This post is an excerpt taken from HCPro’s infection control guide, Infection Control: How to Implement an Effective Approach for Long-Term Care, written by subject matter expert Brian Garavaglia, PhD, FACHCA.
Adults bring a lifetime of experience to the learning situation, and most of them are capable of self-direction. They often relate the development of new skills to competencies they learned in their occupational and social roles. Build on those experiences. They provide a useful connection between their past and their present situation. They also communicate respect for the resident, building rapport and more importantly, trust. Successful instruction depends on an accurate assessment of the resident’s needs, an individualized teaching plan, comprehensive teaching strategies, and evaluation.
Assessment is the first step in resident education. Evaluate your residents’ skills and knowledge in important areas. Consider their reading level, ability to learn, ability to understand English, and use specific resources available to them. Use the findings from your assessment to develop a unique plan for the resident. For instance, a resident who is a retired nurse with experience in infection control is already going to have a sound base on which to build on. Conversely, a person with severe cognitive deficit is probably not an individual who will garner much success from education and instruction in this area.
Most adults like to apply new information quickly. They may not get things right the first time, but each mistake provides an opportunity to learn. Give residents the opportunity to take the lead, again reinforcing respect and trust.
Invite family caregivers to be part of your infection control teaching process. At teaching sessions, you can further assess family dynamics. If one of your goals is to promote resident independence, make sure family members understand that their role is to support the resident in this area, and they should not take over tasks that the resident is able to do on their own. Conversely, if your goal is to teach family members infection control practices that they should follow due to a family member having severe immunocompromised status, make sure that they understand it will become their responsibility to provide safeguards to protect themselves against infections and that frequent hand washing is also necessary for them when they interact with their family member even on a casual basis. Moreover, encourage family caregivers to review and frequently reinforce what the resident is learning to assist in providing a well contained infection control environment
It should be remembered that one of the goals of long-term care is to prevent those in nursing care facilities from having any unnecessary or unanticipated declines. Furthermore, residents should attempt to remain as independent as possible. This includes being able to assist and advocate in their care. That being said, there are some individuals who will be able to be more independent in their daily activities than others. They may still meet the required OBRA standards to be a resident in a long-term care environment, but they also want to still be involved in caring for themselves as much as possible. These individuals provide an excellent opportunity toward being amenable to education and teaching in this area. For instance, teaching ostomy care to the resident if they choose to apply what he or she has learned enhances their feelings of self-confidence and independence, and, quite frankly, it helps out the staff as well. However, it must be done correctly and follow proper infection control procedures—a resident who just takes off an ostomy bag and puts on a new one, leaving the old one open and airborne, does nothing to minimize the infection control risk and actually increases it. So if the resident wants to assist in their care, make sure they follow the infection control procedures correctly.
Teaching any individual is a challenge and teaching individuals who may not be in the best of health, and may even have some memory issues, will need considerable follow-up and reinforcement. Your teaching plan will likely require more than one session. The sessions should contain some overlap so the resident can logically connect the steps covered in each session. Conclude each session with a review of the material you have covered and your goal for the next session. Use a summary session to facilitate the process of integration and to allow for evaluation and feedback. Make sure the resident, after being shown the procedure, is able to demonstrate it to you. Always make sure your instruction is concise, clear, and simple. The slightest ambiguity can cause failure in resident education. Do not hesitate to use reminders that are placed in conspicuous areas, such as hand washing posters by the sink that remind the person to always wash their hands thoroughly for at least 20 seconds with soap and warm water.
Tips for teaching elderly residents
Many of your residents will be over the age of 65. Residents of this age group will need a slightly different approach to meet their learning needs effectively. In fact, Malcolm Knowles (1984) developed the theory of andragogy, as opposed to more pedagogical youth-based learning approaches. According to Knowles, adult individuals learn best when things are practical and relevant to their needs in life. Therefore, teaching and educating adult residents should be based on this premise. Consider the following tips for teaching residents:
- Maintain a positive attitude. Treat the older adult as intelligent and capable of learning.
- Take a few minutes to talk and problem solve before starting to teach. Ask the resident about his or her experience in a given area. Find out what has worked or what hasn’t worked in the past.
- Identify significant cultural or social factors that may affect the teaching and learning process.
- Include the resident in setting learning goals. Keep the material relevant to the learner’s needs.
- Identify and try to accommodate any disability that may affect the learning process. For example, for residents with visual impairment, encourage the use of glasses (if appropriate) and investigate special learning tools, such as large-print material.
- Slow the pace of instruction and gear teaching to the resident’s rate of absorption. Stop teaching if the resident appears tired or stressed.
- Break each topic into small parts. Repeat sessions when necessary. Give pertinent, positive feedback.
- Ask the resident to talk through the procedure before trying it. Provide opportunities for practice sessions and repeat demonstrations. Avoid tests or challenges—these are residents, not students. You are attempting to make sure they understand important principles of infection control to help them. You are not attempting to make them into an infection control expert.
- Assess responses carefully to make sure the information was understood correctly. Gear the frequency and duration of your teaching to match your resident’s learning ability and need to know.
- As previously stated, add cues or reminders within the environment to help remind them about important infection control practices, such as hand washing posters above the sink.