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Submit this assignment by the end of the day on Sunday of Module 3. Name: Linda Cheng Section Number: 1041 Use the following form to complete your teaching plan. The fields will expand as you type. Provide reference list on a separate page after the teaching plan template and below the Literacy Considerations. Type in references (do not copy and paste). Nursing Diagnosis Increased risk of high blood pressure complications amongst adults in Cuyahoga County related to poor diet, economic factors, and lack of knowledge regarding the risks of developing coronary heart disease and lack of access to primary healthcare as demonstrated by an increased trend in the number of deaths related to coronary heart disease Target Population The target population is a church group of 15-20 middle aged and older patients identified by the church nurse as having high blood pressure readings. Long Term Goal: Long term goal is to decrease the average blood pressure readings of the church group by 2.5% within a one-year time frame Short Term Goal: Short term goal #1) inform the patients in the church group about risk factors related to high blood pressure and the potential health problems that may result. Short-term goal #2) implement a monthly blood pressure community clinic to run at least for a 6-month period to provide ongoing assessment, teaching and intervention for the patients in the church group at risk.
Module 3 Assignment: Community Health Nursing Teaching
Plan
Objectives (include 3 – 4 measurable objectives using below cells. One objective for each cell) Content Outline (include content for each objective) Method of Instruction (include teaching strategy for each objective) Time it takes for content to be presented Method of Evaluation (include type of method for each objective to determine if it was met At the end of the six month blood pressure clinic, the patients (learners) will be able to identify normal and abnormal blood pressure readings and review related potentially life threatening events
- Provide for practice using various types of blood pressure reading devices.
- Use visual aids and provide demonstrations to explain normal blood pressure and its readings.
- Have 2 health care providers available on the first and last clinic date, to verify each learner’s blood pressure and treat patients identified at immediate risk.
- Have 2 community health nurses and 1 church nurse present for each session to take blood pressures readings.
- Provide printed material to illustrate the symptoms of heart attack and All teaching strategies for this objective involve the aid of qualified nurses and health care providers.
- Take each patient’s blood pressure upon arrival to clinic.
- Identify normal and abnormal blood pressure through PowerPoint slides and encourage group discussion about risk factors.
- Have 2 health care providers available at the first session to test each patient and create a chart of the blood pressure readings and to All sessions are 2 hours long over 6- month period.
- 2 minutes per patient will be spent taking blood pressure readings (total of 10 minutes per clinic session).
- A period of 30 minutes will be spent during the first session on an introduction to the clinic, explaining its goals, topics to be taught each week, introduction of the health care providers and define their role with clinic, and initiate group discussion on life experiences with this topic and expected outcomes.
- Presentation of visual aids to define and explain normal and abnormal blood pressure will take 10 minutes and At the end of the six month blood pressure clinic, each patient will be able to:
- Demonstrate taking a blood pressure reading and relating whether the reading is normal.
- Describe the health risks associated with high blood pressure by using a game we will hand out coupons to a local grocery store for answers given.
- Identify and relate through question and answer sessions symptoms that require urgent interventions that require calling 911.
- Relate the value of health care providers’ interventions and justify continuing evaluation with provider after blood pressure clinic finishes.
six-month blood pressure clinic, patients will be able to identify healthy foods and develop a healthy eating plan using the DASH eating plan. food models to understand current normal eating habits and to teach the description and implementation of the DASH eating plan and how it applies to modifying high blood pressure.
- Use pictures of various types of foods that members of the group currently eat to demonstrate simple methods to exchange some foods to make healthier choices.
- Have a dietician present to demonstrate cooking healthy and eating food listed in the DASH eating plan.
- Use representative from community grocery store discuss economical ways to shop for food products used in the DASH eating plan. use group discussion, reflect on cultural values and identify behaviors that affect their current choice of foods to eat.
- Present models of various foods to be used through demonstration, showing the group the basics of incorporating the DASH eating plan.
- Arrange a field trip with representatives from a community grocery store to provide shopping ideas, coupons and incentives to encourage patients to buy foods in the DASH eating plan from their store.
- Have patients chose and prepare a sample menu with the assistance of a dietician and have patients discussion and reflection about current lifestyle behaviors and development of new behaviors that should occur over a two to three month period. Recognizing the implementation of changing food choices and behavior will take longer, due to emotional attachment, family dynamics and financial implications.
- Presentation of various food models and explanation of how these foods are incorporated into the DASH eating plan will be covered over 2 successive sessions of clinic starting the third month.
- Transport and shopping teaching session will be done in a 1 week session at the end of the third month.
- Choosing a sample menu will be developed during one session. The community health assess the group’s understanding of the DASH eating plan and discuss ideas to aid implementing of the plan.
- Have patients summarize potential barriers and support systems through question and answer sessions.
- Each patient will demonstrate within group setting the ability to make appropriate food choices according to the DASH guidelines.
- Patients will select appropriate answers to reflect understanding of how high blood pressure can be reduced by using the DASH eating plan through question and answer testing with prizes of grocery store gift cards being handed out for correct answers.
- Patients will verbalize enjoyment of a prepared DASH influenced meal.
participate in preparing the chosen meal. Encourage group discussion about desired results, and expectations of performing this task at home. nurse and dietician will provide food for meals to be prepared by patients.
- Preparing the sample menu will be done over 1 session. At the end of the six-month blood pressure clinic, patients will demonstrate a physical activity plan that involves increasing daily movement to 45 minutes of activity on most days of the week.
- Examine through discussion and review the importance of physical activity and how it relates to blood pressure.
- Teach through demonstration the types of physical movements that with small time increments will help reach a goal of 45 minutes of daily activity.
- Provide space and a fun environment to demonstrate and encourage physical movement with the aid of a physical therapist.
- Have a Physical therapist teach exercises and develop movement plans that will help encourage patients with medical and physical challenges to participate.
- Identify and encourage group discussion to review the importance of physical activity and how it effects blood pressure through exhibits and displays.
- Simulate and teach with the aid of a physical therapist various types of activities that can by slowly increased to a sustainable level for the patients.
- Practice a new type of physical activity at most sessions.
- The patients will be able to explain the importance of physical activity and how it affects blood pressure by month two (after 4 sessions).
- Different types of physical activity will be performed by majority of the patients at most sessions starting with the third session and continue with increasing 5 minute increments most sessions based on the group’s tolerance and ability.
- During the third session, patients with medical and physical challenges will meet with a physical therapist
- Patients will be able to successfully answer questions about physical activity and how it impacts their blood pressure.
- Patients will perform and demonstrate various types of physical activity
- Patients will verbally affirm an increase in the amount of time spent being physically active to 45 minutes most on most days
and carbohydrate levels. Literary Considerations - (see text, pp 140-144) Describe your target population demographics (gender, age range, estimated educational preparation) and explain how their literacy levels affect the content used to implement the teaching plan. Explain what literacy considerations the nurse should take into account for the target audience. The aggregate (group) of patients that my health education plan is geared towards consists of middle aged and older adults who live in an older developed urban area in Cleveland, Ohio. The area in which this community church is located has recently undergone revitalization and includes mostly middle class working families. There are safe parks, walking trails, and a variety of stores within walking distance. The age range of this group is 50 to 70 years of age both male and female. The estimated level of education is 8th grade and higher as described by the church nurse. Most of these patients are 2nd generation Americans of Hispanic or Irish background who state that they have finished middle school and some high school. It is confirmed by the church nurse that both cultures have very strong cultural beliefs and traditions, which are reflected in activities provided by and participated in through the church. At the beginning of each session of the blood pressure program, I propose to take each patient’s blood pressure. While taking each patient’s blood pressure during the first session, I will assess each patient for health literacy using the Single Item Literacy Screener (SILS) (Morris, MacLean, Chew, & Littenberg, 2006). SILS is a single question asked to evaluate health literacy skills of a
patient and takes much less time to evaluate those skills compared to other methods (Morris, MacLean, Chew, & Littenberg, 2006). This method is intended to identify adults who require help to understand printed health materials that will be handed out (Morris, MacLean, Chew, & Littenberg, 2006). The results of evaluating the health literacy of this group will enable the community health nurse to develop appropriate education materials. Within the first objective, I would like to provide printed material to illustrate the symptoms of a heart attack and stroke. This part of the content outline is associated with teaching patients about life threatening events. I will hand out brochures provided by the American Heart Association that are available in Spanish and English and are written at a 4th grade and lower reading level (American Heart Association, 2016). The second type of educational material used is flipcharts, posters, and other visual aids. This type of material will be used for presenting topics such as describing normal and abnormal blood pressure, teaching the symptoms of heart attack and stroke, and learning about the DASH eating plan. The posters describe high blood pressure and the symptoms of heart attack and stoke, and would be obtained along with the brochures from the American Heart Association. These posters and brochures use clear, simple, non-medical language (Nies and McEwen, 2015). Brochures to aid in teaching about the DASH eating plan will be ordered from the National Heart, Lung, and Blood Institute (National Heart, Lung, and Blood Institute, 2015). A third type of educational material used to teach this group is demonstrations using models. Even though I will have assessed each patient’s health literacy level and know most of the patients have at least an 8th grade formal education level, I would be concerned about the patients’ ability to comprehend printed health information and apply the information to their lives. Many patients overestimate their literacy abilities and many healthcare providers overestimate their patients’ abilities to understand medical information (Cornett, 2009). Understanding that this group is
References American Heart Association. (2016). Heart Attack and other educational brochures. Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttackToolsResources/Heart-Attack-and-Other-Educational- Brochures_UCM_314869_Article.jsp#.VwE8ghIrJEI Cornett, S. (2009). Assessing and addressing health literacy. The Online Journal of Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man Morris, N. S., MacLean, C.D., Chew, L.D., Littenberg, B. (2006). The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Family Practice , 7(21). doi: org/10.1186/1471-2296-7- Nies, M., & McEwen. (2015). Community/ public health nursing. (6th Ed.) St.Louis, Missouri: Elsevier Sisters of Charity Foundation. (2012). Health literacy. join the conversation. Retrieved from the Sisters of Charity Health System website, http://www.sistersofcharityhealth.org/blog/post/2013/01/07/Sisters-of-Charity-Foundation-of-Cleveland-shares- perspective-on-health-literacy-in-a-new-report.aspx U.S. Department of Health and Human Services; National Institutes of Health, National Heart, Lung, and Blood Institute. (2015). Your guide to lowering your blood pressure with DASH (NIH Publication No. 06-5834). Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/dash
