Combination teaching provides the best of both
Mixed method gets better results
The learning centers at the University of Wisconsin Hospital and Clinics in Madison have a dual purpose. They offer informal learning by giving visitors answers to their health questions. Also, they provide formal teaching on specific topics that have been defined by the hospital or clinic in conjunction with the learning center at that location.
"When the inpatient units or outpatient clinics send patients to us for teaching, they know what they are getting in terms of the teaching sessions," says Zeena Engelke, RN, MS, senior clinical nurse specialist for patient and family education at the medical center. This is not only because the curriculum is defined, but several research studies have helped to prove their value. (For more information on these studies, see article, p. 107.)
In both inpatient and outpatient learning center settings, patients receive a multisensory approach to teaching with the registered nurses that provide the lessons. These nurses make use of videos, discussion, and hands-on demonstration and skills practice. "Practically speaking, on the inpatient units or even during clinic visits, it may not be possible to provide all those options to patients and families," says Engelke. All education at the learning centers is documented in the patient’s medical record.
Smoking room becomes a learning center
The learning center at the hospital opened in the fall of 1995, in response to a challenge by the vice president of nursing who asked that staff come up with a creative way to use the space that was once the hospital’s smoking room. The learning centers in the clinics are being included with construction of these facilities. The West Clinic learning center opened in June 1999, and the East Clinic learning center will open in November 1999.
The teaching focuses on areas where the clinics or inpatient units have a strong education need that is tough to meet. The first area of need identified for the hospital learning center was preoperative teaching for major orthopedic surgeries such as hip and knee replacements. That preoperative teaching expanded to cardiac surgery. When people come to the hospital for their surgery work-up visit, their first stop is the learning center, where they learn what to expect during the work-up visit and what to expect during their hospital stay.
In the acute care setting, patients who are admitted to the hospital and need surgery also are sent to the learning center for preoperative teaching. In addition, diabetes skills, such as insulin injection or use of a glucose meter, are taught at the learning center. The education focus is on skills that are needed for a safe discharge; therefore patients are not taught how to manage their diabetes. Central catheter care and advance directives are taught to all patients referred for such instruction on the inpatient setting as well.
In the West Clinic location, patients are scheduled for pediatric ear, nose, and throat pre-surgery teaching. Sessions also are scheduled on dermatology medications and general diabetes education. In both inpatient and outpatient settings, appointments are scheduled by referral from a health care professional such as a physician or nurse.
While the specific teaching needs of each location dictate which topics are addressed, the physical design of each facility restricts group sizes. Most of the teaching at the inpatient learning center takes place one on one, but two or three patients can be educated at one session. "It hasn’t been possible to do large groups because of the restrictions of the size of our room, but with the new clinic, I expect to have larger groups," says Engelke.
One room dedicated to walk-in patients
The inpatient learning center is one room, but at the clinic there are three rooms. One room is dedicated to helping walk-in patients who have health questions and is staffed by a program assistant who assists guests with questions and also performs secretarial duties. The room has pamphlets and research capabilities via the Internet.
None of the learning centers has an extensive library. The remaining rooms are for teaching and have a table and chairs, videos, and computers with interactive CD-ROM and Internet capabilities. The room for pediatric teaching also has a rocking chair.
At the hospital, because patients and drop-in guests share the room, time must be allotted for the needs of each group. Therefore, patients are scheduled for teaching between the hours of 8:00 a.m. and 1:00 p.m., and the public can visit the learning center from 1:00 p.m. to 4:00 p.m. Monday through Friday. The clinic setting is open from 8:00 a.m. to 4:30 p.m. Monday through Friday.
A registered nurse is scheduled for all the teaching. At the inpatient learning center, another nurse is available during times when the prescribed teaching needs of the patients are greater than the center’s capabilities.
The RN travels to the patient’s bedside to teach. A total of one full-time nurse and three part-time nurses make up the clinic teaching staff. A full-time program assistant is at the hospital, and a half-time program assistant is located at the West Clinic. Volunteers are not part of the staff mix.
Staff aren’t restricted to either learning center. Engelke plans to rotate the RNs depending on their teaching skills. For example, those who teach diabetes well will do the teaching on that topic at both sites whenever possible.
"Having a learning center raises general awareness of patient and family education through out the hospital and clinics in terms of availability of materials. We see about half patients and families and about half staff," says Engelke.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content