Christy Bowen; Bridget Carey; Jessica Palozie; Maren Reinholdt

Learning Objectives

By the end of this section, you will be able to:

Define the objectives of health teaching
Discuss the facilitators and barriers to patient education
Describe resources utilized in patient education

The purpose of health education is to empower individuals to make the best behavior choices to improve their quality of life, promote adherence to prescribed interventions and medications, increase the understanding of their conditions or treatments, and maximize patient satisfaction (Gusman, 2022). Nurses are the largest group of health-care providers, with the most interaction with patients, putting them in an optimal position to educate patients (AACN, 2023).

Health Teaching Objectives

Health teaching should occur at every encounter between the nurse and patient. Each encounter is an opportunity for health promotion through primary, secondary, or tertiary prevention. The model of incorporating unique learning styles, educational background, and assessment to facilitate increasing patient health knowledge levels is considered health teaching.

Patients will inevitably be diagnosed with new conditions, be prescribed new medications, or be introduced to new health-promotion activities as they move through their life. When a new condition is diagnosed, it is important to start the task of educating the patient about management of the condition and its potential complications. Discussing complications of the condition provides the motivation to manage the condition to the best of the patient’s ability. The more knowledge about the health condition that the patient has, the better they are at self-management, and this improves their quality of life (Lord et al., 2021).

Medication Education

Medication education is critical for patients to understand how to safely self-administer without complications. Medications taken incorrectly can cause side effects, adverse events, or even death. Medication errors cause unexpected hospital admissions, increased lengths of stay, and increased health-care costs (Aldhafeeri & Alamatrouk, 2019). Medication compliance and the importance of taking medications as prescribed for safety and efficacy should also be included in the provided education. When teaching a patient about medications, the nurse must explain the different names, such generic and trade names. Each medication has a generic and a brand name, and it is important that the patient understands this because they could inadvertently take two of the same medications if given bottles with name variations. Another essential aspect of medication education is the medication’s known side effects. A side effect nonlethal but irritating health effect of a medication, and the patient needs to know that it is possible to have them after taking the medication. Conversely, an adverse effect (or complication) is a medication-caused issue that is more serious, may be life threatening, and should be reported to the prescribing provider. The patient should be taught the common adverse effects of a medication so that they report the issues and avoid devasting consequences of taking the medication.

A contraindication is a situation in which a medication should not be taken by the patient for a specific reason, like another disease process or because of another medication. A common contraindication is pregnancy, meaning that if the patient is pregnant, trying to get pregnant, or becomes pregnant, they should not be taking the medication. Knowing the contraindications of medications can help the patient avoid harm related to the contraindicated aspect of their health. Medication safety is a complex topic and may be overwhelming to the patient, especially if they have multiple prescription medications. It is vital that the nurse not rely only on pharmacy handouts to educate the patient regarding important medication safety information. During each encounter, the nurse should address any patient or family concerns regarding the medications.

Because medication safety is an extremely important safety concern for people of all ages, nurses are required to complete a medication reconciliation process when a patient encounters the health-care system. The goal of a medication reconciliation is to prevent common medication errors through a comparison process, making sure the medications that the patient is taking are the medications that have been prescribed, and compiling an accurate list of current medications (Anazi, 2021). The medication reconciliation process has helped to prevent medication errors such as omissions, duplications, dosing errors, or drug interactions (Anazi, 2021).

Discharge Teaching

The nursing intervention that allows the patient to understand how to care for themselves at home after an acute health issue is called discharge teaching. Hospitalization has occurred due to a change in the health status of the individual, whether that change was an illness or surgery. Changes in the health status create a knowledge deficit for the patient, and discharge teaching is designed to bridge the knowledge gap so that the patient can adequately care for themselves at home and not be readmitted to the hospital for further complications. Discharge teaching includes education about any new medications the patient has been prescribed, any new interventions that the patient must perform (dressing changes, medication, etc.), what complications may occur, when and how to report any complications, and when follow-up appointments with providers should take place. The Joint Commission (2018) requires that discharge education include follow-up appointment information, that the patient or caregiver be given a hard copy of any discharge documents, and that the process be thoroughly documented in the medical record. The nurse must not forget to measure the patient’s successful understanding or need to re-teach, reinforce, and re-educate the patient before discharge.

Interdisciplinary Plan of Care

Interdisciplinary Care for Patient Discharge

Nurses work with an interdisciplinary team and coordinate care for patients being discharged from the hospital. The following are examples of these team members:

The nurse is responsible for providing discharge instructions and education.
A respiratory therapist is responsible for providing post-discharge instructions for any pulmonary machines, such as a sleep apnea machine. They provide the patient with education on breathing treatments and pulmonary exercises such as an incentive spirometer.
The provider orders the discharge of the patient and any specialty referrals needed to manage the patient’s care once discharged.
The case manager coordinates ancillary departments needed to sign off on the patient’s plan of care, such as a wound care specialist or dietician and coordinates resources and follow-up for the family once the patient is discharged.

Barriers to and Facilitators of Patient Education

Not all patients have the same level of access to health-care or patient education. Barriers to patient education include reading level, comprehension level, spoken or written language barriers, cultural barriers, learning style, motivation to learn, and health literacy levels (Gusman, 2022). A thorough history and assessment can identify many of these barriers, and a plan to circumvent them can be made. For example, if a patient has a third-grade education level, then the nurse can create handouts that are at an appropriate reading level for the patient to refer to at home.

Another barrier to patient education is health literacy, which is the level of knowledge that an individual has about health care, health issues, and overall health and well-being. Having a low health literacy level can affect the amount of knowledge that a person has about health in general, and especially their understanding of disease processes or treatment options. Patients at risk of having low health literacy levels include those with language barriers, some disadvantaged groups, and older adults (Gussman, 2022). Low health literacy can account for a patient’s noncompliance with prescribed care, missed appointments, and medication errors. Researchers found that approximately 65 percent of patients admitted to the hospital did not understand the treatments they were receiving or why they had been admitted to the hospital (Wang & Lo, 2021). For patients with low health literacy, it is essential to present information in a clear, easily understandable format and avoid complicated medical terms or jargon. Nurses should always evaluate patient understanding using methods, such as teach-back.

Link to Learning

Health Literacy

The definition of health literacy was updated and released with the U.S. government’s Healthy People 2030 initiative.

All nurses are responsible for providing patient education and health promotion, but some specific roles within nursing focus on these objectives directly. Job roles that focus on patient education promote positive patient outcomes and improve patient satisfaction. A nurse navigator or patient navigator role improves the communication between patients and providers, improves the patient’s compliance with appointments and treatments, and works to remove any barriers the patient may have to receiving the care that is needed (Doyle, 2019). Another nursing role that facilitates patient education is the case manager or care coordinator. Care coordinators can bridge the gap between the provider’s prescribed plan of care and the patient’s individual needs and preferences. There are medical roles for specific types of education, such as a diabetes educator or renal transplant educator. Both educator roles focus on a specific patient population and specific education content.

Resources for Patient Education

Topic-specific education resources are available from health-care associations specializing in specific types of health. For instance, if a patient has a heart condition, there are many free patient education resources from the American Heart Association. These resources are organized according to disease process and are available on their website. There are a multitude of health-care associations that provide free educational resources, including the American Stroke Association, the American Cancer Society, and the American Diabetes Association. Patients can be referred to resources like these for their personal use. Nurses can print relevant handouts for patients or obtain patient education ideas from these resources.

Not all educational resources contain legitimate and up-to-date information. The nurse must be able to identify sources of quality information for teaching and referral. Credible resources are relevant to the patient’s situation, backed by research, and contain information written in an easy-to-read format.