1. nurse must provide up to date info on drugs prescribed and prepare for self-admin; pt must be motivated to learn –
2. MOTIVATE by explaining purpose of drug, how helps, make simple and attainable goals, be accepting and positive, make sure physically comfortable.  Also encourage participation, AUTONOMY IMPORTANT, and will lead to better compliance. 
3. Make sure not in pain or anxious.  
4. Can also put in patients learning style (visual, auditory, etc). Important to know own bias of learning style so are not using only that style.

1. COGNITIVE DOMAIN – intellect thought, recall, inferring, etc.  Processing of information, asks questions and makes decisions

2. AFFECTIVE DOMAIN – feelings, beliefs, opinions; develop a therapeutic relationship based on trust, will be more compliant.  Teat respectfully and allow expression

3. PSYCHOMOTOR DOMAIN – learning physical skills like injecting insulin or tasks like chanig a dressing.  Teach step by step and allow hand on practice

• Most taken with water (capsules/tablets) unless directed otherwise
• Don’t chew unless labeled as such b/c some have special coatings with a purpose such as to not irritate stomach lining
• Don’e alter dose
• Don’t stop unless directed
• If no sx relief, call pcp for new dose or drug
• If forget a dose, do not double unless advised to
• Know all the drugs that the pt is taking including OTC
• Pt should keep a drug list in wallet or purse
• Check scripts when filling for size, color, shapr
• MedicAlert bracelet good if taking durgs for long time esp anticoagulants, steroids, oral hypoglycemics, etc
• Know common adverse ractions (side effects)
• Must reports drug allergies
• Don’t give drugs to friends or family
• Good to tell family what taking
• Drug must be kept in container in which it was dispensed or purchased.
• Do not remove original label when used to hold drug
• Do not mix drugs in one container b/c may chemically affect eachother and can lead to mistakes
• Out of reach of childrena pets
• Do not expose to excessive sun, cold heat or moisture
• Don’t save for later use unless advised

Preparing patient and family for drug admin in home:

• Provide written instructions, understandable
• Develop a schedule
• Use calendar
• If trouble with names, refer to by color, etc or number bottles and refer to by number
• Drug organizers
• Keep away from kids/pets
• Keep all supplies for insuling delivery together
• Use approved sharps container
• Dispose of meds properly and do not flush

Adult learning:

·        Adults tend to learn only what feel they need or are motivated to learn. 

·        Most adults are visual learners 83% vs 11% just listening

·        Most adults retain info if they are taught to do something immediately; e.g. show how to admin insulin and let adult do it

·        Adults learn best by applying concepts directly

Nursing Process as a framework for patient teaching regarding drug administration:

I.                    Assessment - Determine needs of patient and family;

a.       Information about drug - What is being taught?; applying an ointment vs delivering insulin; how involved is the teaching sessions; are there materials to give patient/family

b.      Ability of pt/fam to learn and use information – cognitive, affective and psychomotor domains – dementia, anxiety, etc

c.       Barriers to learning -- literacy, language barriers, ability to communicate, learning disability? Cognitive disabilities, visual impairment

II.                 Nursing Diagnosis (Analysis)

a.       Analyze info from assessment to determine if

                                                               i.      Effectieve Therapeutic Regimen Management

                                                             ii.      Ineffective Therapeutic Regimen Mgmt – e.g. might be polypharmic and hard to keep track

1.      This is also the Dx used when discharging a patient since the pt will need further instructions as meds have been managed on their behalf by staff

                                                            iii.      Deficient Knowledge – may have cog disability, or not the psychomotor skills for administering properly

III.               Planning – develop teaching plan including what to teach – ID goals and expected outcomes. 

a.       Examples of teaching points are above.

b.      Make plan individualized according to drug prescribed, learning styles/needs/ability, e.g. foreign language provide in clts language

c.       Select relevant information – to specific drug, to level of understanding, avoid med terminology unless explained

d.      Goal = pt learns how to take drugs correctly

IV.              Implementation

a.       Teach pt

                                                               i.      Appropriate time (no visitors, not in pain, etc)

                                                             ii.      Start teaching immediately upon admissions and continues until discharge

V.                 Evaluation

a.       See if the patient learned the teaching. E.g if learning insuling admin, then have clt do it

b.      Ask patient to repeat any of the teaching points