Patient Education

[crNAtion]

I'm curious how you guys approach patient education with clients who do not seem to care about learning how to manage or prevent exacerbation of their illness. I'm especially with clients who are readmitted frequently for chronic health problems like heart failure, COPD, diabetic crises, etc.

Many of these patients are readmitted within 30 days of discharge from the hospital because of poor self-management of their health. We are finally instituting reimbursement penalties for some of these situations so that healthcare providers have an incentive to keep patients healthy and out of the hospital by instructing them accordingly.

What can we realistically expect from these clients when teaching them about their disease?

[Esme12, ASN, BSN, RN]

Are you a RN? What do you need the answers for? If this is research we have a process for this....Want to submit a research request?

We are happy to help with homework however, we need to know what you think and what your research has revealed to you?

[T-Bird78]

Verbal instruction, written instructions, demonstrations of med administration (inhalers, epi pen devices, etc) but the stubborn ones will just nod at you, acknowledge they need to quit smoking but go about their merry little way. I work with asthma pts and there's a handful that will come in, have a low spirometry, complain their inhalers aren't helping--with their carton of Marlboro's sticking out of their pocket/purse. I advise how important it is to quit smoking and our intake questions ask how much they smoke, how soon they smoke, and any interest in quitting. I really lecture the parents of asthmatic kids who continue to smoke inside the house or in the car with the asthmatic child. One parent even told me that they don't smoke in the kids' room so it's fine. When I reminded parent that smoke travels and it's still getting in the child's room, parent looked at me funny and asked if that could be why child's asthma was so bad.

[firstinfamily, RN]

You have to take every opportunity to teach them. When passing meds, educate them on those, ask them why they need to take them etc. Do you have a protocol for CHF treatments and teaching---a clinical protocol can help keep track of what the patient has been taught, it is also proof in case inspections come in later and ask how these patients are being educated. I am sure there are many CHF protocols/clinical directions out there you could research to see what would be helpful for your facility. I find it interesting that there is not a standard assessment for learning, we assess for other physical changes etc, shouldn't there be a patient learning assessment tool? It is true no matter how you approach some people, they will not change or comply to what you are trying to address. Those are the ones who will suffer under the new healthcare guidelines, they will not be able to use their medicare for frequent acute admissions, especially when they have been educated, they may choose to not follow the directions and that is their patient right, however, they will be paying more out of pocket to cover their medical expenses!!! Get your upper management team involved in developing some guidelines for patient learning/teaching protocols. I have found sometimes teaching in groups of 2-3 helps as then it becomes a competition between patients, and the more senses you stimulate the better they will learn the information.

[laKrugRN]

You gotta teach them no matter what. It can be frustrating when it seems like they don't care or did not apply a darn thing you suggested, but you gotta keep at them. Sometimes if they end up in dire straits, they start to make changes.