first pt teaching plan: sleep deprivation

Daytonite, BSN, RN · Mar 25, 2009

this is a more appropriate diagnosis

nursing diagnosis: sleep deprivation
r/t anxiety, fatigue, stress, poor task management, sustained environmental stimulation and sustained uncomfortable sleep environment
- anxiety, fatigue, stress, and poor task management are not appropriate causes of sleep deprivation, but they are symptoms
[*]aeb compromised concentration, decreased performance observed by family, drowsiness, inability to restore energy even after sleep, lethargic, verbalization of an overwhelming lack of energy, fleeting nystagmus discovered during perrla exam, and bloodshot eyes.

a.learning outcomes/objectives

b.content

c. teaching method/rationale

d. time frame

e. domain

f. evaluation

1a. learning outcomes/objectives:

by the end of the first appointment, pt. will be able to verbalize understanding of the importance of sleep and the effects of sleep deprivation on the body.

1b. content:

association of sleep deprivation with pt's pt's s&sx's and physical findings.

identify risks associated with sleep deprivation

ask pt questions to reveal understanding - this is part of your methodology

ask pt, "do you understand why sleep is so important?" - this is part of your methodology

answer patient and family questions - this is part of your methodology

1c. teaching method/ rationale:

show pt and family pictures of people with and without sleep deprivation. pt learns the physical effects of sleep deprivation and family is able to identify observed changes in the pt's physical appearance r/t sleep deprivation.

family group discussion addressing the observed changes in the pt's performance and mood.

1d. time frame:

1e. domain:

1f. evaluation:

pt explains the importance of sleep and influence of sleep deprivation on other body systems. - this is how you will determine if you were successful in teaching the patient the effects of sleep on the body and the importance of sleep. since your goal is to "be able to verbalize understanding of the importance of sleep and the effects of sleep deprivation on the body." perhaps an appropriate evaluation would be to have a short question period of the most salient points at the very end of the first session to see if they "got" (and to reinforce) the most important ideas from the presentation.

2a. learning outcomes/objectives:

by the end of the first appointment, pt. will be able to construct an outline of daily scheduling and reserved nap times. pt will use this self-constructed outline every day.

2b. content:

(how to create) guidelines to follow when creating a schedule.

issues to address when creating a schedule.

identifying ideal nap points throughout the day

instructor's typical day, ideal nap points and rationale.

2c. teaching method/rationale:

(this is demonstration) instructor creates an outline containing her own activity and sleep patterns as well as points during the day during which she can nap. one-on-one instruction with guidelines to follow when selecting points to nap.

family discussion of ways in which pt will be assisted in obtaining adequate uninterrupted sleep.

group discussion of alterations of living conditions and routines which would aid in pt's achievement of adequate sleep

2d. time frame:

2e. domain:

2f. evaluation:

pt possesses an outline of his daily activity and rest patterns. pt agreed to use the outline to aid in acquiring adequate sleep. (your evaluation is your outcome above)

3a. learning outcomes/objectives:

by the end of the first meeting, the family will understand the importance of sleep and verbalize understanding of the need for adjustments and accommodations to aid in pt's achievement of adequate sleep.

i don't get this at all. it repeats the first outcome. the content focuses on the family and not the patient.

3b. content:

pt and family questioning of daily routines

daily needs of each family member

general scheduling of each family member and rationale

housing architecture

3c. teaching method/rationale:

3d. time frame

3e. domain:

3f. evaluation:

4a. learning outcomes/objectives:

pt will be capable of improving sleep by the follow-up appointment

what does "improving sleep" mean? it is not measurable. back in #2 you have the patient doing a schedule. now, things are broken down. isn't she keeping track of her hours of sleep? that would show whether she is improving or not. what about her symptoms that she had originally? weren't those discussed in week #1. is she tracking those at all? are they improving or getting worse? are we discussing those at these weekly meetings? what was discussed last week anyway?

4b. content:

breathing demonstration why is this even important?

review of printed material - what printed material and about what? why not give it week #1 if it involves sleeping better?

explanation of breathing techniques

4c. teaching method/rationale:

demonstration and return demonstration of healthy breathing and relaxation techniques, printed material discussing several techniques to aid in achievement of adequate sleep, list of websites with information which will aid in sleep enhancement

4d. time frame:

4e. domain:

4f. evaluation:

pt demonstrates breathing and relaxation techniques, pt exited facility with supplementary material. pt agreed to practice the techniques demonstrated.

5a. learning outcomes/objectives:

pt will be an active member of a stress and sleep management support group

5b. content:

5c. teaching method/rationale:

web-sites of support groups and forums with online support groups as well as local support groups and dates and contents of group meetings

5d. time frame:

5e. domain:

5f. evaluation:

by the end of the first month, pt will retain healthier stress and task management, and decreased anxiety. - finally we get to stress and anxiety! but where did it come up in the teaching?