1. Patient Education Chapter 55, Lesson 1
Pearson's Comprehensive Medical Assisting, 2nd ed.
Beaman, Fleming-McPhillips, Routh, Gohsman, and Reagan,
Pearson 2011
MA100: Instructor Mayra Howells 2012

2. Critical Thinking Question
Based on the limited time a physician can spend with a patient, and the limited resources most patients have for gathering correct information, what are some of the health and potential life-threatening situations that could arise if medical assistants were not in the position to help educate the people with whom they come in contact?

3. The Patient’s bill of Rights
Developed by the American Hospital Association
Describes the patient-healthcare provider relationship
A Lists 12 rights patients have, includes:
Right to privacy
Right to confidentiality
Right to considerate and respectful care
Right to obtaining
up-to-date treatment information
Right to making own decisions
Right to have an advance directive
Right to review his/her own records
Right to expect reasonable continuity
of care

4. What’s your role to patient education?
Be prepared to educate the patient on behavior that might improve the patient’s health
Prepare the patient for a procedure
Improve compliance on a therapy or medication
Educate the patient about his or her own health behaviors

5. Patients Learning Styles
Auditory
Learn by hearing
Helpful to repeat information verbally
Visual
Learn by seeing
Visuals such as brochures are helpful
Kinesthetic
Learn by doing
Providing exercises can be helpful

6. Activities and Techniques for Teaching Adults
Setting learning outcomes or goals for patient education
Assess reading and learning capabilities
Make learning practical
Making learning self-directed for adults
Create a brochure
Role-play to enhance patient learning

7. Teaching Methods and tools

8. Motivational Incentives for Adult Learners
Better health
Improved appearance
Pride of accomplishment
Self-confidence
Praise from others

9. Roadblocks to Effective Patient Learning
Using language and communication skills
that are not suited to the learner
Cultural influences
Individual’s stage of development

10. Communications and Language Roadblocks
Ordering, commanding, and directing the patient to learn
Warning or threatening
Moralizing or preaching (“ought to do,” “should do”)
Judging
Criticizing
Name calling, stereotyping, labeling
Sarcasm
Anxiety
Culturally inappropriate treatment plans
Speaking loudly to a blind person
Age-inappropriate speech

11. Effects of Cultural Influence
Readiness
Values
Feelings of inclusion
What aspect of learning the patients choose
How they apply it in their own homes
Use of personal space, distances maintained, facial expressions, body movements, gestures, and expressions

12. Effects of Cultural Influence
Readiness
Values
Feelings of inclusion
What aspect of learning
the patients choose
How they apply it in their own homes
Use of personal space, distances maintained, facial expressions, body movements, gestures, and expressions

13. Effects of Individual’s Developmental Stage
Attitudes and illness have powerful impacts on learning readiness
Some patients may distrust education due to previous negative experiences
Illness affects individuals in different ways;
fatigue and pain can be
obstacles to learning

14. Ways to Overcome Roadblocks
Create a learning environment that encourages patient readiness
Consider rescheduling the session if the patient is not feeling well at the time
Carefully prepare any brochures or materials given to patients to accommodate differences in the learning readiness and processing capabilities of older adults and also of special needs patients such as non-english-speaking patients and those with developmental delays or hearing or visual impairments

15. Critical Thinking Question
What scenario can you think of where role-playing might be useful in teaching a patient a new skill?
What might be some of the challenges to teaching patients who are visually or hearing impaired?
How can these challenges be overcome?

16. Considerations for Creating a Teaching Plan
Honesty where privacy is lacking
Room lighting
Availability of patient education materials
Equipment availability
Honesty with being questioned
Teaching resources; handouts, DVD players, compact disks, videos, or pamphlets
Patients learning styles

17. Ways to Help Patients Be More Compliant
Ensure a positive relationship
Convey to the patient the knowledge they need to make educated decisions about their health care
Reinforce learning
Have a follow-up plan with regular evaluation of progress
Include an objective
A date indicating when the objective should be accomplished

18. Finding Resources to back your teaching
When teaching patients to a healthier lifestyle habit for wellness or how to handle illness your teaching should correlate to what the patient finds in some of these sites.

19. Most education are provided on a need to know basis.
Teach first what the patient needs to know at that moment to help them to meet their objective or deal with the needs for self care.
Lecture Media channel Return demonstration
Q & A Review
Call back Second teaching session

20. Critical Thinking Questions
What is the difference between an objective observation and a subjective observation?
Why, when valuing a patient’s level of pain, is it important to be objective?

21. Mind-Body Connection Endorphins are released when patients are happy.
These proteins:
Have analgesic properties
Benefit physical functioning
Boost immunity to disease

22. Mind-Body Connection
Negative feelings such as fear, anger, and grieving can:
Cause increased heart rate
Cause tightened muscles
Trigger fight-or-flight response

23. The Reality of Pain
Pain is an unpleasant sensory and emotional experience
Patients respond differently to pain, depending on tolerance and pain threshold

24. Teaching About Pain
Sometimes pain is referred, so it is felt in another area than the actual pain
It is important for the medical assistant to assure the patient that pain relief is possible
It is important for the medical assistant not to put subjective value on the patient’s pain
Pain can be physical and psychological

25. Considerations for the Various Aspects of Pain
Pain is a subjective experience for the patient
Pain is what the patient describes it as
Pain can be acute,
such as surgical pain
Acute pain will be strong after surgery and lessen over time
Chronic pain is pain that continues over time

26. Long-Term Effects of Chronic Pain
Anger
Helplessness
Sadness
Depression
Decreased activity
Decreased sleep
Increased irritability
Fatigue
Chemical and/or medication dependency
Mood swings
Lowered self-esteem
Impaired ability to handle stress

27. Teaching about Nutrition
The new My Pyramid
developed by the U.S.
Department of Agriculture
is individualized and includes:
Activity
Moderation in eating
Personalization of diet
Proportionality
Variety and gradual improvement

28. The 2005 Food Guide Pyramid

29. Teaching about Exercise
Before starting any exercise program, a patient should visit the physician’s office to ensure that it is safe for them to exercise
Patients need to be taught how to properly stretch, warm up, and exercise without becoming injured
Some patients with heart or respiratory problems may need to have a modified exercise plan
They generally have regular appointments at the physician’s office, at which time they can expect the medical assistant to assist in establishing and maintaining an exercise regimen

30. Teaching Stress Reduction
To reduce stress
Practice breathing exercises
Meditate
Use guided imagery
Visualize
Exercise
Relaxation
listening to music
performing yoga

31. Methods to Stop Smoking
Use nicotine patch, gum, replacement therapy or substitutes
Choose the right method to quit smoking
Seek telephone support
Participate in support groups
Receive information about success rates

32. Preparing a Patient for a Cast Application
Explain that casts are a form of inflexible bandage that are applied for the purpose of immobilizing a broken bone or muscle strain and sprain
A cast may be applied after a surgical procedure on a limb to immobilize the area until healing takes place

33. Instruments Used for Cast Application
Cast material (bandage roll or tape)
Container of warm water
Stockinette
Webril (sheer wadding)
padding rolls
Bandage scissors
Rubber gloves
Sponge rubber (for padding)

34. Assisting the Physician with Cast Application
It may be necessary to hold the limb at the joint areas as the cast is being applied
Remember to handle a damaged limb gently

35. Assisting the Physician with Cast Application
After the cast has been applied, it must be left uncovered during the drying process
The limb may need to be supported on a pillow at this time
The patient should be cautioned against moving around until the cast is dry
The cast may feel warm or even hot during the drying process – Reassure the patient that this is normal

36. Observations that Patients Should Report
Circulation restricted by the cast
Pain as a result of the cast pinching the skin
Excessive itching under the cast
Numbness or tingling of fingers or toes
Discolored toes or fingers
Swelling of the limb
around the edge of the cast
Discoloration soaking
through the cast
Loosely-fitting cast
Foul odor coming from the cast

37. Types of Casts Short arm cast (SAC) Long arm cast (LAC)
Extends from the finger to just below the elbow – Used for a fracture or dislocation of the wrist or forearm
Long arm cast (LAC)
Extends from the fingers to the axilla, with a bend at the elbow – Used for a fracture
of the upper arm
Long and short leg casts
Extend from the thigh to the toes (LLC) or from below the knee to the toes (SLC) –
They usually include an embedded walking heel

38. Patient Cast Care Clean the cast with a damp cloth
Do not cut or trim the cast – If the edge seems sharp, apply masking tape to the sharp edge or use a nail file to trim it down
Elevate the extremity with the cast on it to reduce swelling and pain
Observe the fingers and toes for color changes, temperature changes, pain, tingling, or decreased sensation

39. Patient Cast Care
When decorating a cast, use only water-soluble paints or marking pens – Otherwise the cast will not be able to breathe
Call the physician’s office if you smell a bad odor coming from the cast, lose sensation or blood flow beyond the cast, feel a burning sensation, or notice blood coming from the cast
After being sure that the patient understands the importance of cast care, the medical assistant must document the teaching in the patient chart

40. Equipment Needed for Cast Removal
Cast cutter
Cast spreader
Bandage scissors
Bag for disposing of
cast materials
Drape

41. Procedure for Cast Removal
After washing hands and draping the patient, explain the process to the patient
The cutter vibrates and does not spin
The patient may feel some pressure and warmth
The patient’s skin under the cast may be white; the muscle tone may have decreased
Patient may need some reassurance that physical therapy will improve the function and appearance of the limb

42. Procedure for Cast Removal
The MA should stand near the physician and hand the necessary equipment as requested
After the cast is removed, the medical assistant should
Provide written instructions for post cast care
Clean the equipment
Wash hands
Document the procedure in the patient chart