1. Hess, Cathy Thomas RN, CWOCN, BSN

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PATIENT EDUCATION and adherence to therapy are the cornerstones of successful wound and skin care. A successful plan of care should be individualized and clearly documented, with specific, achievable, and measurable objectives. Your plan of care also should include the patient's healing potential, clinical goals, functional outcomes, and the patient's goals.


Evaluating the patient's educational needs starts with a nonjudgmental assessment of what he knows about his condition and its management. After you've planned and implemented patient education, evaluating its effectiveness and measuring his retention of the material is paramount for a successful plan.


Let's look at six assumptions on which adult learning is based:


* The need to know. Adults need to know why they should learn something and how it will benefit them.


* The learner's self-concept. Adults have a self-concept of being responsible for their own life and decisions. They resist situations that make them feel as if other people are telling them what to do. They need to be responsible for their own learning and the direction it takes.


* The role of the learner's experience. Adults tend to be heterogenous in terms of backgrounds, learning styles, motivations, needs, interests, and goals. In adult education, the emphasis is on individualizing teaching and learning strategies. Adults need to be able to draw on their life experiences and apply them to new learning.


* Readiness to learn. Adults are ready to learn the things they need to know to be able to cope effectively with real-life situations.


* Orientation to learning. Adults are problem-centered in their learning approach. They learn new knowledge, attitudes, and skills most effectively if these things are presented in the context of how they apply to real-life situations.


* Motivation. The most potent motivators for adult learning are internal, such as the desire for better quality of life, rather than external, such as higher salaries.



The Joint Commission and the Panel for the Prediction and Prevention of Pressure Ulcers in Adults have identified patient education as critical to care delivery. The key principles of effective adult patient education include identifying patient needs (such as skin and wound care learning needs), learning styles, challenges, goals, and physical stressors. Several national healthcare policy organizations, including The Joint Commission, support patient education in their patient-safety goals.


Be sure to incorporate these components into your care plan:


* short-term goals that accurately reflect the patient's status


* long-term goals that accurately reflect the patient's status.



By following these principles, you can tailor patient education to your patient and help him become a partner in his care, so he can have the best possible outcome.