Position Statement

Role of the Professional Nurse Regarding Patient Education

The intent of this position statement is to identify the contributions, role and responsibilities registered professional nurses (RNs) hold as providers of patient education.

Position

It is the position of the New York State Nurses Association that:

Patient education is within the scope of RN practice (Nurse Practice Act, Education Law, Article 139).
Patient education is a fundamental standard of nursing practice.
RN patient care assignments must be created to afford the time necessary to assess, plan, implement and evaluate patient education.
Patient education must include respect for the patients’ and families’ goals and choices regarding care.
RNs provide health promotion and health teaching via methods appropriate to a patient’s developmental level, learning needs, readiness, ability to learn, language preference, culture, and situation.
RNs can improve patient’s physical and mental health, improve their quality of life, decrease personal and environmental risk factors, and prevent disease, illness and disability through patient education (ANA, Scope and Standards of Practice, 2004).

Background

Patient education is an essential nursing practice standard that meaningfully impacts a patient’s health and quality of life. According to Bastable (2006) the, “…education process is a systematic, sequential, logical, planned course of action consisting of two major interdependent operations, teaching and learning” (p. 9). Education Law, Article 139, Nursing, authorizes an RN to provide patient education due to the following definition:

The practice of the profession of nursing as a registered professional Nurse is defined as diagnosing and treating human response to actual or potential health problems through such services as case finding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being (§ 6902).

Regulatory bodies and respected organizations recognize patient education as an important standard of care. The American Nurses Credentialing Center’s Magnet Recognition Program Manual (2005) includes a separate and distinct section describing the role of RNs related to education, titled, Force 11: Nurses as Teachers. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that,

The leaders plan for and support the provision and coordination of patient education activities. The patient receives education and training specific to the patient’s needs and as appropriate to the care, treatment and services provided….The patient receives education and training specific to the patient’s abilities as appropriate to the care, treatment, and services provided (LD-16, PC-21, 2005).

Patient education is a vital component of the nurse-to-patient relationship that requires time and attention. Research conducted by the Agency for Healthcare Research and Quality (AHRQ) has identified a number of factors that lead to medical errors; one being the lack of appropriate patient education (2004). Registered nurses provide the majority of patient education in healthcare settings. With that said, in order to provide comprehensive education RNs need staffing conditions that allow them to meet the needs of each and every patient they encounter. Patient care assignments should be formulated with the educational needs of patients in sight.

The education process has been compared to the nursing process as the steps of each process run parallel to one another. To provide thorough and appropriate education, each patient requires an ongoing teaching plan utilizing the education/nursing process. According to Bastable (2006), this process consists of the following steps:

Assessment: Involves the collection, organization and analysis of information/data about the patient. Through assessment, the nurse is able to ascertain knowledge level, desire/motivation as well as the ability to learn.
Plan: Determination of patient and nursing goals. Develop an individualized teaching plan with patient-centered objectives and goals.
Implementation: Carry out the teaching plan using instructional methods and tools.
Evaluation: Determine if the goals were achieved. Review behavior changes (outcomes) related to knowledge, attitudes and skills.

Education is used to empower the patient and is an important aspect of quality improvement given that it has been associated with improved health outcomes. A registered nurses’ role as a teacher, places them in a unique position. Consumers trust RNs to be their advocate and rely on them to assist in achieving optimal health and self-care independence.

Recommendations

The New York State Nurses Association recommends that:

RNs and employers recognize the positive impact of patient education.
Employers plan and support registered nurses providing patient education activities through measures such as:
- written tools
- audiovisual resources, and
- patient care assignments that enable RNs to incorporate education into the plan of care.
RNs utilize the nursing process in order to create and coordinate teaching plans.

Note: The use of the term “patient” anywhere in this document is intended to be generic and refers to the recipient of nursing care.

Approved by the NYSNA Board of Directors, 4/21-22/83, 9/17/87 and 06/08/06.

This position statement was developed under the direction of NYSNA's Council on Nursing Practice. Approved by NYSNAs Expanded Council on Nursing Practice on June 2, 2006.

References

Agency for Healthcare Research and Quality. (2003). AHRQ's Patient Safety Initiative: Building Foundations, Reducing Risk. Interim Report to the Senate Committee on Appropriations. AHRQ Publication No. 04-RG005, Rockville, MD: Author. Retrieved May 8, 2006, from http://www.ahrq.gov/qual/pscongrpt/

American Nurses Association. (2004). Nursing: scope and standards of practice. Silver Spring,
MD: Author.

American Nurses Credentialing Center. (2005). The magnet recognition program. Recognizing excellence in nursing service. Application manual. Silver Spring, MD: Author.

Bastable, S. B. (2006). Essentials of patient education. Sudbury, MA: Jones and Bartlett Publishers.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (2006). Comprehensive accreditation manual for hospitals: the official handbook. Oakbrook Terrace, IL: Joint Commission Resources, Inc.

Nurse Practice Act. Education Law, Article 139, Nursing, Section 6902: Definition of practice of nursing. Binghamton, NY: Gould Publications

For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.