Implementing A Standardized Patient Teach-back Discharge Education Protocol For Nurses On A Hospital Telemetry Unit
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2023
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University of Hawaii at Manoa
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Problem Statement: Does implementation of a standardized patient teach-back discharge education protocol for nurses on a hospital telemetry unit improve unit HCAHPS scores, compared to current practice, over a 6-month period? Purpose: This DNP project aims to improve the discharge education practice by incorporating the teach-back method, shared-decision making, and clear communication skills to improve care transitions. Methods: An educational presentation was designed to provide nursing staff with knowledge and skills to apply the teach-back method, shared-decision making, and clear communication skills to improve patient health literacy and care transitions. A conviction and confidence survey was administered before implementation, two months post-implementation, and six months post-implementation to measure usability and knowledge of the interventions. HCAHPS scores were obtained on a quarterly basis from the unit’s nursing manager. Results: There was a 43% reduction between care transition scores at pre-implementation and the 6-month post-implementation. However, discharge information scores were able to reach and maintain above the 90th percentile. Results from the pre-implementation and the final post-implementation conviction and confidence surveys showed an overall increase in all aspects, including knowledge, confidence, and frequency of usage of share-decision making and the teach-back method. Discussion: Although the literature review suggests otherwise, the teach-back method, shared-decision making, and clear communication strategies did not improve care transition scores throughout this project. However, the success of the project could be seen in the increased scores of the HCAHPS discharge information category. Discharge information and care transition work in unison with each other. Future research should account for this project's limitations, including changes in HCAHPS processing companies and potential nonresponse bias.
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