Checkbox lists barriers to patient education

ED nurses at Monticello (MN)-Big Lake Community Hospital have added a "barriers to learning identified" checkbox to their nursing documentation form to comply with an accreditation standard that requires assessment of learning needs.

Assessment of learning needs include cultural and religious beliefs, emotional barriers, desire and motivation to learn, physical or cognitive limitations, and barriers to communication. The checkbox lists the following barriers: language, vision, hearing, emotional factors, cultural practices, literacy, disinterest, religious practices, cognitive deficit, denial of need, financial implications of care, and other.

"If a nurse checks one of these boxes indicating a barrier, he or she must write a note explaining what was done to overcome that barrier," says Kathy Soland, RN, BSN, CEN, ED clinician. For example, nurses may document "hearing aids brought in by daughter," "interpreter contacted," or "social worker met with patient." During a May 2006 accreditation survey, the surveyor was pleased with this process, Soland says.

Every patient is not asked about every type of barrier, she explains. "We do not need to know if a patient has a religious opposition to blood transfusions if we are not anticipating giving blood," she says. "We provide annual education for the nurses on possible responses to overcome these barriers along with our other risk assessment education."