Reprinted from the July 1996 issue of RESPIRATORY CARE [Respir Care 1996; 41(7):654–657]
AARC Clinical Practice Guideline
Training the Health-Care Professional for the
Role of Patient and Caregiver Educator
THCP 1.0 PROCEDURE:
The process of enabling the health-care provider (HCP) to facilitate the patient and/or caregiver's acquisition of knowledge, skills, understanding, and positive attitudes related to the patient's medical condition and its management.
THCP 2.0 DESCRIPTION/DEFINITION:
- 2.1 The process of training the HCP as patient and/or caregiver educator includes addressing and assuring adequate knowledge, skills, and attitude mastery for patient rapport and affective teaching.(1) (HCP is defined as any health-care professional involved in the care of the patient).
- 2.2 The ultimate goal of the process is to provide education to the patient and/or caregiver that equips him/her with the knowledge, skills, and attitudes to better understand the patient's condition and to more fully participate in health care. (The caregiver is defined as any person who plays a significant role in the patient's life. This includes individuals who may not be legally related to the patient). This allows a cooperative effort between the health-care provider and patient.(1,2)
THCP 3.0 SETTING:
Any location in which HCPs participate in or can be prepared for patient and/or caregiver education and in which resources are available, including, but not limited to:
- 3.1 acute care hospitals;
- 3.2 outpatient treatment or rehabilitation centers;
- 3.3 physicians' offices;
- 3.4 extended care or skilled nursing facilities or the patient's home;
- 3.5 educational seminars, workshops, and symposia;
- 3.6 postsecondary technical schools, colleges, and universities.
THCP 4.0 INDICATIONS
- 4.1 The presence of HCPs who must participate in education of patients and caregivers who need:
- 4.1.1 knowledge concerning condition or care;(1)
- 4.1.2 skills to participate effectively in care;(1)
- 4.1.3 proper attitude or motivation to participate effectively in care.(3)
- 4.2 Evidence that the knowledge, skills, or attitudes of HCPs are inadequate to convey the necessary information or demonstrate skills to patients, including evidence of:
- 4.2.1 lack of knowledge of effective educational principles and practices specific to patient's or caregiver's age and development;(2,4-9)
- 4.2.2 inability to accurately assess patient's or caregiver's educational needs;(2,7)
- 4.2.3 inability to prepare educational objectives and establish instructional goals;(1,7,10)
- 4.2.4 lack of knowledge of education methods to accomplish objectives and meet goals;
- 4.2.5 inability to prepare patient or caregiver education materials;(11-13)
- 4.2.6 inability to offer supervised practice of skills;
- 4.2.7 inability to assess outcomes of patient or caregiver education;(2)
- 4.2.8 inability to appropriately offer feedback to patient or caregiver;(14,15)
- 4.2.9 inability to modify educational efforts as the result of learning outcome assessment and feedback from patients.(5,6,10)
THCP 5.0 CONTRAINDICATIONS:
There are no contraindications to HCP training to offer patient and/or caregiver education when a need exists.
THCP 6.0 HAZARDS/COMPLICATIONS:
Inadequate training of the HCP can lead to harm to the patient or result in the patient's inability to participate in his/her health-care management.
THCP 7.0 LIMITATIONS OF METHOD:
The effectiveness of educating the HCP to offer patient and/or caregiver education may be limited by:
- 7.1 Limitations in the HCP:
- 7.1.1 unreceptive or incapable HCP;(2,6,7)
- 7.1.2 lack of educational preparation;(2,7)
- 7.1.3 absence of interdisciplinary cooperation;(2)
- 7.1.4 inability to deal with age or development-specific learning patterns;(2)
- 7.1.5 inadequate knowledge of cultural or religious practice that may affect educational process;(2)
- 7.1.6 inability of HCP to communicate effectively.
- 7.2 System limitations:
- 7.2.1 inadequate time to prepare the HCP due to other patient care responsibilities;
- 7.2.2 inadequate space, energy, or financial resources;
- 7.2.3 insufficient or unavailable faculty and preceptors for HCP training program;
- 7.2.4 inconsistency in information provided to the HCP;
- 7.3 Limitations in the patient or caregiver:
- 7.3.1 absolute refusal to participate in education;
- 7.3.2 lack of positive attitude or motivation to participate;(5,6,16)
- 7.3.3 lack of basic education necessary to benefit from instruction;(5,8,10)
- 7.3.4 perception of cultural conflict or presence of a language barrier.(2)
THCP 8.0 ASSESSMENT OF NEED
All HCPs who have patient care contact and opportunity to provide patient and/or caregiver education should be assessed for training as education providers(2) by
- 8.1 observation of HCP in patient education setting to determine if needed skills are present;
- 8.2 verbal questioning by specialist as to knowledge of topics being taught.
THCP 9.0 ASSESSMENT OF OUTCOME:
- 9.1 Evidence by HCP evaluations that the training has met the goals and objectives for preparing patient and/or caregiver educators:
- 9.1.1 verbal or written evaluation;
- 9.1.2 observation of HCP in teaching setting.
- 9.2 The desired outcome of training the HCP as a provider of patient and/or caregiver education is also assessed by meeting the goals of patient and/or caregiver education:
- 9.2.1 knowledge gained by the patient or patient care provider;(10)
- 9.2.2 skills mastered by the patient or the patient care provider;(2,14)
- 9.2.3 positive change in patient outlook and/or attitude;(6)
- 9.2.4 compliance of patient or caregiver in following the care plan.
- 9.3 Long-term assessment through departmental or institutional continuous quality improvement indicators or other quality monitoring system.
THCP 10.0 RESOURCES:
- 10.1 Written materials
- 10.2 Audiovisual materials
- 10.3 Anatomic models, mannequins, patient care equipment
- 10.4 Computer and software
- 10.5 "Appendix--Essentials of the Teaching Process" in Clinical Practice Guideline "Providing Patient and Caregiver Education"(17)
- 10.6 Personnel
- 10.6.1 Education specialists with training in patient education
- 10.6.2 Training specialists in general adult education
- 10.7 Education seminars and clinical seminars with emphasis in patient education
- 10.8 Formal 'for-credit' patient and adult education courses provided by postsecondary institutions of learning
THCP 11.0 MONITORING
- 11.1 The monitoring of the process of training the HCP as educator of the patient and/or patient care provider should include evidence of:
- 11.1.1 classes and inservice training for HCPs as educators;
- 11.1.2 availability of written and audiovisual materials, computers, and software for use with computers for training HCP as educators;
- 11.1.3 HCP evaluation of training effectiveness.
- 11.2 Patient and caregiver education directed at meeting the goals and objectives of the education plan
THCP 12.0 FREQUENCY:
- 12.1 Spontaneous: as often as the HCP has contact with patients or caregivers requiring education for which the HCP is not prepared. (This should take place outside of patient care area.)
- 12.2 Scheduled: a formal HCP-as-educator training program. (This may be included in orientation or as a skills laboratory at least once per year.)
- 12.3 As available: training programs offered by external sources such as professional associations and accrediting agencies.
THCP 13.0 INFECTION CONTROL:
The presence of transmissible infection and/or the presence of compromised immunity in the patient should be taken into consideration when patient and/or caregiver education is undertaken. Appropriate steps to protect patient, caregiver, health-care provider, and trainer should be included in the education plan.
Pulmonary Rehabilitation Focus Group:
Lana Hilling CRTT RCP,
Chairman, Concord CA
Phillip D Hoberty EdD RRT,
Rebecca J Hoberty BS RCP RRT,
Dennis C Sobush MA PT,
Peter Southorn MB,
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- Tolsma DD. Patient education objectives in healthy people 2000: policy and research issues. Patient Educ Couns 1993;22(10):7-14.
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- American Association for Respiratory Care. Clinical practice guideline: providing patient and caregiver education, appendix-essentials of the teaching process. Respir Care 1996;41(8): (in press).
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Interested persons may copy these Guidelines for noncommercial
purposes of scientific or educational advancement. Please credit AARC and Respiratory
Reprinted from the July 1996 issue of RESPIRATORY CARE [Respir Care 1996; 41(7):654–657]