Reference
Improving Patient and Caregiver New Medication Education Using an Innovative Teach-back Toolkit. J Nurs Care Qual 2019; 34(2):E13-E14.
At a glance
A recent article studied how the implementation of new teaching and learning strategy, through Teach-back, improves not only the patient’s therapeutic adherence but also the quality of care.
What is already known
The Medicare and Medicade Service Centers, which offer health coverage to 100 million people worldwide, report that 65% of hospitalized patients always receive information about drug therapy. However, many studies report that many patients do not receive adequate information. This leads to confusion and possible misuse, decreased satisfaction with care and also the risk of hospital readmission.
Information on pharmacological aspects is often dedicated at the time of discharge. Still, it may be too late to ensure that the patient has understood all the information necessary for self-management of therapy. Several factors influence the patient’s ability to know how to take their medicines correctly; however, an education program that involves patient and caregiver can be an essential element in promoting therapeutic adherence.
The Teach-back is a Health coaching technique in which the healthcare professional asks the patient or caregiver to explain in their own words what they have just learned from the same operator, allowing any misunderstandings to be corrected immediately.
Design and Methods
A prospective study was conducted at a Midwestern University Hospital. The pilot phase was conducted in a Medicine ward with 18 beds and 29 nurses. The mean length of hospitalization was 4.5 days, with an average of 16 patients admitted. Subsequently, the project was extended to two other medical-surgical units, each having 36 beds and from 60 to 65 nurses.
The nurses of all three units received training on the Teach-back technique. Still, only the nurses of the pilot structure participated in a pre and post-education phase, which included observations on the practice received and evaluation of the results achieved, through a Confidence and Conviction Scale questionnaire, which measures confidence and importance in using the Teach-back tool.
Patients and caregivers from all three Units were enrolled, discharged at home with at least one drug, for a total of 74 patients and 33 caregivers.
Patients and caregivers who accepted to participate in the study received the educational intervention with Teach-back, before discharge and were contacted, via telephone follow-up, from 2 to 12 days after discharge. The telephone follow-up was asked to remember and state the purpose and at least one side effect of the new drugs. The mean age of the patients was 57.1 years, of which 57% discharged with more than one drug. If during the follow-up call, the patient or caregiver was unable to respond, an educational reinforcement intervention was performed through the Teach-back.
Main results
Patients and caregivers were asked to recall information about the drug’s purpose and side effects. 97% of patients/caregivers remembered the purpose of the drug, and 66% of the side effects.
All caregivers recalled the purpose of the new drug and 84% of the side effects.
Nurses have demonstrated significant growth in educational capacity and effectiveness in the use of Teach-back, evaluating the training received for the use of the tool with patients as significant and relevant to their clinical practice.
After the training and three months later, the nurses reached higher levels of confidence and effectiveness in using the Teach-back technique, achieving a good level of patient satisfaction.
Limitations
A control group was not provided to evaluate its effectiveness. The study was conducted on a small sample. The pre and post-training intervention were carried out only in one structure; this can determine weakness in terms of validity.
What’s new
Establishing a dedicated moment during hospitalization for the patient’s educational intervention about the taking of drugs and carrying it out with a structured method such as the Teach-back it would appear to be an effective intervention for patient education and favouring therapeutic adherence. Caregivers in this study were shown to remember the purpose and side effects of drugs more than patients, so including them at this educational time is very important.
What the Prospects
Teach-back is a learning technique that improves the quality of care, guaranteeing healthcare professionals a reference and standardized model to enhance the learning effectiveness of patients/caregivers in the management of new drugs.
A cura di Michela Barisone
