Nursing diagnosis – READINESS FOR ENHANCED KNOWLEDGE

READINESS  FOR  ENHANCED  KNOWLEDGE

DEFINITION

The presence or acquisition of cognitive information related to a

specific topic that is sufficient for meeting health-related goals and

can be strengthened

DEFINING CHARACTERISTICS

• Expresses an interest in

• Behaves congruent with

learning

expressed knowledge

• Explains knowledge of

• Describes previous experience

topic

related to other topics

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Risk management

• Knowledge

• Values and beliefs

EXPECTED OUTCOMES

The patient will

• Identify new sources for enhancing knowledge in the topic of

interest.

• Make use of all relevant resources to enhance knowledge.

• Ask questions where new information needs clarification.

• Begin practicing new behaviors gleaned from enhanced knowledge.

SUGGESTED NOC OUTCOMES

Knowledge: Health Promotion

INTERVENTIONS AND RATIONALES

Determine:  Assess current health status; problems, restrictions, limita-

tions; personal habits, such as the use of tobacco, drugs, alcohol con-

sumption, level of knowledge about disease process; communication

skills (verbal and written), degree of motivation to maintain health;

familiarity with technology as a source of learning. Assessment infor-

mation will help identify appropriate interventions.

Perform:  Plan a health maintenance program for the patient and

family members addressing current problems. Developing a plan

with the family will increase the probability of compliance by giving

them information to review each day. Provide the family and patient

with a written copy. A written copy can be posted in the patient’s

home where it is always available for review.

Inform:  Provide books and videos that will help the patient’s quest

for enhanced knowledge. Supplying some materials directly may be

a motivation for the patient to search further.

Direct patient and family to use other sources such as libraries,

the Internet, or professional organizations. An independent search

results in the patient developing confidence in his or her ability to

go much deeper into the area of interest.

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Attend: Encourage patient and family to verbalize feelings and con-

cerns related to the knowledge and skills that patient needs. This

promotes greater ease in managing challenging situations.

Demonstrate willingness to repeat instruction and demonstrations

of skills needed by the patient. Repetition will reinforce learning and

give the patient added confidence in his or her ability to comply.

Be available to answer questions and correct misconceptions for

the patient/family to enhance the effectiveness of learning.

Introduce the patient and/or family to individuals who may have

had experience with the health problems in question if that is advis-

able. In many cases, having the opportunity to talk to another per-

son that has coped well with the same problem will provide support

and encouragement to the patient.

Manage:  Refer to social worker/case manager early in the patient’s

hospitalization. This person will begin identifying the types of sup-

port and resources the family and patient will need to prepare for

follow on care.

Refer to social and community resources, such a stroke support

group, and Alzheimer’s family support group, American Cancer

Society. The patient can contact these sources for additional

information as needed.

SUGGESTED NIC INTERVENTIONS

Discharge Planning; Individual; Learning Enhancement; Learning

Facilitation; Referral; Teaching

Reference

Eldh, A. C., et al. (2006, September). Conditions for patient participation and

non-participation in health care. Nursing Ethics, 13(5), 503–514.

Nursing diagnosis – DEFICIENT KNOWLEDGE

DEFICIENT  KNOWLEDGE  (SPECIFY)

DEFINITION

Absence or deficiency of cognitive information related to a specific

topic

DEFINING CHARACTERISTICS

• Inability to follow through with directions

• Inability to perform well on a test

• Inappropriate or exaggerated behaviors (hysteria, hostility,

agitation, apathy)

• Verbalization of the problem

RELATED FACTORS

• Cognitive limitation

• Lack of recall

• Information misinterpretation

• Unfamiliarity with information

• Lack of exposure

resources

• Lack of interest in learning

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Activity

• Nutrition

• Communication

• Sleep

• Coping

• Values/beliefs

• Knowledge

EXPECTED OUTCOMES

The patient will

• Communicate desire to understand disease state and need for

treatment.

• Demonstrate ability to perform new health-related procedures.

• Set realistic learning goals within target dates.

• State intention to make needed modifications in lifestyle.

SUGGESTED NOC OUTCOMES

Cognition; Concentration; Information Processing; Knowledge: Dis-

ease Process; Knowledge; Health Behaviors; Knowledge: Health

Resources; Knowledge: Illness Care; Stress Level

INTERVENTIONS AND RATIONALES

Determine: Determine level of knowledge and skills patient already

possesses about his or her health status; motivation to understand

what is needed to improve health status; obstacles to learning; sup-

port systems; usual coping patterns; beliefs about health and treat-

ment of disease; ethnicity; financial resources. Assessment informa-

tion will assist in identifying appropriate interventions.

Perform: Establish an environment of mutual trust and respect to

enhance learning. Consistency between action and words, combined

with the patient’s self-awareness ability to share this awareness with

others, and receptiveness to new experiences form the basis of a

trusting relationship.

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Develop with patient specific learning goals with target dates.

Involving patient in planning meaningful goals encourages

compliance.

Select teaching strategies that will enhance teaching/learning effec-

tiveness, such as discussion, demonstration, role-playing, and visual

materials. Provide all the equipment needed for the patient to learn.

This reduces frustration, aids learning, and minimizes dependence by

promoting self-care.

Inform: Teach those skills that the patient must incorporate into

daily living. Have patient do return demonstration of each skill to

aid in gaining confidence.

When teaching, go slowly and repeat frequently. Offer small

amounts of information and present it in various ways. By building

cognition, patient will be better able to complete self-care measures.

Include family members.
Demonstrate to family members how each self-care measure is

broken down into simple tasks to enhance patient’s success and fos-

ter a sense of control.

Attend: Encourage family members to participate in and have

patience toward learning process (patient may need to repeat new

skills multiple times) to help create a therapeutic environment after

discharge.

Manage: Have patient incorporate learned skills into care while still

in the hospital. This allows practice and time for feedback.

Provide patient and/or family with names and telephone numbers

of resource people or community agencies so that care is continuous

and follow-up is possible after discharge.

If financial hardship interferes with the ability of the family to

provide equipment and supplies, offer a referral to a social worker

to improve the family’s access to financial assistance.

SUGGESTED NIC INTERVENTIONS

Behavior Management; Behavior Modification; Decision-Making

Support; Energy Management; Family Support; Financial Resource

Assistance; Health Education; Healthcare Information Exchange:

Risk Identification; Learning Facilitation; Support System Enhance-

ment; Teaching Procedure/Treatment

Reference

Shen, Q., et al. (2006, May–June). Evaluation of a medication education pro-

gram for elderly hospitalized inpatients. Geriatric Nursing, 27(3), 184–192.