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Teach-Back Effects on Self-Reported Understanding of Health

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by

Kalise Price

on 16 June 2014

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Transcript of Teach-Back Effects on Self-Reported Understanding of Health

Teach-Back Effects on Self-Reported Understanding of Health & Medication Management after Discharge

by

Kalise Price DNP, RNC, CBE
Laurie Silva DNP, RN, CNE
Mentor:
Shelly Mcfarland MSN, RN

Teach-Back Project

Teach-Back
Effects & Outcome

Relevance to Practice
Standardize RN education process
leading to commitment and culture change

An increase in patients’ self-reported understanding
may increase patient satisfaction, wellness,
illness prevention or management, and
organization’s value-based purchasing
and decrease readmission's and mortality


Problem Statement
Greater than 50% of patients'
self-report a lack of understanding of
how to manage their health
and medication after discharge

Contributing Factors
RN Education Process:
Lecture, discussion, written information, & demonstration

Patient Health Literacy:
Nine of 10 adults lack proficient health literacy skills
required to manage their health; 36% of the nation’s population have a decrease in ability to read, listen,
analyze, make decisions, and apply health
information (National Network of Libraries
of Medicine [NNLM], 2012).
Determine whether the registered nurse
use of the Teach-Back method increased patients' understanding of how to
manage their health and medication after discharge
Project Objectives
Process Objectives:
Educate, train, simulate, reinforce, and
mentor/coach the RN use of the Teach-Back method

Intermediate Outcome Objectives:
The inpatient RN will participate in Teach-Back
validation, reinforcement, and mentoring/coaching

Final Outcome Objective:
10% increase in patients'
self-reported understanding

Project Question
Implications for
Social Change
High quality, safe, and cost effective care focused
prevention and illness management

The Affordable Care Act (ACA) of 2010 focuses on shifting health care from the medical model to a more holistic transitional model (Brock & Boutwell, 2012).

Organizations, such as the Center for Medicare and Medicaid Services (CMS), are unable to financially support the
increased cost of health services constructed around
hospital care (Brock & Boutwell, 2012).
Assumptions

Inpatient registered nurse use of the
Teach-Back method.

Relationship between the inpatient registered
nurse use of the Teach-Back method and
patients’ self-reported understanding
of how to manage their health and
medication after discharge.
References
Brock, J., & Boutwell, A. E. (2012). How Did We Make Transitions Such a Big Deal?. Generations, 36(4), 35-43. http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=8&sid=3aff8760-1f88-47f5-b936-406ad74bfb0b%40sessionmgr113&hid=118
National Network of Libraries of Medicine (2012). Health literacy. Retrieved from http://nnlm.gov/outreach/consumer/hlthlit.html

Advocacy
Caring
Compassion
Compassion
Integrity
Respect
Accountability
Commitment
Patient
Health
Literacy
Registered Nurse
Education Process
Purpose Statement
Will acute-care patients experiencing the
Teach-Back method,compared to a retrospective
sample not experiencing the Teach-Back method,
have an increase in self-reported understanding of
how to manage their health after discharge?


Teach-Back
Purpose, Objectives, & Questions

Quantitative Design
Descriptive Statistics
Inferential Statistics
Population: Acute-care
adult patients
Sample & Instrument:
Minimum sample of 100 HCAHPS surveys
Institution review board (IRB)
approval
Patient-centered
Bridge gaps
High-quality care
Safety
Cost-effective
VBP
Limitations
Patient experience identified on HCAHPS Survey
AIDET, hourly rounding, bedside shift report, care transition coaches, & management rounding
Inpatient registered nurse sustainability
Health care environment
Demographics

Recommendations
Mandatory reinforcement, mentoring, coaching, & auditing
Partnerships
Face-to-face client interviews
Analyze November through January

Project Hypothesis
Nature of the Project
High-quality, safe, and
cost-effective care


Mann Whitney U sum of ranks demonstrated an upward
trend and no significant difference at the .05 level. However,
during implementation, an upward assessment trend of 5.4%
favorable towards bridging communication gaps in
self-reporting satisfaction for HCAHPS Question 25
HCAHPS question 24
Before & After Teach-Back
Strengths
Early teach-back implementation
Leadership & management support
Increased HCAHPS awareness
Increased patient satisfaction
Inpatient registered nurse simulation participation
Implementation of teach-back in ADN program
A sincere thank you to Walden University and St. Luke's Magic Valley for your support and guidance throughout out DNP project.

A special thank you to Shelly Mcfarland for her knowledge, leadership, unwavering support, and commitment to excellence as our DNP mentor, colleague, and friend.
Thank You
Questions?
Will discharged clients from the acute-care hospital that had
teach-back (August 2, 2013 through October 31, 2013)
compared to a retrospective sample of clients without the
teach-back (February 1, 2013 through April 30, 2013) achieve at least a 10% increase in self-reported
satisfaction on the HCAHPS Expanded III Survey score for
Question 25: Reporting a clear understanding of the purpose
for taking each medication.
Project Hypothesis
Intermediate Outcome Objectives
82% validated
32.5% reinforced,
15.6% mentored/coached
Process Objective
12.2% educated
56.7% trained
78.5% simulated
Teach-Back Begins
Teach-Back on the Go
Mann Whitney U test
Sum of Ranks
Significance
Go RN's
Dr. Kalise Price
Dr. Laurie Silva
Full transcript