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Assessment of Educational Level

Nurses   (2,140 Views | 11 Replies)
by zenman zenman (Guide) Guide Expert Nurse

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Recently, some people were amazed that a patient's level of education should be assessed. I just happened to see this in the June 2004 issue of Reader's Digest (which by the way is written to a fourth grade level in order to reach the majority of the population) in the "All In A Day's Work" section.

My friend was assigned a new post teaching English to prison inmates. Not knowing the level of education the prisoners had, he decided to began his first class by asking a basic question: "Okay, who can tell me what a sentence is?"

Gotta love it!

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husker-nurse has 8 years experience as a LPN, LVN and specializes in med-surg.

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That is a question that is asked of every patient on arrival to our unit, right alongside the other 15,000 that they must answer ( along with all they answered in the ER) and preferably right AFTER "when was your last BM?".......

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RN4NICU has 15 years experience as a LPN, LVN.

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Highest level of education completed is standard on the admission forms of every unit I have ever worked in. This applies to the parents of NICU babies as well. After all, we can't give them written instructions or allow them to read a permit and sign it if they can't read, now can we?

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husker-nurse has 8 years experience as a LPN, LVN and specializes in med-surg.

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By the way, Randy, I got the punch-line......hahahahaha

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2 Followers; 2 Articles; 2,806 Posts; 41,755 Profile Views

That is a question that is asked of every patient on arrival to our unit, right alongside the other 15,000 that they must answer ( along with all they answered in the ER) and preferably right AFTER "when was your last BM?".......

Doctors in ancient China/Japan could tell (during their house calls) what was wrong with an entire family by the smell from the outhouse. And docs today need so much more... :roll

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Q. has 7 years experience and specializes in LDRP; Education.

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Assessment of educational level is a practice standard in most hospitals (or should be). It's not the sole factor in determining how to educate a patient, but it's part of a complete learning needs assessment that should be done on all patients.

Patient education should be customized.

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

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I agree with Susy. Did you know that the 'average' American adult has only a 7th-grade literacy level? Neither did many health care practitioners until a few years ago.

If you've ever really looked at the handouts you give patients, you can see that they're written in a relatively simplistic manner. Unfortunately, this was done in response to the above findings, sort of a one-size-fits-all approach to patient education which still goes over some patients' heads while insulting others. Which leaves us pretty much back where we started: we have to individualize patient ed.

How to do this with the limited amount of time we have to spend with each patient? Where I work, we not only assess their educational level, but we also find how they learn best: do they prefer discussion, videos, handouts, or hands-on? Let's face it, a visual-kinetic learner isn't going to get much out of verbal instructions, and handouts are basically useless to someone who can't or doesn't like to read. The point is to tailor education to the individual, then document that teaching---plus whatever reinforcement is necessary---on a single flowsheet we call the Interdisciplinary Patient Education Document (IPED). There is even a place to chart what we tell family members and caregivers, as not all patients desire or are able to be taught (e.g. dementia pts.).

It's simple, it's do-able, and better yet, it works.......most of the disciplines are doing better with patient teaching if charting compliance is any indication, although we nurses are doing the best so far. :) We'll see just how well we're doing come October, when JCAHO visits us........should be interesting.

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11,191 Posts; 54,551 Profile Views

zenman clearly misunderstood the amazement of those who allegedly questioned the educational level, as his question stems from a previous thread.

although it was confirmed that educational levels are part of the initial admission information, all on the form to be filled out, some of us were amazed that a nurse would ask a patient "what is your educational level?" before deciding on what level this patient was to be taught.

when it comes time for teaching, said info can be obtained from the admission forms and should not be brought up to patient when in context of teaching. to fully appreciate and clarify what zenman is posting here, you would understand why a few of us took issue with his question. the way he presented the question (to me personally) was offensive and belittling.

zenman, tell the whole story when posting a question please.

thanks,

leslie

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458 Posts; 5,289 Profile Views

I agree with Susy. Did you know that the 'average' American adult has only a 7th-grade literacy level? Neither did many health care practitioners until a few years ago.

If you've ever really looked at the handouts you give patients, you can see that they're written in a relatively simplistic manner. Unfortunately, this was done in response to the above findings, sort of a one-size-fits-all approach to patient education which still goes over some patients' heads while insulting others. Which leaves us pretty much back where we started: we have to individualize patient ed.

How to do this with the limited amount of time we have to spend with each patient? Where I work, we not only assess their educational level, but we also find how they learn best: do they prefer discussion, videos, handouts, or hands-on? Let's face it, a visual-kinetic learner isn't going to get much out of verbal instructions, and handouts are basically useless to someone who can't or doesn't like to read. The point is to tailor education to the individual, then document that teaching---plus whatever reinforcement is necessary---on a single flowsheet we call the Interdisciplinary Patient Education Document (IPED). There is even a place to chart what we tell family members and caregivers, as not all patients desire or are able to be taught (e.g. dementia pts.).

It's simple, it's do-able, and better yet, it works.......most of the disciplines are doing better with patient teaching if charting compliance is any indication, although we nurses are doing the best so far. :) We'll see just how well we're doing come October, when JCAHO visits us........should be interesting.

This is great news! The last time I read something about it, the average was 5th grade level. And that includes the average college graduate! The Readers Digest used to be written at the 5th grade level, sorry to see that they have had to drop that.

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zenman clearly misunderstood the amazement of those who allegedly questioned the educational level, as his question stems from a previous thread.

although it was confirmed that educational levels are part of the initial admission information, all on the form to be filled out, some of us were amazed that a nurse would ask a patient "what is your educational level?" before deciding on what level this patient was to be taught.

It seems as if you are still confused! Let me try to clear it up. My original post to you:

You are aware that I don't back down from any question. It's just sad that some can't realize the answers. If you restate your particular question and give me your educational level, I'll try to explain it to you. I'm not trying to offend you, but one reason you ask patients their educational level is so you know how to respond to their level when providing patient teaching, for example.

and your reply:

earle58:

you question your patients' educational level before teaching them?????????????????????????

I can see where you might have misunderstood. Someone nurse or whoever, should assess the patient's educational level. If the patient is able to read and write and is able to fill out a form, then, no one "has to ask" the question. If they can't, someone...and yes, it is "before teaching" (as you say) has to actually ask the question. So, basically yes, you need to assess the patients level of education prior to patient teaching. It looks as if you think I meant, that when you go stand in front of the patient, ready to teach them, that you ask them "what is your educational level?" No, (unless the question has not already been asked) the educational level should have already been done prior to this. If my assessment is face to face (preferred), I just ask, "How far did you go in school?" In 30 years, I can't remember anyone not just answering the question outright. Having trained as a psych CNS, my history taking experience into delicate areas might not seem as amazing to me as to you. Are we both clear on this now?

when it comes time for teaching, said info can be obtained from the admission forms and should not be brought up to patient when in context of teaching. to fully appreciate and clarify what zenman is posting here, you would understand why a few of us took issue with his question.

Looking at this last paragraph, it looks as if your perception of what I said was incorrect.

the way he presented the question (to me personally) was offensive and belittling.

I apologize then. My favorite modalities in therapy are Reality Therapy and Provocative Therapy and it shows, eh? Just remember, if you ever come out of the bathroom with toilet paper stringing behind you, I won't wait till you finally discover it. I'll just tell you you have a problem and you can get right to working on it. :chuckle

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11,191 Posts; 54,551 Profile Views

I apologize

it's about time.

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2 Followers; 2 Articles; 2,806 Posts; 41,755 Profile Views

it's about time.

Hummmmmmmmmmm

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