February 10, 2014

Walden University

NURS 6351

Connie Schumacher BScN RN

COMMUNITY SIMULATION: PATIENT EDUCATION FOR CHRONIC

DISEASE MANAGEMENT

Simulation is one teaching methodology used in nursing curriculum. The project topic is patient education to improve chronic disease management using simulation. A community simulation was developed for use at the practicum site, a chronic disease scenario was created to support the student’s use of patient education methods and materials. The goal of the project is to increase the comfort and competence level of the nursing students application and incorporation of patient education into nursing care. Implementing patient education strategies while caring for the patient in the community is an essential step towards facilitating self care behaviors.

COMMUNITY SIMULATION: PATIENT EDUCATION

Changing Landscape of Nursing

She heals with a touchCaptures the art and inquiry

Transforms into health

The final line of the Haiku is a personal reflection on how the profession of nursing is all encompassing. The educator has a very daunting task, the complex needs of the patient and population requires the nurse to strive for promoting healthy behaviours as well as treatment and prevention. The educators of tomorrow will facilitate the assimilation of the art of nursing and inquiry to prepare the profession for the changing needs of the population and the expanded role the nurse will play within it.

Connie Schumacher

Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health (WHO, 1998)

The Nurse’s Role in Health LiteracyPatient EducationCommunicationHealth ContextComplexity of Information

HEALTH LITERACY

Why is Patient Education Important?

Chronic Disease ManagementPatient SafetyFiscal Implications

Are Nursing Students Comfortable Implementing Patient Education?

Focus Group Results: Reported level of comfort was low and students voiced preference for opportunities to practice patient education skills.

NEEDS ASSESSMENT

Mohawk College (2014): Vocational StandardsApply principles of teaching-learning to promote clients’

health and wellness

College of Nurses of Ontario (2011)Goal of care is to promote the best possible outcome

for the patientDirect Practice Implementation RPN:

PATIENT EDUCATION IN NURSING CURRICULUM

Meets identified nursing careneeds of less-complex clientswith predictable outcomes,including health teaching

Advantages of Simulation Technology in Nursing EducationRealistic clinical settingLimits threat to patient safetyConsistent and comparable experiences for all

students (Med ley & Horne , 2005 ) .

Simulation allows for exposure and overlearning, this can enhance the development of intuition (Rob inson & Dearmon , 2013 ) .

Simulation is deliberate practice in a controlled environment, the reflective debriefing is a contemplation of how to approach the problem in the real world (Ruther fo rd -Hemming , 2012) .

SIMULATION IN NURSING CURRICULUM: REVIEW OF THE

LITERATURE

Target Audience Practical Nursing Students Semester 3

Learning Objectives1. The student will define teach-back and its purpose.2. The student will describe the elements of teach-back in

relation to closing the loop.3. The student will apply the teach-back method in a clinical

simulation.

Simulation Scenario Congestive Heart Failure Community Patient: Nick Scott Teach-back Method Debriefing and Personal Reflection

PATIENT SIMULATION METHODOLOGY

Closing the Loop(Sch i l l i nger e t a l . , 2003)

Chunking and Checking

Fundamental PrinciplesClear, plain languageAllow time, slow downUse short statementsConcentrate on 2-3

conceptsUse the Teach-Back to

check for understanding

(M i n neso ta H ea l t h L i t e racy Pa r tne rs h i p , 20 12 )

TEACH-BACK

Chunk and Check

Check for understanding after each concept

Rephrase if the patient does not understand

Involve caregiver and family members

Do not use “Do you understand?”

( M i n n e s o ta H e a l t h L i t e r a c y Pa r t n e r s h i p , 2 0 1 2 )

Examples of statements to confirm understanding

I want to be sure I have explained your _______ correctly, can you explain how you will be taking this medication?

We covered a lot of information today, I want to make sure that I explained things clearly, In your own words please review what we talked about.

What are you going to do tomorrow?

EFFECTIVE COMMUNICATION

LESSON PLAN

LESSON PLAN

SIMULATION: NICK SCOTT( C . S C H U M A C H E R , 2 0 1 4 )

SIMULATION: NICK SCOTT( C . S C H U M A C H E R , 2 0 1 4 )

SIMULATION: DEBRIEF( C . S C H U M A C H E R , 2 0 1 4 )

UtilityImplementation ease,

Institution has community simulation setting

Can be adapted to incorporate increased complexity of patient

Chronic disease can be changed

ImpactIncreases student

comfort level for patient education and communication

Exposure to community nursing issues

Highlights the importance of chronic disease management

PROJECT EVALUATION

Heart Failure Action Plan Congestive Heart

Failure Screencast

PATIENT EDUCATION MATERIALS AND PRESIMULATION PREPARATION

Improving the Human Condition and Social Change

Nursing students that are exposed to health promotion strategies will incorporate patient education into the care plan

Patient education reinforced in the home will promote self care behaviors and improve chronic disease management

The patient simulation developed for the practicum site is being reviewed for implementation in the practical nurse curriculum

PREPARING FOR THE FUTURE

Avoidable Hospital ization Advisory Panel (2011). Enhancing the continuum of care: Report of the Avoidable Hospital ization Advisory Panel. Ministry of Health and Long-Term Care.

Col lege of Nurses of Ontario (2011). RN and RPN Practice: The Client, the Nurse, and the Environment. Retrieved from http:/ /www.cno.org/Global/docs/prac/41062.pdf

Medley, C. F. (2005). Using simulation technology for undergraduate nursing education. Journal of Nursing Education , 44(1), 31-36.

Minnesota Health Literacy Partnership (2012). Teach-back Program. Retrieved from http://healthl iteracymn.org/resources/presentations-and-training

National League for Nursing (2013). Simulation Innovation Resource Center: Simulation Template. Retrieved from http:/ /sirc.nln.org/

REFERENCES

Robinson, B. K. & Dearmon, V. (2013). Evidence-based nursing education: Effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. Journal of Professional Nursing , 29(4), 203-209.

Rutherford-Hemming, T. (2012). Simulation methodology in nursing education and adult learning theory. Adult Learning , 23(3), 129-137.

Schi l l inger D, Piette J , Grumbach K, Wang F, Wi lson C, Daher C, Leong-Grotz K, Castro C, Bindman A. Closing the Loop Physician Communicat ion With Diabetic Patients Who Have Low Health Literacy. Arch Intern Med/Vol 163, Jan 13, 2003

WHO (1998) Health Literacy. Retrieved from http://www.healthl i teracyconnection.ca/healthl iteracy.aspx

REFERENCES