Week11AssgnPractProjectSchumacherC
- 1. February 10, 2014 Walden University NURS 6351 Connie Schumacher BScN RN COMMUNITY SIMULATION: PATIENT EDUCATION FOR CHRONIC DISEASE MANAGEMENT
- 2. Simulation is one teaching methodology used in nursing curriculum. The project topic is patient education to improve chronic disease management using simulation. A community simulation was developed for use at the practicum site, a chronic disease scenario was created to support the student’s use of patient education methods and materials. The goal of the project is to increase the comfort and competence level of the nursing students application and incorporation of patient education into nursing care. Implementing patient education strategies while caring for the patient in the community is an essential step towards facilitating self care behaviors. COMMUNITY SIMULATION: PATIENT EDUCATION
- 3. Changing Landscape of Nursing She heals with a touch Captures the art and inquiry Transforms into health The final line of the Haiku is a personal reflection on how the profession of nursing is all encompassing. The educator has a very daunting task, the complex needs of the patient and population requires the nurse to strive for promoting healthy behaviours as well as treatment and prevention. The educators of tomorrow will facilitate the assimilation of the art of nursing and inquiry to prepare the profession for the changing needs of the population and the expanded role the nurse will play within it. Connie Schumacher
- 4. Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health (WHO, 1998) The Nurse’s Role in Health Literacy Patient Education Communication Health Context Complexity of Information HEALTH LITERACY
- 5. Why is Patient Education Important? Chronic Disease Management Patient Safety Fiscal Implications Are Nursing Students Comfortable Implementing Patient Education? Focus Group Results: Reported level of comfort was low and students voiced preference for opportunities to practice patient education skills. NEEDS ASSESSMENT
- 6. Mohawk College (2014): Vocational Standards Apply principles of teaching-learning to promote clients’ health and wellness College of Nurses of Ontario (2011) Goal of care is to promote the best possible outcome for the patient Direct Practice Implementation RPN: PATIENT EDUCATION IN NURSING CURRICULUM Meets identified nursing care needs of less-complex clients with predictable outcomes, including health teaching
- 7. Advantages of Simulation Technology in Nursing Education Realistic clinical setting Limits threat to patient safety Consistent and comparable experiences for all students (Medley & Horne, 2005). Simulation allows for exposure and overlearning, this can enhance the development of intuition (Robinson & Dearmon, 2013). Simulation is deliberate practice in a controlled environment, the reflective debriefing is a contemplation of how to approach the problem in the real world (Rutherford - He m m i ng, 2012). SIMULATION IN NURSING CURRICULUM: REVIEW OF THE LITERATURE
- 8. Target Audience Practical Nursing Students Semester 3 Learning Objectives 1. The student will define teach-back and its purpose. 2. The student will describe the elements of teach-back in relation to closing the loop. 3. The student will apply the teach-back method in a clinical simulation. Simulation Scenario Congestive Heart Failure Community Patient: Nick Scott Teach-back Method Debriefing and Personal Reflection PATIENT SIMULATION METHODOLOGY
- 9. Closing the Loop ( Schi ll ing er et a l ., 2 0 03) Chunking and Checking Fundamental Principles Clear, plain language Allow time, slow down Use short statements Concentrate on 2-3 concepts Use the Teach-Back to check for understanding (Minnesota Health Literacy Partnership, 2012) TEACH-BACK
- 10. Chunk and Check Check for understanding after each concept Rephrase if the patient does not understand Involve caregiver and family members Do not use “Do you understand?” (Minnesota Health Literacy Partnership, 2012) Examples of statements to confirm understanding I want to be sure I have explained your _______ correctly, can you explain how you will be taking this medication? We covered a lot of information today, I want to make sure that I explained things clearly, In your own words please review what we talked about. What are you going to do tomorrow? EFFECTIVE COMMUNICATION
- 11. LESSON PLAN
- 12. LESSON PLAN
- 13. SIMULATION: NICK SCOTT ( C . S C H U M A C H E R , 2 0 1 4 )
- 14. SIMULATION: NICK SCOTT ( C . S C H U M A C H E R , 2 0 1 4 )
- 15. SIMULATION: DEBRIEF ( C . S C H U M A C H E R , 2 0 1 4 )
- 16. Utility Implementation ease, Institution has community simulation setting Can be adapted to incorporate increased complexity of patient Chronic disease can be changed Impact Increases student comfort level for patient education and communication Exposure to community nursing issues Highlights the importance of chronic disease management PROJECT EVALUATION
- 17. Heart Failure Action Plan Congestive Heart Failure Screencast PATIENT EDUCATION MATERIALS AND PRESIMULATION PREPARATION
- 18. Improving the Human Condition and Social Change Nursing students that are exposed to health promotion strategies will incorporate patient education into the care plan Patient education reinforced in the home will promote self care behaviors and improve chronic disease management The patient simulation developed for the practicum site is being reviewed for implementation in the practical nurse curriculum PREPARING FOR THE FUTURE
- 19. Avoidable Hospitalization Advisory Panel (2011). Enhancing the continuum of care: Report of the Avoidable Hospitalization Advisory Panel. Ministry of Health and Long-Term Care. College of Nurses of Ontario (2011). RN and RPN Practice: The Client, the Nurse, and the Environment. Retrieved from http://www.cno.org/Global/docs/prac/41062.pdf Medley, C. F. (2005). Using simulation technology for undergraduate nursing education. Journal of Nursing Education, 44(1), 31-36. Minnesota Health Literacy Partnership (2012). Teach -back Program. Retrieved from http://healthliteracymn.org/resources/presentations-and-training National League for Nursing (2013). Simulation Innovation Resource Center: Simulation Template. Retrieved from http://sirc.nln.org/ REFERENCES
- 20. Robinson, B. K. & Dearmon, V. (2013). Evidence -based nursing education: Effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. Journal of Professional Nursing, 29(4), 203-209. Rutherford-Hemming, T. (2012). Simulation methodology in nursing education and adult learning theory. Adult Learning, 23(3), 129-137. Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, Leong -Grotz K, Castro C, Bindman A. Closing the Loop Physician Communication With Diabetic Patients Who Have Low Health Literacy. Arch Intern Med/ Vol 163, Jan 13, 2003 WHO (1998) Health Literacy. Retrieved from http://www.healthliteracyconnection.ca/healthliteracy.aspx REFERENCES
Editor's Notes
- #5: Health literacy goes beyond reading and writing capabilities. It is the ability the patient has to perform self-care behaviors. The nurse can play an important role by promoting and employing evidence-based practices of patient education.
- #6: Readmission rates to hospital are higher for chronic diseases, congestive heart failure and chronic obstructive lung disease readmissions are consistently higher across the Province of Ontario (Avoidable Hospitalization Advisory Panel, 2011). Equipping the patient with chronic disease self-care tools will lead to informed decisions and the ability to know how and when to access care. 30 day hospital readmission rates accounted for approximately $705 million dollars in Ontario, 27% of readmissions where felt to be avoidable. A focus group was conducted to explore the nursing student’s level of comfort with implementing patient education.
- #7: Implications for nursing, information should be presented in a clear, simple manner that the patient is able to confirm understanding. A focus group supports that the students would like to increase comfort level and have opportunities to practice patient education skills, as part of the required standards of care patient education should be incorporated into the curriculum.
- #9: The project was developed for semester 3 practical nursing students. Prerequisites include modules on cardiac and respiratory assessments anatomy and physiology and principles of communication modules. Prior to the simulation the student will review the CHF action plan sheet that is sent home with the patient upon discharge, and view the screencast on CHF Management.
- #10: Illustration to explain the loop of communication, helps the educator identify if there are gaps in knowledge. Emphasis is on providing specific information that is patient centered. Use of visual aids and pamphlets are recommended to help reinforce information.
- #11: Ensure understanding of concept before moving to next concept, rephrase rather than repeat. Always try to involve members of the family that will be supporting the patient in their chronic disease management.
- #12: The ASSURE Model was used to develop the lesson. Assists the educator in development of comprehensive lesson plans.
- #14: Advantages to using simulation in Nursing Education: Realistic Scenario, reduced risk to patient, specific and tailored to the needs of the learner (the learning need is increasing comfort level for completing patient education)
- #15: Setting for the simulation is in the home environment. There will be limited resources available to the student, only discharge papers and instructions.
- #16: The debriefing time. Intuition is an aspect of nursing that can be encouraged through situational experiences and repetition (Robinson & Dearmon, 2013). Concepts for exploration: leadership, communication, patient centered care.
- #17: The practicum site has an existing simulation room that is designed to reflect a community environment, it is an apartment with a kitchen, bathroom, bedroom and living area. This room is not in use, there are no community focused simulations. The college does not have any clinical rotations in the community. With increased familiarity and comfort using patient education techniques, and a deliberate exposure highlighting the importance of patient education the more likely it will be used in everyday nursing care.
- #18: The action plan that will be in the patient’s home for simulation. The CHF Management screencast gives an overview of the signs and symptoms of worsening heart failure for the student to view prior to simulation. Tools are introduced. (There was a different tool used in the screencast then from what will be available in the simulation, this was purposeful to reflect realistic scenarios)