T



T



5602


Teaching: Disease Process


Definition: Assisting the patient to understand information related to a specific disease process


Activities:



• Appraise the patient’s current level of knowledge related to specific disease process


• Explain the pathophysiology of the disease and how it relates to the anatomy and physiology, as appropriate


• Review patient’s knowledge about condition


• Acknowledge patient’s knowledge about condition


• Describe common signs and symptoms of the disease, as appropriate


• Explore with patient what she/he has already done to manage the symptoms


• Describe the disease process, as appropriate


• Identify possible etiologies, as appropriate


• Provide information to the patient about condition, as appropriate


• Identify changes in physical condition for patient


• Avoid empty reassurances


• Provide reassurance about patient’s condition, as appropriate


• Provide the family/significant other(s) with information about the patient’s progress, as appropriate


• Provide information about available diagnostic measures, as appropriate


• Discuss lifestyle changes that may be required to prevent future complications and/or control the disease process


• Discuss therapy/treatment options


• Describe rationale behind management/therapy/treatment recommendations


• Encourage the patient to explore options/get a second opinion, as appropriate or indicated


• Describe possible chronic complications, as appropriate


• Instruct the patient on measures to prevent/minimize side effects of treatment for the disease, as appropriate


• Instruct the patient on measures to control/minimize symptoms, as appropriate


• Explore possible resources/support, as appropriate


• Refer the patient to local community agencies/support groups, as appropriate


• Instruct the patient on which signs and symptoms to report to the health care provider, as appropriate


• Provide the phone number(s) to call if complications occur


• Reinforce information provided by other health care team members, as appropriate


1st edition 1992; revised 2000, 2004



5603


Teaching: Foot Care


Definition: Preparing a patient at risk and/or significant other to provide preventive foot care


Activities:



• Determine current level of knowledge and skills related to foot care


• Determine current foot care practices


• Provide information related to the level of risk for injury


• Recommend toe nail and callus trimming by a specialist, as appropriate


• Provide written foot care guidelines


• Assist in developing a plan for daily foot assessment and care at home


• Determine capacity to carry out foot care, (i.e., visual acuity, physical mobility, and judgment)


• Recommend assistance of a significant other with foot care if vision is impaired or if there are problems with mobility


• Recommend daily foot inspection over all surfaces and between the toes looking for redness, swelling, warmth, dryness, maceration, tenderness, or open areas


• Instruct to use a mirror or the assistance of another to carry out foot inspection, as needed


• Recommend daily washing of feet using warm water and mild soap


• Recommend thoroughly drying feet after washing them, especially between the toes


• Instruct to hydrate the skin daily by brief soaking or bathing in room temperature water followed by application of an emollient


• Provide information regarding the relationship between neuropathy, injury, and vascular disease and the risk for ulceration and lower extremity amputation in persons with diabetes


• Advise regarding when it is appropriate to contact a health professional, including the presence of a nonhealing or infected lesion


• Advise regarding appropriate self-care measures for minor foot problems


• Caution about potential sources of injury to the feet, (e.g., heat, cold, cutting corns or calluses, chemicals, use of strong antiseptics or astringents, use of adhesive tape, and going barefoot or wearing thongs or open-toe shoes)


• Instruct on proper technique for toenail trimming, (i.e., cutting relatively straight across, following the contour of the toe, and filing sharp edges with an emery board)


• Instruct on care of soft calluses, including gentle buffing with a towel or pumice stone after a bath


• Recommend specialist care for thick fungal or ingrown toenails, corns, or calluses, as indicated


• Describe appropriate shoes, (i.e., low heeled with a shoe shape that matches foot shape; adequate depth of toe box; soles made of material that will absorb shock; adjustable fit by lace or straps; uppers made of breathable, soft, and flexible materials; changes made for gait and limb-length disorders; and potential for modification, if necessary)


• Describe appropriate socks, (i.e., absorbent material and nonconstricting)


• Recommend guidelines to be followed when purchasing new shoes, including having feet properly measured and fitted at the time of purchase


• Recommend wearing new shoes only for a few hours at a time for the first two weeks


• Instruct to inspect inside shoes daily for foreign objects, nail points, torn linings, and rough areas


• Instruct to change shoes two times, (e.g., 12 noon and 5 pm) each day to avoid local repetitive pressure


• Explain the necessity for prescriptive footwear or orthotics, as appropriate


• Caution about activities that cause pressure on nerves and blood vessels, including elastic bands on socks or crossing legs


• Advise to stop smoking, as appropriate


• Include the family/significant others in instruction, as appropriate


• Reinforce information provided by other health professionals, as appropriate


4th edition 2004




5604


Teaching: Group


Definition: Development, implementation, and evaluation of a patient teaching program for a group of individuals experiencing the same health condition


Activities:



• Provide an environment conducive to learning


• Include the family/significant others, as appropriate


• Establish the need for a program


• Determine administrative support


• Determine budget


• Coordinate resources within the facility to form a planning/advisory committee that can contribute to positive outcomes for the program and provide a forum for ensuring commitment to the program


• Utilize community resources, as appropriate


• Define potential target population(s)


• Write program goals


• Outline major content area(s)


• Write learning objectives


• Write a job description for a coordinator responsible for patient education


• Select a coordinator


• Preview available educational materials


• Develop new educational materials, as appropriate


• List possible teaching strategies, educational materials, and learning activities


• Train the teaching personnel, as appropriate


• Educate the staff about the patient teaching program, as appropriate


• Provide a written schedule, including dates, times, and places of the teaching sessions/classes, to the staff and/or patient(s), as appropriate


• Determine appropriate days/times to reach maximum number of patients


• Prepare announcements/memos to publicize outcomes, as appropriate


• Control the size and competencies of the group, as appropriate


• Orient patient(s)/significant others to educational program and the objectives it is designed to accomplish


• Provide for special needs of learners (i.e., handicap access, portable oxygen), as appropriate


• Adapt the educational methods/materials to the group’s learning needs/characteristics, as appropriate


• Provide group instruction


• Evaluate the patient’s progress in the program and mastery of content


• Document the patient’s progress on the permanent medical record


• Revise teaching strategies/learning activities, if necessary, to increase learning


• Provide forms for the patient to evaluate the program


• Provide for further individual instruction as appropriate


• Evaluate the extent to which program goals were attained


• Communicate the program’s goal attainment evaluation to the planning/advisory committee


• Hold summative evaluation sessions for the planning/advisory committee to revamp the program, as appropriate


• Document the number of patients who have attained the learning objectives


• Refer the patient to other specialists/agencies to meet the learning objectives, as appropriate


1st edition 1992; revised 2000





5606


Teaching: Individual


Definition: Planning, implementation, and evaluation of a teaching program designed to address a patient’s particular needs


Activities:



• Establish rapport


• Establish teacher credibility, as appropriate


• Determine the patient’s learning needs


• Determine patient readiness to learn


• Appraise the patient’s current level of knowledge and understanding of content


• Appraise the patient’s educational level


• Appraise the patient’s cognitive, psychomotor, and affective abilities or disabilities


• Determine the patient’s ability to learn specific information (i.e., developmental level, physiological status, orientation, pain, fatigue, unfulfilled basic needs, emotional state, and adaptation to illness)


• Determine the patient’s motivation to learn specific information (i.e., health beliefs, past noncompliance, bad experiences with health care or learning, and conflicting goals)


• Enhance the patient’s readiness to learn, as appropriate


• Set mutual, realistic learning goals with the patient


• Identify learning objectives necessary to reach goals


• Determine the sequence for presenting the information


• Appraise the patient’s learning style


• Select appropriate teaching methods and strategies


• Select appropriate educational materials


• Provide instructional pamphlets, videos, and online resources, when appropriate


• Tailor the content to the patient’s cognitive, psychomotor, and affective abilities or disabilities


• Adjust instruction to facilitate learning, as appropriate


• Provide an environment conducive to learning


• Instruct the patient, when appropriate


• Evaluate the patient’s achievement of the stated objectives


• Reinforce behavior, as appropriate


• Correct information misinterpretations, as appropriate


• Provide time for the patient to ask questions and discuss concerns


• Select new teaching methods or strategies, if previous ones were ineffective


• Refer the patient to other specialists or agencies to meet the learning objectives, as appropriate


• Document the content presented, the written materials provided, and the patient’s receptivity to and understanding of the information or patient behaviors that indicate learning, on the permanent medical record


• Include the family, as appropriate


1st edition 1992; revised 2013



5640


Teaching: Infant Nutrition 0-3 Months


Definition: Instruction on nutrition and feeding practices through the first three months of life


Activities:



5th edition 2008





5642


Teaching: Infant Nutrition 7-9 Months


Definition: Instruction on nutrition and feeding practices from the seventh month through the ninth month of life


Activities:



5th edition 2008





5645


Teaching: Infant Safety 0-3 Months


Definition: Instruction on safety through the first three months of life


Activities:



• Provide parents with written materials appropriate to identified knowledge needs


• Instruct parent/caregiver to install and use car seat according to manufacturer’s recommendations


• Instruct parent/caregiver to place infant on back to sleep and keep loose bedding, pillows, and toys out of crib


• Instruct parent/caregiver to use only cribs that are safe


• Instruct parent/caregiver to avoid use of jewelry or cords/chains on infant


• Instruct parent/caregiver to use and maintain all equipment properly (e.g., swings, strollers, playpens, port-a-cribs)


• Instruct parent/caregiver to avoid holding infant while drinking hot liquids or smoking


• Instruct parent/caregiver to hold infant when feeding, avoid propping of bottle, and test formula temperature


• Instruct parent/caregiver to monitor experienced/trained childcare providers


• Instruct parent/caregiver how to prevent falls


• Instruct parent/caregiver to test water temperature of bath


• Instruct parent/caregiver to keep pets a safe distance from infant


• Instruct parent/caregiver to never to shake, toss, or swing infant in the air


5th edition 2008


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