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Patient and Family Education (3.5.4)

Patient and Family Education (3.5.4) - Policies, Clinical, UW Health Clinical, Medical Records and Communication, Patient Assessment

3.5.4


UW HEALTH CLINICAL POLICY 1
Policy Title: Patient and Family Education
Policy Number: 3.5.4
Category: UW Health
Type: Ambulatory and Inpatient
Effective Date: December 6, 2016

I. PURPOSE

To recognize that patient and family education is an integral part of patient care and to ensure that quality
education and information is provided to patients their family members and support systems based on their
needs, preferences, and abilities. This would:
ξ Acknowledge the patient’s right to know
ξ Highlight the importance of assessing learning needs and matching methods of education to the
learner’s (i.e., patient and/or family members/support persons) level of understanding
ξ Enhance the knowledge, skills, and behaviors necessary to meet the patient’s health care needs
ξ Actively engage the patient and/or family members/support persons in self-care
ξ Promote speedy recovery
ξ Reduce unnecessary health care costs
ξ Encourage preventive care
ξ Reduce unnecessary readmissions

II. DEFINITIONS

A. Patient and family education encompasses all planned and unplanned learning opportunities which provide
the patient and/or family members/support persons with individualized education and training to enhance
knowledge of illness, treatment needs, and to learn skills and behavior that promote recovery, provide
comfort, improve function, and maximize self-care.
B. Patient- and family-centered care is an “approach to care that recognizes the importance of family in a
patient’s life and the importance of their active involvement in planning and making decisions on health care,
services and treatment, and health care reform. This approach to care provides respectful, compassionate,
culturally safe, and responsive care that meets the needs, values, beliefs, and preferences of the patient,
their family, and others identified as significant to their life from diverse backgrounds and settings” (RNAO,
2015).

III. POLICY ELEMENTS

A. Teaching and learning will occur in a variety of settings (e.g., ambulatory, inpatient, and home) throughout a
health care episode and is facilitated by multiple disciplines (e.g., nurses, physicians, pharmacists, dietitians,
respiratory therapists, social workers, and occupational and physical therapists) working together to
coordinate patient and family education across the continuum.
B. The principles of patient- and family-centered care and plain language/universal communication will be
utilized.
i. Principles of plain language/universal communication (DeWalt et al., 2010; TJC, 2010) include the
following actions by clinicians:
a. Speaking in plain language and avoiding the use of technical terms or medical jargon
b. Actively listening
c. Encouraging questions
d. Addressing concerns
e. Sharing practical information and providing specific instructions
f. Using relevant examples and analogies
g. Incorporating the use of simple pictures into explanations when possible
h. Using the teach-back method
C. A learning assessment and outcomes of patient and family education will be documented in the electronic
health record.

IV. PROCEDURE

A. Assessment
i. The nurse, or designee, is responsible for initially performing a learning needs assessment for each
patient and/or family member/support person identified as a primary or secondary learner that



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Policy Title: Patient and Family Education
Policy Number: 3.5.4

includes the following:
a. Learning barriers such as those related to physical or financial constraints, sedation,
fatigue, pain, anxiety, or emotion which could impede learning
b. Language or literacy issues, noting preferred language for discussing health care
c. Cultural, religious, and spiritual beliefs or practices
d. Learning disabilities due to impaired vision, hearing, speech, or cognition
e. Ability to understand explanations and ask relevant questions
f. Ability to verbalize basic understanding of condition
g. Ability to make decisions about condition and care
h. Preferred learning style(s)
i. Motivation/readiness to learn
j. Learning priorities
k. Strategies to overcome any identified learning barriers
ii. The initial assessment provides a baseline and is documented in the clinical record.
a. For patients occupying inpatient beds, an initial learning assessment must be completed
and documented within the first 24 hours of their stay.
b. For patients in ambulatory and home care settings, an initial learning assessment must be
completed and documented with the first encounter.
c. For all patients, previous learning assessments are reviewed on an ongoing basis and
changes are documented as appropriate by any member of the interdisciplinary team at
any time.
iii. The nurse, or designee, also addresses the specific knowledge and skills of the patient and/or
family member/support person needed to meet the patient’s relevant health care needs, taking into
account the teaching/learning which has occurred prior to the patient’s admission or clinic/home
care visit.
B. Planning
i. When planning for patient education, any member of the interdisciplinary team should refer to the
plan of care and learning assessment to consider the desired patient outcomes and learning
priorities, readiness to learn, and preferred learning style as well as the needs and abilities of the
patient and/or others identified as primary or secondary learners for the patient.
ii. Based on this information, the interdisciplinary team collaborates to develop an individualized
teaching/learning plan that meets the needs of the learners.
iii. In tailoring teaching to the particular needs and abilities of the patient and/or others identified as
primary or secondary learners for the patient, the developmental level of each learner will be
considered when developing content and selecting teaching/learning methods. Education for
children involves parents/guardians whenever possible and is designed to be appropriate for the
developmental level, age, and condition of each learner. Similarly, the teaching plans for
adolescents, adults, and older adults meet the developmental level of the learners involved (see
UWHC policy 4.34, Patient Rights and Responsibilities).
C. Implementation
i. Individual units and clinics are responsible for maintaining and/or accessing all necessary teaching
supplies (e.g., written materials, DVDs, and audiovisual equipment).
ii. Patient education materials produced by and for UW Health, known as Health Facts for You, are
accessible on U-Connect and in select cases, they are embedded within electronic documentation
tools. For more information on Health Facts for You, see UWHC policy 7.35, Health Facts for You.
Other patient education materials may also be available for use on U-Connect and/or within
electronic documentation tools (e.g., Healthwise, American Academy of Pediatrics Patient
Education Online, Lexicomp).
iii. The Learning Center is designed to complement the patient/family education that already exists
throughout the hospitals, clinics, and home care settings. The Learning Center offers planned
programs, and in collaboration with the Patient Education Committee, oversees the development of
patient and family education materials.
iv. For individuals who do not speak, read, or understand English, resources are provided by UW
Health Interpreter Services.
D. Evaluation
i. As appropriate, the teach-back method is used to assess a learner’s understanding and recall of
information and/or mastery of a skill. The clinician asking for the teach-back is doing so in order to
evaluate the effectiveness of teaching with a particular learner. If the learner is having difficulty with



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Policy Title: Patient and Family Education
Policy Number: 3.5.4

the information or skill, the clinician works with the learner to understand the difficulty and tailors
teaching accordingly.
ii. The teach-back method may also be used as part of a quality improvement program to evaluate the
efficacy of teaching/learning approaches in various circumstances.
iii. Identification of the learner(s), readiness to learn, information and/or skills taught, teaching/learning
methods and materials used, and response to education must be documented.
E. Documentation
i. Multiple aspects of patient and family education should be documented in the patient’s legal
medical record. Such aspects should include:
a. Learning assessment (as described in IV.A.i)
b. Content of information taught and materials used
c. Teaching/learning methods used
d. Outcomes of learning (i.e. learner’s understanding, response to education)
e. Recommendations for future learning or need for reinforcement

V. COORDINATION

Author: Manager, Patient and Family Education
Senior Management Sponsor: VP, Nursing and Patient Care Services
Reviewers: Clinical Nurse Specialist, Diabetes
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: November 21, 2016

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities.
This policy applies to facilities and programs operated by the University of Wisconsin Hospitals and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.

VI. APPROVAL

Peter Newcomer, MD
UW Health Chief Medical Officer

J. Scott McMurray, MD
Chair, UW Health Clinical Policy Committee

VII. REFERENCES

A. CMS, Conditions of participation for hospitals, 42 C.F.R. Part 482.
B. DeWalt, D. A., Callahan, L. F., Hawk, V. H., Broucksou, K. A., Hink, A., Rudd, R., & Brach, C. (2010). Tool 4:
Tips for communicating clearly of the health literacy universal precautions toolkit. (Prepared by North
Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, The University of
North Carolina at Chapel Hill, under Contract No. HHSA290200710014.) AHRQ Publication No. 10-0046-
EF. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from
http://www.ahrq.gov/qual/literacy/
C. Joint Commission Resources. (2008). Strategies for improving health literacy. The Joint Commission
Perspectives on Patient Safety, 8(3), 8-9.
D. Registered Nurses’ Association of Ontario (2012). Facilitating Client-Centred Learning. Toronto, Canada:
Registered Nurses’ Association of Ontario. Retrieved from www.rnao.org.
E. Registered Nurses’ Association of Ontario. (2015). Person- and Family-Centred Care. Toronto, ON:
Registered Nurses’ Association of Ontario. Retrieved from www.rnao.org.
F. The Joint Commission (2010). Advancing effective communication, cultural competence, and patient-and
family-centered care: A roadmap for hospitals. Oakbrook Terrace, IL: The Joint Commission. Retrieved from
http://www.jointcommission.org/Advancing_Effective_Communication/
G. The Joint Commission (2012). 2012 comprehensive accreditation manual for hospitals.
H. Health Facts For You (U-Connect)
I. UWHC policy #4.34, Patient Rights and Responsibilities



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Policy Title: Patient and Family Education
Policy Number: 3.5.4

J. UWHC policy #7.15, Discharge Planning Process
K. UWHC policy #7.35, Health Facts For You
L. UWHC policy #7.53, Interpreter Services and/or Linguistic Access
M. UWHC policy #7.60, Medication Reconciliation
N. Nursing Patient Care Policy #13.14, Documentation in the Inpatient’s Clinical Record
O. Nursing Practice Guideline: Patient and Family Centered Care (2015)
P. Nursing Practice Guideline: Patient and Family Education (2014)
Q. Patient Education Policy 3.53, Patient Education Policy
R. The Teach-Back Method (see Related Resources)

VIII. REVIEW DETAILS

Version: Original
Next Revision Due: December 2019
Formerly Known as: Nursing Patient Care policy #14.21, Patient and Family Education