must therefore be effective. Patient education therefore requires keen planning but must be implemented to ensure effective patient education. These barriers should therefore be avoided. Some challenges to effective patient education includes:  decreased lengths of hospitalization, a decrease in acuity and alertness of patients, nursing shortages added to limited time and patient overload, and patients researching their conditions on the internet with risk for receiving inaccurate and outdated information.

It is true that many nurses have acknowledged the success of patient education, but nevertheless they find it difficult to acquire the effective teaching skills, and still not many nurses have a strong commitment toward their teaching role or group role.  However, for patient education to be effective, the barriers to learning, the setting, teaching resources and differences in perception must be taken into consideration, and effective patient education should therefore include the following:

1. Ask the patient how they can best learn. This will save time and effort because, some people are audio learners, some are visual learners while, others are tactile learners and still there are those with combinations of these learning styles. It therefore means that multi-sensory teaching methodologies maybe required and in fact are very effective.

2. Share stories, experiences, anecdotes, and parables to help the patient visualize information taught. This is particularly helpful when teaching multi-cultural patients or patients with learning difficulties. A multi-sensory delivery of patient education is useful with such patients. 

3. Convey messages with an interesting element so that the patient is intrigued and yearns for more information. Summarize what is already known and emphasize what needs to be known.

4. Demonstrate and then role-play a technique or skill. Be a model of what you want the other person to do or to learn. This is particularly critical with self-care skills such as insulin administration, assistive devices and wound care.

5. Encourage your patients to ask questions. This may sound simple, but it is often difficult for people to express themselves. Feedback is important in evaluating the client’s knowledge.

6. Give accurate information and facts. Make an effort not to instill fear, but encourage strength by your words and actions. Truth promotes trust especially if for patients who have difficulty processing information.

Patient education is the process of providing verbal or written material to the patient to improve understanding and prevent complications and offers an understanding of the disease process and instruction about behaviors and activities to assist the patient. Nurses should continually assess whether behavioral objectives are being achieved. The evaluation process should include: (a) measurement of the extent to which the patient has met the learning objectives, (b) indication of any need to clarify, correct, or review information, (c) notation of objectives that are not clear, (d) documentation of shortcomings in the process, (specifically ill content, format, activities, and media), and (e) identification of barriers that have prevented learning from occurring (Rankin & Stallings, 2001; Redman, 2004; Wick & Robbins, 1998). Education provides patients with a knowledge base that empowers active participation in decisions about their own care and outcomes. To achieve desired outcomes, educational goals must be geared to the needs of the patient, with an educational plan that accounts for the learning style of the patient and potential barriers to the educational process.

By continually educating patients about   their condition, nurses can help patients improve their health outcomes, build positive attitudes regarding their treatment, and be more independent.  Barriers in learning can grossly inhibit a patient’s learning process and block keen elements for successful recover and wellness. Most times these barriers are not created intentionally, other factors such as the lack of time impacts negatively on a successful learning outcome. A common result  of not providing patient and family with information is that they fail to understand how” to use the information in their own environment and circumstances, especially after discharge. Nurses have to closely assess the learning needs of their patients and act accordingly. . Effective strategies, approaches and tools to integrate patient education in practice, must be sequentially planned. Patient education will help to develop systems, if selective resources and essential materials are used, and this too will maximize the efficiency and effectiveness of health services and practice.