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Unit-based classes a time-saving teaching strategy
Create curriculum, train teachers, write action plans
Do you work with a unit on education resources for a homogeneous patient population? Do you find that the bedside nurses on this unit struggle with time management because they are repeating the same patient instructions to almost every patient they care for? Is it possible for patients on this unit to leave their room and go to a centralized location for about 30 minutes or so?
If the answer is "yes," then you might want to consider conducting unit-based patient education classes.
Early in 2008, Chicago-based Northwestern Memorial Hospital's patient education department approached the post-partum leadership team to determine if the staff would like to collaborate on such a project. The response was overwhelmingly positive.
The collaboration drew upon the expertise from both areas: The post-partum staff and advance practice nurse provided the clinical knowledge, and the patient education department provided the program structure employing sound educational principles.
During a four-month period, the patient education department worked with clinical staff to develop the learning objectives, supporting course content, and to identify teaching resources. The work was accomplished through a series of meetings, with a patient education specialist handling most of the discussions with unit staff.
The curriculum focused on the basics of care for both mom and baby during the first six weeks after birth.
"It took a while to whittle down the topics and really focus on what was important and what the moms needed to know during that first six-week period," says Magdalyn Covitz Patyk, MS, RN, BC, program manager for the patient education department at Northwestern Memorial Hospital.
The teaching plan drew upon the key topics reflected in the discharge instruction check-off sheet that the post-partum staff was currently using. There was one sheet for baby care and one for new moms, and each had 10-12 topics nurses would check-off as taught.
It was decided that unit-based nurses would teach the class. To assist, the patient education department devised a detailed instructor guide. It includes goals and objectives for class time and information on how to deliver the content. Some information in the guide is not covered in class but is included to make sure instructors have the correct answer should one of the patients ask. For example, it is not the policy of Northwestern Memorial to have staff use alcohol on a baby's umbilical cord, but if moms ask about the use of alcohol, they are told to follow their pediatrician's instructions.
To help train instructors, mentoring sessions were offered by a patient education specialist. The specialist would present the class to the staff instructor and teach them how to handle questions in class. Then the staff instructor would present to the specialist. In this way teachers gained a greater comfort level before instructing patients and their family members.
Classes were to be held in the Patient Education room found on each unit. When a new women's pavilion was built, these rooms were designed to foster access to patient education resources and to provide a venue for conducting classes. The rooms seat about 12 people and have teaching tools available such as white boards, televisions, and computers with printers.
Participant sign-in sheets and a simple four-question evaluation form also were developed by the patient education department.
Before the class was launched, system issues were discussed and action plans devised. For example, management had to determine who would teach, what time of day to hold the class, and how to document the class on the patient's record.
Each unit handled the scheduling of classes and patient care coverage for the instructors. Manager support was invaluable in assuring that the instructors had the out-of-staffing time while teaching the class.
The units are responsible for stocking handouts, sign-in sheets etc. Each new mom receives a post-partum book when admitted, but units supplement this book with internally produced patient education brochures.
The patient education department manages the data. That includes tracking the number of participants, information from the evaluations, and producing program summaries.
Staff nurses are responsible for following up with each patient to see if there are any additional questions, evaluating the response to teaching, and documenting the education in the medical record.
The class was first offered on one unit and then rolled out to the other two post-partum units at one-week intervals. This allowed the initial pool of staff instructors from all three units to team-teach the class and become more comfortable with their instructor role. It also provided the opportunity for other nurses to observe a class to see if they would like to teach the class.
During the initial pilot, the class was about 45 to 50 minutes long. Based on participant and instructor feedback, the content was "tightened up" and now the total class time is 30 minutes.
In most instances, the bedside RN sets the expectation that attending the class is an important part of discharge preparation. As needed, moms are escorted to the patient education room for class. Fathers/partners and grandparents are welcome to attend the class, but only the new mom participation is tracked. It has been seven months since the post-partum discharge class was initiated. During that time, 376 class have been conducted, with a total of 1,378 moms in attendance.
Participant evaluations have been very positive. All three post-partum units offer the classmost on a daily basis.
Currently, Northwestern Memorial patient education department is in the midst of exploring new teaching strategies to add more interest to the classes. Covitz Patyk says she hopes to increase the number of instructors. This would help share the work-load and prevent instructor "burn-out."
For more information on the design of unit-based classes, contact:
Magdalyn Covitz Patyk, MS, RN, BC, Patient Education Program Manager, Northwestern Memorial Hospital, 251 East Huron, 251 East Huron, Galter 3-304A, Chicago, IL 60611-2908. Telephone: (312) 926-2173. E-mail: firstname.lastname@example.org.