The feasibility of using teach-back to reinforce discharge instructions and its influence on the number of 30-day readmissions of heart failure patients

Autor: Karen M. Mack, Mary-Michael Brown, Cathie E. Guzzetta, Eshetu Tefera
Rok vydání: 2014
Předmět:
Zdroj: Heart & Lung. 43:379
ISSN: 0147-9563
DOI: 10.1016/j.hrtlng.2014.06.004
Popis: Purpose: 1. To assess the feasibility of having 4 clinical care nurse facilitators (CCNFs) on two inpatient cardiology units use teachback to reinforce heart failure discharge instructions provided by bedside nurses; 2. Compare the number of 30-day readmissions of those heart failure patients who received teach-back versus those who received the usual standard of care. Background: Early readmissions following inpatient treatment for heart failure may be the result of inadequately preparing patients for their transition from hospital to home. Teach-back (asking patients to repeat in their ownwords the instructions provided by clinicians) and teach-to-goal (patients accurately state the instructions offered during the teaching session) are a means to assess and improve patient comprehension of discharge instructions, which may avert these early, preventable rehospitalizations. Methods: A convenience sample of heart failure inpatients receiving care on a general cardiology or advanced heart failure unit in a 926-bed quaternary care center was invited to participate in the study. After informed consent was obtained, participants were randomly assigned to receive usual care or usual care plus teachback on 4 key discharge instruction topics (name of diuretic, 3 foods to avoid, reportableweight gain, and 3 reportable signs/symptoms of a worsening condition). Feasibility was measured by comparing the duration of the educational sessions between the two groups, the CCNFs subjective rating of the educational session, and if the intervention group patients reached teach-to-goal using no more than 3 teach-backs per key discharge instruction topic. Participants’ 30-day, all-cause readmissions to the study institution were measured. Results: Forty-one patients consented to participate; 29 completed the study– 17 patients in the intervention group (59%) and 12 (41%) in the comparison group. The mean age of participants was 55.7 years old (SD+/-13.1) and 51.7 % were male (N1⁄415). The majority of participants was Black (80%, N1⁄423). Patient characteristics were comparable among groups although alcohol use was more prominent in the intervention group (P1⁄40.03). The mean duration of educational sessions in the intervention group (19.1 minutes, SD +/9.9) was two minutes shorter than the comparison group (21.6 minutes, SD +/8.2) (P1⁄40.36). Using a 0-10 scale, the CCNFs rated the educational sessions high in both groups: intervention group1⁄48.1 (SD+/-1.4); comparison group1⁄48.3 (SD+/-0.9). All intervention group participants reached teach-to-goal in all categories using no more than three teach-backs. Six (21%) of 29 participants were readmitted within 30 days to the study hospital: 2 intervention group patients and 4 comparison group patients (P1⁄40.14).
Databáze: OpenAIRE
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