PBL - NOTES PDF

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PBL Week 2/3 Subjective: information pt provides how they feel/what hurts Objective: assessment on pt actions/behaviour

Goals of pt education: 1. To assist individuals, families, or communities in achieving optimal health 2. Maintain and promote health and prevent illness 3. Restore health 4. Optimize quality of life with impaired functioning 1. How did the following factors impact health teaching?  Learning Environment: pt education takes place in different settings, not ideal environment for learning as a nurse adapt to different situations. Very busy environment.  Ability to Learn: consider what age/language you’re teaching in (differ for a 5 yr old compared to 40 yr old) Consider their physical comfort and pain levels. Emotional capability: are they in an emotional state where they’re open to hear the nurse?  Learning Style & Preference: Hands on learning (ideally use a combination).  Motivation to Learn: no motivation to learn (ex. smoking: no motivation they won’t absorb the teaching, in one ear out the other) Urge to want to learn, no urge? They won’t. We don’t know everything that is going on in a person’s life, if they are going through a hard time, they might not care to hear about their blood pressure.  Social motivation: need for interaction  Physical motivation: positive affect on their health 2. What factors may contribute to facilitators or barriers to learning for pts? (assigned)  Cultural (religion/language)  Social and emotional factors  Physiological  Environmental effects  Family factors (parents’ consent)

3. What health teaching factors should be considered during the assessment phase? Can you think of an example to help explain?  Gather information about pt, conduct interviews, discussing their learning needs, motivation and ability to learn while considering SDOH. We can’t allow our opinions to get in the way. How capable are they of change?  Determining what pts health care needs are 4. After the nurse has identified the foci (focus) for health teaching, learning objectives need to be developed. What considerations need to be made in formulating the objectives? (planning phase)  Planning phase: pts immediate needs to be met, Maslow’s levels of human need (ex. pt in pain would be critical to be dealt with)  Pts level of accountability and SDOH

5. Discuss a variety of teaching methods/approaches/ tools that could be effective for the Cognitive, Affective and/or psychomotor domains. (Implementation phase)  Cognitive domain: refer to things such as memory, and the ability to learn new information (is the pt able to retain the information? Ex. head injury pts)  Affective domain: expression of feelings, take into consideration of their values  Psychomotor domain: showing them and then having them do it (hands on)

EIDM: Evidence informed decision making Quantitative (#): taking notes (bp, O2 etc) measurements, numbers Quality (appearance): a lived experience Note: Using both quantitative and qualitative:  Mixed method study: use both and mix the data into a streamlined result to obtain combined results  Multi-methods: use two different methods without combining What is the 6S pyramid?

When can you stop your search on the pyramid?  When you find what’s going to best support the question  Do research ahead of time for papers Pre-appraised: reviewed by 3 reviewers (articles and people in the field), allows us to know the information will be reliable Large Group Practice: Background: ask for general knowledge about a condition, test or treatment Foreground: ask for specific knowledge to inform PICO Question: P – population – pregnant women I – intervention – herbal supplement C – compare – prenatal vitamins O – outcome – fetal health/healthy pregnancy Question: in pregnant women, do herbal supplements compared to prenatal vitamins improve fetal health?

PICO EXAMPLE A:

P: elderly pts I: screening for depression C: no screening O: overall increase of diagnosis of depression in elderly pts Question: In elderly pts is screening for depression vs not screening for depression effective in increasing diagnosis of depression PICO EXAMPLE B:

P: homeless community I: observing people taking TB medication C: not observing them O: better control of tb spread better health plans Question: In the homeless population, does observing people taking TB medication vs not observing people taking TB medication effective at controlling the spread of TB Another way to view the steps of the PBL process: 1. The problem is presented to the group, terms are reviewed, and hypotheses generated 2. Learning issues and information sources are identified by group members

3. Information gathering and independent study occurs 4. The knowledge acquired during independent study is discussed and debated critically 5. Knowledge is applied to the problem in a practical way and the initial hypotheses are confirmed or refuted 6. Reflection on the content and process of learning occurs Case Study: Valerie Hill What we know:  Valerie (25 years old) and Todd (30 years old) Hill have been married for 3 years.  Valerie is 20 weeks pregnant with their first child  This is a planned pregnancy for Valerie and Todd  Both Valerie and Todd are very excited and feel very fortunate that the pregnancy has been healthy.  Both are from the Mohawk Nation  They value many of the Indigenous traditional ways of knowing around pregnancy, childbirth, and family and want to integrate these values into their experience. Around pregnancy, childbirth, and family and want to integrate these values into their experience.  They have lots of family support from both sides of their family  They currently live in a 3-bedroom bungalow on the Six Nations of the Grand River  Valerie works part time in a local variety store within the community. During the slower season she also works occasionally for a friend who owns an art store.  Todd works full time as an auto mechanic in Brantford, about 20 minutes away What we would want to know  What kind of prenatal care?  First pregnancy? Any miscarriages in the past? – can affect current pregnancy  What type of delivery are they planning on having? Expecting?  Has she been attending each ultrasound?  How far are they measuring?  What are Valerie’s dietary habits through her pregnancy?  What symptoms should you expect throughout pregnancy?  What is our role as a nurse – prenatal care?  What factors does her indigenous culture play into her care? How can we identify/consider those? Homework: Group 2 - Role of Health/health promotion – healthy pregnancy, prenatal care Week 4  Client determines if care is safe  Difference between teaching plan and a care plan Care plan: more broad  Teaching plan: specific for teaching...