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Can you please help me write a reply (with a reference) to this discussion post? Module X “Find an article on patient education related to a common issue in your current clinical practice area (e.g. school nurse, home care, ED, PACU). If you were an APN, how would you use the guidance and coaching competency to enhance patient education for an individual or a group?” As a telemetry float nurse, I am often caring for patients have an array of illnesses including heat failure (HF). A pattern I have noticed, is that there are many patients that are readmitted for heart failure. “Patients with HF often have complex treatment regimens and multiple comorbid conditions, making adherence difficult” (Mills et al., 2019). In 2012, Medicare showed that 67.4 % of heart failure patients experienced readmission (Macchio et al., 2020). With this, it is important to educate the patient to be able to reduce the readmission rate and provide better patient outcomes. Guidance is the “provision of help, instruction, or assistance” (Hamric et al., 2018). To be able to appropriately guide the patient, there needs to be a knowledge baseline establish by asking what they already know about the topic (Hamric et al., 2018). In this case the APN would ask the patient “Tell me what you know about Heart Failure”. By doing this in the pre-guidance stage, “the APRN guidance [will be] more powerful and effective” (Hamric et al., 2018). With this, anticipatory guidance can also be important for those with HF due to the importance of knowing how everyday life would need to be adjusted to be able to prevent hospitalization with it. For example, providing anticipatory guidance on taking medications as prescribed is important to prevent HF symptoms from occurring. Educating the patient on the importance of taking furosemide (Lasix) as prescribed or there will be an imbalance of fluid in the body causing swelling or shortness of breathe. In a recent study, providing patient education of the complex medication regimen that HF patients need to follow allowed for a decrease in re-admission rates as well as improving patient outcomes (Mills et al., 2019). Coaching is “a broad term that encompasses different approaches, philosophies, techniques, and disciplines”(Hamric et al., 2018). When living with a chronic illness, it can be easy to be derailed or feeling defeated. Through coaching the client through navigating their chronic illness such as HF, it can have them be held accountable, encourage self-discovery ,and elicit client-generated solutions and strategies (Hamric et al., 2018). Coaching builds on strengths, allows for the patient to lead or set the agenda, and gives the patient autonomy to guide their needs. This can be important for HF education, because there is an ability to allow for the patient to feel powerful in engaging in their plan of care rather then being told on what to do. With being able to give the patient the power to guide the care, there can be a more trusting relationship which can allow for more vulnerable questions to be asked and more honesty to be provided. Overall, when providing education to patients there should ideally be a combination of coaching and guidance, but it also relies on how much time is allotted. It is interesting to see how both can provide different outcomes for the patient in education. It is also interesting to explore how it can be applied to my current practice in my current clincal practice area.

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