Improving Nurse Communication of Medication Side Effects Through the Teach Back Method
By: Katlyn Carpino, Lillian Finch, Michaela Johnson, Katrina Richardson, Allison Smilek, and Samantha Smith
Abstract
Description of the issue: Memorial Regional Medical Center’s Progressive
Care Unit (PCU), has tried proposing a multitude of ways to have effective
communication between nurses and patients with understanding of their
medication side effects. The unit had a 15% increase in 2022 between Q2
and Q3 with staff communicating about medication side effects, then had a
13% drop in 2022 between Q3 and Q4. Our goal is to propose a solution
using the teach back method effectively to increase patients understanding
of their medication side effects and increase the HCAHPS score by Q2 in
2024.
Data Analysis: Data was collected through interviews during day shift with
nurses, the unit manager, and patients on the progressive care unit at
Memorial Regional Medical Center.
Purpose: The purpose is to improve patient understanding of medication
side effects and improve HCAHPS scores in the domain of “communications
about medicines.”
Root cause: Nurses not utilizing the teach-back method is the root cause of
deficient patient knowledge of medication side effects.
Proposed Solution: Implementing a workday module that educates nurses
on the proper use of the teach back method.
Conclusion: Reviewing and implementing the existing Workday module, will
help educate nurses on utilizing the teach back method and increase patient
understanding about their medication side effects.
Introduction and Description of the
Issue
Macro Description: Medication education is vital for patients.
During hospitalizations and care transitions, medication
education provided by the nurses is limited resulting in
decreased patient outcomes. Research shows that proper
medication education decreases admission rates by improving
patient knowledge and understanding regarding their
medications. To include educating patients on earlier warning
signs that can lead to adverse reactions (Prochnow, Meiers,
Scheckel, 2019). Ultimately, in previous studies the teach back
method showed improved HCAHPS scores (Prochnow, Meiers,
Scheckel, 2019).
Micro Description: The Progressive Care Unit (PCU) at Memorial
Regional Medical Center has had a decrease in the scores of the
HCAHPS questions regarding communication about medications
and staff describing side effects decreased between Q2 and Q3.
Bon Secours Memorial College of Nursing
Data and Analysis of the Issue
Based on interviews and surveys with dayshift nurses and nurse
leader at MRMC Progressive Care Unit in January 2023:
- In 2022 Q2 HCAHPS score was 35% regarding
communication about medication side effects.
- Education side effects are not being communicated
to patients.
- Four out of ten nurses expressed they were rushed
in explaining side effects.
- Only two out of ten nurses utilized teach back
method.
Research data has shown:
- Teach back method has proven to be an effective
method in increasing medication side effect
understanding.
- Teach back method strengthened safe nursing
practices and enhanced the quality in new
medication education (Prochnow, Meiers, Scheckel,
2019).
- After the use of teach back method, 97% of
patients remembered the medications side effects
and purpose (Prochnow, Meiers, Scheckel, 2019).
Root Cause
Nurses not utilizing the teach-back method
effectively negatively affects patient education
of medication side effects and is the root cause
for patients deficient knowledge at MRMC.
Hypothesis: By implementing the teach-back
method on the PCU while administering
medication patient understanding of medication
side effects will improve as evidenced by
HCAHPS question of communication about
medications and staff describing side effects.
Proposed
AIM Solution
- Proposed Solution Conclusion
There is currently no education being provided to nurses at
Aim Statement: We aim to improve the HCAHPS
MRMC about utilizing the teach back method to improve patient
question of communication about medication scores by
education regarding medication side effects. The
15% in Q2, 2024 in the domain of improving nursing
implementation of a Workday education program that focuses
communication of medication side effects on the PCU at on how nurses can utilize the teach back method will improve
MRMC. patient understanding about their medications and the potential
side effects.
Proposed Solution: Implementing a workday module
Nickels (2020) identified implementing the evidence based
that educates nurses on the proper use of the teach back
practice of the teach back method into patient care improved
method in order to improve patients understanding on
HCAHPS scores in the domain of “communications about
their specific medication side effects. medicines.”
Prochnow (2019) found in a QI project that patients were not
Logistics: being properly educated on medication side effects, leading to
Review existing workday module for all nursing staff to provide
education about the teach-back method. misuse and increased side effect reactions.The QI project
implemented the use of an education training session for nurses
Gain approval for the existing Workday teach back method that taught how to use the teach back method during patient
module, assign the module in workday, and educate staff.
care. The results showed 97% of patients remembered the
medication side effects after the teach back method was
utilized.
Stakeholders:
Nursing Staff, Patients, and Nursing Administration
References
Nickles, D., Dolansky, M., Marek, J., & Burke, K. (2020). Nursing
students use of teach-back to improve patients'
Potential Costs:
knowledge and satisfaction: A quality improvement
Paid time to educate staff members.
project. Journal of professional nursing : official journal
Time: 30 min per nurse to take the course. Roughly
of the American Association of Colleges of Nursing,
15 min to implement per patient.
36(2), 70–76.
Prochnow, J. A., Meiers, S. J., & Scheckel, M. (2019).
Improving Patient and Caregiver New Medication
Timeline: Education Using an Innovative Teach-back Toolkit.
Existing Workday module reviewed and proposed
by Q3 of 2023. Journal of nursing care quality, 34(2), 101–106.
Staff education provided 14 days prior to Q4 of 2023. https://doi.org/10.1097/NCQ.0000000000000342
Reassessment of data understanding completed by Q1 of 2024
Data Collection:
Review HCAHPS questions related to nurse
communication and medication side effects
results by Q2 of 2024 to evaluate the level of
performance achieved