Education In Nursing and Advancements for Patient
Current State of Patient Education In Nursing
In many areas, interesting and important advances are being made in patient education, some of them addressing long standing issues. The ability to train individuals to more accurately interpret bodily symptoms is one such advance.
Concept of Patient Focused Education and Advancements in Science
A gradual move (but certainly not yet in full bloom) toward patient centeredness is expressing itself in such areas as patient “lay models of disease and the necessity of understanding and addressing their accuracy and congruence with provider perspectives."
And new areas of need are emerging
because of advances in scientific knowledge (genetics) or very beginning
substitution of basic legal standards with ethical sense of good practice, such
as truly informed consent it 114/124 clinical practice.
Summaries of the quality of care provided in the United States, including patient education, continue to disappoint. A recent survey of adults living in 12 metropolitan areas and their medical records showed participants received 55% of recommended care, varying widely across medical conditions. and processes of care.
By far the worst provider compliance with standard of care occurred with counseling or education;18.3% of patients received this recommended care. In comparison, medication was appropriately provided in 69% and physical examination in 63% of care.
These deficits, which pose serious threats to the health and well being of the US. public, persist despite initiatives by both the federal government and the private health care delivery systems to improve care (Mc Glynn et al., 2003).
Disease and Treatment Based Verbal and Written Educational Material
An anonymous medication safety self assessment conducted by American hospitals showed lowest scores in patient education. About two thirds of respondent hospitals reported that doctors and nurses inconsistently educated patients about their drug therapy.
Written information about critical
drugs was sometimes provided to patients in 61% of respondent hospitals and
always provided in 21% of hospitals, Respondents in 23% of surveyed hospitals
reported that criteria for an automatic consultation by a pharmacist for
patient education had been established (Smetzer et al., 2003).
Patient Education Benefits for Non Educated Patients
A survey of a nationally representative sample of women of childbearing age in the United States (N=55,712) indicated that more than 40% of them were unaware that treatment exists to prevent mother to child transmission of HIV.
Even among pregnant women, who according to practice guidelines should be receiving counseling and the offer of HIV testing as early as possible in prenatal care, only 64.7% were aware that effective treatment exists to prevent perinatal HIV transmission.
These data suggest that women of
childbearing age, particularly those of lower education and socioeconomic
status, could benefit from more education about the effectiveness of perinatal
HIV transmission interventions (Anderson, Ebrahim, & Sansom, 2004).
Much smaller studies show disappointing results, even in areas in which patient education has been well established for years. For example, Kline, Martin, and Deyo (1998) found a lack of knowledge about typical postpartum health in focus groups of new mothers and doctors, with mothers feeling unprepared for the health consequences of pregnancy and delivery.
Decreased functioning was reported months after de livery. Women often felt poorly prepared for the postpartum period in part because functional health consequences of child-birth are not well understood, recovery time and effect of obstetrical interventions on long-term maternal health status are relatively understudied issues. Confidence in parenting and psychological adjustments to it were recurrent subthemes.
Yet other studies continue to demonstrate usefulness of patient education. For example, a randomized controlled trial of educational preparation for endoscopic exams showed a significant association with success of the exam.
Cancellation of procedures because of poor preparation occurred in 4.39% of targeted education patients versus 26.31% of those who did not receive education and 15.38% of those who received phone instruction. Patients who did not attend educational sessions had a sixfold higher rate of procedural failures than those who did.
Besides the accompanying risk to the patient of repeated procedures (bleeding, perforation, and complications from sedation) were additional days lost from work and school and additional use of medications, equipment, and staff time. Lack of education for preparation for procedures costs money (Abuksis et al., 2001).
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