Claude Rochon MSN, RN, CPN Edgewood College American Family Children’s Hospital Masaryk University Faculty of Nursing March 15, 2016 Madison, Wisconsin U.S.A. World 2 Madison 2 2ab I.The Hospital II.The Patient III.The Family IV.The Medical Staff – All Disciplines V.The Nursing Staff VI.The Transfer of Education to the Clinical Area 01_afch ext-3480-81-82_HDR3 TS.jpg us_news_best_childrens_hospital_2015.jpg http://tse1.mm.bing.net/th?&id=OIP.M1449948a3c782a470b40db475e053230o0&w=300&h=200&c=0&pid=1.9&rs=0 &p=0 uUniversity of Wisconsin – Madison u uAmerican Family Children’s Hospital u uWe are rated from number two to number nine of rankings for the most money spent of research and development http://photos.uc.wisc.edu/photos/4386/original/aerial_west_health05_8536.jpg?1286779438 med school_4c_L.png Logo_UWH_AFCH_2c.jpg uInpatient discharges: 4,200 uSurgical procedures: 5,789 uClinic visits: 144,879 uUW pediatric specialists/surgeons: 235 uAverage hospital stay: 5.1 days uCase Mix Index: 1.6 03_Imaging-8665.jpg med school_4c_L.png Logo_UWH_AFCH_2c.jpg uFirst in world with Artis Q.zen imaging equipment. Up to 60 percent less radiation exposure than conventional machines uPrimary uses: uInterventional cardiology uCardiac electrophysiology uInterventional radiology uNeuro-interventional radiology uComplex surgery 12_Imaging-7601.jpg uGraduate from High School 17-18 years old Ø4 year Bachelor Degree Ø4 Year Medical School Ø3-8 Year Residency Ø3-6 Year Fellowship ØAttending Ø Ø uDNP Nurse functions at the same level as a Fellow on most units uGraduate from High School 17-18 years old uAssociate Degree Nurse u2-21/2 years Technical College u4 year Baccalaureate Nursing Degree uMasters of Science – Nursing uEducation uAdministration uDoctor of Nursing Practice uAdministration uPractical uDoctor of Philosophy u u uWhere Does Education Begin? uPlanned Admission uClinical Nurse – Nurse Practitioner / Nurse Clinician uEmergent / Unplanned Admission uEmergency Department uChild Life uNursing Staff in the Pediatric Intensive Care Unit uOpen Policy at the Bedside! uParents Allowed uDischarge Planning Begins Upon Admission u u •Advance Directives •Child Health Advocacy and Safety •Child Life •Flad Family Chapel •Flashes of Hope •Hospital School and School Re-Entry •Interpreter Services •Kids as Partners (KAP) and Teen Advisory Board (TAB) •Kohl's Safety Center •Nutrition and Kids •Oral Health and Dental Care •Parent and Family Advisory Council •Patient Relations •Pediatric Palliative Care •Pet Therapy •Playrooms and Teen Lounges •Positive Image Center •SAFE KIDS Coalition •Social Work Staff •Special Events and Visitors •Spiritual Care Services •Support Groups •Tyler's Place and Sibling Services •Volunteering at the Children's Hospital u uHow do we educate? uWritten Material uVideos uDemonstration uTeach Back uThe effects of stress! uWhen is appropriate to educate in the Pediatric Intensive Care Unit? med school_4c_L.png Logo_UWH_AFCH_2c.jpg 20_Liam-7718.jpg med school_4c_L.png Logo_UWH_AFCH_2c.jpg uNursing Students uMedical Students uFamily uPatient uAge of the Patient uCognitive Ability of the Patient uLaws Protecting the Patient uGreater Than 10 Years old u med school_4c_L.png Logo_UWH_AFCH_2c.jpg 14_MCB Schuetz-8488.jpg med school_4c_L.png Logo_UWH_AFCH_2c.jpg 27_Imaging-7799.jpg uNew medications for a new acute medical diagnosis. uBeata is 2 1/2 years old uDo you teach mother and dad? uDo you teach the siblings uDo you teach Beata? u u3 volunteers – Role Play u uThe Child Life program at American Family Children's Hospital is made up of trained professionals with backgrounds in child development. Certified Child Life Specialists help children, adolescents and families cope with the fear and anxiety associated with the medical environment and hospitalization. The goal of the Child Life program is to promote positive experiences for children and families throughout hospitalization. Play with a Purpose: How Child Life Uses Play uCreate a friendly, familiar environment uTeach about procedures, surgeries, or new diagnosis uDistraction during procedures or times of discomfort uPromote development uAllow children to master their healthcare experience uEncourage peer interactions uSupport emotional and psychosocial needs uProvide opportunities for self-expression uIntroduce medical supplies to encourage learning and reduce fears uInvolve siblings throughout medical experience u http://www.uwhealthkids.org/files/kids/images/childlife/peds_banner_child_life_688.jpg https://youtu.be/Tvhttps://youtu.be/TvTReVA3ZTYTReVA3ZTY uAcute uNurse dedicated to family uOpen policy uChild Life u med school_4c_L.png Logo_UWH_AFCH_2c.jpg uWe are a leader in making patient- and family-centered care a core principle uRooted in the belief that family members know their child best 28_Partnering-5126.jpg med school_4c_L.png Logo_UWH_AFCH_2c.jpg uDaily patient rounds include family members as part of health care team uHas increased patient and family satisfaction uHelps reduce length of stay in hospital uIncreased safety 29_Meinke-3293.jpg med school_4c_L.png Logo_UWH_AFCH_2c.jpg uMutual Respect uCollaboration u uComplexity of the Disease Process uPhysicians uFellows / Nurse Practitioners uResidents uMedical Students uPharmacy uPharmacy Students uNutrition uRespiratory Therapists uOccupational Therapists uPhysical Therapists uSpeech u uWho is Involved In Patient Education uHow do I teach? uLittle Children 2-3 years old uDown on their level! uKeep it simple uPill Case Study uOlder Children uAsk them how much they want to be involved? u uOriginated in our Neonatal Intensive care Unit uPediatric Bone Marrow Transplant Unit uPediatric Hematology / Oncology Unit u uWhat is Teach-back? uA way to make sure you—the health care provider—explained information clearly. It is not a test or quiz of patients. uAsking a patient (or family member) to explain in their own words what they need to know or do, in a caring way. uA way to check for understanding and, if needed, re-explain and check again. uA research-based health literacy intervention that improves patient-provider communication and patient health outcomes1 . u u1. Use a caring tone of voice and attitude. u2. Display comfortable body language and make eye contact. u3. Use plain language. u4. Ask the patient to explain back, using their own words. u5. Use non-shaming, open-ended questions. u6. Avoid asking questions that can be answered with a simple yes or no. u7. Emphasize that the responsibility to explain clearly is on you, the provider. u8. If the patient is not able to teach back correctly, explain again and re-check. u9. Use reader-friendly print materials to support learning. u10. Document use of and patient response to teach-back. u uDiagram uIntensive Care Education uAge of the child uPrevious Understanding of the Disease Process uBedside Nurse uInitiating uRe-enforcement uClinical Nurse Educator u2 to 3 Short Education Sessions uMedical Floor Education uClinical Nurse Educator uClinical Setting https://futiletreatment.files.wordpress.com/2010/12/girlvent2.jpg http://www.yourlawyer.com/blog/wp-content/uploads/2015/06/Tracheostomy-Tubes.jpg uPaper and write everything that you can think of to teach parents and Patient before Discharge. u1). Acknowledgement of the Tracheostomy / Anatomy u2) General Care u3) Suctioning u4) To Go Bag u5) Classroom with Nurse Educator u6) PICU Nurse u7) Support Staff- Family Members 2-4 people other than the parents u8 ) 24 Hour Cares u9) Day Trip u10) Overnight u11) Car Seat Test u12) Equipment http://tse3.mm.bing.net/th?id=OIP.Mf6e19c9aa1092b43fe7388f559c6c033o0&pid=15.1 uSchool Nurse uChild Health Psych uRe-introduction into the classroom. uCPR Training uNose uSpeaking Valve uCuff or Un-cuffed u uNurse – School Reintroduction uMonkey in the Chair uPink Panther Diabetes uNurse Clinical Nurse Specialist http://www.monkeyinmychair.org/images/g_mainFeature.jpg http://wac.450f.edgecastcdn.net/80450F/wjon.com/files/2011/01/Monkey-Kit.jpg http://tse1.mm.bing.net/th?&id=OIP.M1fc5e8d79a55de969cb08a56f8f27a9eo0&w=141&h=169&c=0&pid=1.9&rs=0 &p=0 uNurse Residency Programs uNew Graduate u3 to 6 month Orientation uResidency to last 1 year uOver 1 year in Pediatrics in another hospital uShort orientation period designed to meet the nurse uSpringboard to Pediatrics uHave nursing experience greater than one year in adult population uShadow uClassroom Studies u u uStaged Orientation u1st Stage uOrientation to unit uLearn the dynamics uLearn to communicate with other Disciplines u2nd Stage uStable Patients upairs uSicker Patients usingled u3rd Stage uSickest Patient’s on the Unit uPreceptor in control uResident learns what to expect u4th Stage uReturns to pairs and type of patient first to experience Madison, Wisconsin U.S.A. Logo-Black http://www.uwhealthkids.org/files/kids/images/news/thumb410/img_thumb_AFCH_logo_410.jpg