Nursing students use of teach-back to improve patients' knowledge and satisfaction: A quality improvement project

Background: Nurses provide education on medications to hospitalized patients and this intervention is measured by patient's satisfaction on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey [HCAHPS] (Center for Medicare & Medicaid Services[CMS], 2008).

Purpose: Nursing students implement the teach-back method in a quality improvement project to improve patients' knowledge of medications and satisfaction on the HCAHPS survey. Specific aim 1: increase nursing students use of teach-back from the current state of 0% to 80% of their patient encounters; Specific aim 2: ensure that 80% of the patients approached can state the name, purpose and side effects of their current medications; Specific aim 3: have 80% of the patients satisfied with their medication teaching.

Methods: The Model for Improvement framework from the Institute for Healthcare Improvement was used (Ogrinc et al., 2012). Process and outcome measures and Plan-Do-Study-Act cycles were analyzed.

Results: Senior nursing students used teach back on 82.9%% of their patient encounters. Of the N = 55 patients who received the intervention, 58.2% could state the name and purpose, and 50.9% knew the side effects of their medications. HCAHPS survey responses did not achieve the benchmarks of 77.2% and 52.3% for "always" responses for medication education questions. However, patient satisfaction was measured at 96.4% with the One Minute Evaluation (Appendix A) by nursing students following the intervention.

Conclusion: Integrating QI into the clinical environment is a method to not only increase patient outcomes but also exposes students to the methods of QI. Although the intervention did not meet the benchmark for patient satisfaction in "Communication about Medicines" category as measured by HCAHPS survey results, the teach-back method was an effective evidence-based tool for improving patient knowledge of medications.