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Managerial challenges in patient Education


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Title: Managerial challenges in patient Education

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Managerial challenges in patient Education
  • Fatemeh Heshmati Nabavi
  • Assistant Professor in Nursing management.
    Mashhad University of Medical Sciences
  • 2014

Patient Misunderstandings Are Common
  • Among Patients Discharged from the Hospital
  • 41 able to state discharge diagnosis(es)
  • 37 able to recount the purpose of all
  • 28 able to list all their medications
  • 14 able to state common side effects of meds

Makaryus AN.Mayo Clin Proc.2005.
Managerial challenges
  • Time consuming and complex nature of teaching and
    learning process
  • Organizational culture
  • Interdisciplinary nature
  • Culture of clients and their family

Time consuming and complex nature of teaching and
learning process
Malcolm S. Knowles. 1913-1997.
Time consuming and complex nature of teaching and
learning process
Learning Objectives Skills Knowledge Attitude
Time consuming and complex nature of teaching and
learning process
Step 5 Evaluate Learning Process
Step 1 Assess patient knowledge, learning
styles, and motivation
Step 4 Go teach the patient.
Step 2 Assess barriers to learning
Step 3 Set educational goals with patient
Stromberg A. Eur. J. Heart Failure. 2005.
Additional Barriers to Learning
  • Functional
  • Visual Impairment
  • Hearing Impairment
  • Decreased mobility
  • Illness-Related
  • Pain
  • Fatigue
  • Cognitive Impairment
  • Dementia
  • Delirium
  • Depression

What is the solution?
  • Setting Realistic Goals

What is organizational culture and how can it
affect the quality of PE programmes?
What is Organizational culture
  • Is the behavior of humans who are part of an
    organization and the meanings that the people
    attach to their actions.

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  • It is also the pattern of such collective
    behaviors and assumptions that are taught to new
    organizational members as a way of perceiving,
    and even thinking and feeling.

What is the Solution?
  • Making information giving and patient involvement
    in decision making an integral part of the care
    delivery process.

  • Interdisciplinary nature of PE Program

Shared decision making is the key
  • Patient education developed from the health care
    professional deciding what the patient needed to
    know to a shared decision making design where
    physician and patient are equally influential on
    the decision making process. The development of
    patient education is described for primary and
    secondary health care, as well as the impact of
    biomedical advances, an ageing population and
    cultural diversity on patient education. Some of
    the challenges for future patient education are
    identified training health professionals as well
    as patients, involvement of the patient's social
    environment and application of e-Health
    techniques to patient education.
  • A history of patient education by health
    professionals in Europe and North America From
    authority to shared decision making education
  • Ciska Hovinga, dPatient Education and Counseling
    Volume 78, Issue 3, March 2010, Pages 275281

  • In a review of palliative care teams four of the
    five randomized trials found that the
    co-coordinated specialist approach resulted in
    similar or improved outcomes in terms of patient
    and family satisfaction, anxiety, pain and
    symptom control. Those studies that examined
    costs showed a tendency to reduce hospital days
    and equal or lower costs.

46 A. Deccache, K. van Ballekom / Patient
Education and Counseling 44 (2001) 4348
Fig. 1. Factors facilitating the development of
patient education ( answers).
Patient and family culture
  • Preoperative patient education for open-
  • heart patients A source of anxiety?
  • patient education should not be initiated before
    assessing the patient's cultural and social

  • Makaryus AN, Friedman EA. Patients' understanding
    of their treatment plans and diagnosis at
    discharge. Mayo Clin Proc. Aug 200580(8)991-994.
  • Knowles MS, Holton EF, Swanson RA. The Adult
    Learner. 5th ed. Woburn, MA Butterworth-Heinemann
  • Wehby D, Brenner PS. Perceived learning needs of
    patients with heart failure. Heart Lung. Jan-Feb
  • Eshleman KY. Adapting teaching styles to
    accommodate learning preferences for effective
    hospital development. Prog Transplant. Dec
  • Paradis V, Cossette S, Frasure-Smith N, Heppell
    S, Guertin MC. The efficacy of a motivational
    nursing intervention based on the stages of
    change on self-care in heart failure patients. J
    Cardiovasc Nurs. Mar-Apr 201025(2)130-141.
  • Jeppesen KM, Coyle JD, Miser WF. Screening
    questions to predict limited health literacy a
    cross-sectional study of patients with diabetes
    mellitus. Ann Fam Med. Jan-Feb 20097(1)24-31.
  • Stromberg A. The crucial role of patient
    education in heart failure. Eur J Heart Fail. Mar
    16 20057(3)363-369.
  • Schillinger D, Piette J, Grumbach K, et al.
    Closing the loop physician communication with
    diabetic patients who have low health literacy.
    Arch Intern Med. Jan 13 2003163(1)83-90.

Thank You