Patient Teaching

Patient Teaching: Importance of Repositioning Sean Crayton University of Toledo College of Nursing Patient Teaching: Importance of Repositioning Assessment of Patients Learning Needs M. C. is an elderly male who was admitted and treated for a fall and hip fracture. He had surgery, is bed ridden but is soon to be released. He and his family need proper teaching on the importance of reposition as to avoid obtaining pressure ulcers during his limitations to extensive bed rest and staying off of his feet or performing any unnecessary movements that could cause irritation or reinjuring the recently repaired hip.
As requested we are including the family who will be his primary care takers at home and it is necessary that they all learn how to take care of M. C. properly due to his inability to adequately reposition himself successfully in the early stages of his release. Priority Nursing Diagnosis Knowledge deficit. Patient will need proper positioning teaching. The teaching will pertain to the deliberate placement of the patient or body part in order to promote proper physiological and psychological well-being. r/t.
Lack proper knowledge related to how position/reposition M. C. to avoid development of pressure ulcers. AEB. M. C. was admitted with a hip fracture and received surgery. He is soon to be release to go home but is ordered to long term bed rest. Desired Patient Outcome(s) At the conclusion of the patient teaching and proper diagnosis care we hope to ensure that M. C. and his family adequately know how to position/reposition the body to reduce the risk of pressure ulcers, at more importantly the critical, but all areas of the body.

Time Frame. Being realistic we are giving M. C. and his family the duration of his projected discharge week in order to properly and thoroughly learn the information and techniques required to successfully position/reposition a patient at risk for pressure ulcers. Interventions Managing patients at risk for pressure ulcers relies on a multitude of different interventions implemented by nurses in a hospital or responsible care takers and family members in the home setting.
These interventions include but are not limited to: using support surfaces, optimizing nutritional status, moisturizing critical areas and of course, what we are focused on in this particular patient teaching instance, repositioning the patient (Reddy, Gill & Rochon 2006). Regular turning of patients is routinely used ostensibly to decrease the risk of pressure ulcers, and is considered a standard of care (Peterson, Schwab, Van Oostrom, Gravenstein & Caruso 2010). Pressure from lying or sitting on a particular part of the body results in oxygen deprivation to the affected area.
This normally results in pain and discomfort which stimulates the individual to move. Failure to reposition will result in ongoing deprivation; poor wound healing and further tissue damage. Patients who cannot reposition themselves require assistance (Moore 2010). To better ensure that this will be handled for M. C. we will be including his family in the teaching. Teaching strategies. In order to teach and relay this process and the importance of patient repositioning to M. C. and his family I will be focusing on the utilization of pictures and demonstration.
Teaching will take place throughout the duration of M. C. ’s projected discharge week. During this teaching there will be a chance for them to return the demonstration to me so that they can practice and show they understand before it is necessary for them to do it in the real setting all the while allowing adequate breaks and time for them to process the information and ask questions if any do arise (remember to stay open to conversation with my patient and his family). Rationale. The most important thing that I feel to remember is that all patients or people in general do not learn in the same fashion.
You have your different visual (learn best when presented with graphs and other illustrations, maps, written material), auditory (learn best when they can listen to a lecture or a fast paced exchange of information) and kinesthetic (learn best when they can just do it and are hands on) learners. Before trying to teach your patient or possible care takers how to perform or ensure proper intervention application you should first figure out the best way to teach them. I chose to provide pictures, demonstrate and allow a return demonstration or practice session with M.
C. and his family because from inference and their replies to my questions pertaining to their learning strategies they all learn best visual and when performing and practicing themselves. I will be including M. C. ’s family because they are who he preferred and indicated to take care of him while he is rendered unable at home. Neither M. C. nor his family have experience dealing with caring for a person at risk for pressure ulcers so it is important that I cover all bases and be specific with information.
Knowing that not everyone learns at the same speed or has the same mental capacity is my reason for breaking it up and allowing for conversation and questioning so that everyone is able to comprehend and understand the information and techniques that are being provided during this teaching session. I don’t expect them to learn and understand all this in one day and it is important to break up the session so during the week of M. C. ’s discharge I will be spacing the learning sessions out. Evaluation of Learning
During the return demonstration and their responses to my questions I evaluated their understanding to rate their processing of the information and techniques. M. C. and his family understood all the information and seemed thoroughly prepared to perform the necessary tasks related to patient repositioning and reducing risk of pressure ulcers at the end of the teaching course. It is important that when documenting I provide the patient teaching including the information covered and the resources I used to demonstrate and infuse the importance of repositioning to M.
C. and his family. Reference Moore, Zena. (2010). Systematic review of Repositioning for the Treatment of Pressure Ulcers. EWMA Journal, 10(1), 5-12. Peterson, M. , Schwab, W. , Van Oostrom, J. , Gravenstein, N. , Caruso, L. (2010). Effects of turning on skin-bed interface pressures in healthy adults. Journal of Advanced Nursing, 66(7), 1556-1564. Reddy, M. , Gill, S. S. , & Rochon, P. A. (2006). Preventing Pressure Ulcers: A Systematic Review. JAMA, 296(8), 974-984.

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