Educating Patients: Creating Teaching Moments in Practice
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Question 2: What are some strategies that can be used to help educate Miss Brown and her family? Commentary on question 2 : Individual education will work best for Miss Brown in the emergency department. Using visual aids and written information is important, as she is a visual learner. Teach-back will be a good strategy to check the effectiveness of teaching, and to focus on the information she needs to know for self-care. Including Miss Brown’s mother in teaching when she arrives will help enforce management at home. The use of technology can also enhance teaching with Miss Brown, such as providing trusted websites and videos. Although Miss Brown is considered a minor, she has the ability to learn and retain informa - tion. Patient teaching should be directed at her while including her mother as well. Question 3: What important content should be covered with Mrs. Jones during the initial educational sessions? Commentary on question 3 : Miss Brown needs to know what is wrong and what she will need to do. This includes what her broken collarbone means, pain management, and immobilization of the arm. Miss Brown also requires information about follow-up with an or - thopedic provider after discharge. She also has a possible concussion, so will need informa- tion on what to watch for and signs that she needs to return to the emergency department. Miss Brown’s mother should also be given this information, as she will be helping observe Miss Brown at home. Miss Brown will also be given a prescription for short-term use of ac - etaminophen and codeine for pain management of her fracture. Although Miss Brown may have a concussion, the provider has prescribed one pill of 325 mg acetaminophen with 15 mg codeine as needed every six hours for the next three days. She needs information about what the medication is, how to take it, and its benefits. Miss Brown’s mother arrives, and teaching includes both of them. Teach-back questions include “Please tell me how you will take care of your broken collarbone at home,” “What will you do if you start throwing up or get headaches when you get home?” and “How will you take your medicine when you get home?” Miss Brown replies, “I will make sure I keep my arm in this sling when I get home, and I won’t move it. I also need to see a specialist soon.” She says, “If I start throwing up, I will come back to the emergency department. If I have a really bad headache, I will come back too.” Miss Brown also states, “I will take my pain pills only if I have really bad shoulder pain.” Question 4: What teaching moments are there for Miss Brown? Commentary on question 4 : The statement Miss Brown made about “a really bad head - ache” should be clarified. She needs to know that a headache is a warning sign, and her perception of “really bad” may be different from the physician’s meaning. Her medication should also be reviewed again, including how many pills she should take and how often she can take them. Again, her perception of “really bad” pain in her shoulder may be different from the physician’s perception of what “really bad” pain is. Waiting until the pain is severe can decrease the effectiveness of pain management. Another teaching moment is referring to Miss Brown’s statement about smoking marijuana. There is an opportunity to discuss how smoking—whether it is marijuana or tobacco—affects the lungs. The use of both marijuana and opioids may also cause symptoms that could be confused with concussion.
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