Topic: Discharge Planning

My scenario is 16 years old pregnant teen smoking cigarette.

Discharge planning and teaching begins at admission. The goal of planning is to provide for continuity of care after discharge, whereas the goal of teaching is to empower the client to maintain or to improve health status after discharge. Essential to effective teaching is the selection of appropriate teaching methodologies, as well as accurate information.

Once learning needs are correctly identified and the primary care giver is identified, the client system, caregiver, and the health care providers plan learning outcomes. From this, specific teaching sessions are implemented. Teaching must be relevant to the client's condition, teaching - learning principles applied and delivered using appropriate teaching techniques. Next, it is important for the nurse to evaluate not only achievement of the learning outcomes but the client's response to the nurse's teaching as well. Based on these outcomes and collaboration from others, thoughtful evaluation and modification follow.

PURPOSES OF THE DISCHARGE TEACHING PROJECT - The student will:

1. Design a discharge teaching plan as assigned by instructor.

2. Individualize the teaching for the clients who may also have special needs as identified with given assessment. Such needs might be that the learner is extremely anxious, fearful, blind and deaf, confused or is of low-literacy skills.

3. Present the plan and all materials to the instructor for approval in advance. If approval is not granted, student will not be able to present the teaching plan on the assigned day.

4. Report/present teaching materials and plan to the clinical peer students ("The Learner(s)") on the assigned clinical date.

PROJECT SUMMARY -

1. This project consists of a written discharge teaching plan and a discharge teaching presentation.

2. The grade earned by each student will be based on the written discharge plan, the presentation, evaluation, and student (learner) evaluations.

The Discharge Teaching Plan addresses the following criteria:

TEACHING-LEARNING ASSESSMENT

In order for the nurse to decide which teaching strategies and methods are best for the client system, it is necessary to identify all of the variables that may affect the teaching/learning outcomes. Consider each of the following and incorporate these variables into the teaching strategies planned:

• Neurological and functional status (alertness, sensory, movement)
• Educational level/reading, comprehension, and writing ability
• Readiness to learn
• Preferred style of learning (auditory, visual, kinesthetic)
• Age/developmental level that impacts outcomes/teaching strategies
• Barriers to learning: pain, medications, drug/alcohol abuse, attitudes, perceptions of staff and illness experience, etc. Estimate of learning potential as evidenced by: strengths, weaknesses, non-compliance issues, barriers to compliance, recurrent admits and/or self-care initiatives which can be stated by client or care giver, noted on the chart or observed by the nurse
• Language, religion, or other ethnic customs and habits.
• Psycho/social issues: coping, finances, resources -human & material, family problems, living arrangements, caregiver interest/support, lifestyle (dines out often, travels frequently, etc.)

NURSING DIAGNOSES/PROBLEMS

• Prioritize all teaching/learning need(s): altered health maintenance, knowledge deficit, noncompliance, or ineffective therapeutic management
• Justify each diagnosis by identifying all relevant subjective/objective data from client face sheet, Nursing Process Worksheets and the assessment data
• Write in Nursing Diagnosis format as: Problem, R/T (Etiology), Defining Characteristics
• Prepare a teaching care plan for the identified priority knowledge deficit nursing diagnosis/problem

CLIENT/CARE GIVER LEARNING OUTCOMES

• Identify learning outcomes (goals) in BCTM or SMART terms: the desired client behaviors, conditions, time frames, measurement of the goals to be accomplished.
• Identify learning outcomes by learning domains: cognitive, psychomotor or affective.
• Construct outcomes that are relevant to the problem and are realistically attainable.

INTERVENTIONS/PLANNED TEACHING CONTENT

• Identifies the specific teaching content for the teaching session: who is to be taught, time-lines for the teaching to be done, under what conditions the teaching is to take place, length, equipment, etc. (Teaching to be done during post-conference.)
• Describes methods (visuals, verbal, written, demonstration, models, etc.) How will the content be taught?
• Identifies teaching-learning principles utilized; what is the explanation for the methods used? Provides the rationale as to why selected methodology is to be used to deliver content.

For organizational purposes:

• Number each planned client learning outcome with actual learning outcome
• Number each planned teaching content concept with the modifications, if applicable
• Identify each planned teaching content concept with the applicable and numbered teaching-learning principles
• Provides evidence that teaching is related to the etiology of the nursing diagnosis and provides teaching that is appropriate and individualized to client/family situation.
• Critiques the evidence and analyze current practice. What is current treatment? Discusses the implications for practice. Presents the best evidence to answer the clinical question.
• Briefly describes the background to the nursing diagnosis, its clinical significance, and how you searched for best evidence to answer the question. Do the ideas in the teaching plan support the research?
• Are the ideas organized and flow logically?
• Initiates and presents teaching.
• Uses a minimum of 3 articles from professional nursing journals that indicate evidenced based practice (excluding brochures, pamphlets and non- nursing (World Wide Web resources) less than 3 years old. Cites correctly using APA format on the written teaching plan and verbalize during presentation all journal references used in the "Planned Discharge Teaching Content" section of paper. Includes a full copy of the articles.
• Supplies, modifies or creates all teaching materials such as props, audio-visual or written materials (pamphlets, brochures, written directions) to be used during teaching and/or provided to the client/family.

Attachment:- Assignment File.rar