Class of 2013 Abstract / Specific Aims: The aim of this study was to compare memory retention between two methods (the teach-back method and the standard method) of educating subjects about mock prescription medications during a simulated counseling session. Methods: Men and women ages 18 to 89 years located on the University of Arizona main campus were recruited to participate. Blinded subjects were randomly placed into either the teach-back method or standard counseling method group. The standard method involved telling the subject eight counseling points about two separate fictitious medications while the subject handled mock prescription bottles. The teach-back method added to the standard method by asking three open-ended questions to recall what was taught and correct any misunderstandings. Memory retention was assessed within 5 minutes by a blinded investigator who asked 6 questions concerning the first hypothetical drug. The total score of correct answers between subjects in the two groups were compared using the Mann-Whitney U test. Also, demographic characteristics (age, sex, education, current prescription use) were compared. Main Results: A total of 62 subjects were enrolled in the study. Subjects in the teach-back method remembered one more counseling point on average compared to those in the standard method (median 6 vs 5, mode 6 vs 5, teach-back and standard respectively; Mann-Whitney U test: Z= -3.08, p=0.0021). Conclusion: The teach-back method is a quick and easy counseling method health care providers can use in their daily practice to improve memory retention by patients who receive new medications.

Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the Always Use Teach-Back Toolkit for education and evaluation provided strategies and resources for the project. Five nurse practitioners and a physician assistant, who are responsible for discharge instructions, participated in the study by viewing an online teaching module and completing written surveys. The Conviction and Confidence Tool revealed 100% of the clinicians agreed that Teach-Back education was '10-Very Important' and were '10-Very Confident' in their abilities to apply the Teach-Back methods using a 1-10 Likert scale. Likewise, the practitioners showed significant improvements when comparing the pre-implementation and one-month, post-policy implementation, as indicated in the paired t test of the second part of the Conviction and Confidence Teach-Back Tool. Nursing plays a pivotal role in positive social change by using an evidence-based education method, which improves patient care through medication compliance and decreased readmission rates, thus showing significant transformation in chronic health management.

Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three syllables and (d) discouraging nursing practice of copying and pasting other completed clinician notes in discharge notes. Following the tenets of the logic model and Watson's caring theory, ED nurses (n=45) at a veteran's healthcare facility participated in the modification of the ED discharge note design. A retrospective quantitative design was used to obtain data from 5,474 records related to each patient's language preference, educational level, and the readability index of the discharge note pre-and post-modification of the note. The comparative analysis of the descriptive statistics before and after modification of the discharge note indicated a decrease of 1.75% in the readability index of the discharge note, a 24% decrease in return visits within 30 days and a 40% decrease in readmission rate within 30 days. Healthcare costs and health disparities associated with health literacy decrease if patients comprehend discharge instructions. Understanding verbal and written discharge instructions correlates with healthy communities. Health literacy policies and technological innovation can promote health literacy and research on health literacy.