Published Feb 2, 2012
milosmom
23 Posts
I am doing a management project on ways to improve discharge teaching in the Med-Surg department. Does anyone have effective methods besides the standard hospital protocol that is given at discharge? How do you verify if the patient understands the teaching? Any ideas would be greatly appreciated.
RockinChick66
151 Posts
I don't know what to tell you on your management project, maybe other's will chime in on that. But when I do discharge teaching, I teach disease process, ie., is someone has cirrhosis, I teach to stay away from tylenol, fluid restriction, etc. If some one has diabetes, I reinforce teaching and stress importance of maintaining tight control, etc.
We don't have a protocol. I just try to teach the patient what I know about his/her
condition. I try to teach the patient in the same way I would care for myself or a
family member. And to make sure the pt understands the teaching, I have them repeat
my instructions back to me to make sure they understand and I also assess any needs maybe for social work consult if they have any road blocks that can or will prevent them
from caring for themselves. Some people are just plain hard headed and won't do
anything they're told regardless.
Pixiesmom, BSN, RN
326 Posts
One of the most important things in teaching is to get to know your patient. How do they like to learn? Are they able to read? Do you have a video on the unit that you can present in addition to the printed material? What culture/lifestyle factors play a part in their learning as well as their ability to follow the new plan?
One of the best teaching assignments I've seen was for a Na+ restricted diet and the student brought in food items and taught the pt how to read labels on food items.
tokmom, BSN, RN
4,568 Posts
Discharge teaching should start at admission or as soon as possible when the diagnosis is confirmed. I
have a teaching channel I use, books, printouts and at the end I sit down and talk to the pt and have them teach back what I told them. Dietary also comes in and does their spiel prn.
Our CHF teaching is going to radically change. The pt will be weighing themselves daily and also using a CHF chart that shows three different levels of how they might feel.
Our nurses are lucky. They have myself and another FT nurse to do discharge instrxns. They just have to do teaching as they go, but are not responsible for the final product.
classicdame, MSN, EdD
7,255 Posts
as a diabetic educator I think "survivor skills". These are outlined by ADA guidelines. I give literature, but I focus on those skills. Maybe teaching on other topics should also focus on survivor skills, like how to monitor your condition and when to call MD
MattNurse, MSN, RN
154 Posts
I draw pictures and teach the underlying physiology of their disease (we have whiteboards in the rooms), I give comparison's that they can relate to in real life. When I give written material I take out a highlighter and show them what is important for them by individualizing their care. I role a computer into the room and show them websites that are good and where they can get further information (food labels, dietary information, books). I do give them the discharge paperwork w/ instructions as required.
I also have patient's under my care self administer their insulin if they are a non-compliant diabetic or if I think they need teaching on giving injections. This is a good way to see if they use proper technique and are willing to participate in their care. This of course all depends on their level of functionality. When I give eye drops I have patient try to self administer, you will notice most patient's use more drops then prescribed and contaminate the top of the eye drop bottle.
I always ask my patient's to tell me what they know about their disease/diagnosis/medications prior to my teaching. This is the best way to verify if they understand what is going on, also just being conversational you get an idea if your patient is understanding.